Do psychedelics qualify as a new class of antidepressant?

 

MagicMushrooms
Psilocybin cubensis (magic mushrooms) growing in Maritime Forest on Long Island, NY. A pilot study found their active ingredient psilocybin was remarkably effective at lifting people out of treatment-resistant depression. Photographer: A. Hasan/Flickr

Clinical depression causes misery for hundreds of millions of people worldwide. Around one in five patients fails to respond to any treatment and even among those who do recover relapse rates are high and get progressively worse with each successive episode. The most widely used class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs), can lift some people out of severe depression and help them stay well, but they don’t work for everyone and among the many side-effects are anxiety, weight gain and sexual dysfunction.

Since the SSRIs became available in the 1980s no new class of drugs has emerged, so the news that there may already be a more effective type of antidepressant in existence that is safe and well tolerated is tantalising. The catch is that to possess or supply these chemicals runs the risk of an unlimited fine or prison sentence 

This blogpost was published on the Guardian’s website, Tuesday 17 May 2016. Read on… 

Continue reading “Do psychedelics qualify as a new class of antidepressant?”

Everything is not going to be ok

Amaravati

My publisher recently sent me an audio clip of the opening paragraphs of my new book Siddhartha’s Brain (published in the US on 26 April and 2 June in the UK), spoken beautifully by the British actor Steven Crossley. If you fancy a sneak preview, I’ve embedded it below.

As I recall, that morning the nuns’ and monks’ chant in the Meditation Hall of Amaravati Buddhist Monastery actually moved me to tears, though it’s hard to recapture that emotion – or where exactly it came from – when you’re sat at your computer keyboard back at home. So I simply wrote that, far from finding the chant maudlin (“Birth is dukkha [suffering]; Ageing is dukkha; Death is dukkha; Sorrow, lamentation, pain, grief and despair are dukkha…”) I was strangely moved by its honesty.

We have social taboos about admitting publicly all the types of suffering that are inherent in the day-to-day experience of having a body and a mind. Perhaps this serves a purpose, I don’t know, but for me at that moment and in that special place, speaking the words out loud felt immensely liberating. It somehow opened the floodgates, and out came tears of relief and happiness.

MeditationHall2.jpg

Images: Jake Barnes

Meditation and psychosis

Meditation

There’s something weird going on in the field of meditation and mindfulness research. On the one hand there are voices warning that meditation can cause psychosis – leading people to lose touch with reality and experience symptoms such as hallucinations, delusions and disturbing thoughts – on the other there are equally persuasive voices claiming that it should be used to treat psychosis. Continue reading “Meditation and psychosis”

Is this the brain’s mindfulness switch?

Thalamus small.gif

Journalists adore research that allows them to write stories along the lines of “scientists have tracked down the brain’s love HQ” or “researchers have located the brain’s god spot”. It is very satisfying to imagine that we can divide the brain into neat components with distinct functions like the parts of a car engine. We dream that one day, neuroscientists will be able to lift the bonnet (or the hood if it’s an American brain), point and say “here’s the valve that causes schizophrenia – we can readjust that with this chemical spanner. Here’s the tank that causes OCD when it overflows – we can drain that by turning this tap here. Over there are the spark plugs that we clean up to cure depression …”

Unfortunately the brain is a lot messier and more wonderful than your average motor engine, which is why we’re still standing over it scratching our heads trying to figure out how on earth it all works. It’s a tangle of connections, with myriad networks of components involved in creating thoughts, consciousness, sensations and emotions.

So it is with a mixture of excitement and wariness that I approach a study by researchers at Beijing Normal University in China that seems to point to a particular part of the brain that switches mindfulness on and off. It’s called the thalamus (shown in red on the animated gif), a pair of bulbous structures that sit at the top of the brainstem (yellow) on the midline of the brain. The thalamus plays a pivotal role as the brain’s switchboard, relaying information from all the senses apart from smell to the cerebral cortex, which is the thinking, conscious part of the brain. Continue reading “Is this the brain’s mindfulness switch?”

Meditation or medication for depression? A reality check

Prozac (fluoxetine) antidepressant pills
Research has suggested meditation is as effective as taking an antidepressant for mild depression

There was good news last week about the effectiveness of mindfulness meditation for easing anxiety, depression and pain. Mail Online reported that a study had found “meditation ‘works just as well as anti-depressants’: half an hour a day offers as much relief as tablets”, while The Boston Globe said those who took mindfulness classes experienced improvement in mood after eight weeks “on par with the effect seen with prescription medications”.

This was all perfectly true. A review published in JAMA Internal Medicine had looked at all the best studies to date and concluded that there was “moderate evidence” of improved anxiety, depression and pain among patients. The effect on mild depression was indeed equal to that achieved with anti-depressants.

Like me, though, you may be a bit underwhelmed by that phrase “moderate evidence”. It’s hardly a ringing endorsement, but better than “low evidence” – which was what the reviewers concluded about the efficacy of meditation for improving stress/distress and mental health-related quality of life. Continue reading “Meditation or medication for depression? A reality check”

Mindfulness monthly: bipolar disorder, time perception, older people, and eating disorders

A Buddhist monks blesses tourists on a beach in ThailandEvery month I’m going to round up the latest research about the potential applications of mindfulness. I’ll pick out only four or five nuggets (writing in detail about one, and writing a very brief summary of the others) but link to the awesome Mindfulness Research Monthly newsletter, which provides a much more comprehensive review of the field than I could ever do. Continue reading “Mindfulness monthly: bipolar disorder, time perception, older people, and eating disorders”