Supportive science and clinical safety trials mean controversial treatment using psychedelic medication is edging towards US regulation. AP
Supportive science and clinical safety trials mean controversial treatment using psychedelic medication is edging towards US regulation. AP
Supportive science and clinical safety trials mean controversial treatment using psychedelic medication is edging towards US regulation. AP
Supportive science and clinical safety trials mean controversial treatment using psychedelic medication is edging towards US regulation. AP

How psychedelic medication could open a new toolbox in mental health care


Nick Webster
  • English
  • Arabic

Plant-based treatments and medication inspired by psychedelic drugs could soon treat depression in a new wave of acceptance for alternative therapy.

With 280 million people understood to suffer from depression worldwide, the global antidepressant market is expected to grow from $11.7 billion in 2019 to $18.3 billion by 2027, pharmaceutical analysts predict.

There has been a major overhaul of psychedelic medication used in alternative treatment for mental health conditions in recent years, as more supportive science and clinical safety trials edge the controversial drugs towards US regulation.

Stigma could yet be a major obstacle for psychedelic drugs to clear before they enter the mainstream, and in countries with stricter laws around medication they may never be approved.

As with most of the world, there is a lack of understanding about what these substances can provide, how to manage them and the opportunity for research
Dr Jeff McNairy,
chief medical officer at Rythmia Life Advancement Centre

Experts predict the US Food and Drug Administration could soon approve Methyl enedioxy methamphetamine (MDMA), a stimulant with psychedelic properties, as a treatment for post-traumatic stress disorder (PTSD).

Meanwhile, a variant of ketamine, commonly used as an animal tranquilliser, was granted FDA approval in 2019, also as a treatment for PTSD.

The US state of Oregon last year opened its first medical centre using psilocybin – the hallucinogenic compound found in so-called magic mushrooms – to treat various psychiatric conditions.

A major makeover in the way psychedelic medicines are viewed has opened the door for a number of biotech firms to tap into what could prove to be the next pharmaceutical gold rush.

Anti-depressant alternative

Toronto-based Cybin is one of those on a mission to transform mental health care in the US, where 13 per cent of Americans currently take selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed antidepressant that manages the brain’s feel-good chemicals.

“Psychedelics work extremely rapidly,” said Doug Drysdale, chief executive of Cybin, a company developing medication based on psilocybin.

“After a single dose, many patients are feeling a lot better. Anxiety disorders have a prevalence of about 19 per cent of the population, so collectively they are the largest mental health issue we're facing.

“A 90-minute experience might be enough to put patients in remission.”

The company has received clearance for its CTB004 drug, delivered under clinical observation via an inhaler or injection, after overwhelmingly positive results for phase-two trials in the treatment of depression.

Cybin is now pressing ahead with studies to prove preliminary clinical efficacy, safety and tolerability to allow it to be used in the wider population.

DMT, a hallucinogenic tryptamine drug found in plants, and psilocybin appear to provide rapid and large relief from depression after just a single dose, whereas SSRIs often take several weeks of a daily dosage to work effectively.

Those in trials described their psilocybin experience as “emotionally mystical and spiritual”, lasting for up to five hours.

Cybin’s study results showed 40 per cent of patients were in complete remission from depression at six months after only one or two doses.

“That's really powerful compared to what you see today, where we're really just trying to handle the signs and symptoms of mental illness,” said Mr Drysdale.

Other researchers found similar results. Published data from UK start-up Compass Pathways showed 29 per cent of trial subjects who received the highest dose of psilocybin were in remission, three weeks after treatment.

However, that did not last with only a quarter of those remaining free of depression three months later.

Not all mental health professionals are in agreement with the prospective new wave of treatments.

Marie Byrne, a psychological counsellor in Dubai, said mind-altering drugs were not the answer to helping people overcome mental challenges.

“It is possible to overcome the difficulties of trauma without having to be in an altered state of consciousness,” said Ms Byrne, who runs the Marie Wellness Clinic in Umm Suqeim.

