Another one of the ways that Ecstasy and Psilocybin are Shaking Up Psychiatry is the fact that the drugs “activate a therapeutic, dreamlike state, intensifying sensory perception. And memories pop up like little films”. says Franz Vollenweider, a psychiatrist and neurochemist at the University Hospital of Psychiatry in Zurich, Switzerland. One of the pioneers of the modern era of psychedelic research. He thinks that this receptive state of mind provides an opportunity to help people escape from rigid patterns of thought. This is not unlike Rutter’s automatic circuit.

“People get locked into disorders like depression because they develop this system of thinking which is efficient, but wrong”. says David Nutt, a psychopharmacologist at Imperial College London and an outspoken supporter of evidence-based reforms to government policies concerning illegal drugs. Psychiatry has a term for such thinking: rumination.

The idea behind psychedelic therapy is that the receptive state that the drug confers opens the door to fresh ideas. Ones about how to think about the past and future, which the therapist can reinforce. “There is a growing evidence base to the principle that this is about a synergy between drug-induced hyper-plasticity and therapeutic support.” says Carhart-Harris. THey trained with Nutt. Psychedelic compound in ecstasy moves closer to approval to treat PTSD

Rutters Journay

Rutter says his journey with Carhart-Harris was focused, but flexible. When Rutter first removed a pair of eye shades after the drug took effect, the therapist appeared “fractured.” They seemed to have another eye in the centre of his forehead. “I should imagine I look quite strange to you now,” Carhart-Harris said. Rutter burst out laughing and Carhart-Harris joined him. When the laughter stopped, the two men started talking. Rutter wanted to discuss his resentments, which led to pondering about the word ‘relent’ and its etymology. Carhart-Harris looked it up for him on his laptop. “That was a lovely moment, actually,” Rutter says. He returned for a second session with a stronger dose of the drug. Followed by a second MRI and an ‘integration’ session, to discuss the experiences.

The treatment “made me look at grief differently”, Rutter says. “It was a realization that actually it wasn’t helping, and letting go wasn’t a betrayal.”

Clinical Hurdles

Testing these drugs effectively and translating the clinical research into actual treatments will prove challenging. However, two of the most closely watched studies have grappled with this. One is the recently completed MDMA trial, which was testing the approach in people with severe PTSD. It was a phase III study. Usually the final stage before drug regulators decide whether to approve a treatment. It involved 90 participants at 15 sites around the world. The Multidisciplinary Association for Psychedelic Studies (M.A.P.S.) a non-profit organization in San Jose, California, sponsored the study, but has not so far released the results.

Testing Different Dosages

Meanwhile, the mental-health-care company COMPASS Pathways in London is running a phase 3 trial. They are testing different dosages of psilocybin for treatment-resistant depression. Evaluating the results won’t be simple. One concern revolves around controls. Most individuals given a placebo will know that they are not receiving a powerful hallucinogen. Some studies evaluating psychedelics have attempted to address this by giving people in the control group a pill containing niacin. This elicits a physical sensation — usually a flushing response in the skin. Mitchell says that some participants in her MDMA study who’ve been given the drug thought they received the placebo. While some taking the placebo believed that they had been given the drug.

The studies’ designers must also tackle how important the non-drug aspects of the trial are to the results. These include the mindset of the individual going into the experience, and the environment in which it takes place.

The vibe is definitely hotel spa at the treatment rooms. At least for the COMPASS study at Utrecht University Medical Centre in the Netherlands. There’s a Mexican-style blanket folded at the foot of a twin-size bed. Beanbag chairs hug a potted palm in the corner. And a poster of Van Gogh’s Almond Blossom adorns one wall. All 24 sites in the study are similarly decorated. This is another powerful way that Ecstasy and Psilocybin are Shaking Up Psychiatry,

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