The Psychedelic Revival – New Insights

blob-decoration<

Treatment resistant depression is a major depressive disorder that occurs in up to 30% of the treated major depressive disorder population of the UK. New research from America and Australia is seeking to answer the question of the use of psychedelics for the disorder, and reporting promising results so far. 

Current therapies for treatment resistant depression that are recommended by Mayo Clinic once medication and psychotherapy have proven ineffective can be invasive and distressing for the sufferer and their family and include: 

  • Electroconvulsive therapy (ECT). A type of treatment that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.
  • Repetitive transcranial magnetic stimulation (rTMS).  In which a carefully measured dose of electricity is used to induce seizures in a patient, which in turn appears to cause changes in brain chemistry that can quickly reverse symptoms of major depression. 

2016 saw the beginning of an increasing interest in psychedelic drugs as a therapy for mental health concerns. Clinical trials involving different psychedelic drugs to treat post-traumatic stress disorders such as (PTSD), depression and anxiety sprang up across the globe; one such trial in San Francisco tested the use of MDMA to treat PTSD is currently ongoing. Separately, the FDA recently awarded COMPASS Pathways, a life sciences academy, with ‘Breakthrough Therapy Status’ for their research on the use of psilocybin (the psychoactive ingredient in magic mushrooms) for  treatment resistant depression (TRD). 

In March this year the federal government in Australia released news that they would be releasing $15 million in clinical research funds to sponsor trials that seek to identify the use of  psychedelics in therapy. In 2019, Australia had their first clinical trial lead by Dr Margaret Ross in Melbourne’s St Vincent’s hospital, where the use of psilocybin to treat people in palliative care is being tested. 

This landmark clinical trial of the use of psilocybin in palliative care in Australia became a turning point in destigmatising psychedelics since their initial classification as Schedule I drugs within the Controlled Substances Act (CSA) of 1970. Prior to this classification, psychedelic drugs were of great interest to psychiatrists and psychologists and there were many studies using LSD and psilocybin to treat patients, garnering many promising results.

In the UK, psychedelic therapy is becoming increasingly legitimised. A study led by COMPASS Pathways using psilocybin alongside psychological support to aid in rehabilitation of treatment resistant depression has shown promising results: after two doses of psilocybin (10mg and 25mg, seven days apart) plus talking therapy observed that “marked symptoms of depression were reduced” within the first five weeks of the treatment, and the effect remained for as long as six months after treatment. 

Now classified as a ‘Breakthrough Therapy’ by the FDA, the authors of the study are making plans to move into a phase III study in 2022.  George Goldsmith, Executive Chairman of COMPASS Pathways confirmed that COMPASS Pathways would be working closely with the FDA to “expedite the development process” to get this new treatment to people suffering with treatment resistant depression “as quickly as possible”.

Dr Robin Carhart-Harris, Head of the Centre for Psychedelic Research, Imperial College London, says that the breakthrough therapy designation is a “strong endorsement for the potential of psilocybin therapy”. In an article written for the Guardian in June 2020, Dr Carhart-Harris explains that “psychedelics appear to increase brain “plasticity”, which, broadly speaking, implies an accelerated ability to change” and so by providing a more “comprehensive treatment package” of using controlled amounts of psychedelics alongside “assessment, preparation, and integration” in a therapy setting, one is opening “a window of opportunity for lasting therapeutic change”.

When asked for comment by Private Practice Hub, Lea Milligan, CEO of MQ Mental Health Research UK offered her support of these trials, stating that “there needs to be an approved mechanism of enabling researchers to have ethical and safe access to these otherwise illegal substances.”

In addition to these therapies, Ketamine, another drug widely known for its recreational uses is recommended to be administered in a professional and medical setting. More recently, ketamine has been used in a study in the UK to treat addiction. 

In March of this year, Bristol opened up the UK’s first on-the-high-street provider of psychedelic-assisted psychotherapy, Awakn Life Sciences, with plans to open as many as fifteen to twenty more clinics in the next two years. The clinic’s focus currently is on the use of ketamine with psychotherapy to treat addiction, depression, and PTSD.