“I have a real belief in what people are capable of and that's through counselling, step by step, to come to terms with things and connect with life, as opposed to wanting to live in an altered state of consciousness that doesn't allow them to address the real issue.

“If the actual problem that underlies depression is not addressed directly, it will resurface.”

Transforming perceptions

Attitudes towards alternative treatment methods appear to be changing.

Spravato, a nasal spray based on ketamine, has proved effective in those with treatment-resistant depression, although it is expensive and requires supervision.

Mark Rus is chief executive of Delix Therapeutics, a biotech firm in Boston developing novel therapeutic options for brain disorders that promise a new paradigm of neuroscience treatment.

“It's very hard to drug the brain or develop medicines that are safe, tolerable and effective,” Mr Rus told The National.

“That's why we’ve been stuck with the same class of treatments for decades.

“We've always talked about symptom management but we've never been able to consistently and predictably repair.

"You see all this promise and hype around psychedelics converging with these trends. It's a rich opportunity.”

Brain repairs

Delix Therapeutics focuses on neuroplasticity to regrow brain spines and synapses, working in a similar way to psychedelic medication but without hallucinations and cardiac risks.

“We hope that by 2027, DLX-001 will sit on the medicine cabinet at home and dispense from a pharmacy – we don't see anything in its properties or in our initial regulatory discussions that would prevent that," Mr Rus said.

“We don't believe this will be a once-a-day treatment and it is performing equivalently in terms of how fast they work and how long they last in preclinical models versus ketamine and psilocybin.

“There's a lot of people who can and will be helped by a classic, deep, eight-hour hallucinatory experience.

“But if you're going to move the needle and work at scale, you need approaches like Delix.”

Psychedelics work differently in each individual. Some have certain contraindications with psychotropic medication, while others do not. Some resonate more with the individual based on the person’s specific goals.

A contraindication is a situation where a specific procedure, medicine or surgery should not be used as it could be harmful to a patient.

Just as some people are visual learners and others are auditory, the psychedelic substance that is most effective often depends on the person.

Organic substances such as iboga, ayahuasca, San Pedro and psilocybin interact in a different way than LSD, ketamine and MDMA, for example. All are powerful and all have their role in healing, experts said.

Dr Jeff McNairy has been working in health care for 25 years and believes the western approach to healing and mental health is deficient.

He is chief medical officer at Rythmia Life Advancement Centre, described as a healing hub in Costa Rica where plants such as ayahuasca are used to treat wide-ranging mental health issues.

Dr Jeff McNairy believes the western approach to mental health is deficient and says psychedelics could be the answer. Photo: Rythmia Life Advancement Centre
Dr Jeff McNairy believes the western approach to mental health is deficient and says psychedelics could be the answer. Photo: Rythmia Life Advancement Centre

“The default mode network of the brain plays an important role in our self-perceptions and belief systems,” said Dr McNairy.

“When we have childhood trauma or unresolved emotional events that have shaped our coping styles, psychedelics allow the participant to access components of the subconscious through the interaction between the amygdala and prefrontal cortex of the brain.

“An ego-dystonic framework that is realised through the psychedelic experience allows the individual to 'become their own therapist' and see themselves from an outside perspective that can help build clarity and new levels of self-awareness.”

Set in luxurious surroundings, the Rythmia centre offers a programme fusing ancient South American tribal rituals with modern psychological practices.

But treatment comes at a price, with an all-inclusive seven-day cleansing experience costing $4,900.

“Some people do not qualify for certain psychedelics based on their medical condition,” said Dr McNairy.

“As with most of the world, there is a lack of understanding about what these substances can provide, how to manage them and the opportunity for research, biotechnology and true healing that can result from this field.”

Life-changing experience

A British man who visited the Netherlands for ayahuasca therapy said the results have been transformative.

“I decided trying ayahuasca with the aim of resolving my general feeling of inadequacies and insecurities dating back to childhood,” said the man, who did not want to be named.

