Discussing the History of Psychedelic Therapy

In this video, Heather Flint, senior digital managing editor, Psych Congress Network, talks with Psych Congress Steering Committee Member Andrew Penn, MS, PMHNP, on the history of psychedelic treatments and psychedelic treatment for treatment-resistant mental health disorders. This interview took place in San Antonio, Texas, during 2021 Psych Congress.

Read the Transcript:

Heather Flint: Can you give an overview of how psychedelic treatments have come into play and a brief history of what led to this?

Andrew Penn: Sure thing. There are two compounds that are in the middle of clinical trials. MDMA, which is known as methylenedioxy-methamphetamine, or as a street drug, was known as ecstasy, is being studied as an adjunct to psychotherapy for post-traumatic stress disorder.

The issue with PTSD is, while we have some effective psychotherapies, a lot of people can't tolerate them because they're too upsetting, too triggering of their PTSD. Our options for pharmacotherapy in PTSD are pretty limited. There's two FDA-approved drugs for PTSD. Their effects are pretty modest, at best. Most of the time, in PTSD, when it comes to medications, we're treating symptoms.

MDMA, just to back up a second, is in the middle of phase III. It's getting much closer to approval than any of the other compounds that are being studied. May be available as early as 2023, is the projection. Then the compound that I'm studying as part of the work that we're doing in our lab is psilocybin-assisted therapy, or facilitated therapy, for major depression.

We're looking at that. Major depression is the leading cause of disability in the world. While we have a lot of treatments, they don't always work as well as we would like. There's a lot of people who are still not helped by the treatments that we currently have. We need more options.

The interesting thing about both of those models is that the...One similarity they have, we're using a different drag in the different studies. The idea is that you're not taking this every day. This is given once, twice, maybe three times, very closely surrounded with therapy. There's therapy without drug before. There's therapy without drug after.

The same two therapists that have been with the patient the whole time, the subject the whole time in the studies, are there the whole day of the drug session. It's because a placebo-controlled trial. It could be drug or a placebo. That's really important. That's a lot of what I'm going to talk about today, is this context in which this therapy occurs.

It's a different model. It's a different context than the take-a-pill everyday model that we've had for most of our pharmacotherapies up until now. Probably the closest thing that we have that's similar to this would be ECT. Obviously, the mechanism is very different.

The idea that you might have this done once a year, once every five years, or something like that, rather than...You certainly don't do ECT every day. That's how it's different and why it's needed.