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PSYCH Symposium: advancing psychedelic healthcare in Europe



PSYCH Symposium: advancing psychedelic healthcare in Europe

PSYCH Symposium returned at the British Museum on 6 July to explore how psychedelic medicines can innovate healthcare – from mental health to eating disorders and beyond.

Welcoming hundreds of delegates PSYCH Symposium saw insightful discussions, one on one interviews and workshops exploring different aspects of the psychedelic industry – from the importance of trained therapists to the challenges faced in the drug development pipeline.

Shortwave Pharma’s CEO Rivki Stern kicked off a packed day of sessions with an address to the hundreds of industry stakeholders, medical professionals and investors in the audience. 

See also  PSYCH Symposium: exploring eating disorders and psychedelics

“Every time that I visit the UK or Europe, I observe the duality, the coexistence of old and new… And I believe that this unique combination of tradition and innovation that is so characteristic of the UK and Europe also defines our industry today,” she began. 

Stern explained that, on the one hand, the field of psychedelics is breaking ground in the mental health sector, which has seen little innovation for decades, however, on the other hand, none of this innovation could take place without adhering to the strict and traditional regimen of scientific exploration. 

With government and even the pharmaceutical industry’s interest now piqued, she said the industry was now on the way to commercialisation. 

Psychedelics for eating disorders

To put the real-world potential of psychedelic treatments into perspective, the first session focused on encouraging early research into the treatment of eating disorders, which have increased 140% over the last decade. 

Stern, who was part of the panel, laid out the extent of the issue, suggesting that eating disorders currently cost the US economy around USD$65 billion a year. 

Clinical Psychologist at Sheba Medical Center Yoel Golbert added that ‘the reality is dire, there are lots of patients calling out for quality care, but the reality is we don’t have much to offer’.

Oxford University’s Professor Rebecca Park explained that with conditions such as anorexia nervosa, neurally patients have a very rigid system, with a “desync” between the brain and body which makes it very easy for people to starve to death. 

The panel then explained how both psilocybin and MDMA showed potential in being able to “break this desync” and help encourage much-needed neuroplasticity. 

Golbert said: “There are encouraging indications that brain connectivity and activity create this window of neuroplasticity which can break the inherent rigidity of anorexia. It opens up a window that we can work with through therapy and through integration. 

“MDMA also can help with anxiety-reducing properties. It’s an inducement of self-compassion and self-connection.”

Challenges in drug development

Next, the focus turned to the unique challenges presented by psychedelic drug development and treatment. 

Cybin’s Chief Medical Officer, Dr Amir Inamdar, explained that while psychedelics were not unique in terms of drug development, the fact that they are not taken on a daily basis, they alter consciousness and they are usually taken alongside psychotherapy means ‘they present unique challenges’. 

Because of these unique characteristics, he said that the gold standard, double-blind placebo studies are ‘virtually impossible’, and that his company had had to make ‘certain decisions to that design’. 

Furthermore, Inamdar stated that he was “confident” big pharma and institutional investors would eventually get behind psychedelics “because the economics make sense”. 

He argued that traditional SSRI and CBT treatment represented a “constant drain on resources”, whereas psychedelic treatments needed a small number of sessions that were more intensive. 

“Having been in drug development for over 20 years, I’ve never been so excited. I’m as excited as a child right now. 

“Almost all of us, in some form, have been touched by mental health issues. We’ve been giving out treatments for 50/60 years now, which don’t seem to do much. Here is an opportunity to change how we see and feel about mental health.”

Ketamine-assisted psychotherapy

The following session focused on the potential of ketamine-assisted psychotherapy, which Professor Celia Morgan suggested was often seen as the ‘dodgy uncle of psilocybin’. 

Despite its reputation, Professor Morgan said ketamine has a number of unique properties and presents opportunities other compounds don’t. 

