Finding better treatments for depression in terminal illness

Mind-altering agents like the hallucinogen LSD may have a bad reputation. But understanding how such "psychedelic" drugs buoy up the mood of terminally ill patients could help uncover better treatments for depression.

That's according to Dr Keith Murphy, a principal investigator with the Applied Neurotherapeutics Research Group at University College Dublin's Conway Institute.

Commenting on an ongoing clinical trial in Switzerland - which is looking at the effects of LSD on the mood of terminally ill cancer patients - he says such research could help point the way towards improving drug treatments for depression. "They are taking an interesting approach," he says, as both conventional anti-

depressants and hallucinogenic drugs such as LSD and psilocybin (from magic mushrooms) target the same chemical system in the brain. "From a pharmacological point of view, the nerve chemicals that psychedelic drugs affect are known to be related to depression and to low mood states," he says.

"So it makes perfect sense that they would be useful in improving mood and outlook. And in the setting of terminal illness where people have basically lost hope, you can certainly see an argument for their acute usage to allow a person to come to terms with that situation."

The key is to break a perpetuating cycle of depression, he explains. "I would relate what they are talking about very much to chronic depression, and the substantial issue in that disease state is knocking yourself out of the cycle of depression. That's really what the antidepressant drugs try to achieve, and these [pscychedelic] drugs are doing a similar thing, although they are probably more powerful drugs."

The trial of hallucinogens under medical supervision could be of benefit to mood in some instances of terminal illness, he says. "The drugs are possibly of potential use there, although it may not be effective in every case."

And in the longer term, a better understanding of how psychedelic drugs affect mood may also lead to better and safer ways of treating depression, notes Murphy, whose research looks at molecular changes that happen in the brain in schizophrenia and depression. However, he notes that psychedelic drugs are more powerful than conventional antidepressants and can have serious side effects. "LSD is notorious because even with acute exposures you can have phenomenally long lag times to flashbacks," he says.