Numinus CEO: Psychedelic-assisted Psychotherapy Still Driven by Perceptions

Numinus Co-founder and CEO Payton Nyquvest/Courtesy of Numinus.

Neuroscience research is booming, and psychedelic-assisted psychotherapy is on a path toward mainstream legitimacy. The sea-change is the result of shifting perceptions, loosening of some regulatory restrictions regarding the substances and a global mental health crisis.

BioSpace caught up with Payton Nyquvest, co-founder and CEO of Numinus, to discuss these trends and the company’s work with psychedelic therapy.

BioSpace (BSP): What’s behind the boom in neuroscience today?

Payton Nyquvest (PN): Rates of anxiety, depression, suicidality and substance use are continuing to climb, but there haven’t been any significant innovations in mental health since the invention of selective serotonin reuptake inhibitors (SSRIs) in the late 1980s. Those drugs have their place, but they also have some real limitations. They manage symptoms, which helps people at the moment, but doesn’t address the root cause of the condition.

BSP: What role can psychedelics play in mental health therapy?

PN: Psychedelics aren’t a panacea, but they are proving to have the potential for curative intent, which is something we don’t talk about in mental health. Typically, when you’re diagnosed as depressed or anxious, the assumption is that you’ll be treated for that indication the rest of your life. Psychedelic-assisted therapy seems to be able to deliver actual cures.

BSP: What drew you to this field?

PN: I came to the field as a patient. Psychedelics saved my life. I had suffered chronic pain pretty much since birth and had a lot of associated mental health challenges, including complex post-traumatic stress disorder (PTSD). In my mid-to-late teens I realized my mental health was contributing significantly to my chronic pain symptoms, but I couldn’t get those symptoms rectified no matter what I did. I was being hospitalized three to four times per week and felt I was without options. I turned to psychedelics as a last-ditch effort to try and save my life.

Once on the other side of that experience, I wanted to give back. I never planned on quitting my job, starting a company and doing everything we’ve done, but I saw that philanthropy just wasn’t going to cut it. There was more that I could do.

BSP: How is the regulatory environment changing for controlled drugs and substances?

PN: For my first treatment, I had to go out of Canada to underground therapists. Now a number of U.S. states have decriminalized psychedelics and Canada has placed it on the lowest criminal priority. Health Canada has made significant strides in a very short period of time, changing the Special Access Program. I never planned to take Numinus public, but regulations have moved significantly quicker than I anticipated, so now we’re a public company.

BSP: People often draw parallels between cannabis and psychedelics. Are they valid comparisons?

PN: The only similarity is that they are naturally sourced compounds that go through a drug rescheduling process. What’s happening around cannabis, however, shifted people’s perspectives around drug policy. As a result, for psychedelics, we’re seeing models of accessibility that may fit somewhere between pharmaceutical-like drug approvals and more widespread adoption. Oregon, for example, has stated its intention to legalize psilocybin-assisted psychotherapy, even without waiting for clinical trials to be complete. That opens the potential for insurance providers to subsidize the cost of drug-assisted therapy.

BSP: What results are you seeing from your compounds?

PN: Our most compelling results are in a Phase III (compassionate access) clinical trial with treatment-resistant PTSD. With three treatments of 3,4-Methyl enedioxy methamphetamine- (MDMA) assisted psychotherapy, more than 80% of participants saw a significant clinical reduction in symptoms and 67% no longer met the PTSD criteria. This was, essentially, a cure for them. Those numbers increase over time. We can see treating a host of different mental health challenges.

A single treatment consists of a preparatory session, a dosing session and an integration session. For three sessions, you repeat that three times over about a two-month timeframe. Traditional therapy (without psychedelics) could take, potentially, a lifetime. It’s hard to put a number to that.

It’s important to understand that drug-assisted therapy is not a panacea. You have to continue to be dedicated to your mental health work, but we’ve seen these treatments help people make significant, tangible improvements so they can see the light at the end of the tunnel.

BSP: How does Numinus’ approach integrate with mental health care?

PN: Administering drug-assisted therapy isn’t as easy as offering a psychedelic treatment and sending patients on their way. These are powerful experiences, but if you don’t integrate them into people's lives and get them the help to make tangible improvements, they could just be experiences. Therefore, we are very focused on the service aspect of psychedelic-assisted therapy.

Patients will access psychedelic therapy through a service provider, such as clinics (dedicated to this type of therapy). Psychedelic therapy is among the most significant experiences in the lives of some of these people, and the setting is extremely important. You want someone to feel safe, comfortable and supported. Sterile hospital settings aren’t conducive to that.

BSP: Numinus is developing many different compounds. Why?

PN: Trauma is at the root of much of why we feel the way we feel, and for different expressions of trauma, there are different compounds that could be effective. Determining which substance should be used with specific patients is part of our work. For example, ketamine has been used to treat depression, but as the research advances, I think we may find (the choice of substance) is less about the indication and more about the person’s own orientation – hypervigilant vs calm, or childhood trauma vs. wartime experiences, for instance. That’s where there is great room for innovation.

At Numinus, we offer ketamine-assisted psychotherapy, and work with MDMA and psilocybin as well. Our lab is also licensed to work with virtually all the psychedelic compounds, including mescaline, DMT, LSD, San Pedro (mescaline containing cactus) and ayahuasca (a DMT-containing psychedelic brew from the Amazon).

BSP: How will the just-announced acquisition of Novamind affect Numinus?

PN: Upon completion of that acquisition – expected in early June – we will have 13 clinics, 4 clinical research sites, our bioanalytical testing facility and our production facility.

This marks our first major step into the U.S. and will make us the largest revenue-generating company in the psychedelic space. It gives us a very clear path to profitability and creates a strong foundational platform for us.

BSP: What’s next for Numinus?

PN: Integrating Novamind is our next big step. We’re also carrying out a host of clinical studies, including Phase IIIb studies on MDMA with a partner, are getting our psilocybin Phase I trial underway and are continuing to grow our clinical network. We’re also conducting research with most of the major stakeholders in this space, including the University of Utah. There are lots of opportunities to expand. This industry is at an extremely exciting time.