Psychedelics – the next frontier in mental health?

Nearly two months ago the Guild of Health Writers held a fascinating workshop run by the Psychedelic Research Group at Imperial College in London. I apologise for the delay in reporting on it but I have only just discovered that I had not, as I had feared, recycled my notes…

The workshop was introduced by Professor David Nutt, Head (to give him his full title) of the Neuropharmacology Unit in the Centre for Academic Psychiatry in the Division of Brain Sciences at Imperial College. Many of you may remember him as the ‘drugs tsar’ to the last Labour government. Professor Nutt’s unit has recently carried out a study on the use of psychedelics in the treatment of severe depression and PTSD.

Professor  Nutt pointed out the psychedelics had been in use to ‘open the mind’ and to treat disorders of the brain, from ancient Greece to the mid 20th century. The brain, he explained, is not a camera. What it ‘sees’ is a reconstruction of the information that it receives through the senses – and what it ‘sees’ will depend on how it reconstructs that information. So someone suffering from depression may reconstruct that information in a very different way from someone not suffering from depression.

The Vietnam War

From the 1940s onwards there was a great medical interest in how psychedelics could be used to ‘recalibrate’ the brains of those suffering from various psychiatric conditions. In the 1950s and 60s over 140 different grants funded over 1,000 clinical papers on the subject. AA founder Bill Wilson used LSD to break alcohol addiction and there were no less than six separate (successful) trials using psychedelics for alcoholism.

However, all of this came to an end with the Vietnam war. The US government, desperate to prevent young men escaping the draft by moving to California and living the happy life on LSD, made its use illegal and mounted a major advertising campaign to demonise all psychedelics. They have never been reinstated.

Even though the ban did not include research, the fact that the substances remained illegal effectively killed all research. Whereas in 1970 there were around 250 psychedelics-related publications a year, in 2016 there were 20. And even though there is now most definitely a resurgence in interest in the therapeutic use of psychedelics, it took three attempts to get Professor Nutt’s group’s recent trial through the ethics committee, they had to do three six month safety trials and it took them 32 months to actually access the  supplies of the drugs that they needed at a cost of £1500 per dose.

How do psychedelics work?

Hopefully I have got this right…. There are two parts of the brain – the frontal cortex or ‘thinking, rational’ bit and the core network. In depressives, the core network is massively overactive and is ceaselessly ‘thinking’ about itself and its own activities.  It is this core network that is totally disrupted by psychedelics – interrupting the endless cyclical ‘thinking’ pattern of those suffering from depression.

Psychedelics, or specifically psilocybin (the active compound from mushrooms which was used in the Imperial College trial) also dampens down the  area of the brain linked to depression – which is what normal anti-depressive drugs also do. But while normal anti-depressants work very slowly, or not at all, psilocybin works very fast.  It also ‘loosens’ up the brain grooves which form over time and which make it very difficult to change ‘thinking patterns’.

(For much more on brain grooves you should read Micki Rose’s Healing Plan for Chronic Illness which is Berrydales Books next publication – watch this space….)

The study – and the results

Dr Rosalind Watts, who was Clinical Lead for the Psilocybin Depression Study, and Ian, one of the participants, then described the study and how it worked.

There were 2o participants all of whom had suffered from clinical depression for an average of 18 years and had been prescribed many different antidepressant drugs and talking therapies. Each participant was given one, relatively high dose of psilocybin in extremely well controlled and supported conditions, and was really well prepared for whatever the experience might be.

Ian (and the other participants) felt that this support was extremely helpful and enabled him to ‘go with’ the experience (which include some disturbing memories from his past) rather than turning away from it as he had alway done previously. He was also able to verbalised his negative feelings to his ‘guide’ and while they did not go away, he was able to ‘accept’ them with ‘compassion’.

As a result Ian was totally free of depressive feelings for three months although over the next 6 months they gradually came back. He is now back on antidepressants but the insights that he gained during  the experience have remained as sort of ‘base cushion.’

Of the other participants, six months after the trial six of the 20 were in total remission; at the end of a year, three remained in total remission. The drug had no effect on three participants but  the remaining 11 all had a reduction, if not a total cessation, of their symptoms. Among the improvements were:

• Their connection to their senses – suddenly orchids looked really beautiful when before they hadn’t and, as the effect wore off they ceased to look beautiful again.
• Their connection to themselves – they saw themselves in a new, and more positive, light.
• The connection to others – friends, family, even strangers. They were much more compassionate, empathetic.
• Their connection to spiritual principles – a new way of seeing the world.
• Their connection to emotion – rather than avoiding it or ‘thinking’ around it, they found themselves accepting it. ‘The monkey mind was silenced.’

Many of the participants would have been keen to take the drug again, but felt that the support they had received during the trial was very important to its success.

These results were achieved with one single, relatively high dose. The group has no idea, but would very much like to find out, what the effects of small regular doses, or even micro doses would be or what effect small top up doses after one high dose would be. They  hope to be able to do so in a new trial which will use a range of doses.

The way forward

While psychedelics remain illegal progress in the UK is very difficult. Professor Nutt would, obviously, very much like to see them legalised for medical purposes. However, while the UK and US remain opposed, a big  European multi trial is now underway to establish whether psilocybin does actually work. If the results are positive it will be licensed for medical use in Europe. Meanwhile research continues apace elsewhere with Brazil as the centre for research on psychedelic substances.

For more, see this release from Imperial College last October, or here for the research itself.

With many thanks to the Guild of Health writers for an excellent workshop.