World first study to explore psilocybin for gambling addiction



Marking a world first, researchers at Imperial’s Centre for Psychedelic Research will investigate psilocybin as a treatment for gambling addiction with the support of funding from the UK Research and Innovation (UKRI) fund.

The Centre will be carrying out a small study involving five volunteers with gambling addiction to test if psychedelic therapy is safe and could have therapeutic potential.

From October 2023, the volunteers will be given psilocybin in combination with talking therapy and will undergo braing imaging to monitor patterns of brain acitivity and connectivity using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG).

The study is being led by leading researchers in the field, including Professor David Nutt, Dr David Erritzoe, Dr Matt Wall and Rayyan Zafar, PhD, from Imperial College Centre for Psychedelic Research and Neuropsychopharmacology.

As psychedelics have shown promise in clinical research as potentially innovative treatments for conditions such as depression, post-traumatic stress disorder (PTSD), alcoholism and more, the team believes that psilocybin may offer hope as a treatment for gambling disorder.

Psilocybin, in particular, has been shown in a number of clinical studies to induce brain plasticity, with research proposing this creates a window of time following a psilocybin experience that enables a person to break old patterns of thinking and form new ones – helping people break addictive patterns of behaviour. 

Between April and December 2022, the UK saw record demand for gambling services, with referrals to NHS clinics for gambling addiction up by 16.2% from the same period in 2021, and the north of England having the highest prevalence of at-risk gamblers.

Zafar told Psychedelic Health: “The current clinical treatment paradigm for gambling addiction in the UK is a psychosocial intervention such as Cognitive Behavioural Therapy (CBT) with some patients being prescribed naltrexone off-label. To date, there are no licensed pharmacological interventions for Gambling Disorder.”

Zaffar highlights that recent studies have shown the therapeutic potential of Psychedelic Therapy in the treatment of psychiatric conditions, including substance use disorders, but there have been no specific studies into the use of Psychedelic Therapy to treat Gambling Addiction or other behavioral addictions. 

“Given the similarities in clinical and brain characteristics between substance use addictions and behavioural addictions we believe psychedelics may be able to target the same psychological and physiological mechanisms underlying this condition,” said Zafar. 

“There is currently a large unmet medical need for effective interventional solutions for these individuals given the lack of available or effective treatments.

“Research in psychiatry and addiction has been largely led through serendipitous discovery and this has led to a lack of understanding about disorder pathology and the mechanism of action of therapeutic interventions which has contributed to the large treatment gap that exists in addiction medicine.

“In recent years there have been efforts to incorporate personalised medicine and precision psychiatry approaches utilising human neuroimaging in early phase human addiction clinical research.”

Zafar emphasises such research has enabled the identification of novel drug targets and mechanisms of action of interventions, allowing for neuroscience-informed drug development, and paving the way for more effective interventions to reach addiction clinics. 

fMRI and EEG can be used to identify translational biomarkers that are observable in patients with addiction disorders and that may respond to interventions such as psychedelic therapy, explains Zafar. 

“Integrating these techniques into early phase clinical research of novel interventions like psychedelic therapy is therefore critical to enable for optimal translation,” he said.

“We are currently completing a series of experiments to develop such translational neuroimaging biomarkers for Gambling Didorder using tasks developed in our lab to probe the brain’s reward and plasticity systems which are known to be dysregulated in Gambling Disorder. 

“Our tasks were created to explore the hypotheses that in Gambling Disorder, there is maladaptive reward processing and neuroplasticity which are contributing to the pathology of the disorder. 

“These tasks have been validated as part of my PhD and we know these areas are possible targets for psychedelics – we want to see whether psychedelics can target these systems involved in Gambling Disorder and whether that is how they lead to their therapeutic effects.”

With psychedelic research in the UK receiving minimal state funding to date, the UKRI investment is symbolic of changing attitudes towards psychedelic science. 

“Having support like this is a big step forward for psychedelic research in the UK and we hope this will catalyse more of the same in the future,” said Zafar. 

“The UK is a global leader in psychedelic research and if we are to keep this up we will need sufficient R&D support and funding from institutions and the Government.”

The Centre received UKRI funding following its groundbreaking research investigating psilocybin in combination with talking therapy for depression which showed reductions in depressive symptoms, and another study exploring psilocybin versus Escitalopram for depression, showing secondary outcomes favored psilocybin over escitalopram.

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