OMED23

Psychedelic drugs for mental illness: A brief history and overview

Leslie Madrak, DO, presented at OMED23 on the usage of psychedelics such as ketamine and psilocybin mushrooms to treat mental health disorders.

Katie Arvia

Katie Arvia is a digital content specialist at the AOA.

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Leslie Madrak, DO, recently discussed using psychedelics to treat mental health disorders at OMED23. Dr. Madrak is AOA board-certified in neurology and psychiatry. Her presentation, and all other OMED23 content, is available on the OMED platform through Dec. 31, 2023. Virtual conference registration is open until Dec. 15.

Dr. Madrak began her presentation by acknowledging that Indigenous peoples have used healing properties derived from plants for thousands of years. In 1938, a major advancement took place when a Swiss chemist named Albert Hoffman accidentally performed the fist synthesis of psychedelics and discovered LSD. Extensive research and medical trials followed, exploring the drug’s psychiatric benefits until production was halted in 1965 due to government concerns regarding recreational use of the drug by the general public.

Five years later, in 1970, ketamine was approved by the Food and Drug Administration (FDA) for use in anesthesia and procedural sedation. Infusion studies on ketamine for treating depression began in the mid-2000s. Dr. Madrak discussed the research-based evidence of ketamine’s efficacy in treating mental health disorders, including major depressive disorder, bipolar depression, postpartum depression, eating disorders and more.

The discussion of ketamine also included the potential side effects, drug-drug interactions, the basics of a ketamine consultation and the patients who should be excluded from ketamine treatment. The same discussion format was followed for psilocybin mushrooms.

Helpful tips and information for health care professionals were also provided, including data on patient arousal zones, the unique features and benefits of psychedelic psychotherapy and psychedelic integration sessions.

Dr. Madrak shared the case study of a 33-year-old patient named Daniel, who was diagnosed with obsessive-compulsive disorder (OCD), major depressive disorder, Tourette’s and panic disorder. Using tailored treatment sessions aimed at targeting Daniel’s negative emotions and his desire to focus on his authentic desires versus how he “should” act, Daniel underwent a seven-hour treatment experience.

Throughout his treatment with psilocybin mushrooms, Daniel experienced a wide range of feelings, including a “rebirth.” In his follow-up sessions, Daniel’s OCD symptoms decreased, and he was able to recognize his symptoms, process them and move on. At his one-year follow-up, Daniel celebrated his “re-birthday.” At that time, he was completely free of OCD symptoms.

Dr. Madrak’s entire presentation on psychedelics can be accessed on the OMED virtual platform until Dec. 31, 2023. Registration is open until Dec. 15.

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3 comments

  1. Stephen Slattery, DO

    Interesting case study. This lends itself to explore other mind-altering substances such as marijuana in the treatment of mental disorders. On a historical note, the Psychiatrist Harry Stack Sullivan, MD reported some success with ethanol in the treatment of Schizophrenia in the early 20th century. I’m not recommending this treatment, just pointing out the history of recreational drugs in the treatment of mental disorders. During prohibition in the US(1920-1933),ethanol was legally prescribed for medicinal purposes for a variety of conditions.

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  2. Samuel Garloff, DO

    The case study referenced is of a male 33 years of age with not one but 4(?) concurrent psychiatric diagnostic entities. After psilocybin, one, his OCD abated. Interesting, but not conclusive evidence of success due to psilocybin. Currently the literature is rich with reports of studies using such drugs, especially ketamine. I advise caution when evaluating reported outcomes. Many, if not most, do not include a placebo arm, potentially skewing outcome data in favor of the drug studied. Is this oversight or an indication of researcher bias? I enjoyed reading Dr. Slattery’s comments as they are quite germane. Now we need input from anesthesiologists concerning the use of ketamine. I for one, would not like to experience disassociation!

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    1. Stephen Slattery

      Thank you Dr. Garloff, I liked the points you made as well. In treating( or potentially treating) any condition, for me,medical ethics should be at the forefront: 1) First do no harm( one would think this goes without saying!)2) Informed consent explaining risk benefits and alternatives( including no treatment ie placebo). In treating specifically psychiatric disorders( DSM V), we are dealing with disorders, not diseases( per forward in DSM constructs with no specific claims to etiology or pathology but rather a common language to discuss patients among colleagues) . These can be diagnosed( though not medically treated ie cannot prescribe prescription) by non medically trained professionals such as clinical psychologist. This is not to disparage their profession just to point out the non- physical nature(at least proven) to these disorders. Even more caution is in order to medically treat what in fact may not be a disease at all but ” problems in living” quote Thomas Szasz,MD

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