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It is estimated that 100 million people around the world suffer with depression that is not helped by existing medication. As a community, we need to do something about this. That’s why COMPASS brought together some of the world’s leading experts at the 2019 International Society of Affective Disorders (ISAD) conference in London to discuss the potential for psilocybin therapy in helping people with treatment-resistant depression.

The meeting was chaired by Professor Allan Young, Director of Kings College’s Centre for Affective Disorders, who was joined on a panel by Dr David Erritzoe of Imperial College, London, Catherine Bird and Dr James Rucker from King’s College London, and me, COMPASS Pathways’s Chief Medical Officer.

The need for innovation

The tone of the panel was set by Professor Young, who described the focus on revitalising the field of treating depression, and moving away from ‘another SSRI’, the class of drugs which, many believe, provides insufficient efficacy for many patients with depression. The audience was reminded of the history and neuroscience of psilocybin, how clinical research to date suggests a potential benefit in treatment-resistant depression, and the importance of ensuring the safety of those taking part in the current clinical trials that are actively enrolling patients.

Why set and setting is so important to psilocybin therapy

Of particular interest was our discussion on the importance of ‘set and setting’ during psilocybin therapy. Catherine Bird described the significance of context in a psychedelic treatment experience, how to run clinical trials when there’s no approved ‘model’, and managing this unconventional clinical approach in a safe way. Dr Erritzoe expanded on the effect of music during a psychedelic experience, sparking a debate about the subjectivity of music tastes and the potential for future investigators to be “more creative” about all elements of psilocybin therapy’s context.

Taking a traditional approach for a non-traditional drug

The positive discussion concluded with Dr Rucker attesting that there was “a change in the air” in reference to the number of studies now being conducted in psychedelic therapy, and stating his belief in the potential of psilocybin as a medicine. I reiterated that “the path forward is clear” with the need to complete a full clinical development programme with psilocybin therapy, to the highest standards. With fewer and fewer clincal trials being initiated for new drugs to tackle the unmet need in depression, I highlighted the importance of taking a “traditional approach for this non-traditional drug”.

We thank everyone who attended the meeting at ISAD, and especially our panel members and Chair for a great discussion. We hope it will have answered some of the questions around setting up trials in psilocybin therapy and explained why so many of us believe this is a highly promising innovation for mental health challenges like treatment-resistant depression.

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