‘I took ketamine to treat my severe depression’ – iNews

In early 2021, Rhys Edwards received a Google alert that would transform his life, possibly hopefully for ever. The alert had been set for news about David Nutt, a professor of neuropsychopharmacology. Edwards was interested in Professor Nutts unconventional ideas as an expert in how drugs affect the mind, and particularly on the therapeutic potential of psychedelics.

If youve heard of Prof Nutt, its probably from his most infamous hour, when he was forced to resign as the Labour governments drugs tsar, in 2009. His offence was to say that illegal substances such as cannabis, ecstasy and LSD were less harmful than alcohol and tobacco, a statement he stands by to this day.

The Google alert Edwards opened contained news of a radical treatment for mental health and addiction. The treatment came with Nutts seal of approval and would be available from a private clinic in Bristol run by Canadian biotechnology company Awakn Life Sciences, to any suitable candidates in the UK.

Edwards was immediately interested and eager to know more. He has suffered from depression for most of his life, leading to suicide attempts, stays in psychiatric hospitals and episodes of shockingly brutal self-harm. He tells me hes had a go at pretty much every kind of treatment going.

The approach, which combines medication and psychotherapy delivered to outpatients over a number of weeks, shows startling potential in a field which has made little progress in many decades.

Existing antidepressants are only cleaner versions of those first developed in the 50s, according to Nutt, and there has been no revision of the standard pill a day model. Only 10 per cent of those who may benefit from alcohol intervention treatment receive help and while most stop drinking at first, three-quarters relapse within six months.

We need to do better, says Nutt. Its a maintenance model. Its protecting people from the symptoms but its not getting rid of the cause, and thats something that our new therapy may be able to do.

Ive been invited to a low-key, high-stakes meeting with Nutt, who is also Awakns chief research officer, and other experts as they launch a flagship London clinic, following success in Bristol. All are convinced that it is time to properly explore new options to tackle rising levels of depression and addiction. Nutt, 71, has devoted his career to this.

Psychedelic drugs are the most interesting and innovative developments in this field, he explains.

My own view is that theyre going to revolutionise psychiatry. I dont think theres any doubt about that. I gave a talk to the Royal College of GPs this morning, and they seemed to believe me. The message is getting out there.

As a retired lawyer who made a comfortable sum after selling a consultancy business, Rhys Edwards had plenty of time to read up on the subject from his Somerset home adjacent to the Glastonbury festival site, which he shares with his wife, 10 dogs and a few other animals.

After further research a considerable amount given its unusual nature and the 6,000 price tag he underwent treatment between December 2021 and February this year.

I was on ridiculous amounts of antidepressants, Edwards says. I was pretty stable but it was like being anaesthetised. The only thing they hadnt given me was ECT (electroconvulsive therapy). I was certainly grasping for something that might be my last chance.

He has also drastically cut back on his other medication, giving up one of two heavy duty antidepressants, almost halving the dosage of the other and drinking far less alcohol.

Im not saying Im cured. I still have bad days and I still have depressive episodes. But I can deal with them and put them into context. I feel like Ive got a good life.

But this wonder treatment is ketamine, a drug with a very dark reputation. One of the reasons that it is the first psychedelic legally available for therapeutic use is that we already know so much about it.

Although often dismissed as a horse tranquilliser or party drug, it is a widely used anaesthetic, commonly chosen for use with children and short operations such as fixing dislocated shoulders. A variation called esketamine is already available through the NHS, prescribed as a nasal spray and not offered alongside therapy, which Awakn believes is the key to long-term benefits.

This combination has unique effects on the brain circuitry associated with unhelpful thinking and behavioural patterns, Awakns website states.

It may allow you to work through issues in ways that have not been possible with therapy alone, and help you to relearn the behaviours and thought patterns that hold you back.

The company researches ketamine and MDMA (ecstasy) treatments for alcohol use disorder (AUD). Professor Celia Morgan, who made the ketamine breakthroughs and is head of Awakns ketamine-assisted therapy, runs the Ketamine for Reduction of Alcohol Relapse trial at the University of Exeter. During the Phase II trial involving 96 participants between 2016 and 2020, her findings revealed that low doses of ketamine combined with psychological therapy can help prevent relapse, showing 87 per cent abstinence at six months compared with the usual one quarter.

