Can psychedelics provide effective therapy for generalized anxiety disorder?
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Recent studies indicate that a single dose of the psychedelic compound LSD can significantly alleviate anxiety symptoms without long-lasting side effects.
“This trial represents a groundbreaking effort to evaluate LSD’s effects specifically within the context of generalized anxiety disorder (GAD),” remarks Dan Karlin, a researcher affiliated with MindMed, a biotechnology firm based in New York.
Generalized anxiety disorder manifests as persistent and excessive worrying about numerous aspects of life, including work and personal relationships. Currently, standard treatments include mood-altering medications like selective serotonin reuptake inhibitors (SSRIs) and various forms of psychotherapy.
However, statistically, around half of the patients do not experience relief from these conventional therapies. “SSRIs fail to work for many individuals and can cause side effects such as emotional flatness, as they rely on consistent daily intake,” Karlin states.
Prior investigations have hinted at the potential of LSD as a viable option for anxiety treatment. The drug is typically known for its psychoactive and hallucinogenic properties. It is believed to elevate serotonin levels in the brain, facilitating profound emotional experiences. Additionally, it may enhance the brain’s ability to form new pathways and thought patterns.
Up until now, there has been no placebo-controlled trial that specifically evaluated the effects of LSD on individuals suffering from generalized anxiety disorder.
In an effort to address this gap, Karlin and his team enlisted 198 adults diagnosed with GAD. The participants gradually reduced their intake of any existing anxiety medication, while continuing their psychotherapy sessions if applicable.
Participants completed a standardized survey assessing the severity of 14 anxiety symptoms, including feelings of worry, tension, and difficulty concentrating, rated on a 0 to 4 scale. The average score of 30 was reported, exceeding the severe anxiety threshold of 24.
Subsequently, the participants were randomly assigned to one of five groups, which received different doses of LSD (25, 50, 100, or 200 micrograms) or placebo pills, with participants unaware of their assigned treatment. Remarkably, those receiving 100 and 200 micrograms reported noticeable improvements in their anxiety symptoms one day post-treatment, says Karlin.
A month post-treatment, participants in the groups that received 100 and 200 micrograms exhibited substantial reductions in anxiety, with average decreases of 21 and 19 points, respectively. These positive outcomes were sustained until the study concluded three months after treatment. Approximately 46% of these participants achieved a state of remission, scoring 7 or below.
Comparatively, participants in the placebo and lower-dose groups saw symptom reductions of 14 to 17 points, with approximately 20% entering remission, indicating that the lower doses offered no additional benefit beyond the placebo.
“The improvements demonstrated in the highest dose groups signify a clinically significant reduction in distress and impairment,” states Sunjeev Kamboj, a researcher at University College London.
The placebo group exhibited improvements that are not uncommon in anxiety treatments, likely due to social factors such as a sense of being cared for within the study context, according to Kamboj.
Interestingly, the majority of participants could correctly identify whether they were administered LSD or placebo, which is typical for psychedelic trials due to their vivid sensory effects. Some individuals across all groups also reported mild side effects, including nausea and headaches within 12 hours following treatment.
Participants on the lower doses, as well as the placebo group, experienced visual perception changes at significantly lower rates compared to those receiving higher doses. This raises questions about whether the discernible improvements in anxiety were a result of the drug’s pharmacological impact or the psychological expectations driven by subjective experiences of the drug, Kamboj notes.
Despite these nuances, the study yields some of the most encouraging evidence supporting LSD’s potential as an anxiety therapy. “The rapid onset of symptom relief evidenced is profoundly relevant for patient needs,” he asserts.
These findings are sufficiently promising that the US Food and Drug Administration has classified MindMed’s LSD formulation as a Breakthrough Therapy, expediting its development process. Following this, Karlin highlights that the research team is planning comprehensive trials to monitor long-term effects, anticipating results in the next few years.
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