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Lowe MX, Kettner H, Jolly DRP, Carhart-Harris RL, Jackson H. Long-term benefits to psychological health and well-being after ceremonial use of Ayahuasca in Middle Eastern and North African immigrants and refugees. Front Psychiatry 2024; 15:1279887. [PMID: 38666090 PMCID: PMC11044680 DOI: 10.3389/fpsyt.2024.1279887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
Background Refugees and immigrants can experience complex stressors from the process of immigration that can have lasting and severe long-term mental health consequences. Experiences after ayahuasca ingestion are shown to produce positive effects on psychological wellbeing and mental health, including anecdotal reports of improved symptoms of trauma and related disorders. However, data on the longitudinal health impact of naturalistic ayahuasca use in Middle Eastern and North African (MENA) immigrant and refugee populations is limited. Aims The current longitudinal online survey study was conducted to gather prospective data on ceremonial ayahuasca use in a group (N = 15) of primarily female MENA immigrants and refugees and to provide further insight into the patterns and outcomes surrounding that use. The study sought to assess self-reported changes in physical and mental health, well-being, and psychological functioning, examine relationships between aspects of individual mindset (e.g., psychedelic preparedness) prior to ayahuasca use and observed outcomes during (e.g., subjective drug effects) and afterwards (i.e., persisting effects), characterize risks and negative experiences, and describe trauma exposure and personal history. Results/Outcomes Our findings revealed ceremonial use of ayahuasca is associated with significant improvements in mental health, well-being, and psychological functioning, including reductions in depression, anxiety, and shame, and increases in cognitive reappraisal and self-compassion. Most participants reported no lasting adverse effects and experienced notable positive behavioral changes persisting months after ingestion. Conclusion/Interpretation While preliminary, results suggest naturalistic ayahuasca use might hold therapeutic potential for MENA populations exposed to trauma prior to and during the process of migration.
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Affiliation(s)
| | - Hannes Kettner
- Psychedelics Division, Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | | | - Robin L. Carhart-Harris
- Psychedelics Division, Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
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Luppi AI, Rosas FE, Noonan MP, Mediano PAM, Kringelbach ML, Carhart-Harris RL, Stamatakis EA, Vernon AC, Turkheimer FE. Oxygen and the Spark of Human Brain Evolution: Complex Interactions of Metabolism and Cortical Expansion across Development and Evolution. Neuroscientist 2024; 30:173-198. [PMID: 36476177 DOI: 10.1177/10738584221138032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Scientific theories on the functioning and dysfunction of the human brain require an understanding of its development-before and after birth and through maturation to adulthood-and its evolution. Here we bring together several accounts of human brain evolution by focusing on the central role of oxygen and brain metabolism. We argue that evolutionary expansion of human transmodal association cortices exceeded the capacity of oxygen delivery by the vascular system, which led these brain tissues to rely on nonoxidative glycolysis for additional energy supply. We draw a link between the resulting lower oxygen tension and its effect on cytoarchitecture, which we posit as a key driver of genetic developmental programs for the human brain-favoring lower intracortical myelination and the presence of biosynthetic materials for synapse turnover. Across biological and temporal scales, this protracted capacity for neural plasticity sets the conditions for cognitive flexibility and ongoing learning, supporting complex group dynamics and intergenerational learning that in turn enabled improved nutrition to fuel the metabolic costs of further cortical expansion. Our proposed model delineates explicit mechanistic links among metabolism, molecular and cellular brain heterogeneity, and behavior, which may lead toward a clearer understanding of brain development and its disorders.
