The Psychedelic Drug Trial: Can psychedelic drugs really cure depression?

Despite the many advances in medicine, there are still only a few health problems that can be cured. Most of what medicine can offer is managing symptoms. For the millions who experience depression, any suggested “cure” is bound to attract attention and provide much-needed hope. That is what The Psychedelic Drug Trial to be aired tonight (19 May) on BBC2 appears to offer.

There is considerable interest and investment in the potential that psychedelic drugs like psilocybin, the active ingredient found in magic mushrooms, could have for the treatment and potential cure of depression. Given that more people will experience depression than heart disease or cancer, it is easy to see why these drugs have caught the attention of the pharmaceutical industry as the potential for profit is huge.

The Psychedelic Drug Trial is based on recent work by Professor David Nutt and Robin Carhart-Harris, researchers based at Imperial College, London. The study used the classic randomised control trial method of comparing the response of two groups of participants. One group were given 25mg of medical-grade psilocybin while the other took a commonly used anti-depressant – escitalopram.

Carhart-Harris summarised the programme based on this research saying – “The programme brings home the human impact of psychedelic therapy perhaps better than can be achieved through science alone. Viewers will be able to grasp on a visceral level, how this treatment can be effective, seeing how it relaxes defence mechanisms and facilitates access to buried memories and emotions that can then be worked through with therapeutic support.”

On first reading, the results look impressive as the researchers report that those taking the psychedelic compound were far less likely to go into remission than those taking the anti-depressant. So, although the researchers could not detect any statistical difference in depressive symptoms between the two groups, they could see that psilocybin appeared to reduce the potential for relapse. This, it seems, supports the claim that these types of drugs could “cure” depression. But such a hefty claim needs to be treated with caution as it is based on an assessment made at the six week follow up point. As the researchers acknowledge, this along with other limitations to the study need exploring further. Most people with depression would want to know that they free of their disabling symptoms for more than six weeks.

Nonetheless, this is important research and adds to a growing body of evidence pointing to the potential these drugs have to improve people’s lives, and a significant number at that. But like all research, there is a troubling and persistent lag between research and practice. On average it takes a decade between new evidence emerging and this becoming adopted in clinical practice. On this basis, it could be 2031 before we see psychedelics being routinely offered to individuals with depression, even if – and it’s a big if – the government were to change current policy that makes accessing these drugs very difficult.

Then there is the unequal way that these novel treatments are accessed. Despite the Home Office changing policy on medicinal cannabis two years ago, only a handful of people have been able to secure a medicinal cannabis product legally, most of these through a private clinic. There is a significant chance that the same thing will happen with access to psychedelic therapy.

This treatment relies on delivering therapy to guide the patient through the experience, helping them to make sense of it, as well as consuming the psychedelic drug. Not everyone will be able to access a suitably qualified and trained therapist to assist them through this treatment journey. It will be those with the financial ability who are most likely to be able to source and then pay for psychedelic therapy.

So, while we all continue to be dazzled by new exotic-sounding therapies and treatments, ensuring equal access to them is critical. It will take more than a pill to do this, instead, it is the structural roots of inequality that need to be addressed such as unemployment, poor housing, poverty, poor education and so on. Tackling those is known to be the most effective cure for all manner of health problems including depression.