“It has some useful properties, and one of those is that it’s probably the most common useful analgesic in the world. It’s something that is known to physicians and I think in that way, it is quite accessible – and we know that clinicians are risk averse,” she said. 

In a presentation of her preliminary research, Morgan explained that early indications of ketamine’s ability to treat Alcohol Use Disorder (AUD) found that there was a significant increase in abstinence for those treated with ketamine. 

In a separate study, she suggested that esketamine was found to significantly increase participants’ engagement and willingness to participate in mindfulness practice, while also helping to limit cravings for alcohol. 

“The ketamine cat is already out of the bag, particularly in the US. It has the potential to be the groundwork for the introduction of psychedelics into mainstream medicine, but it could also be a drag on all the other psychedelics.” 

Access to treatments

Following the recent significant developments in Australia, which are set to give mental health patients access to psilocybin and MDMA, the next panel focused on the recent progress and remaining barriers to accessing psychedelic treatments. 

See also  Australian patients can now access psilocybin and MDMA

While the panel agreed that these compounds were overdue a reassessment of their current classification given their clear medical potential, they suggested that one of the biggest barriers was reimbursement. 

Professor Chris Langmead, Deputy Director, of Neuromedicines Discovery Centre, told the audience: “At the moment, there is no reimbursement available through the Australian healthcare system. 

“So, all of this will essentially have to be privately paid for, and that is not a sustainable situation if the global mission is trying to make these therapies as accessible as possible for the patients that really need them.

“We need to be leveraging the breakthroughs we are having now to really move the dial.”

Facilitating psychedelic investment

The following sessions of the morning turned to attracting investment into the psychedelics space, starting with a presentation of a recent survey conducted by PSYCH Symposium sponsor, FTI Consulting. 

According to its survey of 104 international institutional investors, who managed a collective USD$10 trillion, there was ‘interest across the board’ in the psychedelics sector. 

However, investment remained thin on the ground due to residual issues with public perception, poor company management and a lengthy return on investment. 

This was echoed by Apeiron Investment Group’s founder Christian Angermayer, who said that, in a nutshell, institutional investors simply “don’t think the stock will go up”. 

He continued that this was due in large part to the poor performance of the biotech sector during the past 18 months, which has been hit hard by growing inflation because of its often extended periods of loss-making before generating revenue. 

Crucially, however, big pharma companies are “not sure what to make” of psychedelic treatments because they stray so far from the traditional model of selling “pills to patients every day”. 

“We have to prove to ourselves that we can make this new paradigm work.” 

Angermayer said he was more optimistic than many investors because he believes the rollout will be quick and organic. 

“I have a very optimistic view because we have that infrastructure already there, because we have therapists. It’s practically just a bit of an add-on to traditional therapy, with a little bit more training.”

Additionally, he said that from personal experience everyone he knew who had tried psychedelics as a treatment found not only that it was effective, but also that it immediately turned them into an advocate. 

“Why is this so important? Because once these medications are approved, we’re gonna see an unprecedented bottom-up drive. I think that is the number one issue which will determine the success of psychedelics – patients will demand it from their doctors.” 

The future of psychedelic medicine in the EU

The final session of the morning saw some of Europe’s leading progressive politicians discuss the ‘The Future of Psychedelic Medicine in the EU’ in a session led by Psychedelic Health’s Stephanie Price.

Despite Albert Hoffman discovering LSD in Switzerland in 1938, the scheduling of psychedelic substances on the continent has seen 50 years of scientific censorship. 

However, with numerous clinical trials now being carried out, policymakers in Europe are now starting to take notice.

Panelists agreed that the outlook in the EU was changing due to the growing prevalence of psychedelic clinical trials, and growing clinical evidence showing the efficacy of psychedelics as potential mental health treatments, however, they empahsised one of the key barriers to the rollout of these therpie in Europe was the ‘disparity of healthcare systems across the EU’. 

Cyrus Engerer, MEP for Malta, explained: “In the EU, we have one single market when it comes to all other products. However, when it comes to pharmaceuticals and medicine, we have 27 separate markets, and that does not make sense.

