- One third of depressive patients struggle with treatment-resistant depression
- DMT promotes neuroplasticity in rodents
- Psychotherapy is key for DMT to effectively treat depression
Around 264 million people around the world struggle with depression. As with most mental illnesses, the most common treatment for depression involves a combination of psychotherapy and medication. However, approximately one third of depressive patients do not respond to any form of treatment. Treatment resistant depression can be very challenging for both the patient and the physician.
In the past few years, doctors have noticed the powerful impact that psychedelics can have on mental health. For example, LSD is currently being used in trials to treat anxiety with great success. Other substances, like MDMA, show great potential for treating difficult conditions such as PTSD.
The promise of substances like ketamine and psilocybin in treating depression makes researchers wonder if DMT could also be an effective tool.
How is DMT Being Integrated Into the Treatment of Depression?
DMT, which is sometimes referred to as “the spirit molecule”, is naturally present in plants and has been used as a sacred entheogen for thousands of years by many indigenous communities, particularly in the Americas. Recent research has shown that the molecule could offer a viable and effective treatment for conditions such as depression, anxiety, and even PTSD.
In rodents, studies show that DMT promotes neuroplasticity and increases synaptic connections, which are both related to improvement in the symptoms of depression. While the most common way to use DMT is to ingest it via an ayahuasca brew, in clinical settings it is usually administered intravenously, though researchers are looking into developing multiple DMT-based delivery products to offer different routes of administration.
The main problem with medicalizing intravenous DMT is that it does not always have a short duration of action, and the effects can be very intense. The aim in formulating products that allow for a different method of administration is to be able to slow the onset of the compound’s effects, as well as controlling the duration of the experiences.
Recent studies have found that using a combination of a psychedelic drug and psychotherapy is what is the most beneficial for patients. This is due to the fact that therapy allows for the patients to be prepared beforehand and to be monitored after the treatment.
Small Pharma and Imperial College London
In 2020, UK regulators approved a clinical trial involving the use of DMT to treat depression. The trial, which is being conducted by Small Pharma in collaboration with Imperial College London, started in February 2021 and will have two parts. This is the world’s first patient clinical trial involving DMT.
The study’s first phase will administer DMT to healthy volunteers in order to determine the safety, tolerability and pharmacokinetic effects of the molecule. Subjects will not be told whether they are receiving DMT or a placebo substance. This phase started in February 2021 and results are expected to be published before the summer.
The second phase of the trial is expected to commence in the summer of 2021 and will be testing the safety and efficacy of DMT therapy in patients suffering from moderate or severe major depressive disorder. Both phases of the trial will combine psychological support delivered by therapists and psychiatrists trained in the study of psychedelics with the administration of DMT. Two therapists will be present during every session to provide support and guidance.
During both stages of the clinical trial, patients will receive a single intravenous dose of DMT in a relaxed, controlled setting. Sessions will last approximately one hour. All patients will receive a number of preparation sessions to help them feel at ease with the therapist and the setting. Patients will be encouraged to explore their intentions for the treatment.
Following the DMT session, patients will discuss their experiences with their therapists in order to integrate insights and breakthroughs from the session to help them break away from challenging and limiting beliefs, behaviors, and patterns.
What Are The Risks of Using DMT For Depression?
Because the world’s first clinical trial using DMT to treat depression is in very early stages, not a lot is known about the risks of using DMT for depression specifically. However, some anecdotal evidence has been gathered. In 2017, the Journal of Psychoactive Drugs published a case report that chronicled the story of a retired male psychiatrist who tried to treat his bipolar disorder by smoking DMT.
While the subject had experienced a prior manic episode, he reported having undergone episodes of depression for most of his life. He also reported having tried antidepressants, mood stabilizers, antipsychotics, electroconvulsive therapy, and ketamine with no success. The man then purchased DMT on the dark web and began consuming up to one gram daily.
While it might not sound like it, one gram of DMT is a very large quantity. He claimed to feel better initially. After six months, he abruptly stopped taking his daily DMT due to travel, and not wanting to carry an illegal substance with him. A few days after discontinuing the DMT, he had a psychotic break that landed him in hospital. He had to be restrained by six security guards and ended up having a seizure.
His medical report explained that he was pressured in his speech, hyper-religious, and delusional. He believed that demons were leaching into his soul and even asked for the medical staff to exorcise him, thinking that he was possessed.
As this particular subject was self-medicating and using large amounts of a very powerful substance, the case highlights an admittedly extreme example of a general caveat to psychedelic therapy. Patients with a history of psychosis or mania should avoid hallucinogens.