"Under the influence of such substances I was able to leave behind the rigid conceptions of the world."
Beyond his "massively filtered perception" lies another world that is just as real but twice as beautiful. "Without blind anger, without a reason for blind anger." British Prince Harry reports in his biography "Reserve" on experiences with psychedelic drugs. Experimenting with it has played a central role in coping with mental health problems, he said in a recent online conversation with Canadian trauma expert Gabor Maté.
The 38-year-old is addressing a topic that has been the subject of quite a bit of hype for some time now. Hopes are pinned on illegal substances such as psilocybin (magic mushrooms), MDMA (ecstasy) and LSD: do they have the potential to help against various mental illnesses? Against depression, anxiety, obsessive-compulsive disorders and addictions or post-traumatic stress disorders? According to the guideline on depression, previous findings were not sufficient to justify use outside of clinical studies.
The sometimes high expectations are related, for example, to smaller studies and the effect on certain brain regions and receptors - in the case of psilocybin, among other things, for the messenger substance serotonin, which is associated with depression. The topic is not new: the effects of LSD and psilocybin on the psyche were already being studied in the 1950s and 1960s. Subsequent bans then interrupted research for a long time.
criticism from Great Britain
In Great Britain, Harry's statements attracted criticism, according to the "Daily Mail" an increased interest in quack therapies is feared. In the book, Harry mentions mushrooms and the hallucinogenic potion Ayahuasca (DMT). He calls the application “purely medical”, but the substances are illegal in many countries.
This brings back memories of 2009: Two men died of an ecstasy overdose during an illegal drug therapy session in Berlin. Five other people were hospitalized with poisoning. The convicted doctor had weighed the drug incorrectly.
Nowadays, a possible effectiveness against certain diseases must first be shown in larger clinical studies. The questions are, for example, whether the effect goes beyond the effect of a dummy drug and whether the benefit is greater than with existing therapies. Researchers want to know how long possible effects last and how undesirable side effects influence the risk-benefit ratio. The right dose is also important.
A study on psilocybin is being conducted by the Central Institute for Mental Health in Mannheim, in which the Charité in Berlin is also involved. It is about depression, the treatment of which has so far been unsuccessful. According to the study website, the substance triggers a state similar to a daydream for a few hours, often associated with increased emotions. There is no evidence that the substance is addictive. Results are expected to be available in 2024, said Charité study coordinator Michael Koslowski.
Use of the drug ketamine
The use of the anesthetic and painkiller ketamine is more advanced. Also known as a party drug. In people with therapy-resistant depression, under certain conditions it can be administered intravenously, under the skin or, since the end of 2019, as a nasal spray (then as esketamine). The advantage is that the effect occurs quickly. As a result of the gift, patients are virtually disconnected from their environment for a while.
"We have had amazing success with ketamine in those affected. I see it as a valuable addition to the therapeutic options," says Andreas Reif, Director of the Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy at the University Hospital in Frankfurt. "But such therapies must always be embedded in an overall psychiatric treatment."
In other words, you should never think of a self-directed drug trip as a simple solution to complex psychological problems. On the contrary. That could backfire. Self-experiments increasingly appeared on portals such as YouTube, reports Koslowski from the Charité. That is considered very risky. Imitators ran the risk of suffering dangerous complications: anxiety reactions, psychoses, accidents and risks to the heart, for example if too much is taken or a mixture of several substances is taken.
According to current knowledge, the substances are not a savior for all patients, says Reif, who is on the board of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPNN). "But you shouldn't demonize them either. We should be happy about every additional drug that we have available." From Reif's point of view, further psychedelics should be added in the future for use in the psychiatric field. Experts say that with psilocybin, for example, it will still be a question of several years.