“The fragmentation of the European market leads also to exclusivity. So, certain medicines are exclusive to certain patients only across the European Union, and that is unacceptable. It should be their right to access these treatments.”

The panel said that this framework is now on the verge of being overhauled with the introduction of a new European pharmaceutical revision – the first in 20 years – aiming to make access to medicines easier and more affordable, and to foster innovation in the medicines space.

Tadeusz Hawrot of the Psychedelic Access and Research European Alliance (PAREA) empahsised the significance of the review, noting that: “The ambition is to normalise access across the EU. And the second goal is stimulating innovation.”

MEP Mikulas Peksa – Czech biophysicist and member of the Pirate Party – emphasised that the main hurdles to the rollout of psychedelic medicines and therapies in the EU was the UN’s scheduling of substances such as psilocybin and LSD.

Whether this will change remains to be seen – but the UN this year, for the first time in its history, has included a section on psychedelics in its Word Drug Report 2023. This, coupled will the European Medicine Agency’s response to a cross-party call to be more active in psychedelics – leading to a psychedelics workshop being held in the European Parliament this year – may reinforce the changing attitudes towards these substances that have suffered decades of stigmatisation.

Reporting by Ben Stevens and Stephanie Price.

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Psilocybin therapy for end-of-life care supported by 79% of Canadians



The Entourage Effect in Mushrooms: Natural psilocybin may outperform synthetic

A new survey has revealed that over 79% of Canadians support psychedelic-assisted therapy for existential distress at the end of life.

People facing a terminal diagnosis often experience significant distress. Depression, anxiety, existential distress and loss of meaning or purpose can make this type of diagnosis difficult to deal with.

Current treatments consist of counselling of cognitive behaviour therapy (CBT), but these are not always effective for everyone, creating a need for innovative new approaches to end-of-life care.

Increasing research is now showing that psychedelic therapy may be beneficial for treating existential distress in patients diagnosed with incurable diseases.

For example, a review published in 2018 in Neuropsychopharmacol Biol Psychiatry found that patients with life-threatening diseases associated with symptoms of depression and anxiety benefitted from the anti-anxiety and anti-depressant properties of psychedelics.

The studies reviewed anecdotally reported that patients experienced quality of life improvements along with a reduced fear of death.

A randomized double-blind trial carried out by John Hopkins University also revealed that high-dose psilocybin produced significant decreases in depression, anxiety and death anxiety, and improvements in quality of life, life meaning, and optimism.

A further clinical trial from New York University found that 60% to 80% of participants experienced anti-anxiety and anti-depressive effects from the treatment, along with benefits for existential distress, quality of life, and attitudes towards death, noting that “the psilocybin-induced mystical experience mediated the therapeutic effect of psilocybin on anxiety and depression.”

Supporting psychedelics for end-of-life care

In light of psychedelic therapy’s inclusion in Canada’s Special Access Programme in 2022, which enables authorised patients to receive access to these therapies if other treatments have been unsuccessful, a team of researchers set out to understand the public’s opinion on the potential easing of rules surrounding the medical use of psilocybin.

The survey, published in Palliative Medicine and carried out by Michel Dorval and Louis Plourde at Université Laval’s Faculty of Pharmacy and researchers from McGill University, Université de Montréal and UQAR, revealed that nearly four out of five Canadians support the use of psilocybin as a treatment for end of life existential distress.

In a statement, Dorval commented: “Studies have already shown that psilocybin, combined with psychotherapy, produces rapid, robust and lasting anxiolytic and antidepressant effects in patients suffering from advanced cancer.

“This substance can bring about a profound awareness that leads the patient to view existence from a different perspective. Treatment with psilocybin, combined with psychotherapy, can produce relief for up to six months.

“Our results seem to indicate that the social acceptability of this intervention is high in the Canadian population. If we consider only Québec respondents, the acceptability rate is similar to the national average.”

