Could psychedelic drugs revolutionise mental health care in the UK?

ITV News' Natalia Jorquera visits the clinic that is looking to offer psychedelic drugs to patients as part of their mental health treatment

The UK’s first psychedelic assisted therapy clinic of its kind plans to open its doors to the public this autumn.

The clinic wants to combine psychedelic drugs - including ketamine and MDMA - with psychotherapy to treat patients with a wide range of mental health problems.

Dr Ben Sessa, Chief Medical Officer at Awakn Life Sciences in Bristol, believes psychedelic assisted psychotherapy will turn on its head the way traditional pharmacology is used in psychiatry.

“We tend to treat psychiatric problems with maintenance therapy. You take an antidepressant every day, day in, day out for weeks, months, years, decades to mask your symptoms", Dr Sessa told ITV News.

"Now, the way we use psychedelic assisted psychotherapy is very different. You take the drug only one, two or three times alongside psychotherapy in order to get better and then not need to take daily drugs.”

What are psychedelics?

Psychedelics are a loosely grouped class of drugs that are able to induce altered thoughts and sensory perceptions, some can induce hallucinations.

Ketamine

The initial treatment offered when Awakn's clinic opens later this year will be ketamine-assisted psychotherapy for depression, anxiety, eating disorders, addiction and post-traumatic stress disorder (PTSD).Ketamine, is a Class A drug so it is illegal for recreational use, but approved for medical use and has been shown in several clinical trials to offer a brief, rapid antidepressant effect.Initially the clinic will offer patients will a nine week course of ketamine-assisted psychotherapy, which involves 11 visits to the clinic. On four of those occasions, a patient take ketamine assisted by their therapist, with the majority of the sessions will be 'talking therapy'.Although Dr Sessa hopes that one day their services will be available on the NHS, the therapy course will be for private patients, costing £6,000.

However, ketamine isn’t the only psychedelic medicine that Awakn plans to offer. Dr Sessa believes in the next couple of years that MDMA and psilocybin – known more commonly as magic mushrooms - will be approved for medical use, as both are in advanced stages of clinical trials in the UK.

Psilocybin

Imperial College London launched the first psychedelic research centre in the world looking at the use of psychedelics in mental health care and have recently conducted trials into comparing psilocybin therapy with a conventional antidepressant drug.

Research leader, psychiatrist and neuroscientist Dr Robin Carhart-Harris told ITV News that their initial findings were very promising.

“Results were quite consistent showing that the psilocybin therapy was really quite markedly better at reducing depressive symptoms. And actually more than that, it was also able to improve quality of life.”

During the Imperial trial, all participants received talking therapy alongside taking either psilocybin or escitalopram – the conventional antidepressant. Response rates in the psilocybin group averaged at 70%, compared with 48% in the escitalopram group.

How does psilocybin work in the brain?

“Like other psychedelic drugs is it works on a part of the brain or a system in the brain called serotonin system and serotonin. And the particular aspect of it that psychedelics work on is involved in something that we call plasticity, which means the ability of something to change, to be shaped or moulded", Dr Carhart-Harris said.

In Imperial’s brain imaging research they found that psilocybin increased plasticity and opened up new communication pathways.

As well as psilocybin, scientists also believe you can use MDMA to access a brain state where brain plasticity increases.

MDMA

Earlier this year the first published study of advanced clinical trial using MDMA in the US was found to be highly effective in treating PTSD. Researchers at the Multidisciplinary Association for Psychedelic Studies (MAPS), found that after three MDMA sessions, 67% of participants no longer qualified for a PTSD diagnosis and 88% experienced a reduction in symptoms.This data is why UK charity Supporting Wounded Veterans, backed by the head of the UK Armed Forces, General Sir Nick Carter, is calling for a UK trial.Gilly Norton, director of Supporting Wounded Veterans told ITV News that they see so many veterans with PTSD who are treatment resistant that they are are in need of a new therapy.

“We see so many desperate veterans coming to us for help, most of them have been in treatment for about 10 years and not with great success, she said.

"There have been known new treatments in mental health now for 30 years and the medicine cabinet is completely bare.”

The charity has been fundraising securing £300,000 from NHS England for UK clinical trials, but a gap of around £725,000 means that British veterans suffering from PTSD could face years of delays in receiving MDMA-assisted therapy, because regulatory approval is not possible without UK research.

For veteran Martin Wade, who came back from his tour in Afghanistan with PTSD, trials can’t come soon enough.

“My body's in a state of tension, I suffer with chronic pain. I am hypervigilant, I jump at even modest, unexpected sounds. I still have intrusive thoughts and nightmares and I just find daily living a struggle", he said.

Martin has had over 1,000 hours of therapy and has tried almost every method, including cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR). Nothing has provided him with much alleviation of his symptoms, so a treatment with such high success rate is what he's looking for.

When asked why he wanted to try this new therapy and what a life without PTSD would mean to him, Martin said: “I would love to have a greater sense of inner wellbeing. So when I smile on the outside, I can feel it in the inside.”

MDMA and psilocybin became Class A drugs under the Misuse of Drugs Act 1971, halting all research into them. Although this didn’t stop people from taking them, it did create a stigma around them that they were only party drugs.  It was only 15 years ago that psychedelic research was able to resume, but the substances do come with possible adverse effects - some psychedelic drug could cause extreme dissociation from reality, panic attacks and nausea.

The UK’s Advisory Council on the Misuse of Drugs are currently considering barriers to legitimate research with controlled drugs, but told ITV News that there are no plans to reschedule MDMA under the Misuse of Drugs Regulations 2001.

However, that hasn't stopped millions of pounds being invested in the area - new startups are developing psychedelic initiatives and clinics around the world. The psychedelic market has been estimated to be worth around £5 billion by 2027.

The US state of Oregon have voted in favour of legalising psilocybin therapy and will begin treatments in 2023, so when do scientists think psychedelics could be a real alternative to conventional medicine?

Both Dr Sessa and Dr Carhart-Harris believe that MDMA and psilocybin will be licenced in the UK by 2025. At the moment, psychedelics still remain an experimental treatment and more research is needed in the area before they stand a chance of becoming a mainstream mental health therapy option in the UK.