World-first LSD trial in Auckland could open door to its use as medicine

Suresh Muthukumaraswamy, from the Auckland University School of Medicine, was involved in a couple of the most important recent psychedelic studies. Photo / Greg Bowker

Auckland University is looking to trial the effects of small doses of LSD on healthy people, which could eventually pave the way for its potential use as a medicine.

Its application comes on the back of overseas research showing promising results from using psychedelic substances LSD and psilocybin, the active ingredient in magic mushrooms, to treat conditions as diverse as PTSD, existential distress in palliative patients and addiction to smoking.

The application for the world's first randomised-controlled trial of LSD microdosing, at Auckland University's Faculty of Medical and Health Sciences, is seeking final approval and aims to start next year.

It is being led by Associate Professor Dr Suresh Muthukumaraswamy, who spoke at an event hosted by Victoria University last month called Psychedelics in Medicine: What's The Buzz?

Dr Fiona Hutton, senior lecturer at the Victoria's school of social and cultural studies, opened the event with an overview of the social stigma associated with psychedelic substances and the promising research overseas.

She said there were 2018 and 2019 studies about the potential of psychedelics to repair brain function or help combat degenerative diseases such as Alzheimer's, and noted another study where they had helped palliative patients.

Two 2016 trials, one from John Hopkins University and one from New York University, gave palliative care or incurable cancer patients a single dose of magic mushrooms, and 80 per cent had no depression or anxiety for six months.

Given the mental health crisis in New Zealand, Hutton asked why this kind of research was not being pursued in New Zealand.

Don't try this at home

But Muthukumaraswamy told the Herald it was too early to say anything definitive about LSD as a medicine.

"The data looks promising, but it's not clear yet about whether the risk-benefit ratio is there and we're not sure yet whether it might work over and above a good placebo."

He noted a study with positive results in treating depression, but it only involved 20 people.

"Drug tests in pharmaceutical companies usually involve hundreds of people in each study across multiple studies and multiple centres in order the get the data that you need to say it works, that we have a really good side-effect profile, and we know how to do this in the safest possible manner.

"We're just not even close to there yet. The lesson is, don't try this at home. That's really risky, and I've had emails from people who have tried that and it hasn't worked out very well."

LSD tablets. Photo / Sarah Bicknell

This caution was reinforced by Auckland doctor Will Evans, one of the co-authors of the pilot study and an advanced trainee in palliative care.

"They are actually dangerous. People taking them recreationally are taking their mind into their own hands and predisposing themselves to a suboptimal experience. They require respect and caution."

But Evans said thousands of psilocybin doses in overseas research, given in medical settings, had not led to a single serious adverse effect.

"Blood pressure could go up a bit, and anxiety if previous traumatic experiences resurface.

"That's where psychotherapy and medical supervision comes in to keep people safe, as well as screening of predisposition to psychosis or a family history of schizophrenia, anxiety disorders."

He agreed that overseas research was young but promising.

"The numbers are small but they were with different patient populations and different clinicians, and they came up with almost an identical therapeutic effect profile. That in itself has statistical power that we should pay attention to.

"It's all looking like legalisation [of psychedelic substances for medical purposes] through the Food and Drug Administration (in the US) in the next five years, or even sooner. If that happens, it would be logical and rational for the New Zealand Government to follow."

Let the data speak for itself

The overseas evidence was centred on the therapeutic potential of taking full doses, and the Auckland pilot would be the first of its kind to look at microdoses of LSD.

Muthukumaraswamy hoped that a pilot could lead to further research.

"We're interested in a controlled design where people take a course for, say, six weeks, and are measured against a placebo to see if that stacks up or if it's just placebo expectancy effects.

"You have to start with healthy volunteers so that you understand what the potential dosing should be, how to construct the environment and run the screening correctly."

If there were indications of improvements in mood over and above the placebo effect, he said there might be potential for microdosing to treat a mood-related disorder.

Similarly, other indications might show potential to treat neuro-degenerative or cognitive disorders.

"Those seem like the likely scenarios from anecdotes, but we would let the data drive that."

The application was awaiting final approval with the Health Ministry.

Asked if the social stigma about LSD was a barrier to getting approval, Muthukumaraswamy said: "I'll let you know in two months' time. I would like to think not. I would like to think it would be an open, fair process."

Meanwhile Evans has set up a Givealittle page in the hope of getting more funding for this type of research.

Psychedelics NZ is also in the process of setting up the Entheos Foundation to look for donors, as well as generate public debate on the potential for psychedelics as medicine.