The findings also revealed that public support for psilocybin is higher among respondents who have already been exposed to palliative care, as well as higher in respondents who have already used psilocybin.

“Having been close to loved ones at the end of life, or having witnessed their distress, could explain this openness to new approaches designed to help people at this stage of their life,” added Dorval.

“There are still many prejudices against psychedelic substances. Familiarity with these substances probably helps to better understand their true effects as well as their therapeutic potential.”

The authors write: “The social acceptability of psilocybin-assisted therapy for existential distress at the end of life is rather high in Canada. These findings may contribute to efforts to mobilise resources and improve access to this emerging therapy in palliative and end-of-life care settings.”

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Ketamine: understanding the K-Hole



Ketamine: understanding the K-Hole
Photo by Gary Meulemans on Unsplash

Ketamine is an FDA-approved medical anesthetic and recently a prescription nasal spray version of ketamine called esketamine (Spravato) was approved for treatment-resistant depression.

Ketamine is an interesting drug because it can exist in three different forms, R-ketamine (the aesthetic version), S-ketamine (the psychedelic version), and a mixture of the two (racemic ketamine).

Ketamine is typically used to put you under before surgery, however, lighter doses that don’t put you to sleep are being used to treat depression, pain, and other mental health and substance use disorders.

These “off-label” uses have led to the popularization of the therapeutic use of ketamine. This has given rise to ketamine clinics where one can pay out-of-pocket for a dose administered by a doctor in a luxuriously curated “set-and-setting” (more on ketamine therapy in Nina’s Notes #18).

The patented, FDA-approved formulation of S-ketamine, Spravato, is estimated to generate $1 billion in revenue in 2023.

In addition to the rise in ketamine use for mental health, and despite its legality, the recreational use of ketamine is rising in popularity and has quite a history of illegal recreational use.

A term frequently used with the recreational use of ketamine is “k-hole”. People use it by saying things like, they are “stuck in a k-hole” or they could have “fallen into a k-hole.”

What is a k-hole?

A k-hole is the term referring to the dissociated, trance-like state that sometimes follows acute, excessive use of ketamine.

K-holes most often occur in recreational settings, like a nightclub or house party.

The dissociative effects of ketamine are dose-dependent, meaning the more you administer the greater the felt effects.

Receiving a ketamine treatment at a ketamine clinic will likely not result in a k-hole. The dose for the therapeutic experience is finely measured for the client, is administered in a safe clinical setting, and a physician can closely monitor the medicine’s effect.

When in a k-hole, one may be unable to interact with surroundings, control motor functions or maintain awareness of their external reality. An individual may temporarily be unable to speak, walk properly or maintain their balance. They may even find themselves feeling temporarily “paralyzed” or physically inhibited.

These motor-control symptoms are often paired with a strong internal experience, visions or visuals and an altered state of consciousness.

Experientially, it can feel like “falling into a hole” which is where the term k-hole comes from. K-holes can last as long as 5 minutes or up to roughly 30 minutes.

For some, experiencing a k-hole can be highly transformative and powerful, for others it may be a frightening experience.

Why does it happen?

Ketamine is a dose-dependent drug, the larger the dose, the bigger the effects.

While entering a k-hole is rarely the aim of a ketamine user, it can easily happen in a party setting where people may be taking multiple doses within a short period of time.

Ketamine is a white powder, similar to cocaine, which many users ingest through snorting. If a ketamine user has a history of cocaine use, they may use the drug at the same frequency due to previous habits, which can sometimes lead to k-holing.

Why is that? It’s because the half-lives of cocaine and ketamine are both short, but very different.

The half-life of ketamine

Half-life is the time it takes for the total amount of a drug in the body to be reduced by 50%. The half-life of ketamine is about 2.5 hours.

