Ayahuasca Psychedelic DMT Shows Promise as Depression Therapy
A phase II clinical trial has revealed that dimethyltryptamine (DMT), a key psychoactive component in the traditional Amazonian psychedelic ritual ayahuasca, may offer a promising new avenue for treating depression. The study, sponsored and designed by the psychedelic pharmaceutical company Small Pharma (now Cybin UK), was led by Dr David Erritzoe, a psychiatrist and neuroscientist at Imperial College London, with results published this month in the journal Nature.
Study Design and Key Findings
In the trial, seventeen participants received an injection of a synthetic DMT compound developed by Small Pharma, while another seventeen received a placebo. All participants were provided with psychotherapeutic support throughout the process. Two weeks post-injection, those who received DMT experienced a significantly greater reduction in depressive symptoms compared to the placebo group.
Tommaso Barba, a PhD candidate at Imperial College London and co-author of the study, highlighted the critical role of therapists in preparing patients for the experience and helping them integrate insights afterward. However, he cautioned that the trial was small and preliminary, stating, "There's still more to do, but it's promising."
Differences from Traditional Ayahuasca
Traditional ayahuasca involves drinking a tea made from plants containing psychedelic components and enzymes that slow digestion, often causing nausea and vomiting. In contrast, the synthetic DMT formulation used in this trial produces a short but intense 30-minute psychedelic experience without inducing vomiting.
Dr Daniel Perkins, a senior research fellow at the University of Melbourne's psychedelics research unit, noted that vomiting in ayahuasca can have cathartic effects for some, but overall, it didn't significantly impact therapeutic outcomes. He explained, "In our research, people do report that vomiting can have quite psychologically, emotionally cathartic effects," but added that it didn't make a major difference in benefits between those who vomited and those who didn't.
Therapeutic Context and Comparisons
Psychedelic-assisted therapy, similar to ayahuasca, involves facilitators guiding participants through the experience to aid processing and healing. In clinical settings like this trial, contemporary psychotherapy replaces traditional rituals and chanting.
The US Food and Drug Administration (FDA) approved Spravato, a ketamine-based nasal spray for treatment-resistant depression, in 2019, marking the first psychedelic-adjacent treatment for depression. Other substances under investigation include psilocybin (from "magic mushrooms") and MDMA, though the FDA recently declined to approve MDMA-assisted therapy for PTSD due to ethical and data reliability concerns.
Perkins suggested that psychedelics like psilocybin and DMT might be more suitable for therapy, as evidence indicates therapeutic benefits even outside clinical settings, unlike recreational MDMA, which lacks strong mental health benefits and can create compromising situations with therapists due to touch cravings.
Challenges and Future Considerations
Despite promising results, Barba pointed out hurdles for psychedelic therapy. The FDA regulates drugs, not therapies, potentially leading pharmaceutical companies to minimize therapeutic components. While DMT therapy is faster than some alternatives, it requires clinic administration via injection with a therapist, which may be less desirable than pharmacy pills for many patients. Additionally, not everyone is willing to undergo an intense, potentially uncomfortable psychedelic experience.
Barba emphasized that DMT isn't a "quick fix" for depression but can act as a catalyst for change, helping individuals understand necessary shifts in mentality or lifestyle. Improvement often stems from combined work with therapists and the "capacity to make uncomfortable decisions over time," such as quitting a job if it contributes to depression.
This research adds to growing interest in psychedelic therapies, though further studies are needed to validate and refine these approaches for widespread clinical use.
