A recent study suggests psilocybin may treat depression more effectively than conventional medicines – but what would treatment look like, and how close are we to getting psychedelics on the NHS?
Earlier this month (April 11), a team of scientists shared a new study that shows how psilocybin – AKA the psychedelic compound found in magic mushrooms – could help treat mental health disorders in the UK. Compared with traditional treatments, they found, the compound does a better job of breaking free from “negative thinking patterns” brought on by depression, by “opening up” the patient’s brain.
Run by researchers at Imperial College London, the study consisted of two trials, including just under 60 participants. In one, participants with treatment-resistant depression tripped on psilocybin. The other – a randomised control trial – compared psilocybin with the conventional SSRI antidepressant escitalopram, for the treatment of more general depression. In both cases, patients received the treatments alongside talking therapies with mental health professionals.
What difference did tripping on psilocybin make? Well, according to Professor David Nutt, head of the Imperial Centre for Psychedelic Research, the trip “changed brain circuits that have become locked into negative thinking patterns”.
“Mood improves within hours of the trip,” Nutt tells Dazed (to no one’s surprise). However, the increase in brain connectivity wasn’t only observed during the course of the treatment. For many patients, the changes were still present up to three weeks later, and were linked to self-reported improvements in their depression. Administered the day after the trip, meanwhile, talking therapy (or “integration sessions”) helped understand its effects and took advantage of the reduced rigidity in brain activity to “consolidate new ways of thinking”.
In a time that’s seen an unprecedented global surge in depression and anxiety (largely linked to the coronavirus pandemic) this study marks a significant step toward the mainstream acceptance of psychedelics as a revolutionary form of treatment. Of course, this idea in itself isn’t entirely new. A so-called “psychedelics renaissance” has seen researchers in the UK, US, Australia and beyond explore the therapeutic possibilities of substances, including psilocybin, DMT, MDMA, and ayahuasca in recent years, with ketamine even gaining approval for use in private clinics.
Throughout this research, psychedelics have been shown to work faster, and can also work for people who haven’t responded to traditional drugs, Nutt continues. “It’s also important to note that just one or a few doses are given” in most psychedelic treatments, he adds. “It’s not daily dosing like current treatments. This means very few adverse effects.” Due to the clinical setting and controlled use of substances, a bad trip is also highly unlikely.
Understandably, there’s “lots of interest” in this growing space, from researchers and patients alike. However, navigating the UK’s drug control laws and negative preconceptions remains a challenge for those developing psychedelic medicines, and may be turning away potential investors. “[It’s] sad,” Nutt says, “given that the UK has pioneered not only this treatment, but also the neuroscience behind it.”
Nevertheless, Nutt remains hopeful about the future of psychedelic treatments for mental health disorders in the UK. Within five to ten years, he says that he expects all local psychiatric units to have a “special psychedelic treatment centre on the NHS” – alongside private clinics – “using psilocybin and also likely DMT” alongside talking therapies. “We are also doing studies in anorexia nervosa, OCD, and chronic pain,” he adds. “Other groups in the US are looking at addictions such as tobacco and alcohol.”
🍄 On the latest @imperialcollege podcast: Hear from @ProfDavidNutt about new @Imperial_PRG research which shows that psilocybin - the psychedelic compound in magic mushrooms - helps to “open up” depressed people’s brains https://t.co/C43Bm3lU3Q
— Imperial Department of Brain Sciences (@ImperialBrains) April 27, 2022
In fact, several US states are well on the way to legalising medical psychedelics, amid a broader push to decriminalise drugs such as psilocybin, peyote, ayahuasca. In January 2022, for example, Washington state lawmakers introduced a bill that would legalise psilocybin for “supported use” by adults over 21.
Back in 2020, Oregon actually became the first state to approve an initiative to legalise psilocybin for therapeutic use, and is currently in the middle of a two-year development period, scheduled to end on December 31 this year. “We are the first state to develop a comprehensive regulatory framework for the manufacturing of psilocybin and provision of psilocybin services,” Angela Allbee, of the Oregon Psilocybin Advisory Board, tells Dazed. “Setting the stage for a standard of practice will be part of the work moving forward.”
Like proposed therapies in the UK, treatment in Oregon is set to involve supervised trips followed by integration sessions – unsurprisingly, people aren’t going to be able to buy magic mushrooms over the counter and take them home for personal use. “This is such an exciting time for psilocybin, specifically for implementation of a unique model that is not a medical model,” adds Allbee. “That said, we have an enormous responsibility to ensure that we create a successful regulatory framework and that we continue learning, adjusting, and evolving in a way that centres safety, equity, and clients having access to services.”
Similarly, the authors of the Imperial College London study emphasise that their exploration of psychedelic therapies is ongoing. Follow-up data will need to be analysed to determine why psilocybin affects the brain differently from conventional medicines, and how long its mind-expanding effects could last. In the meantime, hopes are high for a psychedelic revolution in mental health care.