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When it comes to the treatment of mental health conditions, new treatment options are continuously being developed, researched and tested. 

New applications are being developed for old treatment methods, while at the same time researchers are seeing interesting results with novel forms of treatments. Recent research suggest that treating depression with psychedelic drugs may offer the fastest response in treatment of depression ever reported.

This is according to Professor Piet Oosthuizen, a healthcare practitioner specialising as a psychiatrist and a speaker at a psychiatric symposium sponsored by Cipla earlier this year. 

“As researchers, we should keep an open mind and not allow prejudice to cloud our judgement when it comes to new treatment methods that may add value to the lives of our patients, as long as the research is done properly, within the accepted limits of current scientific and research criteria.”

 He explains that psychiatrists are continuously exploring new options in the treatment of patients who do not respond to traditional treatment methods. One of the most interesting developments has been the revisiting of so-called "psychedelic drugs" as potentially beneficial in the management of otherwise treatment-refractory conditions.

“Although this is exciting and interesting, it is important to note that there is still a lot of research that has to be done on this topic. It will entail a very long process of extensive, in-depth research. This is particularly true in this case, given that these are currently banned substances with purported potential for abuse.”  

Oosthuizen says that the renewed interest in hallucinogenic drugs started in 2000, when ketamine was first reported to be a potentially revolutionary treatment option for depression. 

Ketamine, a chemical ingredient commonly used for anaesthesia, was used in low doses to treat patients with resistant depression. The researchers reported remarkable, positive results, with significant alleviation of symptoms within hours of treatment in patients who previously had not responded to any other treatment. 

“Based on these startling results, researchers started to reconsider and revisit different psychedelic substances, like LSD and psilocybin - the active ingredient in so-called "magic mushrooms" - among others. Most of these psychedelic drugs are substances that cause an altered state of consciousness in the user, with some users reporting intense, psychospiritual epiphanies.”  

When these substances were banned in the early 1970s, almost all research into their medicinal use came to an end, he states. 

“However, over the past few years some researchers have started to look at these substances again, to use it in small dosages and within heavily regulated environments to explore the potentially beneficial effects these substances may have on patients with mental illnesses.”

Despite the potential that these relatively old - and currently banned - substances may hold, Oosthuizen emphasised that there are no "silver bullets" in medicine. 

“At most, these drugs may offer hope to some people whom we could not help before, but only when used within the right context, together with very specific, targeted psychotherapies delivered by well-trained specialists.”  

According to Oosthuizen, some of the research suggests that these substances may create an environment where the brain is more amenable to psychotherapy. 

“Although the precise methodology for optimal use is not yet defined, it seems fairly certain that a highly skilled treating team will do a detailed analysis to create the right environment where a patient who is adequately prepared will benefit from psychotherapy in a milieu optimised by the use of the substance. However, at this point it is only preliminary, and only time will tell whether there is something truly beneficial to be gained.”  

He adds that there are many, significant, known and perhaps unknown dangers in exploring this route. This is fairly unchartered territory where our excitement should be tempered with a healthy dose of scientific scepticism, particularly as these are drugs known to hold significant risk of abuse. 

 One of the potential dangers that Oosthuizen highlights, is the misinterpretation or misrepresentation of scientific findings, where certain members of society may abuse research findings to promote a certain personal or political agenda.

 “Furthermore, some people may think that this can be a "do-it-yourself" treatment, which could lead to tragic consequences. This is therefore a unique situation where researchers and clinicians have to tread very carefully to not create the wrong impression. This is most certainly not a free-for-all, where individuals can use mental illness as an excuse for substance abuse,” Oosthuizen concludes.

Paul Miller, CEO of Cipla SA, says that it is important to take note of research like this in order to ensure that healthcare evolves to ensure effective treatment. “This information must be shared among all stakeholders, including the healthcare industry, government and patients, to ensure a collaborative effort is made towards alleviating mental health conditions in South Africa.”

(Adapted from press release)