Transforming Perspectives on Psychedelics: A Journey Beyond the Trip
In a keynote discussion at HLTH Europe in Amsterdam, leaders in psychedelic medicine shared their perspectives on the potential of psychedelic compounds to transform mental health treatment while also highlighting the challenges that lie ahead for the field.
Genevieve Jurvetson, co-founder of the Jurvetson Foundation, which focuses on mental health initiatives, moderated the discussion with Florian Brand, CEO and co-founder of atai Life Sciences, and Kabir Nath, CEO of Compass Pathways. All three have a personal connection to the devastating impacts of mental illness.
“The World Health Organisation estimates that a billion or one in eight people suffer from mental illness,” said Jurvetson. “Until psychedelics, the last major innovation in psychiatric care were SSRIs which in the mind country of the United States, 14% of US adults are taking SSRIs or even detectable in our water supply. And sadly, they don’t work great for most people and certainly fall short of their products.”
The promising results from early clinical trials of psychedelics like psilocybin, MDMA, and DMT for treatment-resistant depression and PTSD have generated excitement that a paradigm shift in psychiatry may be on the horizon. “We have in psychedelic compounds something that can lead to a true paradigm shift in psychiatry,” said Brand.
However, the leaders emphasised the need to be realistic about what psychedelics can and cannot do. “Yes, it’s great that we can see some profound responses. But the idea that we’re going to be able to cure depression or PTSD seems inherently unlikely,” cautioned Nath. “I think we need to be cautious around the hype.”
Brand and Nath highlighted that each psychedelic compound is distinct, with differing subjective effects, duration of action, and administration protocols. Psilocybin, for example, typically induces a 6–8 largely self-directed hour experience, with a therapist present mainly for safety. In contrast, MDMA-assisted psychotherapy is a more interactive process between patient and therapist. Novel short-acting psychedelics like 5-MeO-DMT may offer therapeutic benefits with just a 1–2 hour dosing session.
Finding the optimal treatment protocols will require much more research. “We are incredibly early in the rediscovery of psychedelics,” said Nath. “Nobody else is yet even in phase three trials. So there is a huge amount that we still have to learn.”
Equally important is determining how to deliver psychedelic treatments to the patients who need them. Training enough therapists and building the healthcare infrastructure to accommodate lengthy in-clinic visits pose major challenges to access and scalability.
Compass Pathways has now trained over 300 therapists to provide psychological support for psilocybin treatment. “What we’ve actually discovered is we need to kind of untrain therapists from intervening,” explained Nath. Using psychiatric nurses and group preparation sessions are some strategies being explored to increase capacity.
Atai Life Sciences is investigating short-acting psychedelic compounds and non-hallucinogenic psychoplastogens that could fit within a 2-hour dosing paradigm, following the model of ketamine, which is administered in-clinic. “We hope to replicate those later stage trials, and again, it’s a good trade-off in terms of commercial and patient access, given the two-hour window paired with that initial data that that makes us excited,” said Brand.
As psychedelic medicine advances, maintaining a patient-centric approach is paramount, especially given the highly vulnerable population of people with serious mental illness. “We must always keep the patient and the vulnerability of the patient at the centre of everything we do,” emphasised Nath.
Bringing psychedelic therapies through clinical development, regulatory approval, and into mainstream medical practice will require collaboration across the entire healthcare ecosystem. “What we need to do is really push through the ecosystem approach and multi-stakeholder approach,” said Brand. “We’re at a great place here to look at what tools can be helpful, what service providers can be helpful and how can we think about infrastructure, especially also in Europe, to make these therapies successful.”
Despite the hurdles ahead, the potential of psychedelics to provide much-needed mental health breakthroughs and ease suffering for millions around the world makes the effort worthwhile. With rigorous research, strategic planning, ethical practices, and a steadfast commitment to patients, psychedelic medicine may indeed launch a new era in psychiatry in the years to come.
