Posted by pinksharkmark (64.32.72.194) on March 16, 2001 at 13:07:05:
To go to the link you need to sign in the Time's site: http://www.nytimes.com/2001/03/13/health/13DRUG.html
March 13, 2001
Scientists Test Hallucinogens for Mental Ills
By SANDRA BLAKESLEE
Hallucinogenic drugs like LSD and peyote — derided as toys of the hippie generation — are increasingly drawing the interest of neurologists and psychiatrists who want to test the idea that they may be valuable tools in treating a range of mental disorders.
Although there are anecdotal reports that psychedelic drugs can help some people with mental illness, the idea has never been substantiated by mainstream psychiatry and remains highly controversial — some would say outlandish.
And even the researchers involved in the new work are not suggesting that people start medicating themselves with hallucinogens.
But researchers like Dr. David E. Nichols, a professor of pharmacology and medicinal chemistry at Purdue, believe the drugs' potential should be investigated.
For example, Dr. Nichols, an expert on hallucinogenic drugs, said there were reports that symptoms of obsessive compulsive disorder, like washing one's hands dozens of times a day, subside under the influence of psilocybin, a hallucinogen derived from mushrooms.
Dying patients given LSD have reported less pain and less fear, he said. Ayahuasca (a Brazilian plant extract) and peyote (derived from cactus) have reportedly helped alcoholics stay sober.
"We now know a lot about how they work in the brain, but we have not begun to investigate their potential for treating brain disorders," he said.
Dr. Nichols is the founder of the Heffter Research Institute, begun in 1993 and named for Arthur Heffter, a 19th-century chemist who was the first person to identify a hallucinogenic molecule, mescaline, which he extracted from peyote. Backed by private donors like Laurence S. Rockefeller and Bob Wallace, a Microsoft millionaire, the institute is financing clinical trials with LSD, psilocybin and other hallucinogens to treat phobias, depression, obsessive compulsive disorders and substance abuse, said James Thornton, its executive director.
Dr. Nichols said trials were under way or planned in Switzerland, Russia and the United States. Most of the work is being done overseas, he said.
Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the Food and Drug Administration, said that any proposal to study the medical use of a hallucinogen must meet the same rigorous medical and scientific standards used to evaluate any other unapproved drug.
Furthermore, because hallucinogens are controlled substances, the investigator will need a license from the Drug Enforcement Agency to use such a substance in a clinical trial.
The D.E.A. classifies hallucinogens as drugs with no known medical value — purely "drugs of abuse." But if a valid medical use is found for hallucinogens, Dr. Woodcock said, the F.D.A. has safeguards to prevent the drugs from being diverted and used for unapproved purposes.
Separating a drug's beneficial effects from the harm it can cause is possible, said Dr. Alan Leshner, director of the National Institute on Drug Abuse. "Morphine works for pain, but it's horrendous when used in an addictive way," he said. "The same may or may not be true for hallucinogens. It's a mistake to confuse the two issues."
Much has changed in the half-century since LSD was first used by psychiatrists and then found widespread recreational use in the 1960's and 70's. Modern psychiatry has embraced drugs that affect the same brain molecules that are tweaked by hallucinogens. Tools for studying the brain's neurochemistry and response to drugs like LSD are far more advanced than they were in the 1960's and 70's.
Moreover, many of the people who hold political and scientific power today came of age during the 1960's, and they, unlike their parents, are not as afraid of hallucinogens, Dr. Nichols said.
By definition, hallucinogens are drugs that produce bizarre sights, sounds and feelings that appear to have no basis in reality. All work by changing levels of a brain chemical called serotonin, a substance involved in the modulation of many brain states, including depression, euphoria and appetite.
While antidepressants like Prozac work by making the neurotransmitter serotonin linger in the gaps between brain cells, hallucinogens have a different mechanism of action. They are what are called serotonin agonists — molecules that are very similar to the body's natural serotonin and, when taken in large doses, push the serotonin system into overdrive, making many brain systems more sensitive, Dr. Nichols said. "It's like turning up the volume on your radio. Suddenly you can hear very weak stations."
