Potential of DMT as a Therapy for Depression
A recent phase II clinical trial has suggested that dimethyltryptamine (DMT), a key psychoactive component found in the traditional Amazonian psychedelic brew ayahuasca, might offer a new therapeutic approach for depression.
The trial, designed and sponsored by the psychedelic pharmaceutical company Small Pharma (now known as Cybin UK), was led by Dr. David Erritzoe, a psychiatrist and neuroscientist at Imperial College London. The findings were published in Nature this month.
In the study, 17 participants received an injection of a DMT compound developed by Small Pharma, while another group of 17 received a placebo. Notably, all participants participated in psychotherapeutic support sessions. Two weeks after their injections, those who received DMT reported a more significant reduction in depressive symptoms compared to those given the placebo.
Tommaso Barba, a PhD candidate at Imperial College London and one of the authors of the study, highlighted the importance of therapists in preparing patients for the experience and in helping them integrate it afterward. However, he also cautioned that the trial was small and preliminary.
“There’s still more to do, but it’s promising,” Barba noted.
In traditional ayahuasca ceremonies, participants drink a tea made from various plants, which can induce nausea and vomiting as part of the experience. In contrast, the synthetic DMT used in this trial produces a shorter, more intense psychedelic experience lasting about 30 minutes without the vomiting side effect.
Dr. Daniel Perkins, a senior research fellow at the University of Melbourne, mentioned that the vomiting aspect associated with ayahuasca can, in some cases, hold its own therapeutic value, although not everyone experiences it. He noted that some participants report emotionally cathartic effects during the moment of vomiting when processing trauma. However, he added, the overall benefits between those who vomited and those who didn’t seemed comparable.
Psychedelic-assisted therapy shares similarities with ayahuasca in that it includes a facilitator guiding participants through the experience, but typically relies on modern psychotherapy methods rather than traditional rituals.
In 2019, the FDA approved Spravato, a ketamine-based nasal spray designed for treatment-resistant depression, marking the first psychedelic-adjacent therapy to gain such approval. Trials are currently underway for other substances like psilocybin (found in “magic mushrooms”) and MDMA. Recent concerns about ethics and data reliability led the FDA to withhold approval for MDMA-assisted therapy for PTSD.
Perkins argued that substances like psilocybin and DMT might be more suitable options, given that there’s some evidence suggesting they can yield therapeutic benefits even outside clinical settings. In contrast, there isn’t robust evidence supporting the mental health advantages of recreational MDMA, which can also lead to a craving for touch that may complicate therapeutic relationships—something not typically associated with DMT or psilocybin.
While Barba acknowledges the encouraging results from the recent trial, he points out several challenges that lie ahead for psychedelic therapy.
The FDA regulates drugs rather than therapies, which means pharmaceutical companies might try to minimize the therapeutic elements in their treatments. The DMT therapy, although potentially quicker than other psychedelic options, still requires clinical administration through injection and with the oversight of a therapist. This might not be appealing to everyone, especially when compared to the convenience of a pharmacy pill. Additionally, Barba mentioned that intense psychedelic experiences may not suit everyone’s preferences.
One complexity Barba mentioned is that DMT may not serve as a “quick fix” for depression.
“It can act as a catalyst,” he explained, emphasizing that the DMT experience could help individuals identify necessary changes in their mindset or life path. Often, improvements in depressive symptoms may not solely stem from DMT itself, but also from therapy and the willingness to make uncomfortable decisions over time.
For instance, if a patient realizes that their job contributes to their depression, they may need to leave that position to genuinely experience the benefits.
