Patrick Freyne: Psychedelic research could hold key to treatment-resistant depression

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Latest data is ‘promising’, says psychiatrist and clinical senior lecturer at Trinity and Tallaght University Hospital and an investigator with the new trial

Between March 2019 and October 2021, a number of Irish people went to a room in Sheaf House, a HSE community mental health service in Tallaght, where they were given a dose of psilocybin, the psychoactive ingredient in magic mushrooms, and spent six hours with a psychotherapist. They came individually, lay down on a bed wearing eye masks and listened to soothing music and, unlike most people who take this drug recreationally, they did so after several sessions of preparatory therapy.

Psychedelic research has a fascinating and controversial history. Psychoactive plants have long had a role in spiritual rituals around the world. Psychedelics have orbited psychiatry since the Swiss chemist Albert Hofmann first synthesised LSD in 1938, an attempt to create a respiratory and circulatory stimulant, and first ingested it in 1943. This triggered a few decades of research into these drugs for the treatment of psychological disorders.

“But the backlash was also politically driven. Nixon saw the counterculture as his enemy and sought to disrupt it by outlawing LSD and cannabis. The fact is the psychedelics were disruptive and threatening to the powers that be – Nixon may have been right to say LSD was fuelling the anti-war movement and leading young men to refuse to fight in Vietnam – so a reaction was likely to happen.”

When a person takes psilocybin, they can feel the whole gamut of emotions – sadness, joy – and that can be a little bit overwhelming if you’re not preparedShe explains the therapeutic process to me. “Set and setting” are very important, she says. “The ‘set’ refers to the person’s mindset and the ‘setting’ is physically where they take [the drug] and who’s around them.

I ask Michael Pollan to describe what he got from his own experiences of taking psilocybin. “I had a couple of powerful experiences on psilocybin,” he says. “One experience of complete ego dissolution changed my relationship to my ego, made me realise, since I survived its dissolution, that I was not identical to it and therefore could choose sometimes to ignore it – a very healthy thing.”

 

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