Patients with mental health conditions will soon be able to access psychedelic drugs that are already showing “promising” results in clinical trials, a conference in Trinity College Dublin will hear on Monday.
Separate trials testing the use of psilocybin for depression and MDMA for post-traumatic stress disorder are well advanced, with approval by US regulators expected soon, the conference will hear.
The Food and Drug Administration is likely to approve the MDMA indication by the end of next year, with the authorisation for psilocybin, the active ingredient in hallucinogenic mushrooms, expected to follow a year or two later, according to Dr David Erritzoe, who runs the world’s first psychedelic research centre in London.
He believes a combination of psychedelics and psychotherapy can deliver new mental health treatments for patients struggling with existing options.
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Australia last week became the first country in the world to allow doctors to prescribe the two drugs for these conditions, despite concerns among some scientists about their safety and effectiveness and the amount of regulation in place to govern access. Critics accused regulators of caving in to commercial pressure and a grassroots campaign.
“It’s a very brave move,” Dr Erritzoe said of the Australian decision, “but I agreed with it because these treatments look extremely promising.
“You have so many people who are struggling with mental health issues and not responding to existing conventional pharmacotherapy and other treatments. There’s a big need.”
The psychiatrist and lecturer at Imperial College London told The Irish Times that “the evidence, while not massively solid yet, does look consistently positive, promising and safe”.
Imperial carried out the first trial into the use of psilocybin for major depression. Dr Erritzoe and colleagues are now looking at the use of the drug to treat other conditions – addiction, obsessive compulsive disorder, anorexia and chronic pain. Other research is looking at the potential of ayahuasca, a psychedelic drink originating in South America, for the treatment of depression.
Dr Erritzoe foresees an “appealing paradigm” of treatment mixing the use of psychedelics with therapy.
“It’s a place where talking therapy meets pharmacology and psychiatry. These normally very separate fields in mental health are suddenly sitting in the same model and working together,” he said.
“This is not a molecule you take repeatedly like normal medicine. It’s a compound that induces an altered state of consciousness that allows material to surface and be reframed. The psychological support and therapy around it is essential.”
He added: “The psychedelic model offers a potential alternative to prescribing people a drug for months and years, maybe even the rest of their life, that might not have many benefits but has side effects. Instead, you give very few doses of a drug in a psychological setting and you work with material that comes from the person’s mind.
“For this reason, it may be difficult for companies to spin gold from it. It’s a model that is difficult to scale up.”
As for potential harms, he said “there are risks with any medication and even talking therapies. Psychedelics have been used by some indigenous cultures for centuries. Expert supervision is needed during the experience, and support and therapy after it.”
Psychedelic drugs are illegal worldwide, with some exceptions. Dr Erritzoe said: “Caffeine is a drug, so is alcohol. They are all mind-altering or psychoactive compounds used for different but overlapping reasons.
“Psychedelics are at the less harmful end of the spectrum. They work through the serotonin system in the brain. That’s not associated with dependent addictive behaviour. They’re much, much safer than opioids. With MDMA there’s a tiny bit more dependence but it is very low. In contrast, alcohol has a significant harm profile.”
He continued: “At this point in history, you couldn’t say the war on drugs has proved particularly efficient. But look at the experience of Portugal. When it decriminalised drugs over 20 years ago, this had a very positive impact on public health and drug-related statistics.
“I find it strange that a drug that is very harmless, as long as it’s taken under the right conditions, that grows everywhere around us, is illegal. I struggle to get my head around that completely.”
About 600 people are expected to attend this week’s conference hosted by the Trinity Centre for Natural Products Research, on behalf of the International Society for Medicinal Plant and Natural Product Research.
Natural products are said to be those derived from plant, microbes and marine sources that have use as medicines, foods and cosmetics.
