Does the Treatment of Severe Depression Need to be Drastically Re-thought?

“I’m John. This trial gave me back my life for a few months. Then like melting snow the life I had begun to enjoy melted to nothing. I’m on even more antidepressants now. I can’t sleep at night so I pace around the house. I never venture outside anymore, other than trips to the Doctor – and I have to take diazepam before I go”.

“My wife and children worry that I’ll do something very silly. I used to be a scientist and very recently I was offered an opportunity to get back into research but I’m not dependable. Life sucks. I’m just waiting for my ticket out.”

Psilocybin for Depression trial. Imperial College, London.

The trial John is referring to was the first ever UK medical trial to use a psychedelic drug (magic mushrooms). Twenty volunteers suffering from ‘untreatable’ depression signed up in the hope that, where nothing else has worked, this controversial and experimental treatment may offer hope.

John was one of three that agreed to have their experiences documented in a feature length documentary – Magic Medicine[1].

A treatment that treats the cause, not the symptom?

People’s attitudes to psychedelic drugs and depression are often negative and not from any direct personal experience. Luckily these attitudes are developing. In the most recent and largest global drug survey of its kind[2] 87,000 people responded to questions relating to their mental health.

Only 40% said that they would accept traditional psychiatric medications. Interestingly this was the same percentage as those willing to accept psychedelic assisted therapies.

For those that had had experience with psychedelics and were looking for treatment for depression or PTSD this figure jumped to 59%. The report concluded that, “people’s desire to go to root of their mental health problems was the top driver for choice of treatment type.”

This suggests that in the minds of many, anti-depressants will not help those suffering from mental illness to get better. We see first-hand in the documentary that for some anti-depressants only do enough to make life manageable and their sometimes disabling side-effects are, “just something they have got to live with.”

What may be most striking about the survey is how the perception of anti-depressants is changing. There is much bad press, especially in the affects they have on young people[3] who are increasingly being prescribed them and how some big pharmaceutical companies fund a lot of the research and distort / hide some results to suit their needs[4],[5].

By contrast, psychedelics are having a resurgence with much of the media coverage focusing on their potential healing properties and not their perceived harm.

The ever-increasing cost of depression.

What all media does agree on is how devastating and unforgiving depression is. We all know the numbers. 300 million people around the world experience major depression. By 2030 it is believed it will be the disease with the highest global burden.[6]

The numbers are on the increase and to make matters worse depression is often not properly diagnosed – something that is much more prevalent in developing countries.

To add further concerns to this, a new study[7] of just over 241,000 cases found that only a third get treatment with minorities even less likely to get the help they need (30% less than whites).

It is estimated that in America the annual cost of depression is $210 billion in healthcare and lost productivity. This alone is a good reason to explore new treatments that show promise.

MDMA, Ketamine and Psilocybin (Magic Mushrooms) have all shown great promise in early (but small) trials, yet Psilocybin is virtually impossible to do research with because it is a Schedule 1 drug (meaning that, along with being illegal, it is deemed to have no medical research value).

Results of the trial                            

The trial that I filmed had twenty volunteers who had suffered with depression for an average of 18 years. Part of the criteria for the trial was to come off the anti-depressants – the pills had kept them afloat (but not living full lives according to most volunteers) and five weeks after the trial had ended (one taster dose and one treatment dose – 25mg – of a psychedelic drug) six of them were depression free.

Two years on two were still depression free. I am not a scientist but as a film-maker focusing on a human story it seems counter-intuitive not to encourage and make the research of this drug, which has proved to be incredibly safe, easier[8].

In the Global Drug Survey only 0.4% of people who took magic mushrooms recently required emergency medical treatment compared to 13.6% with heroin and 1.6% of alcohol users. Belief in a need for new treatment is not restricted to just a few liberal fringe scientists.

COMPASS Pathways recently raised over $25million to run 15 trials across Europe and the US and just over a year ago, the FDA designated Psilocybin as a ‘Breakthrough Therapy’ which means that if it continues to show promise it could be fast-tracked to approval.

Make research easier for a more positive future

In an interview with Inverse.com[9], Roland Griffiths, Ph.D., a professor of psychiatry and behavioural sciences at Johns Hopkins University says, “We don’t have an area of science — except possibly chemical weapons or germ warfare — where there’s a cultural consensus that this is so dangerous that we shouldn’t do anything with them.”

But due to the work done in the past 18 years at Johns Hopkins, Imperial College London (who conducted the trial that was filmed), New York University, and other academic institutions around the world, this cultural consensus is shifting.

Professor David Nutt, who oversaw the Imperial trial believes, “that psilocybin represents one of the most significant advances in psychiatric treatment of the last 50 years,” and that, “its potential will never be realised until we discard the historical legacy of imagined harms and remove it from Schedule 1 status.”

From what I saw during the filming of Magic Medicine and my continued interaction with the three men who agreed to be filmed the sooner this happens the better.

As you read at the top of the page, John’s depression is back to at least as bad as it was before the trial (something unfortunately, he shares with the other two volunteers in the documentary) and there is currently nothing they can legally be prescribed that works for them.

They are desperate and sometimes have suicidal thoughts. That alone tells you what it must be like knowing that something does work but cannot be accessed.

Dr Rosalind Watts, the Clinical Lead Psychologist, psilocybin for depression study at the Imperial Centre for Psychedelic Research understands John’s dilemma but points out that, “We are at the early stages of understanding the immense potential we see in our therapeutic work with this substance. Our dedication to carefully exploring this potential is echoed by psychedelic researchers across the world.” She goes on to say that, “the day that psilocybin is removed from Schedule 1 will mark the beginning of a new era in mental health and consciousness research, with important implications for everyone.”  I hope Magic Medicine continues to play a role in pushing this conversation forward.

To have a screening of Magic Medicine at your office please contact [email protected]

[1] www.magicmedicine.net / https://vimeo.com/ondemand/magicmedicine