“While I hadn’t taken any medication to resolve my symptoms, I had tried meditation and journalling, which had only partially helped.

“Ayahuasca is intense and it brought up many difficult memories and emotions, which I then processed during the ceremony. After I finished the retreat, I felt completely reborn and the recurring negative thought patterns completely disappeared.

“I look back on it as the most important experience in my life.’’

Mental disorders are one of the largest healthcare challenges of modern times.

They affect a huge number of people, with high treatment costs and lost productivity affecting economies.

An estimated 165 million are affected each year in the EU, with more than half the population of middle and high-income countries expected to experience at least one mental disorder during their lifetime.

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if you go

The flights

Emirates have direct flights from Dubai to Glasgow from Dh3,115. Alternatively, if you want to see a bit of Edinburgh first, then you can fly there direct with Etihad from Abu Dhabi.

The hotel

Located in the heart of Mackintosh's Glasgow, the Dakota Deluxe is perhaps the most refined hotel anywhere in the city. Doubles from Dh850

 Events and tours

There are various Mackintosh specific events throughout 2018 – for more details and to see a map of his surviving designs see glasgowmackintosh.com

For walking tours focussing on the Glasgow Style, see the website of the Glasgow School of Art. 

More information

For ideas on planning a trip to Scotland, visit www.visitscotland.com

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How to invest in gold

Investors can tap into the gold price by purchasing physical jewellery, coins and even gold bars, but these need to be stored safely and possibly insured.

A cheaper and more straightforward way to benefit from gold price growth is to buy an exchange-traded fund (ETF).

Most advisers suggest sticking to “physical” ETFs. These hold actual gold bullion, bars and coins in a vault on investors’ behalf. Others do not hold gold but use derivatives to track the price instead, adding an extra layer of risk. The two biggest physical gold ETFs are SPDR Gold Trust and iShares Gold Trust.

Another way to invest in gold’s success is to buy gold mining stocks, but Mr Gravier says this brings added risks and can be more volatile. “They have a serious downside potential should the price consolidate.”

Mr Kyprianou says gold and gold miners are two different asset classes. “One is a commodity and the other is a company stock, which means they behave differently.”

Mining companies are a business, susceptible to other market forces, such as worker availability, health and safety, strikes, debt levels, and so on. “These have nothing to do with gold at all. It means that some companies will survive, others won’t.”

By contrast, when gold is mined, it just sits in a vault. “It doesn’t even rust, which means it retains its value,” Mr Kyprianou says.

You may already have exposure to gold miners in your portfolio, say, through an international ETF or actively managed mutual fund.

You could spread this risk with an actively managed fund that invests in a spread of gold miners, with the best known being BlackRock Gold & General. It is up an incredible 55 per cent over the past year, and 240 per cent over five years. As always, past performance is no guide to the future.

if you go

The flights

Air Astana flies direct from Dubai to Almaty from Dh2,440 per person return, and to Astana (via Almaty) from Dh2,930 return, both including taxes. 

The hotels

Rooms at the Ritz-Carlton Almaty cost from Dh1,944 per night including taxes; and in Astana the new Ritz-Carlton Astana (www.marriott) costs from Dh1,325; alternatively, the new St Regis Astana costs from Dh1,458 per night including taxes. 

When to visit

March-May and September-November

Visas

Citizens of many countries, including the UAE do not need a visa to enter Kazakhstan for up to 30 days. Contact the nearest Kazakhstan embassy or consulate.

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Chancellor Rachel Reeves set markets on edge as she appeared visibly distraught in parliament on Wednesday. 

Legislative setbacks for the government have blown a new hole in the budgetary calculations at a time when the deficit is stubbornly large and the economy is struggling to grow. 

She appeared with Keir Starmer on Thursday and the pair embraced, but he had failed to give her his backing as she cried a day earlier.

A spokesman said her upset demeanour was due to a personal matter.

Key facilities
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UAE currency: the story behind the money in your pockets
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