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Affiliation(s)
- Andrea I Luppi
- Department of Clinical Neurosciences and Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - Fernando E Rosas
- Department of Informatics, University of Sussex, Brighton, UK
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - MaryAnn P Noonan
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Pedro A M Mediano
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychology, Queen Mary University of London, London, UK
- Department of Computing, Imperial College London, London, UK
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Robin L Carhart-Harris
- Psychedelics Division-Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Emmanuel A Stamatakis
- Department of Clinical Neurosciences and Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Anthony C Vernon
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Marrocu A, Kettner H, Weiss B, Zeifman RJ, Erritzoe D, Carhart-Harris RL. Psychiatric risks for worsened mental health after psychedelic use. J Psychopharmacol 2024; 38:225-235. [PMID: 38491857 PMCID: PMC10944581 DOI: 10.1177/02698811241232548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND Resurgent psychedelic research has largely supported the safety and efficacy of psychedelic therapy for the treatment of various psychiatric disorders. As psychedelic use and therapy increase in prevalence, so does the importance of understanding associated risks. Cases of prolonged negative psychological responses to psychedelic therapy seem to be rare; however, studies are limited by biases and small sample sizes. The current analytical approach was motivated by the question of whether rare but significant adverse effects have been under-sampled in psychedelic research studies. METHODS A "bottom margin analysis" approach was taken to focus on negative responders to psychedelic use in a pool of naturalistic, observational prospective studies (N = 807). We define "negative response" by a clinically meaningful decline in a generic index of mental health, that is, one standard error from the mean decrease in psychological well-being 4 weeks post-psychedelic use (vs pre-use baseline). We then assessed whether a history of diagnosed mental illness can predict negative responses. RESULTS We find that 16% of the cohort falls into the "negative responder" subset. Parsing the sample by self-reported history of psychiatric diagnoses, results revealed a disproportionate prevalence of negative responses among those reporting a prior personality disorder diagnosis (31%). One multivariate regression model indicated a greater than four-fold elevated risk of adverse psychological responses to psychedelics in the personality disorder subsample (b = 1.425, p < 0.05). CONCLUSION We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population.
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Affiliation(s)
- Alessia Marrocu
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Hannes Kettner
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Brandon Weiss
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Richard J Zeifman
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Carhart-Harris Lab, Departments of Neurology and Psychiatry, University of California San Francisco, San Francisco, CA, USA
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Vohryzek J, Cabral J, Lord LD, Fernandes HM, Roseman L, Nutt DJ, Carhart-Harris RL, Deco G, Kringelbach ML. Brain dynamics predictive of response to psilocybin for treatment-resistant depression. Brain Commun 2024; 6:fcae049. [PMID: 38515439 PMCID: PMC10957168 DOI: 10.1093/braincomms/fcae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/16/2023] [Accepted: 02/14/2024] [Indexed: 03/23/2024] Open
Abstract
Psilocybin therapy for depression has started to show promise, yet the underlying causal mechanisms are not currently known. Here, we leveraged the differential outcome in responders and non-responders to psilocybin (10 and 25 mg, 7 days apart) therapy for depression-to gain new insights into regions and networks implicated in the restoration of healthy brain dynamics. We used large-scale brain modelling to fit the spatiotemporal brain dynamics at rest in both responders and non-responders before treatment. Dynamic sensitivity analysis of systematic perturbation of these models enabled us to identify specific brain regions implicated in a transition from a depressive brain state to a healthy one. Binarizing the sample into treatment responders (>50% reduction in depressive symptoms) versus non-responders enabled us to identify a subset of regions implicated in this change. Interestingly, these regions correlate with in vivo density maps of serotonin receptors 5-hydroxytryptamine 2a and 5-hydroxytryptamine 1a, which psilocin, the active metabolite of psilocybin, has an appreciable affinity for, and where it acts as a full-to-partial agonist. Serotonergic transmission has long been associated with depression, and our findings provide causal mechanistic evidence for the role of brain regions in the recovery from depression via psilocybin.
