Critique of the Royal Australian and New Zealand College of Psychiatrists Psychedelic Therapy Clinical Memorandum, Dated May 2020

Abstract

Objective: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has positioned itself against medically controlled patient access (at this current time) to 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin-assisted therapies in its Therapeutic Use of Psychedelic Substances Clinical Memorandum, May 2020. The main reason given by the RANZCP for its stance is safety concerns. Methods: Every reference in the clinical memorandum (CM) was checked against the original publications used by RANZCP to justify its position. In addition, the search engines Google Scholar, PubMed, ScienceDirect, the Multidisciplinary Association for Psychedelic Therapies (MAPS) website, the Therapeutic Goods Administration (TGA) website, relevant Australian and New Zealand legislation were searched for pertinent and up-to-date- information. Results: There is no scientific or medical evidence from the last 70 years to suggest that either psilocybin or MDMA, when administered as an adjutant to therapy in a controlled clinical setting, are linked to either mental illness or negative health outcomes. On the contrary, MDMA and psilocybin have been shown to be safe, non-toxic, non-addictive, and efficacious when administered in a medically-controlled clinical environment. All associated risks are apparent in an uncontrolled setting. Conclusion: The RANZCP’s position is based on outdated, irrelevant, misinterpreted, and misinformed evidence. With the recent positive media coverage of the efficacy of these medicines when used as an adjunct to therapy, there is an intrinsic risk of self-medication or underground therapy. This means that any medical discussion must also purvey the ethical responsibilities and social duties associated with these substances.

The Theoretical Synthesis and in silico Modelling of Lysergic Acid Biscinnamylidene Amide from the Adduct Formation of d-Lysergic Acid Amide and Cinnamaldehyde

“…A bioactivity score of under 0.50 is presumed to be inactive [Agwon, 2019]. The main serotonin psychedelic receptor is the serotonin subtype-2A (5-HT2A) receptor [10]. The 5-HT2A is a GPCR.…”

Review of Psilocybin Use for Depression among Cancer Patients after Approval in Oregon

“…These positive effects were often sustained for several months after the psilocybin sessions [89][90][91]. The legalization of psilocybin therapy in certain regions, such as Oregon, in the United States, and Canada, reflects the growing acceptance and recognition of its potential therapeutic benefits [92].…”

“…The state of Oregon has taken a progressive stance on psilocybin therapy by legalizing it through Oregon Measure 109, the Psilocybin Mushroom Services Program Initiative [92]. This initiative allows adults aged 21 years and older to take psilocybin under supervision in state-licensed service centers, making Oregon the first state in the United States to decriminalize the use of psilocybin-containing mushrooms [113].…”

A systematic literature review and meta-analysis of the effect of psilocybin and methylenedioxymethamphetamine on mental, behavioural or developmental disorders

“…By contrast, prohibited substances or drugs have no established therapeutic use and are only available for medical or scientific research, or for analytical, teaching or training purposes following approval from Commonwealth and/or State or Territory Health Authorities. The decision to not down-schedule was criticised on the basis that the TGA had placed excessive weight on sources that emphasised adverse effects in uncontrolled or recreational, as opposed to clinical settings (Chiruta et al, 2021). Importantly, the TGA deferred making a final decision, pending an independent report into the risks and therapeutic benefits of the drugs (Kisely et al, 2021).…”