Taking a ‘trip’ to improve mental health

A UK neu­rophar­ma­ceu­ti­cal com­pa­ny is plan­ning the world’s first clin­i­cal tri­al to treat depres­sion by com­bin­ing psy­chother­a­py and the mind-expand­ing psy­che­del­ic med­i­cine dimethyl­trypt­a­mine (DMT). 

DMT is a nat­u­ral­ly occur­ring chem­i­cal found in tiny amounts in the human brain and in larg­er amounts in plants. Chem­i­cal­ly sim­i­lar to the neu­ro­trans­mit­ter sero­tonin (5‑HT), it is involved in a vari­ety of phys­i­o­log­i­cal func­tions, includ­ing eat­ing, sleep and mood reg­u­la­tion. 

The Small Phar­ma tri­al fol­lows on from the dri­ve, led by the world-renowned Impe­r­i­al Col­lege Lon­don, to bring psy­che­del­ic-assist­ed ther­a­py out of the fringe into the sci­en­tif­ic main­stream. Small Phar­ma is focused on iden­ti­fy­ing rapid-act­ing treat­ments for depres­sion and oth­er men­tal health dis­or­ders, and is col­lab­o­rat­ing with Imperial’s Cen­tre for Psy­che­del­ic Research.

Dr Robin Carhart-Har­ris, the centre’s head, says: “Psy­che­del­ic ther­a­py holds a great deal of promise for treat­ing some very seri­ous men­tal health con­di­tions and may offer new hope to vul­ner­a­ble peo­ple with lim­it­ed treat­ment options.”

Poten­tial patients include many peo­ple with depres­sion, who can­not find an anti­de­pres­sant that works for them or can­not tol­er­ate the asso­ci­at­ed side-effects.

Coro­n­avirus has exac­er­bat­ed a crit­i­cal sit­u­a­tion, caus­ing dis­turb­ing increas­es in sui­ci­dal thoughts, espe­cial­ly among young adults, accord­ing to a study pub­lished in Octo­ber in The British Jour­nal of Psy­chi­a­try.

Psy­che­delics have been shown to have ther­a­peu­tic ben­e­fits in dis­or­ders such as depres­sion, sub­stance abuse and post-trau­mat­ic stress dis­or­der. These so-called inter­nal­is­ing dis­or­ders are char­ac­terised by debil­i­tat­ing flows of recur­ring neg­a­tive thoughts.

DMT was select­ed for Small Pharma’s tri­al fol­low­ing pre­clin­i­cal and clin­i­cal research sug­gest­ing it may have ben­e­fit in treat­ing depres­sive dis­or­ders.

Small Phar­ma has pro­duced its own DMT-based prod­uct in line with good man­u­fac­tur­ing prac­tice guide­lines laid down by agen­cies con­trol­ling autho­ri­sa­tion and licens­ing of phar­ma­ceu­ti­cal prod­ucts.

Psy­chother­a­pists will sup­port the 36 tri­al patients before, dur­ing and after the intra­venous admin­is­tra­tion of DMT, which is designed to pro­duce a short psy­che­del­ic expe­ri­ence or “trip” last­ing about 20 to 30 min­utes.

The psy­che­del­ic expe­ri­ence has been proven in oth­er stud­ies to be crit­i­cal for the ther­a­peu­tic process of treat­ing the men­tal health con­di­tion. The expe­ri­ence can induce visu­al imagery or hal­lu­ci­na­tions, such as see­ing colour­ful pat­terns, see­ing or hear­ing things that are not real, and a sense of detach­ment from thoughts and feel­ings, changes in sense of time and space, and intense emo­tions, includ­ing hap­pi­ness and grief.

Dr Car­ol Rout­ledge, chief med­ical and sci­en­tif­ic offi­cer at Small Phar­ma, explains: “Pub­lished research into psy­che­del­ic treat­ment for depres­sion has con­clud­ed that dif­fi­cult emo­tions and upset­ting con­tent dur­ing a trip can be ther­a­peu­ti­cal­ly ben­e­fi­cial as they can lead to impor­tant insights, which can be dis­cussed with the ther­a­pist. They will help patients to inter­pret and deal with the expe­ri­ences they have on their trips.”

How does psy­che­del­ic-assist­ed ther­a­py work? Rout­ledge explains: “Think of a Christ­mas ‘snow globe’: you shake up the snowflakes and then allow them to reset­tle. DMT is equiv­a­lent to the shak­ing up, and the reset­tling process to the psy­chother­a­py. 

“The shak­ing up dis­rupts unhealthy, ingrained thought pat­terns, allow­ing the brain to reset itself by cre­at­ing new neur­al path­ways. This helps the patient to receive and ben­e­fit much more from the psy­chother­a­py that wraps around the admin­is­tra­tion of DMT.“

Clin­i­cal research has shown DMT increas­es con­nec­tiv­i­ty between dif­fer­ent brain net­works. In turn, this increas­es synap­tic plas­tic­i­ty – the bio­log­i­cal process of brain cells chang­ing their con­nec­tions – enabling learn­ing and mem­o­ry.

The Small Phar­ma tri­al will com­pare the effect of giv­ing either one or two dos­es of DMT. Patients will be assessed at inter­vals of up to three months and giv­en addi­tion­al psy­chother­a­py if nec­es­sary. The ben­e­fits of treat­ment are expect­ed to last six months, but could be sig­nif­i­cant­ly longer.

For more infor­ma­tion please vis­it smallpharma.co.uk

Ref­er­ences

O’Connor R.C. et al, Men­tal Health and Well­be­ing dur­ing the COVID-19 Pan­dem­ic: Lon­gi­tu­di­nal Analy­ses of Adults in the UK COVID-19 Men­tal Health and Well­be­ing Study, The British Jour­nal of Psy­chi­a­try, Octo­ber 21, 2020

Pro­mot­ed by Small Phar­ma