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In December 2019, a ketamine-like drug – esketamine – was licensed for use in the UK as a rapid-onset treatment for major depression: it starts working in hours, compared with weeks or months with traditional antidepressants. This new treatment proved so promising that, in 2018, the US Food and Drug Administration (FDA) awarded breakthrough therapy status to psilocybin ( given only to drugs that “demonstrate substantial improvement over available therapy”) as a treatment for TRD.
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In the study, two doses of psilocybin (10mg and 25mg, seven days apart), plus therapy, resulted in “marked reductions in depressive symptoms” in the first five weeks, which “remained significant six months post-treatment”. This is when a person doesn’t respond to two or more available therapies it is particularly debilitating and, recent data shows, affects about a third of all people with depression.
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As far back as 2016, Robin Carhart-Harris and his team at Imperial College London published promising findings from the world’s first modern research trial investigating the impact of psilocybin (the active ingredient in magic mushrooms) alongside psychological support, on 19 patients with treatment-resistant depression (TRD). In recent years, research into psychedelic-assisted mental healthcare has shed its outsider status. To understand myself and my drinking, and why I behaved the way I did… With the ketamine therapy I got there in a few weeks. “It wasn’t even on my radar, so it blew my mind. “I could see it was the root of the negative emotions that drove my drinking, and a lot of other bad habits and behaviours.” He says it’s a realisation he might have taken years to come to with standard talking therapy.
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“I suppose what I realised in that therapy session was that I’d felt overlooked as a child and that had caused me pain.” Over the years, that pain crystallised, and alcohol became a crutch. “They had a lot of commitments, they were very busy people,” he says. What was in short supply was his parents’ attention. “Growing up, love was never in short supply,” Grant says. They were also fosterers who, over the span of their marriage, gave a home to more than 200 children. His parents were evangelists Grant’s father was a teacher and lay preacher, and his mother ran a nursery from home. It hadn’t been on my radar – but with ketamine I got there Most vividly, he remembers the consequences: “I got my parents’ attention.” I realised feeling overlooked as a child drove my drinking. The next day, in a therapy session at the hospital, the motorbike story and other memories swirled up from his subconscious: being caught smoking at school and caned, and other instances of “playing up” as a child. I felt very serene and humbled I finally understood my place in the universe, just a white speck of light, I wasn’t the centre of everything and that was fine.” I was up on the ceiling, looking at myself, but I was just this white entity. “Then I became white… and I left my body. “It was like I was sinking deeper and deeper into myself,” he says. Under its influence, Grant had an out-of-body experience he struggles to put into words. But while investment money pours in and new experimental trials launch almost weekly, ketamine remains the only psychedelic drug that’s actually licensed for use as a medicine. Thanks to its world-leading academic institutions, the UK has become a home to many of the biotech companies developing these treatments. And if advocates are to be believed, that cure will be available on the NHS within the next five years. What was once a fringe research interest has become the foundation of a new kind of healthcare, one that, for the first time in modern psychiatric history, purports to not only treat but actually cure mental ill health. To date, more than 100 patients with conditions as diverse as depression, PTSD and addiction have been treated in research settings across the UK, using a radical new intervention that combines psychedelic drugs with talking therapy. The day before, a team of specialists at the Royal Devon and Exeter hospital had given him an intravenous infusion of ketamine, a dissociative hallucinogen, in common use as an anaesthetic since the 1970s, and more recently one of a group of psychedelic drugs being hailed as a silver bullet in the fight to save our ailing mental health.