January 13th, 2021
Unlike most other mental health disorders that can be treated successfully by medication, eating disorders have not been found to be as responsive to traditional psychiatric medicines. Anorexia nervosa has one of the highest mortality rates of any psychiatric illness, and there are few effective psychological treatments and no effective psychiatric medications for the illness.
Even for those disorders such as anxiety and depression for which psychiatric medications exist, the development of new traditional psychopharmacology agents has slowed.((Schenberg, Eduardo Ekman. 2018. “Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development.” Frontiers in Pharmacology 9 (July). https://doi.org/10.3389/fphar.2018.00733.))
To expand the arsenal of treatments for various psychological disorders, some researchers are now looking at psychedelic medicines as a treatment alternative. And most recently, researchers have begun to examine some of these as potential treatments for eating disorders.
What Are Psychedelics?
Psychedelics, sometimes referred to as hallucinogens, are substances that alter perception, mood, and cognitive processes. They can cause hallucinations: seeing or hearing things that are not real. Psychedelics can occur naturally in trees, plants, and fungi or can be manufactured in laboratories.
A Brief History
The use of hallucinogenic plant medicines in ancient indigenous populations predates written history. LSD, or lysergic acid diethylamide, is a hallucinogenic drug that was first synthesized by a Swiss scientist in the 1930s. Psychedelics were studied as treatments for mental disorders in the 1950s and more than 1000 clinical papers were published in the 1950s and early 1960s.((Foldi, Claire J., Paul Liknaitzky, Martin Williams, and Brian J. Oldfield. 2020. “Rethinking Therapeutic Strategies for Anorexia Nervosa: Insights From Psychedelic Medicine and Animal Models.” Frontiers in Neuroscience 14. https://doi.org/10.3389/fnins.2020.00043.))
However, in the late 1960s LSD and marijuana (which is sometimes classified as a hallucinogen) were embraced by youth protesting the Vietnam War and were consequently scapegoated by the mainstream culture as contributing to the corruption of youth.
In reaction, strict laws were passed to prevent their use. The Controlled Substances Act of 1970 placed LSD and other psychedelics known at the time onto Schedule 1, the most restrictive category of drugs. This classification made them virtually impossible to study clinically and effectively ended any significant research into the pharmacology and medical value of psychedelics for more than 3 decades.((Nichols, David E. 2016. “Psychedelics.” Pharmacological Reviews 68 (2): 264–355. https://doi.org/10.1124/pr.115.011478.))
After a lull of several decades, changes in political attitudes and advances in science and technology allowed research to begin again on psychedelics in the 1990s.((Multidisciplinary Association for Psychedelic Studies)) Most recently, there has been a renewed interest in their use for psychiatric illnesses and studies are once again underway.
How Might Psychedelics Help People with Psychiatric Disorders?
The exact mechanisms of action of psychedelics are not fully understood, but it is theorized that they significantly reduce activity in the brain’s default mode network (DMN). The DMN are the habitual pathways of communication between brain regions. Just like on a snow-covered hill, we tend to follow the tracks that are already there. Over time, it becomes difficult to take any path other than the ones already established.((Carhart-Harris, Robin L. 2019. “How Do Psychedelics Work?” Current Opinion in Psychiatry 32 (1): 16–21. https://doi.org/10.1097/YCO.0000000000000467.))