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Affiliation(s)
- Jakub Vohryzek
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Joana Cabral
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, University of Minho, Portugal
| | - Louis-David Lord
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Henrique M Fernandes
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
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5
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Timmermann C, Zeifman RJ, Erritzoe D, Nutt DJ, Carhart-Harris RL. Effects of DMT on mental health outcomes in healthy volunteers. Sci Rep 2024; 14:3097. [PMID: 38326357 PMCID: PMC10850177 DOI: 10.1038/s41598-024-53363-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
Psilocybin, a serotonergic psychedelic, is being increasingly researched in clinical studies for the treatment of psychiatric disorders. The relatively lengthy duration of oral psilocybin's acute effects (4-6 h) may have pragmatic and cost-effectiveness limitations. Here, we explored the effects of intravenous (IV) N,N-Dimethyltryptamine (DMT), a closely related, but faster-acting psychedelic intervention, on mental health outcomes in healthy volunteers. Data is reported from two separate analyses: (1) A comparison of mental health-related variables 1 week after 7, 14, 18, and 20 mg of IV DMT versus IV saline placebo (n = 13) and, (2) A prospective dataset assessing effects before versus 2 weeks after 20 mg of IV DMT (n = 17). Mental health outcomes included measures of depression severity (QIDS-SR16), trait anxiety (STAI-T), Neuroticism (NEO-FFI), wellbeing (WHO-5), meaning in life (MLQ), optimism (LOT-R), and gratitude (GQ-6). In both the prospective and placebo-controlled datasets, significant improvements in scores of depression were found 1-2 weeks after DMT administration. Significant reductions in trait Neuroticism were only found for the placebo-controlled sample. Finally, changes in depression and trait anxiety correlated with acute peak experiences (assessed via 'Oceanic Boundlessness'). While the use of two separate cohorts in pooled analysis limits the generalizability of these correlational findings, these results suggest that DMT may reduce depressive symptomatology by inducing peak experiences. The short half-life of IV DMT and its potential for flexible dosing via controlled infusions makes it an appealing candidate for psychedelic medicine. Further research in clinical samples is needed to corroborate the therapeutic potential of DMT.
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Affiliation(s)
- Christopher Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.
| | - Richard J Zeifman
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- NYU Langone Center for Psychedelic Medicine, NYU Grosssman School of Medicine, New York, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Centre for Psychiatry, Division of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, USA
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6
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Mediano PAM, Rosas FE, Timmermann C, Roseman L, Nutt DJ, Feilding A, Kaelen M, Kringelbach ML, Barrett AB, Seth AK, Muthukumaraswamy S, Bor D, Carhart-Harris RL. Effects of External Stimulation on Psychedelic State Neurodynamics. ACS Chem Neurosci 2024; 15:462-471. [PMID: 38214686 PMCID: PMC10853937 DOI: 10.1021/acschemneuro.3c00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 01/13/2024] Open
Abstract
Recent findings have shown that psychedelics reliably enhance brain entropy (understood as neural signal diversity), and this effect has been associated with both acute and long-term psychological outcomes, such as personality changes. These findings are particularly intriguing, given that a decrease of brain entropy is a robust indicator of loss of consciousness (e.g., from wakefulness to sleep). However, little is known about how context impacts the entropy-enhancing effect of psychedelics, which carries important implications for how it can be exploited in, for example, psychedelic psychotherapy. This article investigates how brain entropy is modulated by stimulus manipulation during a psychedelic experience by studying participants under the effects of lysergic acid diethylamide (LSD) or placebo, either with gross state changes (eyes closed vs open) or different stimuli (no stimulus vs music vs video). Results show that while brain entropy increases with LSD under all of the experimental conditions, it exhibits the largest changes when subjects have their eyes closed. Furthermore, brain entropy changes are consistently associated with subjective ratings of the psychedelic experience, but this relationship is disrupted when participants are viewing a video─potentially due to a "competition" between external stimuli and endogenous LSD-induced imagery. Taken together, our findings provide strong quantitative evidence of the role of context in modulating neural dynamics during a psychedelic experience, underlining the importance of performing psychedelic psychotherapy in a suitable environment.
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Affiliation(s)
- Pedro A. M. Mediano
- Department
of Computing, Imperial College London, London SW7 2AZ, U.K.
- Department
of Psychology, University of Cambridge, Cambridge CB2 3EB, U.K.
| | - Fernando E. Rosas
- Department
of Informatics, University of Sussex, Brighton BN1 9RH, U.K.
