Using a psychedelic to treat an anxiety disorder, depression or even an addiction is what the Addictology Department of the University Hospitals of Geneva (HUG) has been offering for example since 2020. “If psychotherapy assisted by psychedelic (PAP, editor’s note) established throughout the world, it can be practiced under medical supervision in Switzerland since 2014. Now, the Federal Office of Public Health is overwhelmed with requests, as this approach arouses so much interest,” explains Professor Daniele Zullino, chief physician of the HUG Addictology Department.
Why such medical enthusiasm for these drugs whose consumption is usually associated with recreational use? “LSD or psilocybin (substance present in certain hallucinogenic mushrooms, editor’s note) modify brain connectivity. As part of PAP, patients explore other neural pathways, which can remove certain obstacles and unblock problematic situations. Perceptions change, including that of time, the person sometimes has the feeling of connecting with the whole world and manages to put the problems they encounter into perspective. This therapy, which is organized over several sessions, is interesting for treating disorders for which the neural circuits are fixed, which occurs in cases of depression for example,” continues the expert.
Investment of time and money
Note that PAP is not offered as first-line treatment, it is intended for people for whom traditional treatments have already been tried without success. In addition, it requires a personal and also financial investment, the substance used not being reimbursed. Another important clarification: its benefits are not systematic. Indeed, in a third of cases, the use of psychedelics does not bring notable results. Contraindications also exist: PAP is in principle not offered to people who have had psychotic or bipolar disorders.
In practice, the substance is taken in the morning in the hospital and requires staying there for the entire duration of the “trip” (six to eight hours under psilocybin, between ten and twelve hours under LSD). “A nurse does the preliminary assessment. This meeting is essential to establish a bond of trust and define the therapeutic intentions of the session. He or she then stays alongside the person throughout the PAP to support them, particularly in sometimes very intense moments (when, for example, certain traumas come to the surface), and help them refocus on their sensations. bodily without interpreting them,” explains Laurent Szczesniak, nurse responsible for coordination at the Addictology Department. Headaches, nausea and sometimes problems falling asleep the night following the experience are among the rare possible side effects.
The day after the PAP, the person returns to the hospital to discuss their experience with the doctor who is following them in therapy and who therefore prescribed the substance, as well as with the nurse who presents the eve, when taking the psychedelic. “This allows us to share the observations made during the session and to link it to the objectives that had been defined,” specifies the nurse. And Professor Zullino points out: “This session is part of a psychotherapeutic follow-up with the doctor and is not sufficient in itself.”
-What about the risks of developing an addiction to these hallucinogenic products? “LSD and psilocybin actually help fight addictions by acting on dopamine in the brain, so they do not develop them,” concludes the expert.
“LSD broke down the walls I had built around myself”
Hélène*, 60 years old, explains: “I followed several therapies for 25 years and I had the impression that I was no longer moving forward. I heard about psychedelic-assisted psychotherapy and wanted to try it.” Hélène then obtains an appointment for this approach, in addition to long-term therapeutic follow-up: “I did three sessions under LSD. It was quite scary at first, as I relived my childhood traumas. I knew I was going to go through this and the presence of the nurse in the room was reassuring. LSD broke down the walls I had built around myself to protect myself.” By then talking about these experiences with her psychotherapist, Hélène was able to approach things from another angle and thus progress and feel much better.”
* Borrowed first name.
