Heroic Hearts UK research director Grace Blest-Hopley discusses the organisation’s groundbreaking study that will investigate the use of psilocybin for treating brain trauma in veterans.
Part two of two.
Heroic Hearts UK is conducting a groundbreaking observational study to investigate both the psychological and physiological effects of psilocybin on the brains of veterans who are living with post-traumatic stress disorder (PTSD) or traumatic brain injury (TBI).
Current research into psilocybin focuses on its use for the treatment of mental health conditions such as anxiety and depression, with clinical trial results demonstrating the compound’s efficacy for major depressive disorder. More recently, hopes have been raised around the compound’s efficacy for the treatment of PTSD.
Blest-Hopley points out, however, that alongside promising evidence of its psychological effects, there is emerging anecdotal evidence showing promise for the use of psilocybin as a treatment for TBI – a condition affecting up to 20% of soldiers who served in Afghanistan or Iraq, according to the Ministry of Defence, with many more possibly going undiagnosed.
“If we take it down to a biological level, we know that psilocybin works on the serotonin system and generates a feeling of wellbeing and happiness,” said Dr Blest-Hopley, a postdoctoral researcher at King’s College London.
“When your body is in danger there is a “fire alarm” that goes off and psilocybin seems to dampen the effect of that. From a psychological perspective, it enables you to discuss, process and think about traumas that you have had, without that fire alarm going off – processing the trauma in a much more cognitive way without the body reverting to the more primal fight or flight instincts.
“PTSD is this idea that the unconscious part of the brain holds on to the memories or feelings around particular incidents, and those incidents are not properly dealt with. So, by taking psilocybin, you are able to take those memories out, as it were and go through them, allowing the more unconscious parts of you to process them.”
Blest-Hopley explains that one of the distinguishing features of psilocybin compared to other therapeutic substances such as MDMA, is that the compound floods the functional neuronal connections in the brain – breaking down continuous and repetitive thought processes.
“It allows for thoughts to come in from other areas of the cortex, and not just be driven by these primaeval responses. Once you have gone past that acute experience you then get the after-effects of psilocybin. We have seen in studies that have looked at animals and cells that have been treated with psilocybin, that there are alterations in the cells, which increases plasticity and actually causes neurogenesis, which is actually growing more of those connections. It also increases the expression certain of genes – all of which are very relevant for head trauma.
“One thing that is now important to research further at the brain cell level, is the idea that psilocybin appears to show some kind of anti-inflammatory effect. We talk about psilocybin’s effects on the 5-HT2A receptor,but there is a lot of serotonin receptors involved, one of which is involved in inflammation.
“There is a lot of work to be done now on exactly which receptors psilocybin is engaging with. But there is certainly good evidence to suggest that is what’s happening. So, these are the reasons, acute and chronic, biological and psychological, of why we think psilocybin will work for PTSD and brain trauma.”
At the retreat, the team will be using a number of different methods to measure the impact of psilocybin including electroencephalogram (EEG) brain imaging, which will look at the functioning of the brain and different brain oscillations as current research on PTSD suggests that brain oscillations are altered.
Cognitive and attentional testing will also be carried out using a computer programme that will assess memory, attention and finger tapping, to understand the participant’s motor control, alongside questionnaires to investigate psychological aspects such as depression, anxiety and PTSD, as well as a subject’s head trauma.
The importance of group setting, mystical experiences and integration
The study will also explore the importance of different aspects of using psilocybin as a treatment, including the group setting, the ceremonial, mystical and psychedelic experience itself, and the importance of psychological integration.
“Questions will be included around the idea of the psychedelic experience, as well as the ceremonial and mystical experience because that is something Imperial College are very interested in. After discussing with them, we wanted that to be part of our protocol as well, but also, as we move forward and we collect more evidence, I think it is important for us to start thinking about what the optimum environment for improvement looks like.
“If we do get allowances to use these treatments in a few years time, is that going to be someone going into a very sterile clinical environment on their own and going through that process alone? Or, do we find that they will find the group experience to be part of that process of getting better?”
Participants will also go through an integration process following the ceremony through a combination of group and individual sessions.
“The integration is being conducted by an external party that has been working for a number of years, and are very well versed in, the integration of psychedelic experiences, as well as having worked with veterans.
“We want integration to be in a group environment to foster the idea of camaraderie which is spoken about often within veteran populations. We have also decided to add individual sessions which will be counselling, where participants can speak on a more personal level about things they may not initially want to divulge in a big group setting. They can explore how they felt at the retreats and what they have discovered about themselves – all the work does not happen on one night. Actually, it is in the weeks after.
“We are also hoping to develop an alumni network within the project where veterans who have gone through the programme will have a support network with each other after the retreat.
“I really think it is time that we break down the preconceptions that we have around these medicines and start looking at them in a really serious way, and how they can be used going forward with veterans.
“This population are incredibly deserving of treatment, and it is something they have been really let down on. I think it is time that the people in power, as it were, perhaps look at why we are holding the regulation in the position that we are considering the evidence that now exists.”
Hopes are that the study will act as a pilot for larger and more rigorous investigations of head traumas and PTSD, and of how valuable the group and ceremonial experience is.
