Recent advancements in understanding mental health and the brain have allowed us to identify possible commonalities between different mental health conditions. One of the shared experiences among patients with conditions like treatment-resistant depression (TRD), bipolar II disorder and PTSD is the inability to move on and the presence of repetitive thoughts or ruminations. These thoughts can be persistent, counterproductive and even self-destructive. Patients often describe feeling disconnected from the world including friends and family. Although our ability to measure brain activity in humans is limited, doctors can use magnetic resonance imaging (MRI) to observe blood flow, which is closely linked to brain activity. When there is an increase in blood flow in a specific area, it indicates increased local activity, particularly at synapses.
The brain is a highly energy-demanding organ, and different parts of the brain tend to fire together as modules rather than operating as completely independent entities. These modules control various functions such as vision, sensory/motor control of movement, the emotions, attention and even a default mode network associated with rumination and internal dialogues. This default mode network is where patients may experience the persistent and intrusive self-critical voice in their minds. In a number of mental health conditions, these functional modules appear to be more connected within and less between each other compared to individuals without the condition. Understanding the commonalities revealed by human imaging studies across conditions offers valuable insights for rethinking treatment approaches and providing proper care, especially for patients with unmet needs.
This is why the world of psychedelics is especially promising when it comes to mental health care. Drugs producing psychedelic experiences have shown promise in treating mental health conditions, perhaps by disrupting the connectivity of functional modules altered in depression, anxiety, and other conditions. For example, by reducing activity in the default mode network, it has been suggested that these drugs may also help individuals break negative thought patterns and ruminations. Animal studies suggest that they may help in promoting neuroplasticity and repairing neural circuits, which may lead to improved and sustained mental health outcomes in some patients. This potential is exciting and more research is needed to understand how psychedelics may be used.
COMPASS Pathways’ CMPS innovative approach has received FDA Breakthrough Therapy designation in the U.S. and Innovative Licensing and Access Pathway designation in the U.K. for their investigational COMP360 psilocybin in TRD. Moreover, in late 2021, COMPASS Pathways announced the completion of a randomized, controlled double-blind phase 2b study of investigational COMP360 psilocybin treatment involving 233 patients with TRD in 22 sites across Europe and North America.
While the company is currently focusing on TRD, it is also researching PTSD and anorexia nervosa, in part because of neurological similarities. Companies like COMPASS Pathways are working to develop interventions that address these common factors and support patients on their path toward improved mental well-being. For patients who have found no relief with current medications, this would be meaningful progress.
Featured photo by Pawel Czerwinski on Unsplash.
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