Psychedelic-assisted therapies are another PTSD treatment that has shown great promise, and is finally gaining acceptance in the mental health community. Psychedelic assisted-therapies refer to the therapeutic use of micro-doses of various psychedelic drugs, and plant-based medicines.
In particular serotonergic psychedelics, LSD, psilocybin, DMT, MDMA, mescaline, ketamine, Ibogaine, and Ayahuasca show the most promise to assist in psychotherapy (Mithoefer, 2018). The Multidisciplinary Association for Psychedelic Studies (MAPS) is the organization that supports and funds most of the clinical trials for MDMA-assisted psychotherapy. MAPS has been a pioneer and paved the way for psychedelic research, which includes plant-based psychedelics such as Ibogaine and Ayahuasca.
According to Mithoefer (2018) while many individuals with PTSD respond to current trauma-focused psychotherapies (Monson et al. 2006; Resick et al. 2008; Foa et al. 2007) they are ineffective for a significant population (Koenen, et al. 2017; Steenkamp et al. 2015). The Multidisciplinary Association for Psychedelic Studies MAPS is currently in stage three clinical trials for FDA approval of methylenedioxymethamphetamine (MDMA) to assist in the psychotherapy treatment for PTSD.
Preliminary research has found MDMA-assisted therapies in conjunction with psychotherapy can help patients overcome PTSD, and other disorders such as addiction and depression (Mithoefer et al., 2018). Mithoefer et al., (2018) stated “MDMA-assisted psychotherapy resulted in a marked improvement of PTSD symptoms in both veterans and first responders with chronic PTSD, who had failed previous treatments” (p. 2742).
Additionally, there was a significant improvement in sleep quality and dissociative symptoms in comparison to the control group. Furthermore, significant gains in psychological, occupational, and social functioning were also observed in informants treated with active doses of MDMA. Even more importantly consistent improvements in PTSD symptoms continued in the year following treatment.
Mithoefer et al., (2018) found a significant increase in Posttraumatic Growth Inventory (PTGI) scores, while perceptions of self, others, and life events were reframed during the therapeutic processing. Consequently, this suggests MDMA-assisted treatment effects went beyond mere reductions in PTSD and mood symptoms to include psychological growth as well. MDMA is known for increasing feelings of trust and compassion towards others, which may make an ideal adjunct to psychotherapy for PTSD (Mithoefer et al., 2018).
Plant-based entheogens are also beginning to receive much attention. For instance, Ayahuasca, a plant-based entheogen is currently being studied for treatment-resistant depression. Ayahuasca is a brew traditionally used for healing and spiritual purposes by indigenous populations of the Amazon Basin (Luna, 2011). Vollenweider & Kometer (2010) found although both ketamine and ayahuasca are associated with rapid antidepressant effects, their response time, courses, and mechanisms of action were different, brain circuits modulated by psychedelics displayed a substantial reduction in mood disorders.
Over the last two decades, mental health evaluations found ayahuasca users experienced preserved cognitive function, increased well-being, marked reduction of anxiety and depressive symptoms when compared to non-ayahuasca users (Bouso, et al., 2012). Barbosa et al., (2016) observed a single dose of ayahuasca enhanced mindfulness-related capacities and meditation therapies with no serious side effects.
The prohibition of psychedelics in the late 1960’s forced research with psychedelic substances to come to a screeching halt. Prior to these restrictions, psychedelics were in the early-stage testing for many psychiatric conditions, including obsessive-compulsive disorder, alcohol dependence and PTSD.
By mid-1960 over 40,000 subjects had participated in clinical research with psychedelics, most of them in uncontrolled settings (Vollenweider & Kometer, 2010). Palhano-Fontes (2018) conducted the first randomized placebo-controlled trial to investigate the antidepressant potential of a psychedelic in a population of patients with treatment-resistant depression. According to Palhano-Fontes et al., (2018) a single ayahuasca session in patients with depression increases blood flow in brain regions consistently implicated in the regulation of mood and emotions.
This study found new evidence to support the safety and therapeutic value of psychedelics, dosed within appropriate settings, to help treat depression. Depression severity changed significantly when compared to the placebo groups. In conclusion current scientific evidence on acute and long-term effects of ayahuasca as a therapeutic modality suggest ayahuasca, as a treatment is relatively safe and has strong therapeutic potential (Barbosa et al., 2012; Bouso & Riba, 2011; dos Santos, 2013; Gable, 2007: & McKenna, 2004).
