Could psychedelic drugs cure depression, alzheimers and chronic pain?

In the 1950s and 1960s, psychedelic drugs (including LSD) showed real potential to treat psychiatric disorders and addictions, including alcoholism. Then the counter-culture embraced LSD for recreational use, and medical trials of psychedelics largely dried up. Cultural and political attitudes hardened and for decades, psychedelics were off-limits.

Imperial College London is working on clinical trials using psilocybin which is the psychoactive compound found in magic mushrooms

Now the tide might be turning and one expert watching with interest is Leigh Fell, Founder and Director of Edinburgh-based Caritas Neuro Solutions, which is committed to developing new therapies for all mind and brain conditions.

Leigh wants to increase the number of trials - and deliver better drugs - for a wide range of neurological conditions, which she says are the poor relation in terms of drug trials and therapies. She is calling for a more open-minded approach to psychedelics and the part they might play in treating addictions, Post-Traumatic Stress Disorder, depression, Alzheimer's Disease, chronic pain and more.

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Leigh Fell of Caritas Neuro. Picture: Ian Georgeson

However, any progress must be based on carefully-controlled trials under rigorous scientific regimes: “This is not about the recreational use of psychedelic drugs, but trialling them under very stringent conditions conducted by industry professionals,” Leigh stresses.

This is the message too from David Nutt of Imperial College London (ICL), driving-force behind the creation of the Centre for Psychedelics Research at ICL in April 2019, which works closely with a similar unit at Johns Hopkins University in the United States. “These powerful therapies require trained medical supervision,” Professor Nutt says.

Leigh Fell says the ICL centre was a real breakthrough in returning psychedelics to mainstream research: “Imperial is a well-respected institution and its work shows psychedelics are starting to be looked at seriously after decades in the cold.” In a commentary published in scientific journal Cell, Dr Nutt and colleagues suggested new research into the applications of psychedelics represented "one of the most important initiatives in psychiatry and brain science in recent decades”.

Leigh highlights ICL’s work on clinical trials to develop psilocybin therapy into a licensed treatment for depression. It will also investigate the potential of psilocybin [the psychoactive compound found in magic mushrooms] in treating other conditions, including anorexia.

Scientists believe psychedelics work by activating the 5-HT2A serotonin receptor in the brain. These receptors play an important role in cognitive function and high numbers of them are found in ‘thinking’ parts of the brain.

Dr Robin Carhart-Harris, Head of Psychedelic Research at ICL, says psychedelics can “reveal aspects of our mind that ordinarily we’re not fully conscious of” - and this resonates with Leigh: “The idea that psychedelics might be able to ‘re-set’ parts of your brain is very attractive to me, as a person who has suffered from depression. It's amazing to think you can create happier pathways in your brain.

Leigh points to growing global investor interest in psychedelics research, with the value of the industry estimated last month [May 2020] at more than $5 billion. There almost 50 registered global trials for psilocybin, which is where psychedelics research is heavily focused. However, Leigh says there is little activity in Scotland, with no evidence of university research into psychedelics and only one company openly working in this area.

Ketamine

The firm, Neurocentrx, has developed two oral formulations of Ketamine, and is fundraising for clinical trials to test their ability to treat patients with Major Depression Disorder, safely and effectively, with a competitively priced product.

Leigh sees this as another very interesting area but notes that an esketamine anti-depressant nasal spray was rejected for use in January in England and Wales by healthcare watchdog NICE - because of uncertainties about the correlation between cost and clinical benefits.

“This decision attracted some criticism because esketamine was shown to lift the mood of patients with hard-to-treat depression within hours,” says Leigh. “Traditional antidepressants can take 6-8 weeks and mental health charities have been very supportive of esketamine and its positive impact on patients.”

Leigh is keen to stimulate more research into psychedelics and other drugs to treat neurological conditions in Scotland, using her expertise as a clinical research professional to support businesses through complex regulatory processes.

She is also very interested in the bigger picture of mental health and neurological conditions: “Psychedelics are only part of the puzzle, alongside other drugs, plus mindset coaching, talking therapies and lifestyle, especially exercise and nutrition. Effective drugs are not an answer in themselves to neurological conditions; they need to be deployed as part of a broader solution."

When it comes to bringing psychedelics in from the cold, Leigh points out that the NHS already uses opioids, including diamorphine, for pain relief, again stressing the difference between controlled medical use and recreational use of such drugs.

She is also hopeful that the more open-minded attitude towards cannabinoids for medical reasons is helping to shift the dial - and foster a more tolerant approach towards drugs shunned for cultural and political reasons, which might help unlock some of the secrets of the brain.

“Having previously worked with cannabinoids, I see the opportunities but also the challenges in this area," says Leigh. “However, I really hope research into psychedelics is given a chance to test the potential - benefits because they could be really significant for people with a range of psychological and neurological disorders.”