Over the last few years, evidence has piled up that psychedelic drugs can provide relatively rapid relief from the symptoms of clinical depression. The drugs seemingly work by boosting the brain’s ability to remodel connections among neurons and incorporate new experiences. While we have a good picture of which proteins are responsible for the drug’s hallucinogenic effects, we’re still figuring out how those pathways plug into the brain’s ability to change itself.
Those lingering uncertainties aren’t standing in the way of people trying to develop potentially life-altering treatments. One of the big challenges is probably the hallucinations themselves, which can potentially incapacitate someone for hours after a treatment. But researchers have now described a study showing that the shortest-acting psychedelic, DMT, appears to be just as effective as the rest.
Fast-acting
DMT, or dimethyltryptamine, is probably best known as a key component of ayahuasca, a liquid made from a combination of two or more plants. The mixture is important because the body produces an enzyme that rapidly digests DMT, blocking its effects. The additional plants contain a chemical that inhibits this enzyme, providing a longer-lasting experience.
In the absence of this inhibitor, however, the body clears DMT pretty quickly (it has a half-life of only about five minutes). Which means it’s potentially a great treatment, given that patients could be released from care shortly after receiving the drug. But it’s also possible that this brief stimulation wouldn’t be as effective at generating the sort of long-term changes in the brain triggered by other psychedelics. While there’s some evidence for an antidepressant effect, it has been limited so far.
A large collaboration set up a small clinical trial based at some London hospitals to gather more evidence of the effects. The study involved a blinded trial of a single DMT dose with a placebo control group (there were 47 people each in the experimental and control arms), coupled with counseling for depression. Two weeks later, everybody involved in the study got an open-label dose. Whether you can actually have a blinded trial of a psychedelic depends strongly on the degree to which you can have placebo-driven hallucinations, which seems pretty debatable. Depression symptoms were tracked weekly for 14 weeks after the initial dose.