The goal of this clinical trial is to learn if MLS101 (psilocybin) is a possible treatment for women with Premenstrual Dysphoric Disorder (PMDD). The main question it aims to answer is: • Test the safety and tolerability of the study drug, MLS101 in premenopausal women (ages 18-50 inclusive) with PMDD.
The purpose of this trial is to investigate the safety and tolerability of intermittent low-dose MLS101 (psilocybin) 2mg, 4mg, and 8mg versus placebo in participants with PMDD. These doses are less than one third of the doses typically administered in high-dose psilocybin studies. The study will enroll premenopausal women, ages 18-50 (inclusive) with an existing diagnosis of PMDD and history of having tried at least 1 prior treatment for PMDD. There is an initial Screening/Preparation Period of up to 2-5 weeks. The 16-day Treatment Period will span the luteal phase of 1 menstrual cycle. During this time, participants will receive 6 doses of MLS101 capsules in the clinic approximately every 3 days. After the Treatment Period, there is a Follow-up Period of approximately 1 month. Participants will be monitored after receiving each dose for at least 8 hours in the clinic and must meet specified criteria before discharge. All participants will be escorted home by a companion or via concierge care service after each dosing session.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
32
Patients will be randomized in a 1:1:1:1 ratio to receive 6 doses of either placebo or MLS101 at 2 mg, 4 mg, or 8 mg
Placebo group will receive a total of 6 intermittent doses of placebo
Number of participants with treatment-related adverse events as assessed by CTCAE v6.0
Safety and tolerability of MLS101 and placebo from baseline through Visit 11/Final Telehealth Visit (Day 44 ± 5) as assessed by type, frequency, severity, timing, and relationship to MLS101 of any adverse events (AEs), adverse events of special interest (AESIs) serious adverse events (SAEs)
Time frame: From baseline through the final telehealth visit at week 11
No change from baseline to end of study in mitral valve leaflet thickness as measured by transthoracic echocardiogram
Baseline transthoracic echocardiogram to measure mitral valve leaflet thickness. Mitral valve leaflet thickness of \< 3 mm is normal, whereas \>3 mm in mitral valve leaflet thickness is considered abnormal in an echocardiogram.
Time frame: From baseline to week 11
Change in Maximum Plasma Concentreation (Cmax)
Blood samples will be collected at 30 minutes, and 1, 2, 3, 4, 6, and 8 hours after a single dose of study drug to determine the change in Cmax
Time frame: Day 1 of treatment only
Change in subjective psychedelic experience from pretreatment to 8 hours after treatment
The Acute Subjective Effects Scale (ASES) is a visual analog scale from 0-10 with 0 being no psychedelic experience and 10 being the most intense. Participants will have to score less than or equal to 2 to be considered recovered from treatment effects.
Time frame: From pretreatment to 8 hours after treatment each treatment day
Participant reported drug liking
Drug liking will be assessed using the drug Liking Visual Analog Scale (VAS) which is a scale from 0 which indicates strong dislike to 100 which indicates strong liking and a score of 50 is neutral.
Time frame: Once at the end of treatment
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
No change from baseline in Standardized Field Sobriety Test (SFST)
The SFST will be administered before treatment and 8 hours after treatment. There are 3 sections of the test: Horizontal Gaze Nystagmus (HGN) with a score of 0-6; Walk and Turn (WAT) with a score of 0-8 and One Leg Stand (OLS) with a score of 0-4. In each section, a lower score is passing sobriety. To pass the SFST, a score of equal to or less than 4 is required. To pass the WAT and OLS, a score of equal to or less than 2 is required.
Time frame: From baseline pretreatment to 8 hours after treatment
Mini Mental Status Examination (MMSE) to assess general mental status
The MMSE is a scale with a maximum score of 30, with lower score indicating impairment. Participants will be administered the MMSE before treatment and at 8 hours post treatment. Participants must have a score of equal to or greater than 24 to receive treatment, and a score 24-30 AND no more than -3 points worse than pretreatment after 8 hours to be considered unimpaired.
Time frame: From pretreatment to 8 hours after treatment.
Change in suicidal ideation and behavior as assessed by the Columbia-Suicide Severity Rating Scale (C SSRS)
The CSSRS will be administered prior to treatment on each dosing day, at 8 hours after treatment, and at all follow-up telehealth and in-clinic visits. Participants with C-SSRS ideation score of 4 or 5, or suicidal behavior will not receive treatment. Participants with an acceptable score for treatment will need a score of less than or equal to 3 and no more than 1 point worse than baseline at 8 hours after treatment.
Time frame: From pretreatment baseline to 8 hours after treatment and at each telehealth and clinic visits
Change in sleep quality from baseline to end of treatment
The Pittsburgh Sleep Quality Index (PSQI) will be administered at baseline and at end of treatment. This is a subjective assessment of sleep quality. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties.
Time frame: From baseline to day 17
Change in subjective psychedelic experience from pretreatment to 8 hours after treatment
The 5-Dimensional Altered States of Consciousness (5D-ASC) scale is a 94-item subjective questionnaire to evaluate the subjective psychedelic experience that rates 11 dimensions from 0-100 with higher scores indicating a more intense subjective psychedelic experience.
Time frame: Day 1 of treatment only, prior to treatment to 8 hours after treatment
Change in drug withdrawal symptoms from the day after the last treatment to the final telehealth visit
The Common Drug Withdrawal Symptom Scale - Psilocybin Version (CDWS-Psil) is a subjective scale the evaluates symptoms of drug withdrawal from psilocybin. The scale is comprised of 32 symptoms that the participant rates as no experience (none) a mild experience, a moderate experience and a severe experience.
Time frame: From the day after the last study treatment to the final telehealth visit