AUD is a prime focus given its prevalence it affects 400 million people globally but it is hoped that behavioural addictions such as gambling, food and sex may also be candidates.

Whats so exciting is it brings psychology and psychiatry back together, says Nutt.

I certainly think psychiatrists are ready for it. Im not sure about psychologists. It challenges what theyve been telling their patients for a long time that you should never take drugs. Ive had flak for even talking about these treatments.

Other psychedelics including psilocybin (magic mushrooms) and MDMA are also being trialled. There is little evidence of addiction to psychedelics but opiates such as morphine and fentanyl, which are known to be highly addictive, are routinely prescribed by doctors.

When I was invited to attend the opening of the flagship London clinic last month, where the course costs 7,500, the concept still felt somewhat cloak-and-dagger.

Psychedelics have been around for a long time, but the approach is young and the potential dangers of mind-bending drugs and bad trips are embedded into Western culture.

The clinic space is warm and contemporary. It could be a tech start-up or an independent caf as much as a therapy clinic. The name, Awakn, puts me in mind of the TV series Nine Perfect Strangers, in which Nicole Kidmans mysterious guru character invites struggling guests to her unconventional wellness centre. I suppose we are hard-wired to associate anything related to psychedelics as woo-woo. Certainly, Britons will need to lay down some new neural pathways to get on board.

Scientists such as Nutt and Morgan have long suspected the potential of psychedelics. But theyve found it almost impossible to run trials, even though it has been an area of interest for scientific researchers since the 50s, especially in the US.

Alcoholics Anonymous (AA) co-founder Bill Wilson even intended LSD as the 13th step in the organisations approach to addiction, and credits it for his own recovery. Ultimately, he was ostracised for these views.

Psychoactive plants such as ayahuasca and datura have been used therapeutically by those living close to them for centuries.

Wilson took LSD with the psychologist Betty Eisner and psychiatrist Sidney Cohen. Both were at the forefront of American research into how psychedelics could work alongside talking therapy to treat depression and addiction.

But with the war on drugs in the US came the demonisation and criminalisation of these drugs and practices. Most illegal substances were lumped together, bureaucratically and in the general psyche, as public enemy No 1. Eisner and Cohens work was kneecapped.

It remained legal to use MDMA therapeutically until the mid-80s, when the authorities caught up with its popularity as a party drug. Decades on, Nutt and Morgan seem as surprised as anyone that their work is finally available to the public at large. When had they expected this to happen? They laugh. From Nutt it is more of a guffaw. Never, he replies.

In March, the Royal College of Psychiatrists announced a record 4.1 million referrals to mental health services in 2021, urging the Government to publish a fully funded recovery plan. Awakn, of course, plans to be part of that.

Theres no question places like this are going to be important, says Nutt. The cost burden of severe depression is enormous and clinics like this are going to provide better outcomes at a lower cost.

This is no quick fix though. Theyre not having fun, says Nutt of those who have undergone the treatment. Theyre dealing with the damage theyve done to themselves and their families with alcohol or depression, going back to places where theyve been abused.

I viewed it as work from the outset, confirms Edwards. I think it works on a whole lot of levels. Its great fun in places, it can be very intense in others.

Id gone into it wanting to explore my relationship with my parents and I had the experience of meeting them and was able to clear the air. I wrapped them up in my love and sent them off.

The Awakn programme typically takes place over eight weeks and includes 11 psychotherapy sessions, four ketamine sessions of around two hours each (given by injection) and a final post-course evaluation.

During the ketamine sessions clients are settled under a blanket with music and assisted by a clinical specialist, although it is unusual to talk during thispart.

Psychotherapy sessions follow about 24 hours after the ketamine, when the brain is at its optimum plasticity. This is the time when we are best able to create new ways of thinking.

The ketamine allows users to gain a fresh some call it a fully objective or out of body perspective on their lives and past experiences. The psychotherapy which follows gives them the tools to embed this new outlook into their neural pathways.

Each potential client is assessed individually and will have previously tried other treatments such as antidepressants or substance detoxes. The markers for AUD relate more to how alcohol use is affecting someones life than the volume drunk.

Clients include a photographer who had been drinking three or four beers a night but couldnt stop, a retired civil servant who had struggled with drinking for 40 years and a nurse who didnt want her children to grow up using alcohol as she was.

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'I took ketamine to treat my severe depression' - iNews