As these psychedelic treatments are becoming more acceptable to the public, more and more options for treatment are becoming available to patients who struggle with depression, addiction and PTSD. The more legitimacy that these studies begin to gain, the more training there is available to psychologists and therapists who would like to learn more about it. 

In Australia there is already a wave of psychologists signing up for training in these therapies so that they will be ready once the use of psychedelics are recognised and permitted as a legal and viable treatment for mental health problems, citing MAPS (Multidisciplinary Association for Psychedelic Studies) as the “the most famous and reputable training” available at the moment, with studies in using MDMA to treat PTSD across America, Canada and now Australia. 

By keeping up to date with the trends in using psychedelic drugs in a therapy setting, psychologists and therapists are keeping their focus on the future and eager to find new solutions for old problems, and looking to keep up with the times. 

Sources

Awakn Life Sciences. 2021. Awakn Clinics – The Effective Treatment Alternative. [online] Available at: <https://clinics.awaknlifesciences.com/> [Accessed 1 June 2021].

Doblin, R., 2021. From the Desk of Rick Doblin, Ph.D. – Autumn 2020 – MAPS. [online] MAPS. Available at: <https://maps.org/news/bulletin/articles/479-bulletin-autumn-2020/8663-from-the-desk-of-rick-doblin-ph-d-autumn-2020> [Accessed 1 June 2021].

Mayo Clinic. 2021. Treatment-resistant depression. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/depression/in-depth/treatment-resistant-depression/art-20044324> [Accessed 1 June 2021].

Rosenbaum, D. and Boyle, A., 2021. Psychedelics for psychological and existential distress in palliative and cancer care. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726261/> [Accessed 1 June 2021].

Valentish, J., 2021. The psychologists signing up for psychedelic therapy training: ‘Amazing things can happen’. [online] the Guardian. Available at: <https://www.theguardian.com/society/2021/may/30/the-psychologists-signing-up-for-psychedelic-therapy-training-amazing-things-can-happen> [Accessed 2 June 2021].

U.S. Food and Drug Administration. 2021. Breakthrough Therapy. [online] Available at: <https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy> [Accessed 2 June 2021].

Carhart-Harris, R., 2021. We can no longer ignore the potential of psychedelic drugs to treat depression | Robin Carhart-Harris. [online] the Guardian. Available at: <https://www.theguardian.com/commentisfree/2020/jun/08/psychedelic-drugs-treat-depression> [Accessed 2 June 2021].

Jones, A., 2021. ‘The ketamine blew my mind’: can psychedelics cure addiction and depression?. [online] the Guardian. Available at: <https://www.theguardian.com/lifeandstyle/2021/mar/13/it-blew-my-mind-can-psychedelic-drugs-cure-addiction-depression> [Accessed 1 June 2021].

Compass Pathways. 2021. COMPASS Pathways receives FDA Breakthrough Therapy designation for psilocybin therapy for treatment-resistant depression. [online] Available at: <https://compasspathways.com/compass-pathways-receives-fda-breakthrough-therapy-designation-for-psilocybin-therapy-for-treatment-resistant-depression/> [Accessed 2 June 2021].

Compass Pathways. 2021. Treatment-resistant depression. [online] Available at: <https://compasspathways.com/our-research/psilocybin-therapy/clinical-trials/treatment-resistant-depression/> [Accessed 2 June 2021].

Counseling Today. 2021. The return of psychedelics to counseling: Are we ready? – Counseling Today. [online] Available at: <https://ct.counseling.org/2020/10/the-return-of-psychedelics-to-counseling-are-we-ready/> [Accessed 2 June 2021].

Nature.com. 2021. How ecstasy and psilocybin are shaking up psychiatry. [online] Available at: <https://www.nature.com/articles/d41586-021-00187-9> [Accessed 2 June 2021].