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Use of psychedelics to treat mental health has been divisive, patients say the results speak for themselves

Mathew McLaughlin knew the drug was kicking in when he couldn’t find the words to speak. It had only been about 30 minutes after he swallowed one of two pills when he began to visualise the house he had lived in until the age of 16. “It started in black and white and then everything came into colour until it was full HD,” the 47-year-old said. “I was walking around the house and it was in full detail, with people and scenes from 40 years ago. It was a full sensory experience, I could even smell my Dad’s leather briefcase, it was so clear.” Mr McLaughlin, with his headphones and black-out mask on, is not hallucinating. Instead, he’s undergoing MDMA-assisted therapy to “reprocess and reframe” the trauma he had experienced in his 20-year career as a firefighter, which exposed him to accidents, fires and suicides. “I got my first diagnosis of post-traumatic stress disorder in 2011. At the time, I just thought I was depressed after a few breakdowns,” Mr McLaughlin said. But flashbacks became the biggest warning sign of his declining mental health. He recalls attending a job that involved two children dying in a house fire — scenes that started crossing into his own experiences as a parent. Another example was seeing scenes of suicide he had dealt with on the job in everyday settings. Australia in February 2023 became the first country to legalise the use of psychedelics to treat some mental health conditions. The Therapeutics Goods Administration approved the prescription of MDMA to treat post-traumatic stress disorder, while psilocybin — which is found in magic mushrooms — can be used for treatment-resistant depression. Prescribing is limited to authorised psychiatrists. Less than 12 months after the reclassification of MDMA and psilocybin as medicines, ASX-listed biotech Emyria received authorised prescriber status from the TGA. It allowed Emyria — which is backed by Andrew and Nicola Forrest’s private investment group Tattarang — to prescribe MDMA for PTSD and and psilocybin for treatment-resistant depression at its two Empax clinics in Perth. “MDMA is known as an empathogen. It increases feelings of trust and reduces fear in patients who take it in a temporary way,” Emyria executive director Michael Winlo said. “And so they can process difficult or challenging memories without being overwhelmed by fear or shame. “That’s a really important feature of the medicine in that it allows psychotherapy to be more effective and for people to really process deeply traumatic experiences.” Patients who qualify for MDMA-led therapy will typically have two 60-minute preparatory sessions before the first dosing session. They will meet with their therapists — usually a psychologist and psychotherapist — to discuss their history and treatment goals. A dosing session typically lasts about eight hours. Across the course of one session, the patient will have two doses of the drug and be guided through intensive therapy while under the influence of MDMA. Patients will normally undergo two or three dosing sessions. Following each dosing session is an hour-long integration session, or follow-up meetings, aimed at helping patients process their experience. “For conditions like PTSD, (there’s been) no new drug approvals for over 20 years, almost 25 years,” Dr Winlo said. “These treatments are, in many ways, a rethinking of how we tackle our most challenging mental health conditions.” Emyria medical director Jon Laugharne said the biotech had prescribed 40 patients with MDMA and two patients with psilocybin over the past two years. “We are seeing something like 80 per cent of the people so far having good, positive improvement, and (of those) at least 50 per cent significantly high improvement,” Dr Laugharne said. “For some people, (they’re seeing) a transformational improvement. “These are all people who . . . are seen as treatment resistant, they’re not the easiest to treat.” Dr Laugharne and Dr Winlo expect patient numbers to grow exponentially after the WA biotech recently inked a landmark deal with Australia’s biggest health insurer, Medibank. Dr Laugharne, who has worked as a psychiatrist for over 30 years, said “more and more people are starting to understand that this is a legitimate treatment, properly supervised”. Part of the insurer’s $50 million investment into mental health, the multi-year agreements with Medibank will provide full funding to eligible WA customers accessing Emyria’s MDMA and psilocybin-led treatment programs. The cost for treatment ranges between $20,000 and $30,000. “(This) major funding is absolutely a watershed moment,” Dr Winlo said. “I think it will attract additional funding, it will no doubt increase the number of patients we can provide these treatments to. “And if we do our job right and pay good attention to what’s happening with each patient, we’ll be able to contribute to the field and improve both the care treatments and patient outcomes over the long term.” Medibank group chief medical officer and practising psychiatrist Andrew Wilson last month said these types of treatments were expensive and as a result, were out of reach financially for many patients. “We are committed to helping our customers with their mental health and making treatment more accessible and affordable,” he said. “Poor mental health now ranks as one of the largest contributors to ill-health and loss of productivity worldwide.” But there also doubts and concerns around MDMA-led therapy. Richard Harvey, chair of the Royal Australian and New Zealand College of Psychiatrists’ psychedelic-assisted therapy steering group, said the evidence for using MDMA and psilocybin outside of research settings was still limited and emerging. He warned “we need to move forward carefully”. “While interest in psychedelic therapy is high, it’s not a first-line treatment recommended for people with either PTSD or treatment-resistant depression and not a magic cure,” Professor Harvey said. “Right now, psychedelic treatment is expensive for most Australians and only a small number of psychiatrists are authorised by the TGA to prescribe these medicines. “We’d encourage people to first explore other proven treatments for depression and PTSD that are both affordable and backed by robust evidence.” Chris Langmead, co-founder of the Neuromedicines Discovery Centre at Monash University, said it wasn’t “quite as clear cut as should you or shouldn’t you use psychedelic drugs to treat mental illness”. “It depends on the context and, most importantly, the evidence supporting clinical use on a case by case basis,” he said. “What we do know is that there is mounting evidence through numerous clinical trials to suggest benefits of (MDMA-assisted psychotherapy) in improving PTSD symptoms, response rate and remission rate compared to psychotherapy alone. “However, as per the TGA guideline, how clinical trial evidence translates into the clinic is conditional.” Mr McLaughlin is now back at work after two rounds of MDMA-led therapy at Emyria’s Empax Centre, one in December 2024 and in February this year. “My memories were organised into a sort of jukebox that played records, each representing, visually, a traumatic incident,” Mr McLaughlin recalled. “As each one played, I would get taken back to the scene, in full HD — accident scenes, fire scenes, suicides and more. “When I was there, things would rewind until the person was OK, their loved ones were with them and happy, and it would reframe my perceptions of the death.” Recalling the night his Dad died from a heart attack in 2016 was particularly vivid, Mr McLaughlin said, but therapy had given him a chance to reframe the course of events. “In my mind it was a terrible night, but in this (alternative) version of events it was just a really nice time,” he said. “We had been there for dinner and left the kids for a sleepover. “But in my MDMA-experience of the night, I stayed and watched him and mum clean up after dinner, he spent time with my kids, read them a book and tucked them in and he was really happy. (It was) an alternative version that wasn’t all doom and gloom.” After two doses, Mr McLaughlin said he felt like his “internal coil has unravelled” and described himself as being in remission. “I pretty much don’t raise a blip on any of the PTSD scales anymore,” he said. “I went from literally having a panic every time the bells went off for a call (at work) to loving every second of being there.”

The West Australian exclusiveUse of psychedelics to treat mental health has been divisive, patients say the results speak for themselves

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Use of psychedelics to treat mental health has been divisive, patients say the results speak for themselves