“We started our company knowing that women over 40 are prescribed antidepressants at more than three to four times the rate of men, which has led to one in every five women taking an antidepressant to get through the day,” says Juan Pablo Cappello, cofounder and CEO of the ketamine therapy platform Nue Life, which is FDA approved and raised $23 million in April.
Through platforms like Nue Life, or in one of the hundreds of ketamine therapy clinics across the US, patients can take a controlled amount of a psychoactive substance under the careful guidance of a trained clinician to induce an altered state of consciousness (a trip). Having received tons of airtime in recent years for its supposed ability to treat PTSD, anxiety, and substance abuse, ketamine is now being studied as an effective way to alleviate symptoms of postpartum depression as well.
A recent study in the Journal of Affective Disorders suggests that in patients at high risk of postpartum depression, a single dose of ketamine administered before anesthesia during cesarean sections could be effective in preventing it. Another ketamine therapy startup, Field Trip, is also about to start in-person, phase I clinical trials for FT-104, a psychedelic molecule that’s similar to psilocybin but has a much shorter trip time. (Nikhita Singhal’s father, Sanjay Singhal, an entrepreneur who started audiobooks.com, is an advisor to Field Trip.) “FT-104 has all the characteristics that make psilocybin so interesting and attractive from a therapeutic perspective—safety and efficacy—but with a very short duration of action,” Field Trip cofounder and executive chairman Ronan Levy told me. According to Levy, Field Trip’s existing preclinical studies signal that FT-104 will leave the body after 12 hours, meaning breastfeeding can hypothetically resume within 24 hours—something that will need to eventually be validated in human trials and undergo scientific peer review.
Kelsey Ramsden, the former CEO of Vancouver-based psychedelics company Mindcure (which was researching MDMA-assisted psychotherapy to help women with a lack of sexual desire until it shut down earlier this year for lack of funds), also says the postpartum depression market is appealing for psychedelic development because there’s currently only one drug for the condition (Zulresso). Ramsden is a believer in part because psychedelics worked to alleviate her own symptoms after she had her first child. “The change in my lived experience resulted in recurring depressive cycles, and it wasn’t necessarily a hormonal thing that was the ongoing problem,” she says. “It was just the change in my experience as a result of becoming a mother in a society that expected me to be a certain way.” She says she tried SSRIs and traditional therapy at first, but she finally arrived on stable footing after trying psychedelic-assisted psychotherapy.
Ramsden believes that the entire psychedelic industry is still in its earliest days. But she can envision a culture where it is normal for women to openly take psychedelic drugs. When something health-related works for women, she believes, the good news spreads like wildfire.
Allison Feduccia, who has a PhD in neuropharmacology, believes that the best evidence we have of how psychedelics affect women is still mostly anecdotal. For example, there are accounts suggesting that peyote boosts milk productionan idea supported by preliminary research from the 1970s. For years, folks have reported the ways psychedelics have altered their menstrual cycle, linking them to heavier periods, a period that arrives early, or—alternatively—a more regular cycle. Research has shown that estrogen intensifies the brain’s dopamine reward pathway, so it’s also possible that a woman’s reaction to a particular drug is more pleasurable depending on the phase of her menstrual cycle.
Feduccia posits that psychedelics might be particularly helpful for the “rites of passage” that most women go through. “Psychedelics could bring a better perspective when you get your first period, have your first child, and then go through menopause,” she says. “I just hope that women can benefit [from psychedelics] without having to drop $20,000 for a guided approach.”
That guided approach is not only expensive but fraught with ethical concerns. Multiple high-profile cases of abuse in psychedelic therapy have made headlines in recent years. Richard Yensen, an unlicensed therapist who was a sub-investigator for MAPS, was accused of sexually assaulting a PTSD patient during a MAPS clinical trial on MDMA. Allegations of sexual abuse were also made against Aharon Grossbard and his wife, Françoise Bourzat, leaders of a prominent group in the Bay Area that has been practicing psychedelic-assisted therapy for over 30 years.