MAGIC MEDICINE

Herald Sun - - FRONT PAGE - GRANT McARTHUR

DY­ING pa­tients will be treated with syn­thetic “magic mush­rooms” in a Mel­bourne med­i­cal trial that aims to ease the paralysing anx­i­ety felt by many who are in pal­lia­tive care.

It is hoped that the use of the mind-bend­ing drug, guided by psychiatrists, will give ter­mi­nally ill pa­tients an al­tered per­spec­tive that will help dis­pel the fear and de­pres­sion that for many can come to dom­i­nate their fi­nal months.

It has taken more than a year for the con­tro­ver­sial St Vin­cent’s Hos­pi­tal trial to be ap­proved by ethics com­mit­tees and state and fed­eral au­thor­i­ties. Treat­ment of the first of 30 pa­tients will be­gin in April.

St Vin­cent’s clin­i­cal psy­chol­o­gist Dr Mar­garet Ross said pa­tients in the Mel­bourne study would be given a sin­gle dose of psilo­cy­bin — the psy­choac­tive in­gre­di­ent in magic mush­rooms. Its ef­fect on the brain is so pow­er­ful it can re­sult in an al­ter­ation of out­look last­ing six months or more.

US stud­ies found psilo­cy­bin was able to over­come se­vere de­pres­sion in about 70 per cent of cases: it was so suc­cess­ful the treat­ment was awarded break­through drug sta­tus.

“It is a lit­tle bit con­tro­ver­sial be­cause ob­vi­ously we are us­ing a psy­che­delic com­pound, and it is a com­pound which is a syn­thetic ver­sion of what is col­lo­qui­ally known as magic mush­rooms,” Dr Ross said.

Dr Ross said: “The US study was really pro­found: some peo­ple were able to tran­scend their ideas about dy­ing. It really re­laxes those old rigid ways we have built up in the way we look at the world. They had re­mis­sion of symp­toms (of psy­chi­atric dis­tress).

“It was rapid, it was dra­matic, and it was be­yond im­pres­sive, be­cause it lasted for up to six months,” she said.

Up to three in 10 pal­lia­tive­care pa­tients can ex­pe­ri­ence ex­treme dis­tress in their fi­nal months. Dr Ross said an­tianx­i­ety med­i­ca­tions or psy­chother­a­pies, such as talk­ing or mu­sic ther­apy, could re­lieve that in some, but not oth­ers.

“For many peo­ple, when they are di­ag­nosed and liv­ing with a ter­mi­nal ill­ness, it is ab­so­lutely dev­as­tat­ing.

“Peo­ple can live for months and years in pal­lia­tive care, and it is a long time to live with that hang­ing over your head.

“Peo­ple can be quite paral­ysed by anx­i­ety and de­spair, and feel de­mor­alised and with­drawn. It can have a pro­found im­pact on qual­ity of life and their ex­pe­ri­ences with their pre­cious time,” she said.

Stud­ies at the Im­pe­rial Col­lege in Lon­don showed psilo­cy­bin re­laxes a part of the brain known as the De­fault Mode Net­work, which is as­so­ci­ated with a per­son’s con­cept of them­selves and of their past.

The drug has al­most no phys­i­cal ef­fects. But it can have ad­verse psy­cho­log­i­cal im­pacts on pa­tients who have a his­tory of psy­chosis or con­di­tions such as bipo­lar dis­or­der, on those given too high a dose, and on those who are un­pre­pared or who take it in an un­suit­able en­vi­ron­ment.

The 25mg dose be­ing used at St Vin­cent’s will have a peak ef­fect about the 90- to 100minute mark. But pa­tients will be ac­com­pa­nied by two clin­i­cians in a safe, sup­ported en­vi­ron­ment for at least four more hours while ef­fects wear off.

Dr Ross said: “This could po­ten­tially help so many peo- ple, but it needs more re­search, and we need to un­der­stand the ex­act mech­a­nisms of how psilo­cy­bin helps peo­ple and how we can op­ti­mise treat­ment.”

St Vin­cent’s direc­tor of pal­lia­tive medicine As­so­ciate Pro­fes­sor Mark Boughey said: “There will be some de­gree of back­lash be­cause ev­ery­one will as­sume this is just about magic mush­rooms. But if you look at the stud­ies … it has min­i­mal … se­ri­ous ad­verse ef­fects … it has great po­ten­tial.”

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