MUSC psychiatrist studying psychedelics calls them potential catalysts for change

November 08, 2022
A group of golden and cream colored mushrooms. They contain an active ingredient being studied in psychedelic research.
Psilocybin, the active compound in magic mushrooms, and MDMA, are the psychedelics getting the most attention from researchers.

Jennifer Jones, M.D., knows MDMA.

“There is a local trial that I've worked on,” said the psychiatrist and assistant professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. The Phase 3 trial, the final step in the preapproval process, tested MDMA – a synthetic psychedelic also known as ecstasy and molly – as a treatment for people with post-traumatic stress disorder.

Yes, that means MDMA may become part of the therapy for certain conditions in the not-too-distant future. “If all goes according to plan, the Food and Drug Administration will be looking at the results in late 2022 or early 2023. So yeah, exciting times with MDMA-based work,” Jones said.

Exciting times for the field of psychedelics as a whole, too, from her perspective. Drugs outlawed decades ago are poised to make a comeback, with research reframing them as potentially beneficial instead of a bane, when used in therapeutic sessions for hard-to-treat mental health problems.

“There's a couple of reasons for the renewed interest. One, culturally, people are more open, I think, to alternative treatments. And two, over the last 15 years, mental health has really undergone a renaissance in the way that we talk about it with one another. It's not destigmatized entirely, but it’s much less stigmatized than it was.”

Jones said psychedelics were associated with the counterculture movement in the past, one of the key factors that led to laws against them. And concerns about psychedelics linger to this day. For example, the National Institute on Drug Abuse says MDMA bought on the street may contain other drugs the buyer doesn’t know about, including meth, heroin and cocaine. The agency also says psychedelics can have negative side effects such as a raised heart rate, nausea, panic, paranoia and psychosis.

Jennifer Jones, MD 
Dr. Jennifer Jones

Jones is well aware of all of that. “In uncontrolled settings, there can be risk associated with the use of these substances. In a perfect world, individuals would only be using these psychedelics in a highly supportive context. But that's not always the case. And there is potential for psychiatric harm, in theory, when it's used in not supportive settings or by people with certain medical or psychiatric conditions,” she said.

“It’s really important to note that these can be thought of as catalysts for change, hopefully in a positive way. That change often comes through the therapy incorporated with these treatments and making sure that it's safe.”

Jones said MDMA and psilocybin, the active compound found in so-called magic mushrooms, are the psychedelics getting the most attention from researchers, including some at MUSC. “We are still finalizing the details on psilocybin and MDMA trials. I think that that is something that we can safely say is in the works and will hopefully be coming in 2023.”

Psychedelics are believed to affect the brain’s serotonin receptors. Serotonin plays an important role in regulating mood, memory and perception. Jones said psychedelics may help people see things in a new way when combined with therapy.

“There are the effects of the compound, but really, it's more about what the compounds are catalyzing for someone. They're taking inventory of different areas of their life, where maybe things aren't optimal. One of the reasons that I think that we see such wide effects for psychedelics on so many different conditions is that it's not speaking probably as much to the underlying neurobiology as it is to helping people in the context of therapy to figure out what it is in their life that they need to move forward in. How do they need to change?”

Jones got interested in psychedelics’ potential several years ago. “I did my residency training at MUSC in psychiatry and internal medicine. And then I did a postdoc fellowship on ‘the road less traveled in research.’ I was looking for new therapeutics for PTSD and substance use disorders. And I was reading through the older literature from the 50s and 60s, with ketamine and psychedelics, and even back then, the data was very exciting.”

Psychedelics have been around for thousands of years, according to the American Psychiatric Association. Indigenous people have used them for healing and religious purposes. In the United States, the federal government funded more than 100 clinical trials testing psychedelics as a treatment for a range of mental health problems between the 1950s and 1970s until they were outlawed.

More recent research cited by the American Psychiatric Association found MDMA “had a large effect size” for people with PTSD, and psilocybin had “sustained and strong effects” in reducing depression in clinical trials.

But in a June 2022 document, the association also noted that research on psychedelics is still in a relatively early stage. Jones’ work is no exception. The data is still being analyzed in the MDMA trial she mentioned. But the psychiatrist is encouraged to see psychedelic-assisted therapies, with their potential to help ease several hard-to-treat mental health problems, getting a serious shake.

If they do become approved treatments, they will join ketamine, which is already in use in psychotherapy at MUSC Health’s Centerspace Clinic. What’s the difference between the substances? According to a report in Psychology Today, “ketamine works by relaxing the brain’s inhibitory architecture,” whereas “psychedelics work by overriding it.”

Jones put it this way. “I usually frame this idea as while ketamine works mostly on a different type of neurotransmitter than MDMA and psilocybin, all of these compounds can have psychedelic effects, depending on the dose that is taken.”

She said she’s excited to see where research on psychedelics goes next. “These therapies have been studied in many conditions, including depression, PTSD, obsessive compulsive disorder, substance use disorders and anorexia as well as for wellness optimization. Seeing psychedelics in the context of helping people, which is what I love to do – help people figure out what part of their life they'd like to seek progress in and helping them to figure out how to get there – that's every clinician's dream.”

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