When it comes to LSD and magic mushrooms, many people think of bad trips. In contrast, science sees great opportunities in them: Neuropsychologist Dr. Katrin Preller on her research with hallucinogenic drugs as a therapy for depression.
BRIGITTE: Psychedelics are drugs that our parents always warned us about. What makes it so interesting for you?
Dr. Katrin Preller: On the one hand, they are incredibly exciting for basic research as a kind of window into the neurochemistry of the brain. And the other thing, of course, is clinical application: we have a potential new drug here that we can probably use to help patients across different diagnoses.
What diseases is it about?
We are currently conducting a clinical study on the therapy of depression and one on alcohol addiction.
50 or 60 years ago there was intensive research with psychedelics, in Germany LSD was on the market as a drug until 1971. Why did it take so long for science to be interested in it again?
When substances are banned, as was the case with LSD and psilocybin, research is still allowed, but the requirements become stricter. And when a state treats a substance so restrictively, it is not necessarily prepared to spend money to support research. A large part of the studies worldwide is still financed through private donations. And you have to get them together first.
Horror trips, risk of addiction: are these really the risks associated with psychedelics?
What can be said clearly is that people don't get addicted. Long-term studies have shown that too. On the contrary, the consumption of alcohol, for example, tends to decrease after taking LSD. But there are risks. For one thing, they acutely increase blood pressure. That is why we exclude people with cardiovascular problems from our studies. And people who are predisposed to psychotic disorders – anything that goes in a schizophrenic direction. Such a thing can be pushed further in this direction through a psychedelic experience. But we have now examined around 1,000 people and have never seen anyone having long-term negative consequences.
What can you expect if you have been selected as a test subject for one of your studies?
Set and setting play an important role. At Set we talk about what someone brings to the attempt, in what condition he comes to us. If he is very stressed, this is not a good prerequisite for engaging in the experience. These are more likely risk factors.
For a bad trip?
No. What we are more likely to see are people developing fear under the substance. And that quickly becomes uncomfortable. When people feel ready for the experience, come to us relaxed, it reduces the risk of a negative experience.
And what is the setting?
The frame. And our setting is of course very different from, I'll say: taking LSD at a festival. We try to create a pleasant atmosphere. And the people who take care of the trip are trained psychologically and medically.
In fact, people often report very positive feelings after a trip: connectedness, joy, love. How come
What we are seeing at the moment is that the areas in the brain that are responsible for processing our sensory impressions communicate very strongly with each other under psilocybin. The visual world and body perception change. At the same time, those areas of the brain that ensure that a coherent image is created – just as we normally perceive our reality – are weaker with one another. And if we suddenly bring this information together differently, this allows us to break out of our usual thought patterns and experience the world and ourselves in a new way. It's very impressive for people.
Is this what makes psychedelics so promising for depression?
Yes, this is definitely a mechanism that could be helpful and that we are also testing in the new studies. Another hypothesis is that the substances stimulate neuroplasticity. This makes it easier for our brain to absorb new information. And maybe easier to forget old ones. With addictions, for example, there are very often triggers in the environment: If I go back to a place where I used to use drugs, it can trigger a relapse. If one could forget such associations more easily, it could make therapy easier.
350 million people worldwide suffer from depression, only just under half respond to antidepressants. Are Psychedelics a Solution?
It's likely not that you just take psilocybin and then the magic happens. Rather, it's more about psilocybin-supported therapy. This includes the safe environment. The accompaniment and most likely also a follow-up to these meetings. But if we see that the effects are actually that long-lasting, and that people are really doing so much better, then the effort would not be greater than that of standard treatment with antidepressants and accompanying therapy.
How likely is it that psilocybin will be approved as a drug in the next few years?
If our studies deliver reliable results, and if this is also confirmed in phase III studies, i.e. in large studies with a large number of patients, then the chances are very good.
Dr. Katrin Preller researches psychedelics at the Psychiatric University Clinic Zurich. She is currently working on the world's first placebo-controlled study with the "magic mushroom" active ingredient psilocybin as a potential drug for depression.
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