Can we expect psychedelics to make the leap over to mainstream medical use in the near future?
Psychedelics (also known as hallucinogens) are a class of naturally occurring psychoactive substances that produce changes in perception and mood. They work by targeting the brain’s serotonin 5-hydroxytryptamine 2A receptors, which are involved with cognitive function, memory, spatial awareness and sensory perception. They are generally considered physiologically safe, particularly compared with opiates and psychostimulants, and do not readily lead to addiction as they have no direct effect on the brain’s dopaminergic systems.
There is renewed interest in the potential of psychedelics. This is not a new area; indeed a number of research groups in Europe and the United States have looked into using psychedelics for treating depression over the past few decades, but we are seeing new research and investment. In particular, there is an interest in the potential for psychedelics as a viable alternative treatment for some mental health conditions, including depression and anxiety, which are traditionally treated with antidepressants such as selective serotonin reuptake inhibitors (SSRI) and serotonin-noradrenaline reuptake inhibitors (SNRIs).
The psychedelic compounds of particular interest are psilocybin (the magic in “magic mushrooms”), mescaline (found in members of the cactus family), and dimethyltryptamine or DMT (found in ayahuasca).
The use of psychedelics is restricted in many countries, including the US and the UK, where they are listed as Schedule 1/Class A drugs under the relevant legislation (i.e. substances with no known medical potential). However controlled drugs can be researched and used in clinical research with a special licence and in accordance with relevant ethics approvals, and perceptions around the use of long-standing controlled drugs for renewed purposes are shifting. We saw that happen with cannabis and cannabinoids earlier in the decade and we may see a shift with psychedelics, particularly if the current clinical research bears fruit. The UK Government is also being lobbied to move certain psychedelic drugs, such as psilocybin, from Schedule 1 of the Misuse of Drugs Act to Schedule 2. It would then be in the same category as medical cannabis, which was moved in 2018.
John Hopkins and Imperial College London are two research institutes pushing psychedelic research and both have launched dedicated centres for research in recent years. There have been a couple of notable studies in the last few years; Imperial’s Centre for Psychedelic Research’s study into the use of psilocybin for treating severe depression (2019-2020) and John Hopkins’ research into the use of psilocybin on tobacco addiction (2014) and as a treatment for alcohol dependency (2019). John Hopkins received the first US Federal grant for psychedelic research in over 50 years for its study into the potential impact of psilocybin on tobacco addiction in 2021.
Psychedelic biotech companies such as Compass Pathways and Mindset Pharma also have a number of research and development programmes on the go. Compass has completed an exciting Phase IIb study of psilocybin for treatment-resistant depression and is entering Phase III this year.
Recent clinical studies add to the growing evidence supporting further investigation of psychedelics. Whether we will see psychedelic-based treatment hit the mainstream or big pharma getting involved is perhaps too early to tell, but we expect to see more investment in the space in the coming months and years as investors recognise the growing potential for psychedelics.