Over the past year, Awakn, the UK’s first private clinic offering psychedelic treatment in combination with psychotherapy for addiction, anxiety, depression, PTSD, eating disorders and other issues, has opened centers in Bristol and London. But the costs of private treatment are high (an 11-week session at Awakn costs around £7,500) and other scientists point out that while prescribing antidepressants is a breeze, psychedelic therapy is far more complex.
“It has great potential, but I think it’s not going to be trivial to roll it out to a large number of people,” says Jennifer Barnett, a psychologist and cognitive neuroscientist at the University of Cambridge, who is chief executive of Monument Therapeutics, a Cambridge-based biotech company. develops new therapies in psychiatry and neurology.
“It’s not prescribing someone a medication and walking away; it is much more complicated than that. It requires giving patients the medications and then giving them specialized psychotherapy during and after the travel experience. And there is a lack of good psychologists”.
If the evidence base continues to grow, some wonder if psychedelics could one day be available on the NHS. Last fall, Boris Johnson agreed to overhaul the legal landscape surrounding psilocybin to make it possible for more clinical trials to take place in the UK, but even psychedelics’ biggest proponents agree they retain an image problem.
While the therapeutic doses and uses of drugs like MDMA and ketamine for mental illness are very different from nightclub culture, they remain tainted by their association with teen overdose. Some are concerned that patients may try to self-medicate with psilocybin or other psychedelics. Nutt says they should only be used in clinical settings under the strict guidance of a trained psychotherapist, with doses carefully controlled.
Nutt also admits that many psychiatrists are still uncomfortable with the idea of prescribing a therapy that gives their patients a hallucinogenic experience, especially since long-term safety data is still lacking.
One idea is to give up the name psychedelics altogether. “We can say they are serotonin 5-HT2A receptor drugs and maybe that sounds better than saying psychedelics,” says Barnett.
In the next few years, the entire field of psychedelic research is likely to grow, and Big Pharma will begin to show interest. Earlier this year, Japanese pharmaceutical giant Otsuka announced a partnership with Canadian psychedelics company Mindset Pharma, as researchers try to identify different biomarkers that could determine which patients are likely to benefit most from these drugs.
For Nutt, given the overwhelming need for better treatments, he believes finding ways to make this therapy more available is critical because the need is so great.
“Whether we’re talking about depression or addiction, it shortens life,” he says. “Around 10 years old, particularly with severe depression. And it’s not just suicide, people also die prematurely from things like heart disease. And it’s getting worse.”
“For me, there were no hallucinatory hallucinations, it was more like a daydream”
In 2011, Jemma Rapley was diagnosed with clinical depression following the collapse of her marriage.
“It manifested itself in paralyzing insecurity and criticism,” he recalls. “I failed, he wasn’t good enough, he would never get better. Eventually, I stopped leaving my apartment, ate the same thing every night, lost friends, had problems at work, and fell into debt. I felt very alone.”
Although her GP prescribed different antidepressants and she tried mindfulness and cognitive behavioral therapy to deal with negative thoughts, the benefits were minimal. “Talk therapy was extremely limited on the NHS so I looked for alternative coping strategies but nothing was able to pull me out of despair,” she says.
After reading about psilocybin and its potential to help with depression, she was accepted into a clinical trial at Imperial College London in 2019. The effects were immediate. “For me, there were no hallucinatory hallucinations, it was more like a daydream,” she says. “I was waking up, feeling discharged for the first time in years. I was finally able to clearly recognize the people and things that were important to me, and the positive aspects of my life that depression had hidden for so long.”
She credits the treatment with helping her endure the repeated lockdowns of the last two years and emerge mentally unscathed from the pandemic. In particular, her connections to a song she played during her first psilocybin session, ‘Ma,’ by Kundalini yoga therapist Benjamin Steele, have given her stability.
“Since the trial, I’m happy to report that I haven’t needed any more treatment for depression and I think I really have beaten it,” he says. “Every time I hear that song, I feel freed from a new burden: it has given me a noose to be happier and a way to get back there if I ever find myself slipping. After this life-changing experience, I am excited about the future again.”
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