Thus, for example, hallucinogens amplify signals in the visual system to produce distortions of form and size. Instead of seeing one object, a person sees many copies of that object, he said. Perceived motion is similarly distorted. People begin to "hear" colors and "see" sounds or have out-of-body experiences. Some are so disoriented they experience a terrifying "bad trip."
But very little is known about how hallucinogens can be used therapeutically, Dr. Nichols said. "The first thing we want to know is, Are they safe?"
Dr. John H. Halpern, a psychiatrist at McLeans Hospital in Boston, is looking at this question in a study financed by the Heffter Research Institute and the National Institute on Drug Abuse. The study will involve members the Native American Church who, as part of their religious rituals, take peyote in a group setting but use no other drugs, not even alcohol.
Using a battery of tests for mental and social health, three groups of Native Americans — 70 church members, 70 alcoholics and 70 people from local communities in the Southwest — are being followed and compared for two to three years. The goal is to see whether peyote users are healthier or less healthy than the others.
Similar studies in Brazil showed that violent alcoholics who took hallucinogens in a ritualistic context often stopped drinking and had higher blood levels of serotonin, said Dr. Dennis McKenna, Heffter's director of ethnopharmacology.
Those changes may reflect an increase in their brain levels of serotonin, added Dr. McKenna, who is also a lecturer at the University of Minnesota Center for Spirituality and Healing, which seeks to integrate cultural and spiritual aspects of care with the biomedical aspects.
Dr. Francisco Moreno, a psychiatrist at the University of Arizona, and his colleagues there have permission from their hospital review board and expect final approval from the F.D.A. soon to carry out a study on obsessive compulsive disorder and psilocybin.
"We want to know if psilocybin can reduce symptoms, and if so, how much do you need to take?" Dr. Moreno said. Subjects will be closely supervised while under the influence of the drug and kept in the hospital overnight as a precaution.
At the University of Zurich in Switzerland, Dr. Franz Vollenweider has permission from his government to explore hallucinogens in treating depression and schizophrenia. "We are interested in the nature of the human experience, of the subjective me-ness or self that guides our behavior," Dr. Vollenweider said.
He wonders whether a medically facilitated experience in which the self temporarily "dissolves" might reduce the symptoms of a clinical depression.
With money from the Heffter Institute, Dr. Vollenweider and his colleagues are conducting a three-year study of 64 depressed patients treated with psilocybin.
In related research, Dr. Vollenweider plans to continue brain imaging studies of healthy volunteers who have taken psilocybin and LSD.
"We can tease out specific brain regions responsible for hallucinations and ego boundaries," he said in a telephone interview.
At Harvard, Dr. Harrison Pope, a professor of psychiatry, is planning to carry out a study to see whether LSD can alleviate fear and anxiety in dying patients. Studies in the 1960's suggested that the drug reduced pain and improved mood, he said, but they were not done under rigorous standards.
Eighty patients would be given an "active placebo," a drug that has physiological effects but is not hallucinogenic, or LSD under close supervision of a psychiatrist or trained mental health worker, Dr. Pope said.
And in St. Petersburg, Russia, Dr. Evgeny Krupitsky, chief of the research laboratory at the Leningrad Regional Center of Addictions, is administering ketamine, an anesthetic with strong hallucinogenic properties, to alcoholics and heroin addicts, as they are treated with talk therapy.
One day, advocates of this research say, their results will be valuable.
"If hallucinogens ever find their way into mainstream medicine — and I am convinced they will — they will never be handed out like Prozac," said Dr. George Greer, Heffter's medical director and a psychiatrist in private practice in Santa Fe, N.M. "People will need guidance. These are not drugs you administer every day."
Copyright 2001 The New York Times Company
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Some minor inaccuracies and speculation in the above article (particularly when describing the mechanism by which hallucinogens work... still far from proven) but on the whole a light on the horizon.
pinky