Sarah Radcliff
SLCC e-Portfolio
Biology 1610
Signature Assignment
Small Study Links Psilocybin to Positive Mental Health Effects for Treatment-Resistant Depression
By Sarah Radcliff
Article: https://www.nature.com/articles/s41598-017-13282-7#Sec1
For the first time, a group of scientists was able to document the effects of psilocybin treatment on a small group of treatment-resistant major depressive patients. The scientists involved in this study closely followed the scientific method. Before drafting their study, scientists researched previous studies/experiments involving the effects of psilocybin treatment on mental health patients. The research proved that psilocybin paired with integrative psychological treatment can have a positive effect on patients suffering from a variety of mental illnesses, including end-of-life depression and anxiety, tobacco and alcohol addiction, obsessive compulsive disorder, and treatment-resistant major depression. From this information, scientists were able to pose a valid question: “What brain mechanisms mediate the effects of positive mental health outcomes when psilocybin is paired with psychological treatment?”.
Scientists designed an experiment using functional magnetic resonance imaging (fMRI) that would help them measure the effect of psilocybin treatment on two different mechanisms of the brain: cerebral blood flow (CBF) and blood oxygen-level dependent resting-state functional connectivity (RSFC). Using inductive reasoning from previous research studies, the scientists were able to hypothesize that the “resting-state CBF and RSFC would be altered post treatment and correlate with immediate and longer-term clinical effects”.
The idea of this study was to measure changes in brain function and corresponding changes in depressive sypmtoms of patients with treatment-resistant major depression before and after psilocybin treatment. Participants were administered two oral doses of the drug: 10mg was administered for the first dose and one week later a 25mg dose was administered to each participant. Before and after each dose, patients were evaluated for depressive symptoms using the Quick Inventory of Depressive Symptoms (QIDS-SR16).CBF and RSFC were then measured by fMRI. The changes in CBF and RSFC of each brain scan was recorded, and changes in depressive symptoms were calculated by splitting the sample into responders (50% or more reduction in QIDS-SR16 scores) and non-responders. Participants would be evaluated for symptoms of depression before the trial, before each treatment, during each treatment, after each treatment, and at a five week follow up.
The following data was recorded during the study: Whole brain CBF analysis pre and post treatment was calculated and contrasted with QUIDS-SR16 scores of each participant and seed-based RSFC analysis of four pathways: the subgenual anterior cingulate cortex (sgACC), the ventromedial prefrontal cortex (vmPFC), the bilateral amygdala, and the bilateral parahippocampus (PH). Pre and post treatment was calculated and contrasted with QUIDS-SR16 scores of each participant.
Whole brain CBF analysis showed that decreases in CBF were only seen post treatment. Statistically significant decreases in CBF were found in the following regions: the Heschl’s gyrus, left precentral gyrus, left planum temporale, left superior temporal gyrus, left amygdala, right supramarginal gyrus and right parietal operculum. Reductions in CBF in amygdala were statistically significant in brain scans during treatment and correlated to a decreased depressed mood. The effects were not significant after the five-week follow up. The sgACC and vmPFC RSFC increased initially post treatment, but showed no signs of reduced depression symptoms in participants. vmPFC increased continued, however, after the five-week follow up and was associated with reduction in depression symptoms in participants.
PH showed decreases post treatment in RFSC, but had no significant impact on participants depression symptoms
Overall, the results of the study showed that treatment with psilocybin did produce rapid and sustained antidepressant effects. All participants showed some decrease in depressive symptoms after one week of treatment.
Reflection
The study I chose to describe for my Biology 1610 signature assignment is one that could have a significant impact on my own mental health. I was diagnosed as a teenager with bipolar I disorder during my first manic episode. I had also been diagnosed with and treated for ADHD as a child, and doctors warned that ADHD treatment could cause more manic episodes. Treatments for bipolar disorder that were prescribed to me were typically not prescribed in conjunction with the medication I was already taking for ADHD. I was quickly changed from a stimulant ADHD medication to being treated with mood stabilizers and antipsychotics.
The treatments for bipolar seemed to be almost as dibilitating as the disease itsself, especially for a teenage girl. My grades plummetted as I tried to make my way through my new, foggy brain. I was constantly tired. Instead of coming home and doing homework, I would go back to bed right after school. I couldn't concentrate in class and had no willingness to even try. I was just so tired. The lack of motivation made me anxious about my grades, but sitting down to concentrate on homework was completely impossible. My brain felt like it was clogged or something. Mentally, I became angry at myself. The physical changes were equally as devastating for a teenage girl: acne and weight gain. I talked to my doctor about the symptoms and over the course of 2 years we switched from one type to another type or a combination of two types. It seemed to go on and on with no relief. I finally was fed up. I didn't think the medications were helping, and if they weren't helping my brain, what permanent, negative side effects of my brain funcition could they be contributing to?
I started asking my doctor about different treatment options. I was finally referred to a mental health professional who was up for the challenge. I was immediately taken off of bipolar disorder medications and was established as treatment-resistant for mania and depression. Under close watch, he agreed to put me back on my previous ADHD medication. We agreed to psychological counseling as a method to help monitor and control my bipolar symptoms. My life saw immediate improvements after I stopped taking bipolar medication, though I still experience frequent symptoms. Psychological counseling, rather than medicinal therapy, has proved to be helpful. I still often look into new treatments for bipolar, specifically for depressive episodes and speak openly about them with my doctor. Unfortunately, typical medications used to treat depression, like serotonin reuptake inhibitors (SSRIs) are not recommended for bipolar patients. As an adult, I feel like the depressive episodes of bipolar are far more challenging to navigate.
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I am always happy to see that new treatments for bipolar depression, which has a high risk of being treatment-resistant, are being researched. This particular study, along with recent ketamine trials, have been met with a particular controversy because they are both classified as hallucinogenic drugs that have been heavily regulated in the past. Because of strict regulations, scientists have not been able to research the effects these drugs have on the brain in the past. Recent spikes in mental health issues and a rise in treatment-resistant patients have helped urge lawmakers to become more lenient on medical testing of hallucinogens. I'm very hopeful that this research, and future research of hallucinogens will create a shift to more productive treatment options for patients with mental health disorders.