From Raves to Remedies
Last month, UK Youth Mental Health Ambassador Dr Alex George launched the #PostYourPill campaign which sparked an important conversation around the de-stigmatisation of anti-depressants. The outpouring of responses demonstrated the pivotal role that pharmaceuticals have come to play in the mental health treatment landscape, and recent evidence has supported the beneficial effects of a range of medications in treating acute depression.1 However, the question remains: are existing treatments good enough?
There is evidence – albeit contested – that conventional anti-depressants may cause more debilitating side effects than is widely recognised, and many patients experience withdrawal effects when attempting to discontinue their treatment.2 Furthermore, 100 million people worldwide are reported to suffer from treatment-resistant depression, highlighting the profundity of unmet need in current treatments.3 This rise in demand for more effective medicinal treatments has opened the door for pharmaceutical companies to conduct cutting-edge research into alternative remedies: the therapeutic use of drugs that are, in most contexts, illegal.
Indeed, the past decade has witnessed a profound cultural shift whereby the status of psychedelic drugs has evolved from being associated primarily with the hedonic rave scene, to being hailed as a ground-breaking therapeutic tool within the mental health landscape.4 This shift has taken place in the context of a series of trials into the antidepressant properties of substances such as MDMA and magic mushrooms, the outcomes of which are strikingly promising.
The Magic of Mushrooms
Robin Cahart-Harris, psychologist and neuroscientist at Imperial College London, has long been fascinated with the remedial properties of psychedelic drugs, and has carried out several trials on psilocybin - the psychoactive compound found in magic mushrooms - to explore its effectiveness among patients with depression.5 A phase II trial published in April 2021 revealed that when compared against the conventional anti-depressant Escitalopram, psilocybin-assisted therapy produced a remission rate that was twice as high and had fewer side-effects.6 Speaking to The Guardian’s ‘Today in Focus’ podcast, Cahart-Harris reflected on the internal journey that psilocybin facilitates, explaining that the drug’s effect on serotonin, the brain’s mood-hormone, gives you ‘the ability to open up so that you can experience more of yourself and more of the world’, creating an ideal state of mind for therapy sessions.7
Magic mushrooms are not the only psychedelics to be recognised for their therapeutic uses. In a phase III trial published in May 2021, MDMA-assisted therapy was found to be twice as effective as placebo in alleviating severe post-traumatic stress disorder (PTSD), for which there are currently no available medicinal treatments.8
What Are the Ethical Implications?
Despite the promising evidence, there is still some concern surrounding the potential widespread availability of psychoactive substances. So far, this type of treatment has only been explored in highly controlled environments, and transforming clinical trial evidence into tangible treatments will undoubtedly prove challenging. Regulators and treatment providers will need to grapple with the conditions under which these potent substances can be safely distributed. As Cahart-Harris points out, psychedelics are ‘not a one-way-ticket to wellness, there can be some de-stabilisation and a kind of heightened sensitivity after the sessions’.9
Despite this, regarding the legal and ethical status of using psychedelics Cahart-Harris also commented that ‘the legality is sort of an irrelevance, you know, as a scientist you’re trying to do ethical work…the evidence says that we can do more good than harm here’. This principle of benefit outweighing risk is reflected in psilocybin receiving Breakthrough Therapy Designation from the US Food and Drug Administration (FDA) in 2018, which is given only to drugs that ‘demonstrate substantial improvement over available therapy’.10,11
With depression representing the leading cause of ill-health and disability worldwide, it is more important than ever that pharmaceutical companies invest in and apply innovative thinking in the realm of mental health, and breakthrough advances such as psilocybin and MDMA-assisted therapy demonstrate the enormously promising potential that rigorous, safe and responsible research can have.12
Conclusion: Med Comms and the Emerging Treatment Landscape
As psychedelics inch closer to becoming a mainstream treatment option, robust medical communication campaigns will play a pivotal role in the success of this emerging landscape for mental health. As an award-winning medical communications agency, TVF specialises in educating and raising awareness of pharmaceutical advances, combining science, creativity, and strategy to deliver high quality communications to a range of audiences. To find out more about how our services could contribute to this exciting breakthrough within medicine, visit our website and get in touch.
By Jess Caines
