Would you take a mushroom instead of your antidepressant?


Would you take a mushroom instead of your antidepressant?

mushroom Ichhori _Webp

Antidepressant medication is ineffective in up to 30% of patients with depression. This could be due to patient biological differences as well as the fact that medications often take a long time to work, with some people quitting after a while. As a result, there is a pressing need to broaden the pharmacological options available to those suffering from depression.

Psychedelics, such as psilocybin, the key ingredient in "magic mushrooms," have received a lot of attention in recent years. Despite several clinical trials demonstrating that psilocybin can effectively treat depression, including cancer-related anxiety and despair, little is known about how psilocybin acts in the brain to alleviate depression.

Two new research published in The New England Journal of Medicine and Nature Medicine has given some insight into this enigmatic process.

Psilocybin is a hallucinogen that alters the response of the brain to the neurotransmitter serotonin. It creates an altered state of consciousness and perception in users when it is broken down by the liver (into "psilocin").

Psilocybin appears to diminish activity in the medial prefrontal cortex, a part of the brain that helps regulate a number of cognitive functions such as attention, inhibitory control, habits, and memory, according to previous research employing functional MRI (fMRI) brain scans. The chemical also reduces connections between this area and the posterior cingulate cortex, which is thought to be involved in memory and emotion regulation.

The brain's "default mode network" usually includes an active connection between these two locations. When we rest and focus inwards, whether reminiscing about the past, visualising the future, or thinking about ourselves or others, this network is active. Psilocybin may be loosening the restrictions of the internal "self" by reducing network activity, with users experiencing an "opened mind" and greater perception of the world around them.

Rumination, or being "stuck" in negative ideas, especially about oneself, is an interesting feature of depression. We also know that patients with higher levels of negative rumination had more activity in the default mode network than in other networks at rest, making them less sensitive to their surroundings. It's unclear if these changes in activity are caused by depression symptoms or if those with a more active default mode network are more likely to be depressed.

What happened in a study that pitted mushrooms against medicine?

A double-blind randomised controlled experiment (the gold standard of clinical studies) compared a group of sad people taking psilocybin to a group of depressed people using the existing antidepressant medicine escitalopram — something that had never been done before. The trial's findings were compared to those of another recent clinical trial employing fMRI brain images.

fMRI measurements demonstrated an overall increase in connection across the brain's various networks just one day after the initial dose of psilocybin, which is generally lowered in patients with severe depression. The default mode network was diminished at the same time that connectivity between it and other networks was increased, corroborating prior, smaller research.

Some persons had more connectedness as a result of the dose than others. The persons who had the highest increase in network connectivity also had the greatest improvement in their symptoms six months later, according to the study.

Six weeks after starting treatment, the brains of persons taking escitalopram exhibited no change in the connection between the default mode and other brain networks. It's possible that escitalopram will cause modifications in the future. However, because psilocybin's antidepressant effect takes action quickly, it may be great for people who don't respond to other antidepressants.

The researchers believe the impact is due to psilocybin's more concentrated influence on brain receptors known as "serotonergic 5-HT2A receptors" than escitalopram. Serotonin activates these receptors, which are found in all network brain areas, including the default mode network. We already know that psilocybin's amount of binding to these receptors causes psychedelic effects. However, it is still unknown how their activation causes changes in network connectivity.

Is this the end of traditional antidepressants?

This raises the question of whether changing brain network activity is required for depression treatment. Many patients who take standard antidepressants claim that their symptoms improve without them. In fact, the study found that both groups reported improved symptoms six weeks after starting medication.

However, psilocybin had the largest effect on total mental wellness, according to several depression rating systems. In addition, patients treated with psilocybin had a higher rate of clinical response than those treated with escitalopram (70 per cent versus 48 per cent ). At six weeks, more patients in the psilocybin group remained in remission (57 per cent versus 28 per cent). The fact that some patients do not respond to psilocybin or relapse following therapy demonstrates how tough depression treatment may be.

Furthermore, both therapy groups received care from mental health specialists during and after the trial. Psilocybin's success is highly reliant on the circumstances in which it is consumed. This indicates that self-medicating with it is a poor idea. Patients were also carefully chosen for psilocybin-assisted therapy based on their medical history to avoid psychosis and other negative side effects.

Despite the drawbacks, these trials are extremely promising and get us closer to broadening the therapeutic options for depression patients. Internalized negative thought processes are also not exclusive to depression. Other diseases, like as addiction or anxiety, may benefit from psilocybin-assisted therapy in the future.


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