This means that it takes 150 minutes for a dose of ketamine to become a half dose in your body. Meanwhile, the ketamine high lasts about 30-45 minutes. In comparison, the half-life of cocaine is 40-90 minutes, and the high is about 15-25 minutes. Cocaine is metabolized very quickly and the high lasts about a third of the half-life of the drug.

So half of the drug is cleared from the body at close to the same rate as the user feels the effects. Drug gone = effects end.

Because the half-life of Ketamine is about 150 minutes and the high is about 1/5th of that, a user could be going for a second, third or even fourth dose before half of the first dose is metabolized by the body.

So, with repeating doses, the total amount of ketamine in your body builds over time. A user may not feel the strong effects of ketamine anymore, but they still have more than half of a dose still in their body. When they take another dose, they risk falling into a k-hole.

What happens in a k-hole?

A k-hole can lead to intense feelings of dissociation causing feelings of being disconnected from or unable to control one’s own body.

It may also affect the ability to speak and move easily. One way to think about a k-hole is a state between intoxication and a coma. Some refer to a k-hole as an out-of-body or near-death experience. A k-hole can be frightening and induce strong feelings of powerlessness. This can be especially intense if the ability to speak is affected.

Others might not notice someone in a k-hole. They might just look immobile and intoxicated, but their mind is far from quiet. They may be experiencing vivid, dream-like hallucinations and distortions of time and space. Other k-hole symptoms include confusion, unexplainable experiences and floating sensations.

While some people find the psychedelic experience enjoyable, others find it terrifying. Some describe falling into a k-hole like a bad LSD trip. Keep in mind the whole experience may last from 10 minutes to an hour.

Signs of a ketamine overdose

Know the signs of a ketamine overdose so that if someone at a party is exhibiting symptoms, you can get them immediate medical attention.

Although the risk of an overdose from ketamine is low, it can increase outside of a clinical setting. The overdose risks are higher when ketamine is mixed with other substances such as alcohol, opioids or other recreational drugs.

Overdose symptoms can include anxiety, chest pain, elevated blood pressure, hallucinations, loss of consciousness, nausea or vomiting, rapid or irregular heart rate, and seizures.

A k-hole, however, is a common experience due to excessive use of ketamine over a short period of time. It is not a ketamine overdose.

Though a k-hole is a temporary experience, there are several long-term side effects with extended recreational ketamine use, such as bladder problems, cognitive effects, heart problems, and seizures.

While there is no way to guarantee a perfectly safe experience with ketamine, using it outside of doctor supervision, its effects can be extremely unpredictable compared to other drugs.

With the rising popularity of ketamine in both medical and recreational spheres, this calls for a balanced perspective, appreciating the therapeutic potential of ketamine while being acutely aware of its potent effects and the dangers of excessive use.

This article was first published on Nina’s Notes and is republished on Psychedelic Health with permission.

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Beyond Psilocybin: the fascinating world of functional mushrooms



Beyond Psilocybin: the fascinating world of functional mushrooms

I typically write about psilocybin, the hallucinogenic compound in mushrooms. But mushrooms have many more interesting properties than just psilocybin.

There are well over 14,000 species of mushroom-producing fungi that have been identified so far. It is believed that many more exist and have yet to be discovered. In 2017, an article in Microbiology Spectrum estimates that there are between 2.2 and 3.8 million different species of fungi.

Functional mushrooms are a category of mushrooms that have been traditionally used for their health benefits.

See also  Lion’s mane boosts memory through nerve growth, say researchers 

They have been incorporated into Eastern medicine for thousands of years, especially in Asian cultures. These mushrooms are not your typical culinary mushrooms. They are often found in supplements, teas or other preparations to be used for health-enhancing benefits.

Popular Functional Mushrooms

Reishi (Ganoderma lucidum)

Known as the “mushroom of immortality,” reishi mushrooms are often used for immune support and to promote relaxation.

Reishi mushrooms may positively affect white blood cells, a critical part of your immune system. A 2006 study found that ingesting reishi could increase the number of white blood cells in those with colorectal cancer.