- Centre
for Psychedelic Research, Department of Brain Sciences, Imperial College London, London SW7 2AZ, U.K.
- Centre
for Complexity Science, Imperial College
London, London SW7 2AZ, U.K.
- Centre for
Eudaimonia and Human Flourishing, University
of Oxford, Oxford OX1 2JD, U.K.
| | - Christopher Timmermann
- Centre
for Psychedelic Research, Department of Brain Sciences, Imperial College London, London SW7 2AZ, U.K.
| | - Leor Roseman
- Centre
for Psychedelic Research, Department of Brain Sciences, Imperial College London, London SW7 2AZ, U.K.
| | - David J. Nutt
- Centre
for Psychedelic Research, Department of Brain Sciences, Imperial College London, London SW7 2AZ, U.K.
| | | | | | - Morten L. Kringelbach
- Centre for
Eudaimonia and Human Flourishing, University
of Oxford, Oxford OX1 2JD, U.K.
- Department
of Psychiatry, University of Oxford, Oxford OX1 2JD, U.K.
- Center
for Music in the Brain, Department of Clinical Medicine, Aarhus University, Aarhus 8000, Denmark
| | - Adam B. Barrett
- Sussex
Center for Consciousness Science and Department of Informatics, University of Sussex, Brighton BN1 9RH, U.K.
| | - Anil K. Seth
- Sussex
Center for Consciousness Science and Department of Informatics, University of Sussex, Brighton BN1 9RH, U.K.
- CIFAR Program on Brain, Mind, and Consciousness, Toronto M5G 1M1, Canada
| | - Suresh Muthukumaraswamy
- School
of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Daniel Bor
- Department
of Psychology, University of Cambridge, Cambridge CB2 3EB, U.K.
- Department
of Psychology, Queen Mary University of
London, London E1 4NS, U.K.
| | - Robin L. Carhart-Harris
- Centre
for Psychedelic Research, Department of Brain Sciences, Imperial College London, London SW7 2AZ, U.K.
- Psychedelics
Division, Neuroscape, University of California
San Francisco, San Francisco, California 94117-1080, United States
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Luppi AI, Girn M, Rosas FE, Timmermann C, Roseman L, Erritzoe D, Nutt DJ, Stamatakis EA, Spreng RN, Xing L, Huttner WB, Carhart-Harris RL. A role for the serotonin 2A receptor in the expansion and functioning of human transmodal cortex. Brain 2024; 147:56-80. [PMID: 37703310 DOI: 10.1093/brain/awad311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023] Open
Abstract
Integrating independent but converging lines of research on brain function and neurodevelopment across scales, this article proposes that serotonin 2A receptor (5-HT2AR) signalling is an evolutionary and developmental driver and potent modulator of the macroscale functional organization of the human cerebral cortex. A wealth of evidence indicates that the anatomical and functional organization of the cortex follows a unimodal-to-transmodal gradient. Situated at the apex of this processing hierarchy-where it plays a central role in the integrative processes underpinning complex, human-defining cognition-the transmodal cortex has disproportionately expanded across human development and evolution. Notably, the adult human transmodal cortex is especially rich in 5-HT2AR expression and recent evidence suggests that, during early brain development, 5-HT2AR signalling on neural progenitor cells stimulates their proliferation-a critical process for evolutionarily-relevant cortical expansion. Drawing on multimodal neuroimaging and cross-species investigations, we argue that, by contributing to the expansion of the human cortex and being prevalent at the apex of its hierarchy in the adult brain, 5-HT2AR signalling plays a major role in both human cortical expansion and functioning. Owing to its unique excitatory and downstream cellular effects, neuronal 5-HT2AR agonism promotes neuroplasticity, learning and cognitive and psychological flexibility in a context-(hyper)sensitive manner with therapeutic potential. Overall, we delineate a dual role of 5-HT2ARs in enabling both the expansion and modulation of the human transmodal cortex.
