Based on the report itself, my impression is that high-quality academic research into microdosing and into flow-through effects* of psychedelic use is much more funding-constrained. Have you considered those?
Yes, but only relatively briefly. You’re right that these kinds of research are more neglected than studies of mental health treatments but we think that the benefits are much smaller in expectation. That’s not to say that there couldn’t be large benefits from microdosing or flow-through effects, just that these are much more speculative.
Note that we think it’s more likely than not (59%) that psilocybin will turn out to be less effective than existing treatments for depression (pg. 35). Even the mental health benefits are fairly uncertain and these other benefits you mention are even less likely to materialise. The kinds of research you suggest could be valuable but I think it makes sense to focus on the mental health treatments first.
On microdosing specifically, we mention our specific concerns (pg. 21):
Another psychedelics intervention that is often suggested as potentially promising is microdosing: taking psychedelics in very low doses. Here, however, the evidence is even sparser. We currently see no reason to think this will have benefits comparable to those of higher-dose psychedelic-assisted mental health treatments, as there is reason to believe that with classic psychedelics, the latter benefits are mediated by ‘mystical-type’ experiences, which microdosing doesn’t occasion. Furthermore, we don’t know much yet about the risks of prolonged microdosing, and from a legal perspective, making microdosing available for healthy people seems much further away than psychedelic-assisted mental health treatments.
I think the last point, about microdosing being further away than mental health treatments, applies to many flow-through effects. If, indeed, psychedelics could bring about wide-ranging benefits, then the best first step is probably to get them approved as mental health treatments anyway and so advancing this seems valuable. If approved, it will also be easier to carry out other kinds of research.
2. Did you consider more organisations than Usona and MAPS? It seems a little bit unlikely that these are the only two organisations lobbying for drug approval?
This is related to your other comment, so I’ll answer both together.
I was confused about the usage of the term drug development as it sounds to me like it’s about the discovery/creation of new drugs, which clearly does not seem to be the high-value aspect here.
Drug development can but need not involve the creation of new drugs. It’s the process that has to happen in order for banned or new substances to be approved for medical use. It involves high-quality studies to prove efficacy and safety. Drug development is very expensive—it costs at least tens of millions of dollars (usually more) to go through the FDA approval process. So actually, there just aren’t many organisations able to do this. Usona and MAPS aren’t just lobbying for approval, they’re conducting clinical research in order to approve psilocybin and MDMA for medical use.
Another org also doing drug development of psilocybin (but for treatment-resistant depression, rather than major depression) is Compass Pathways. Compass is for-profit though, so we didn’t consider it as a funding opportunity here.
Thanks for your questions, Siebe!
Yes, but only relatively briefly. You’re right that these kinds of research are more neglected than studies of mental health treatments but we think that the benefits are much smaller in expectation. That’s not to say that there couldn’t be large benefits from microdosing or flow-through effects, just that these are much more speculative.
Note that we think it’s more likely than not (59%) that psilocybin will turn out to be less effective than existing treatments for depression (pg. 35). Even the mental health benefits are fairly uncertain and these other benefits you mention are even less likely to materialise. The kinds of research you suggest could be valuable but I think it makes sense to focus on the mental health treatments first.
On microdosing specifically, we mention our specific concerns (pg. 21):
I think the last point, about microdosing being further away than mental health treatments, applies to many flow-through effects. If, indeed, psychedelics could bring about wide-ranging benefits, then the best first step is probably to get them approved as mental health treatments anyway and so advancing this seems valuable. If approved, it will also be easier to carry out other kinds of research.
This is related to your other comment, so I’ll answer both together.
Drug development can but need not involve the creation of new drugs. It’s the process that has to happen in order for banned or new substances to be approved for medical use. It involves high-quality studies to prove efficacy and safety. Drug development is very expensive—it costs at least tens of millions of dollars (usually more) to go through the FDA approval process. So actually, there just aren’t many organisations able to do this. Usona and MAPS aren’t just lobbying for approval, they’re conducting clinical research in order to approve psilocybin and MDMA for medical use.
Another org also doing drug development of psilocybin (but for treatment-resistant depression, rather than major depression) is Compass Pathways. Compass is for-profit though, so we didn’t consider it as a funding opportunity here.