They were also shown to improve the function of lymphocytes in athletes when they are exposed to stressful conditions.

Reishi mushrooms may also reduce fatigue and depression.

Lion’s Mane (Hericium erinaceus)

This pom-pom shaped mushroom is native to North America, Asia and Europe.

It is recognized for its potential neuroprotective effects, protecting nerves from disease or decline.

Lion’s mane has also been studied for its effect on neurons, and has gained the title “the smart mushroom” due to its potential to boost cognitive function and minimize brain fog.

It may also have potential benefits in addressing the cognitive decline associated with conditions like Alzheimer’s and Parkinson’s diseases. The bioactive compounds in Lion’s mane, hericenones and erinacines, may promote the production of growth factors and protect against brain damage.

Chaga (Inonotus obliquus)

Chaga is a black, parasitic mushroom, which looks like a lump of burnt coal.

It’s high in fiber, low in calories, but rich in minerals and vitamins.

Chaga has been used to treat diabetes, parasites, tuberculosis, and inflammation.

The oldest reference to the use of chaga mushrooms as a medicine comes from Hippocrates in his Corpus Hippocraticum, in which chaga is used to wash wounds.

For medical treatment, chaga is usually ground to a fine powder and made into a tea for its antioxidant properties and immune support.

Cordyceps (Cordyceps sinensis)

Fortunately, not the Cordyceps that infect the brains of mankind in the popular The Last of Us series.

Though creepy to look at, Cordyceps is a fungus that lives on certain caterpillars in the high mountain regions of China.

It is traditionally used to boost energy and improve athletic performance.

Cordyceps is believed to increase the flow of oxygenated blood throughout the body, boost metabolic rates, increase stamina and help muscle recovery.

Turkey Tail (Trametes versicolor)

Turkey tail is valued for its immune-boosting properties, specifically its medicinal properties as an antitumor, antimicrobial, immunostimulant and antioxidant.

It is also believed to improve bone strength and regulate blood glucose.

And some report that turkey tail can prevent urinary tract infections (UTIs) and protect against age-related cognitive decline.

Shiitake (Lentinula edodes)

Apart from being a popular culinary mushroom, shiitake is also known for its immune-modulating effects.

Traditional Chinese medicine considered shiitake a food that enhances vital energy. It is a great source of nutrients, high in protein, low in fat, and contains iron, calcium, zinc, along with vitamins B, E and D.

Easily accessible at any grocery store or market, shiitake mushrooms can be prepared to eat, or taken as a supplement for its functional properties.

What are some popular functional mushroom products?

You may have seen Ultimate Shrooms in your local health store. It’s a product that contains Cordyceps, Reishi, Chaga, Lion’s mane, Turkey Tail, Maitake, Shiitake and Oyster mushrooms.

Live Ultimate, the brand behind Ultimate Schrooms recommend adding two tablespoons with a full glass of water, juice or smoothie in the morning on an empty stomach.

Mushroom Coffee is also gaining popularity, like the product Four Sigmatic which contains Chaga and Lion’s Mane.

Some functional mushrooms, like Reishi, are less appetizing when eaten in their natural form. Thus people have begun consuming them in a power form, adding them to smoothies, teas and coffee, to improve the taste.

Functional mushrooms can offer a wide range of health benefits, though it’s essential to purchase mushrooms from a reputable source, and understand their proper preparation. Not all claims for health benefits have been substantiated by clinical trials.

It is also important to consult a healthcare professional before incorporating functional mushrooms into your diet and routine, especially for those with pre-existing medical conditions.

This article was first published on Nina’s Notes and is republished on Psychedelic Health with permission.

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Psychedelic Health is a journalist-led news site. Any views expressed by interviewees or commentators do not reflect our own. We do not provide medical advice or promote the personal use of psychedelic compounds. Please seek professional medical advice if you are concerned about any of the issues raised.

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