What Exactly is a Psychedelic Medicine?
Science-backed research continues to show the effectiveness of psychedelic compounds in treating various mental health conditions.
The success of these trials opens doors to new compounds becoming potential medicines for treatment and therapeutic application for conditions like depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), and other conditions.
As the prevalence and research surrounding psychedelic medicine continues to grow, a common question that is asked is: What differentiates a psychedelic medicine from a psychedelic drug or compound?
What is a Psychedelic Medicine?
Psychedelic medicines are compounds that have psychoactive properties that affect one’s conscious experience, and are shown by clinical research and trials to be effective in treating a physical or mental health condition.
While there are many compounds or substances that could fall under this classification, in the United States there are currently three compounds that are being reviewed by the US Food and Drug Administration (FDA) as psychedelic medicines with therapeutic benefits: ketamine, psilocybin, and MDMA (3,4-methylenedioxymethamphetamine).
The following compounds, while not officially recognized or approved for their medicinal use by regulatory bodies, have been included in limited clinical trials in the United States or abroad, or are anecdotally considered to have medicinal benefits:
- LSD (lysergic acid diethylamide)
- DMT (N,N-Dimethyltryptamine)
- 5-MEO-DMT (5-Methoxy-Dimethyltryptamine)
- Mescaline (peyote)
- Ibogaine (iboga)
How the FDA Approves Medicines
The FDA approves new medicines —or existing medicines for a new treatment application— in a multi-phase approach. This process relies heavily on clinical trials to ensure the medicine’s safety and efficacy, and does so through increasingly large sample sizes across its three main trial phases before approval:
Phase 1 FDA trials test for safety and dosage of the administered medicine in up to 100 healthy volunteers, or those with the condition.
Phase 2 FDA trials monitor for efficacy and side-effects of the medicine in several hundred people with the condition.
Phase 3 FDA trials continue to monitor efficacy and adverse reactions in up to 3000 volunteers who have the condition.
This determines the viability of a specific medicinal intervention for the condition being treated, while considering:
- Method of administration
- Adverse side effects
- Positive clinical outcomes
As an example, in 2019, the FDA approved esketamine (a ketamine derivative) administered intranasally (as a low-dose nasal spray) after it was proven to be effective in treating treatment-resistant depression.
To learn more about the approval process, the FDA provides an in-depth guide to its drug review process.
Current Psychedelic Medicines
Ketamine is a dissociative psychedelic, and is the only psychedelic medicine available for prescription through licensed clinicians. Due to its original FDA-approved application as an anesthetic in 1970, its decades of clinical application have allowed for a longer period of research and study into its medicinal and mental health benefits beyond anesthetic use.
Research has shown ketamine can be beneficial in treating a variety of mental health conditions, including depression, anxiety, PTSD, and suicidal ideation. There are other potential areas of application being explored, such as eating disorders, treatment-resistant conditions, and smoking cessation. Ketamine is allowed as an off-label prescription to treat mental health conditions, subject to a clinician’s approval.
As mentioned above, ketamine can be applied in different ways: intravenous infusion, intramuscular injection, intranasal spray, or via tablets or troches.
Ketamine’s FDA status
In 2019, the FDA approved intranasally-delivered ketamine derivative esketamine as an intervention for treatment-resistant depression (TRD).
Here are a few examples of ketamine studies currently in FDA trial Phases:
Phase 1 trials
Phase 2 trials
- Intravenous administration of ketamine for major depressive disorder (MDD)
- Intravenous administration of ketamine for PTSD
Psilocybin is a psychedelic compound derived from hallucinogenic mushroom varieties, most commonly the psilocybe cubensis family. It is considered a “classical” psychedelic due to its effect as an agonist on the 5-HT2A (serotonin) receptor. LSD, DMT, and mescaline are other compounds considered classic psychedelics that also affect this receptor network.
Despite being the active compound in psychedelic mushrooms, it is not the mushroom bodies themselves that are used in psychedelic therapy, nor as psychedelic medicines. In clinical trials and treatments, synthetic psilocybin is used, and is either ingested or injected.
There are promising studies showing the efficacy of psilocybin as a psychedelic medicine in the treatment of:
Psilocybin’s FDA status
While more research is needed, psilocybin is currently moving through FDA clinical trials for approval as a psychedelic medicine.
Psilocybin has also been given a Breakthrough Therapy designation from the FDA for the treatment of depression, to help push the treatment and medicine through regulatory approval.
MDMA is another psychedelic medicine receiving attention from researchers and regulatory bodies. It works primarily on the serotonin system in the brain, and does not normally induce a classical psychedelic experience. For this reason, MDMA’s status as a psychedelic is largely a semantic discussion.
MDMA is often referred to as an empathogen or entactogen, and it has equal potential when compared to other medicines currently being studied for treatment of mental health conditions.
MDMA’s FDA status
MDMA-assisted psychotherapy in the treatment of PTSD and complex PTSD is currently moving through the final stages of FDA approval.
Spearheaded by the Multidisciplinary Association for Psychedelic Studies (MAPS), MDMA-assisted psychotherapy for PTSD has received Breakthrough Therapy designation, and is currently in its final Stage 3 trials of regulatory FDA approval. If successful, as early indicators show, MDMA treatment may be available for use in clinical settings by 2023.
Where Can I Receive Treatment Using Psychedelic Medicine?
If you think that you could benefit from treatment with psychedelic medicines, or are interested in the experience for yourself, there are currently two potential avenues available to you: clinical research studies, or ketamine treatment.
If you’re interested in participating in a study, learn how to find, apply, and enroll in clinical research studies.
As mentioned, the only psychedelic medicine currently available for clinical prescription is ketamine or esketamine (Spravato) treatment. Depending on your country, you can find a ketamine clinic or service provider near you. If you’re in the U.S., and you’d like to experience ketamine treatment from the comfort and safety of your own home, see if you’re a candidate for treatment with Mindbloom.
The other psychedelic medicines such as MDMA, psilocybin, or other compounds are all moving through various stages of research or regulatory approval, and are not available to the public at the time of this writing.
Defaulting to the FDA-approval Pipeline is the Current Leading Indicator
The line that separates a psychedelic compound from a psychedelic medicine is not yet agreed upon, though drawing the line at those that have research backing, clinical support, and regulatory approval (such as by the FDA) is a wise decision.
Just because a psychedelic compound is not currently viewed as a psychedelic medicine does not exclude it from becoming one in the future. Psychedelic therapy is an emerging field. While some psychedelic medicines are in their initial phases of research, they will likely see an increase in research, applications, and accessibility in the years and decades to come.
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
The testimonials appearing on this website reflect the experiences of individuals who used Mindbloom's services. However, individual results may vary. Mindbloom does not claim, nor should you assume, that any individual experience described is typical or representative of what any other person might experience. Some testimonials may have been edited for clarity, relevance, and length. Mindbloom is not responsible for the opinions or comments posted in these testimonials, and does not necessarily share the opinions or commentary contained therein. All opinions expressed are strictly the views of the individual subjects. Testimonials on this website are not intended, nor should they be construed, as claims that the services mentioned will cure or prevent any disease, although they are designed to help people with legitimate healthcare issues. No testimonial has been clinically proven or evaluated, and no medical claims whatsoever were made and no statements on this website have been evaluated by the FDA.
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety