Supercyrus and psychedelics

Cyrus Engerer is on another dicey mission. He’s all over the media trying to convince us he’s found the magic bullet for psychiatric illness. The future of mental health care, according to the Engerer, is psychedelics, a group of drugs such as LSD, ibogaine and psilocybin.

Engerer is no psychiatrist,  He’s no pharmacologist.  He’s no scientist. But he’s suddenly taken it upon himself to convince us that “finally a cure is being created”.

In a bizarre article, Engerer writes, “the reason why I want to make the case for psychedelic healthcare is because the results coming out of those clinical trials show that psychedelic healthcare may possibly be the pill that finally helps us understand”.

Engerer is so enthusiastic about psychedelics because he met one person he claims “got rid of his acute post-traumatic stress disorder” through psychedelic treatment.

Sadly for Engerer, medicine is not built on anecdotes. Recommendations about treatment aren’t based on the uncontrolled results of the treatment of a single individual.

Clinical recommendations for drug use are based on robust clinical trial data, including thousands of cases from multiple centres. Clinical research is hardly Engerer’s area of expertise, which begs the question, why is Engerer so passionate about psychedelics?

All psychedelic compounds are still considered Schedule I drugs by the American Food and Drug Administration. Schedule I drugs have no currently accepted medical use and have an extremely high potential for abuse.

It is true that ongoing trials are investigating the potential of psychedelic drugs to treat post-traumatic stress disorder, depression and addiction with FDA approval. But the results are still awaited.

A non-profit organisation, the Multidisciplinary Association for Psychedelic Studies (MAPS) only completed its second Phase 3 trial of one such drug (MDMA) in November 2022.  It expects to submit its new drug application to the FDA around June 2023.

Compass Pathways is scheduled to begin Phase 3 trials into psilocybin therapy by the end of 2022.

Research into psychedelics is still at an early stage, and much work still needs to be done.  For Engerer to present psychedelics as the panacea for all psychiatric diseases is not only unfounded but is reckless and irresponsible.

Early promise in preliminary trials is not a guarantee of definite clinical benefit.  Even if such benefit is proven and drugs approved, they’re likely to be for specific conditions in strictly defined clinical contexts.

Engerer must have some motivation for pushing for more funding opportunities for psychedelics.  He must have some reason for insisting that “the number of projects under this remit must expand”. He must have good reason to want “to push boundaries”.

A 2022 KPMG report stated that if the FDA approves MDMA treatment for post-traumatic stress disorder, it “would open the floodgates for further development”.  A handful of publicly traded companies are already taking advantage.

Banking giant Morgan Stanley released a pivotal psychedelics market research report in mid-2022.  It specified that the most immediate challenge is navigating clinical trials and achieving FDA approval before advancing to administration and treatment protocols.

Morgan Stanley identified significant long-term growth potential in the psychedelic drug market. There is scope for huge profits if clinical trials are successful and drugs are approved.

Those companies involved in the market must be busy lobbying for more funding to achieve their aim of hitting the jackpot. Engerer’s newfound passion for psychedelics and unsubstantiated overinflated claims raise suspicion.

Engerer has not declared any conflict of interest in his Malta Today article.  Yet Engerer’s ‘Nothing to Hide’ website indicates that on 8 November at 3pm he met lobbyists from AstraZeneca.

In the Global Psychedelic Drugs Market Analysis Report 2022, AstraZeneca was listed at the top of the market key players list.

But Engerer wants us to believe he’s some superhero.  “It takes courage to take a topic which has always been viewed as a taboo and still speak about it publicly when you know that the current is against you,” he said in his article published by Malta Today. “Bringing up these topics is not just about courage, it is about being on the right side of history.”

Superman never told anybody he was Superman.  Not Cyrus Engerer.

Our Supercyrus is happily trumpeting his pseudo-virtues as he pumps out disinformation. “Finally, a cure is being created,” he wrote.

First, this isn’t “a cure”. It’s treatment.  Second, there is no approved treatment as yet.  There are some promising ongoing trials.  But there are no psychedelics currently approved for the treatment of any condition.

Engerer’s article is littered with gross distortions. Regarding research into psychiatric treatment, he declared “little has been done in the field – until now”.  Wrong.

Research and development in the field have been ongoing for decades – that’s what’s given us sertraline, escitalopram, bupropion, fluoxetine, citalopram, clonidine, paroxetine, and so many other beneficial drugs.

Everybody’s heard about Valium, Xanax, Prozac and Ativan.  Except for Supercyrus, it seems.

Some of those drugs have been helping treat millions of patients for years. But according to Cyrus, who has just woken up to the complex world of mental health, nothing’s been done until now.

“At the risk of sounding very controversial when it comes to mental health, there are pills to pick you up, pills to bring you down, pills to make you sleep, pills to make you eat, pills to make you go quiet, and others to make you speak up,” Engerer wrote.

His uninformed comments don’t make him sound controversial, just plain stupid. That’s not how psychiatric treatment works. That’s just a dumb infantile impression of somebody without the remotest clue about brain function, psychiatric pathology or its treatment.

Engerer isn’t on the right side of history, as he claims.  He’s an agent of deception and puerility.

Prof Kevin Cassar is professor of surgery at the University of Malta.