The use of ecstasy and magic mushrooms to help treat mental illness is currently being considered by the national medicine regulator in Australia, but Tasmanian psychiatrists say they are currently wary of psychedelic therapies.
The Therapeutic Goods Administration (TGA) is set to deliver an interim decision next week on whether to declassify the illegal substances MDMA and psilocybin for clinical purposes.
MDMA, otherwise known as ecstasy, is being raised as an extra treatment for post traumatic stress disorder (PTSD), while psilocybin, which is the psychoactive ingredient in magic mushrooms, is argued as a useful therapy for depression, anxiety, addiction, and possibly, anorexia and obsessive compulsive disorder.
They are currently listed as prohibited substances, sitting alongside drugs such as heroin and cannabis, but psychedelic therapy proponent Mind Medicine Australia has applied for the drugs to become controlled substances, like morphine and ketamine.
This means they could more easily be used as treatments for mental illness in controlled medical environments, but The Royal Australian and New Zealand College of Psychiatrists (RANZCP) warns that the efficacy and safety of such therapies are as yet unknown.
While there is emerging evidence for the use of psychedelic therapies in the treatment of mental illnesses, further work needs to occur before it can be considered a safe and effective intervention in clinical practice.- RANZCP
RANZCP Tasmanian branch chair Ben Elijah said more research into MDMA and psilocybin is necessary to inform future potential use in psychiatric practice.
"While there is emerging evidence for the use of psychedelic therapies in the treatment of mental illnesses, further work needs to occur before it can be considered a safe and effective intervention in clinical practice," Dr Elijah said.
"As psychiatrists, we must promote evidence-based best-practice advice on new and emerging treatments for mental health.
"Whilst we encourage and are open to better and more effective treatments, further evidence for efficacy of psychedelics is necessary".
Edith Cowan University senior lecturer Stephen Bright, who founded PRISM for Psychedelic Research in Science and Medicine, recently wrote on The Conversation that increasing research exists, which shows these drugs could be used as psychotherapy treatments.
"Australia was a little later to get involved than some countries, but in the past 18 months we've succeeded in initiating clinical research locally," he said.
"Edith Cowan University, Monash University, the University of Melbourne, and St Vincents hospitals in Melbourne and Sydney all have research on psychedelic-assisted therapies either in the pipeline or already underway," he said.
We need to see Phase 3 clinical trials completed before any informed decisions can be made.- Stephen Bright
But Mr Bright added that he did not believe the TGA will reschedule the drugs as medicines at this stage.
"We need to see Phase 3 clinical trials completed before any informed decisions can be made... This approval process is important so we know the drugs are effective and safe, including understanding any side effects," he said.
"Even the COVID-19 vaccines Pfizer, AstraZeneca and Moderna are fast-tracking internationally have been required to complete stringent, widely scrutinised Phase 3 trials."
Despite concerns, Mind Medicine Australia submits that its applications to the TGA support an opportunity to improve the mental health outcomes of suffering Australians.
In an application for psilocybin it said that psilocybin assisted therapy has yielded extremely positive clinical results for depression and anxiety in many university trials, and has led to remission in 60 to 80 per cent of cases.
This was compared to remission data from current existing treatments showing remission in 35 to 42 per cent of cases.
"The rescheduling of psilocybin from Schedule 9 to Schedule 8 will make it easier for Australians suffering from depression and anxiety disorders and substance abuse - and potentially other illnesses such as anorexia and OCD - to access psilocybin-assisted therapy through their psychiatrists and specialist addiction physicians in strictly medically controlled environments."
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