When we think about psychedelic drugs, we often imagine rockstars taking trips to far-flung lands. However, NHS medics in the North East are now at the forefront of life-changing clinical trials using these substances to treat depression.
Dr Mourad Wahba, a consultant psychiatrist leading the COMP006 trial in Newcastle, works at the CAPE clinic run by the Cumbria, Northumberland, Tyne and Wear NHS Trust. This is part of the Northern Centre for Mood Disorders, a collaboration between the NHS Trust and Newcastle University.
What is the COMP006 trial?
COMP006 is a phase three clinical trial investigating the efficacy, safety, and tolerability of giving two doses of a synthetic form of psilocybin called COMP360, produced by Compass Pathways, to patients with treatment-resistant depression.
Dr Wahba has been involved in psychedelic research since 2018. He said: 'We were delivering the very first COMP trial here. The results were published in the New England Journal of Medicine. Since then, many sponsors have wanted to involve us, but we have only participated in a few trials. COMP006 is important because it is one of two Phase 3 trials that Compass can take to the FDA in the US.'
How do psychedelics work?
Dr Wahba explained that psychedelics cause a 'rewiring' of the brain, altering how sensory information is processed. 'A psychedelic experience is a very strong mind-altering space. The brain changes how it processes information. Patients may experience sensory changes, cognitive shifts, or even feel they are dissolving into the world around them. Some may become scared and think they are dying. These strong emotional reactions can be therapeutic if managed properly.'
He added that preparing patients is crucial: 'It is like explaining meditation to someone who has never meditated. We tell them they might feel they are dying or have gone mad, but we support them throughout.'
Life-changing potential
Dr Wahba emphasised that for some patients, the treatment is transformative. 'For the people it works for, it is life changing, and I do not say that lightly. Those are not just my words, but those of a patient. His experience was not entirely positive, but it was a gamechanger. When you are in this headspace, you realise things that may change how you view yourself. It might be something you do once or twice every six months, which could be much better than taking medication daily.'
Patients often arrive well-informed about psychedelic therapy. Dr Wahba cautioned: 'If you go in thinking you will come out a different person, you will be disappointed. You need to be ready to experience whatever happens. We are here to support you through challenging experiences, which can sometimes lead to anxiety or even PTSD. No treatment is without risk, but we are clear upfront.'
Positive preliminary results
Preliminary reports from the trials are encouraging. Compass Pathways' CEO Kabir Nath previously stated that three well-designed trials involving over 1,000 people showed 'consistent, highly statistically significant results' with a 'clinically meaningful effect'. Dr Wahba noted: 'Things are moving very quickly. The idea is to go to the FDA this year. They might work with non-trial patients in the US next year, which could see demand outstrip supply.'
A balanced view
Dr Wahba urged a balanced perspective: 'Psychedelics are either demonised or idolised. They are neither the devil nor the angel. Look at this for what it is.' He stressed that psychedelic drugs should not be taken outside medical supervision. Those interested in research trials can contact the CaPE team at cape@cntw.nhs.uk.
