Yale Panel Welcomes ​“Psychedelic Renaissance”

Researchers psyched about bringing psychedelics from the underground to the therapist’s office are confident that drugs like MDMA can help those suffering from Post-Traumatic Stress Disorder (PTSD).

What they’re less sure about: how such experimental treatments might interact with antidepressants, which are widely taken by many patients who would benefit most from a therapeutic trip.

Those notes of hope and concern were expressed Thursday during a panel held at the Yale School of Management’s vertiginous Zhang Auditorium. 

Six psychiatric researchers, entrepreneurs, and healthcare industry professionals came together as part of the 10th annual Yale Innovation Summit to discuss the state of therapeutic psychedelic research. This particular panel was entitled, ​“Biotech: Exploring The Psychedelic Renaissance.”

The ensuing discussion revealed how some of those on the cutting edge of bringing psychedelics into the medical mainstream think such drugs might help with a range of conditions. It also identified existing medical infrastructure that makes access to new treatments difficult.

According to venture capital fund AlleyCorp CEO Kevin Ryan, one of the panelists, the average patient in an MDMA clinical trial has been living with post-traumatic stress disorder (PTSD) for roughly a dozen years — and in a recent clinical trial, some patients reached remission after just 10 weeks. 

“For an insurance company,” Ryan said, ​“that’s a ​‘drop the mic’ moment.” 

Ryan also bemoaned the public stigma around psychedelics: ​“There are no unbiased jurors,” he said, before favorably comparing psychedelics to alcohol and traditional psychiatric practice. 

“Psychiatrists have slept with their patients for decades,” Ryan said, yet people are still ​“hyper-cautious” around psychedelics. ​“There is a double standard that is hard to overcome.” 

But according to Dr. Christopher Pittenger, Yale’s Elizabeth Mears and House Jameson Professor of Psychiatry, there is some room for caution. ​“I worry just as much about unreserved enthusiasm” as about stigma, he told an attendee after the panel.

According to Pittenger, one of the stumbling blocks is that ​“we don’t know” how psychedelic therapy works biologically. There are three main hypotheses. The first is that psychedelics work on a molecular level, like most pharmaceuticals; the second is that the ​“resetting” effects on ​“brain networks” are responsible for the effects; and the third option is that psychedelics might allow patients to reconnect with meaning in life. As Pittenger put it, ​“so much of our society can be described as alienation from meaning.”

Another difficulty comes from federal drug laws. Because MDMA and psilocybin are Schedule I drugs (defined as ​“drugs with no currently accepted medical use and a high potential for abuse”), the only legal way to access psychedelic therapy in the United States is through clinical research trials. But many of these trials do not enroll patients currently taking antidepressant selective serotonin reuptake inhibitors (or SSRIs for short). 

This in part is because of the uncertainty around mixing psychedelics with SSRIs, and in part because the presence of SSRIs might make it difficult to isolate the specific effects of the psychedelic therapy. 

“The vast majority of people with PTSD are treated with SSRIs,” said Yale Professor of Psychiatry, Neuroscience, and Psychology Dr. John Krystal, the panel’s chair — meaning that even accessing these experimental psychedelic therapies can be extremely difficult for those PTSD patients who might benefit the most. 

There’s hope that psychedelic therapy can target a broad suite of conditions beyond PTSD: Pittenger pointed to Obsessive Compulsive Disorder, nicotine and alcohol addiction, depression, and traumatic brain injuries as diagnoses that have shown improvement in response to psilocybin therapy. And because of the range of possible benefits, continued research on the effects of psychedelics may reveal flaws in current diagnostic approaches. 

It may be the case, Pittenger said, that ​“we’re carving nature at the wrong joints.” 

For many, despite the logistical questions, this is an exciting moment in psychedelic medicine. Alexander Hamilton, an undergraduate studying physiology and neurobiology at the University of Connecticut, attended the panel after learning about developments in therapeutic psychedelics online. 

He was ​“happy to hear” that Yale was hosting this panel, which he hoped would help ​“introduce [psychedelic therapy] into the larger lexicon.” The panel, which was sponsored by pharmaceutical company Boehringer Ingelheim, largely echoed Hamilton’s optimism. As Ryan put it, the expenses and logistical difficulties of getting psychedelic medicine approved are worth it because, after all, ​“what’s the cost of not putting something out there?”