Thursday, November 25, 2021

Life-awakening and antidepressant?

 During my last semester as an undergraduate, I took medical botany because I thought it would be cool to learn about some plants and, I was told it was an easy upper-level elective so why not. Here we discussed a multitude of plant species two of which were the Banisteriopsis caapi and the Psychotria viridis. A brew made of these two plants gave rise to Ayahuasca, which means soul of the vines in Quechua. Originally the cocktail was made for religious purposes, later gained some attention for its life awakening effects but most recently it has been investigated as an anti-depressant drug.

Ayahuasca is rich in some mood affecting chemicals, which are the reversible inhibitors of monoamine oxidase (MOAi) which comes from B. caapi and N, N-dimethyltryptamine (N,NDMT) from P. viridis (Palhano-Fontes et al, 2021). MOAis essentially work like SSRIs while N,NDMT acts an agonist of serotonin, glutamate and dopamine, therefore making a basis for its pharmacological use. What I found really interesting is that the presence of these MOAis in cocktail are essential for the prevention of N,N-DMT deamination which allows it to reach the bloodstream, sneak through the blood-brain barrier and cause its effects on the central nervous system.

A recent randomized placebo-controlled trial investigated the effects of ayahuasca on 29 patients who had previously had unsuccessful pharmacological treatment for their depression (Palhano-Fontes et al, 2021). Severity in depression was assessed through several questionnaires which showed significant decrease in days 1 through 7 in comparison to baseline results. In addition, three physiological systems related to depression were assessed. First, was the stress system which was evaluated through cortisol levels. Patients showed a positive increase in salivary cortisol levels after treatment. The second system was the Brain-Derive Neurotrophic Factor (BDNF), patients also had an increase after treatment. Last is the inflammatory system. Here the serum levels of Interleukin-6 and C-Reactive Protein (CRP) were assessed however patients only had a significant decrease in the CRP levels. The changes in the last two systems mentioned were correlated with decrease in depressive symptoms.

While more studies need to be made to further assess its mechanism of action, ayahuasca does show some promise as the next antidepressant. On the other hand, for those who are not depressed and are looking for a new meaning in life ayahuasca may be your next try, that is if you don’t mind a little bit of vomiting first.

 

Palhano-Fontes, F., Soares, B. L., Galvão-Coelho, N. L., Arcoverde, E., & Araujo, D. B. (2021). Ayahuasca for the Treatment of Depression. Current topics in behavioral neurosciences, 10.1007/7854_2021_277. Advance online publication. https://doi-org.dml.regis.edu/10.1007/7854_2021_277

3 comments:

  1. Hey Steffany,

    It’s super interesting to read about the different types of alternative therapies that have been used to treat depression. Ayahuasca is not the first drug I think of when I think of antidepressants, so I got curious and googled some unique treatments for depression. In the same vein as N,NDMT, I found that ketamine is being used to treat depression as well. According to Matvevchuk et al. (2020), ketamine provides a faster reaction (reduction of depressive symptoms in 2-4 hours post administration) compared to typical antidepressants (hours to days post-administration). It regulates glutamate by acting on the NMDA and AMPA receptors. There is research suggesting that it can affect neural plasticity and activate BDNF (Matvevchuk et al., 2020). However, the benefits only lasted about 1 week with a single dose or 18 days with repeated administration. I’m curious to see where the world of unique drug therapies can go. It is great to see that there are many options for depression treatment in case certain drugs cannot work. Maybe one day, we’ll get to see ayahuasca and ketamine being more widely used (under supervision of course).

    Matveychuk, D., Thomas, R. K., Swainson, J., Khullar, A., MacKay, M. A., Baker, G. B., & Dursun, S. M. (2020). Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers. Therapeutic advances in psychopharmacology, 10, 2045125320916657. https://doi.org/10.1177/2045125320916657

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    1. Hi Steven,

      Thank you for your comment! I think there's a greater level of attraction to the idea of taking a single dose of a certain antidepressant for an X number of days in comparison to one every single day. This is the case for most of the commonly prescribed drugs. Hopefully these two new potential antidepressant make it through the realm of clinical trials so that people can have more options into the different types of pharmacological treatments.

      https://familydoctor.org/how-to-safely-take-antidepressants/#:~:text=Antidepressants%20are%20usually%20taken%20every,long%20to%20take%20your%20antidepressant.

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