5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety

Based on survey data from a group (n=362) that uses 5-MeO-DMT in a group setting, many (80%) with depression and anxiety reported that their conditions improved. This correlated with the intensity (mystical) of the experience.

Abstract

Background: A recent epidemiological study suggested that 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used for spiritual and recreational reasons is associated with subjective improvement in depression and anxiety. Further exploration of the potential psychotherapeutic effects of 5-MeO-DMT could inform future clinical trials.

Objectives: We examined self-reported improvement in depression and anxiety among people who use 5-MeO-DMT in a group setting with structured procedures guiding dose and administration of 5-MeO-DMT. Such procedures also include activities for the preparation of, and support during/following sessions, which are similar to procedures used in clinical trials of hallucinogen administration. Next, we examined whether depression or anxiety was improved following use, and whether the acute subjective effects (mystical/challenging) or beliefs about the 5-MeO-DMT experience were associated with improvements in these conditions.

Methods: Respondents (n = 362; Mage = 47.7; Male = 55%; White/ Caucasian = 84%) completed an anonymous web-based survey.

Results: Of those reporting having been diagnosed with depression (41%) or anxiety (48%), most reported these conditions were improved (depression = 80%; anxiety = 79%) following 5-MeO-DMT use, and fewer reported they were unchanged (depression = 17%; anxiety = 19%) or worsened (depression = 3%; anxiety = 2%). Improvement in depression/anxiety conditions were associated with greater intensity of mystical experiences and higher ratings of the spiritual significance and personal meaning of the 5-MeODMT experience. There were no associations between depression or anxiety improvement and the intensity of acute challenging physical/psychological effects during the 5-MeO-DMT experience.

Conclusions: Future prospective controlled clinical pharmacology studies should examine the safety and efficacy of 5-MeO-DMT administration for relieving depression and anxiety.”

Authors: Alan K. Davis, Sara So, Rafael Lancelotta, Joseph P. Barsuglia & Roland R. Griffiths

Notes

  • Large dataset (but only survey data)
  • Significant part of the depressed and anxious participants improved (80%), almost none worsened (2-3%)
  • Global lifetime prevalence of anxiety and depression is 13% and 10%
  • (5-MeO-)DMT last much shorter than psilocybin or LSD, so might be more easily used in therapy
  • This paper follows Davis et al. (2018) which was the first epidemiological study on this drug

“However, despite these advances, the widespread dissemination of psilocybin-assisted psychotherapy is potentially challenging, given that drug administration sessions consist of a 7- to 10- hour day with two therapist guides and a medical monitor, which may be difficult to implement in traditional outpatient mental health settings. Therefore, short-acting psychedelics may warrant examination as potential therapeutics in order to overcome these barriers.”

This is something that will have to be figured out over the coming years. The costs alone of this long intervention might not make it feasible (even though the long-term costs are probably much lower than another non-effective treatment).

The effects of 5-MeO-DMT only last between 35-45 minutes (peak of 5-15 minutes, see Psychonaut Wiki).

“Potential respondents for this study came from an email distribution list of people in the US that use 5-MeO-DMT in a group setting.”

The paper describes a group that uses DMT in a very intentional and therapeutic way. There is a safe space for participants to try it and to talk about their experience afterwards (integration). Or in other words, it’s about more than only the experience and the experience itself is shaped by the environment in which it’s done.

“Moreover, at the time of survey most respondents (73%) reported that their first 5-MeO-DMT session was among the top five or single most personally meaningful experience of their life, and 80% reported that their session was one of the top five or single most spiritually significant experience of their life.”

This high level of significance is common with the use of psychedelics. And those who rated their experience as more meaningful were also the ones who were more likely to experience the benefits (e.g. Griffiths et al, 2011).

“Of those with anxiety (n = 173), 79% (n = 136) reported that their anxiety was better following 5-MeO-DMT use, 19% (n = 33) reported no change in anxiety, and 2% (n = 4) stated that they experienced a worsening in this condition. Interestingly, only 6 respondents reported that they used 5-MeO-DMT specifically for help with anxiety and only 1 respondent reported using for help with depression.”

Although this is ‘only’ survey data, it might be a hint that psychedelics might also work when someone is not directly looking for a specific solution. In other words, by shaking up the brain, it might let things fall back in place even if the participant wasn’t actively thinking about mental health issues.

“This study also lacks a standardized assessment for anxiety or depression, and we used other self-report measures, and thus is limited by retrospective recall bias.” and “Additionally, because of the nature of this specific group of people who use 5-MeO-DMT and the context within in which this group prepares for, administers, and integrates these psychedelic experiences, we cannot determine the extent to which any changes in depression or anxiety are accounted for by the connections fostered within this community and the social support provided therein.”

The limitations of this study design (survey) are large and show that this can only be a first step in the right direction. It’s difficult to say here what caused the positive effects, it could even have been the conscious step to join such a group that self-selected people who were already likely to improve. As always, “Future controlled laboratory studies are a critical next step.”

This is something that (among others) Beckley PsyTech will work on.

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