“Ketamine has a major role to play in treating eating disorders, Alcohol Use Disorder, depression and anxiety-related disorders.”
Awakn Life Sciences’ Lead Clinical Psychologist, Dr. Laurie Higbed, is talking about the versatility and effectiveness of the ketamine-assisted therapies that are available in our flagship Bristol, UK clinic.
A close colleague of our Chief Medical Officer, Dr. Ben Sessa, Laurie has worked in the NHS and witnessed first-hand the poor outcomes that existing therapies sometimes have.
“Anorexia Nervosa is the mental health problem with the highest morbidity rate,” she resumes. “Our current treatments for it aren’t particularly successful and there have been no major treatment breakthroughs for several decades. The best we can hope for based on current evidence is a 50% recovery rate. There’s a real pressing urge for us to come up with better novel treatments. In addition to ketamine-assisted therapies, which can be accessed straight away in Bristol, MDMA and psilocybin-assisted therapies will be provided as part of research protocols and could be fully available to us by 2022.”
Our knowledge and understanding of psychedelics, says Laurie, is growing at an exponential rate.
“There’s so much research coming out at the moment about how they can be used in all sorts of areas like palliative care and brain injuries. Researchers from Yale recently published findings from a small preliminary trial indicating that one dose of psilocybin reduced the frequency of migraines by 50% for at least two weeks. Psychedelics are really adding to the psychiatry tool-kit, and it’s a fascinating and rewarding area to research.”
That research has brought the limitations of existing treatments into sharp focus.
“If you don’t benefit from traditional antidepressants or courses of psychotherapy, which can be tough going, there are new options with generally excellent outcomes,” Laurie resumes. “Psychological therapy for PTSD for example, can be very effective, but dropout rates tend to be around 30%, and we are still left with around 50% of people seeking treatment for PTSD who have not benefited from currently available therapies or medication. I was blown away by the data from Mithoefer’s study in 2012, which demonstrated that MDMA-assisted psychotherapy for chronic PTSD benefited over 80% of participants and, crucially, these benefits lasted long-term.”
Laurie is aware of the need to reposition ketamine as a therapeutic drug.
“A lot of people when you say ‘ketamine’ think horse tranquilisers or something a little bit weird or scary,” she reflects. “What they perhaps don’t know is that it’s a safe anesthesia used on children and in Accident & Emergency Departments if you need to sedate someone but don’t know much about their medical history. It has relatively few side effects making it the go-to drug in those areas. In mental health, there are studies showing that ketamine, particularly when combined with psychotherapy, can benefit people with depression, anxiety disorders, and substance use disorders, especially if traditional treatments aren’t working for them.”
Having examined all of the available data – and there’s lots of it! – Laurie and Ben have devised a customised ketamine programme with a wide-range of therapeutic applications.
“What we’ll be doing at Awakn is using ketamine as an adjunct to psychotherapy,” she says. “We can use it in a nuanced fashion based on the best treatment protocol for the individual. At low to moderate doses you’ll be able to engage with therapy while being under the influence, and at higher doses you’ll do the therapy afterwards as you start to make sense of the new perspectives and insights you may have gained with the help of ketamine. It's not a danger drug; it’s used across the health service and we’ve now got it in our mental health repertoire.”
Together with Ben, Laurie has been carrying out her own research into psychedelics since 2015, with one of their first collaborations being the much-trumpeted Bristol-Imperial MDMA-for-Alcoholism Study (BIMA).
“The premise of it being that we’d seen people in America get unbelievable relief from their PTSD symptoms with MDMA-assisted psychotherapy, which lasted for up to nine months,” she explains. “Underlying a lot of Alcohol Use Disorder is what we call either Big ‘T’ or Little ‘t’ trauma. Big ‘T’ meaning that they’ve experienced significant trauma commonly associated with PTSD and are still suffering the effects of that, and Little ‘t’, which could be some sort of childhood adversity like parental discord or significant bullying that an individual can nonetheless find incredibly hard to cope with into adulthood. The outcome of the BIMA Study being that MDMA-assisted therapy is incredibly effective in treating Alcohol Use Disorder.”
Like Ben, Laurie is looking forward to training other healthcare professionals in the use of psychedelics.
“There will be an online learning element with modules about psilocybin, MDMA and ketamine and then there’ll be the face-to-face training with myself and Ben lasting approximately ten days,” she concludes. “You’ll get to role-play, watch videos and get a real feel for the therapies. I was blown away when I was first introduced to psychedelics by Ben, and I think they will be too.”