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Affiliation(s)
- Andrea I Luppi
- Department of Clinical Neurosciences and Division of Anaesthesia, University of Cambridge, Cambridge, CB2 0QQ, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, CB2 1SB, UK
- The Alan Turing Institute, London, NW1 2DB, UK
| | - Manesh Girn
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
- Psychedelics Division-Neuroscape, Department of Neurology, University of California SanFrancisco, San Francisco, CA 94158, USA
| | - Fernando E Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
- Data Science Institute, Imperial College London, London, SW7 2AZ, UK
- Centre for Complexity Science, Imperial College London, London, SW7 2AZ, UK
| | - Christopher Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - David J Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - Emmanuel A Stamatakis
- Department of Clinical Neurosciences and Division of Anaesthesia, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - R Nathan Spreng
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
| | - Lei Xing
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, 01307, Germany
| | - Wieland B Huttner
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, 01307, Germany
| | - Robin L Carhart-Harris
- Psychedelics Division-Neuroscape, Department of Neurology, University of California SanFrancisco, San Francisco, CA 94158, USA
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
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8
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Weiss B, Ginige I, Shannon L, Giribaldi B, Murphy-Beiner A, Murphy R, Baker-Jones M, Martell J, Nutt DJ, Carhart-Harris RL, Erritzoe D. Personality Change in a Trial of Psilocybin Therapy vs Escitalopram Treatment for Depression - CORRIGENDUM. Psychol Med 2024; 54:217. [PMID: 37466289 DOI: 10.1017/s0033291723002039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
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9
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Luan LX, Eckernäs E, Ashton M, Rosas FE, Uthaug MV, Bartha A, Jagger S, Gascon-Perai K, Gomes L, Nutt DJ, Erritzøe D, Carhart-Harris RL, Timmermann C. Psychological and physiological effects of extended DMT. J Psychopharmacol 2024; 38:56-67. [PMID: 37897244 PMCID: PMC10851633 DOI: 10.1177/02698811231196877] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/30/2023]
Abstract
N,N-Dimethyltryptamine (DMT) is a serotonergic psychedelic that induces a rapid and transient altered state of consciousness when inhaled or injected via bolus administration. Its marked and novel subjective effects make DMT a powerful tool for the neuroscientific study of consciousness and preliminary results show its potential role in treating mental health conditions. In a within-subjects, placebo-controlled study, we investigated a novel method of DMT administration involving a bolus injection paired with a constant-rate infusion, with the goal of extending the DMT experience. Pharmacokinetic parameters of DMT estimated from plasma data of a previous study of bolus intravenous DMT were used to derive dose regimens necessary to keep subjects in steady levels of immersion into the DMT experience over an extended period of 30 min, and four dose regimens consisting of a bolus loading dose and a slow-rate infusion were tested in eleven healthy volunteers (seven male, four female, mean age ± SD = 37.09 ± 8.93 years). The present method is effective for extending the DMT experience in a stable and tolerable fashion. While subjective effects were maintained over the period of active infusion, anxiety ratings remained low and heart rate habituated within 15 min, indicating psychological and physiological safety of extended DMT. Plasma DMT concentrations increased consistently starting 10 min into DMT administration, whereas psychological effects plateaued into the desired steady state, suggesting the development of acute psychological tolerance to DMT. Taken together, these findings demonstrate the safety and effectiveness of continuous IV DMT administration, laying the groundwork for the further development of this method of administration for basic and clinical research.
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Affiliation(s)
- Lisa X Luan
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Emma Eckernäs
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Michael Ashton
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Fernando E Rosas
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
- Department of Informatics, University of Sussex, Brighton, UK
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Malin V Uthaug
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht, Netherlands
- Somnivore Ply Ltd, Australia
| | - Alexander Bartha
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Samantha Jagger
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Kiara Gascon-Perai
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Lauren Gomes
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - David Erritzøe
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
- Psychedelics Division–Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Christopher Timmermann
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
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Weiss B, Ginige I, Shannon L, Giribaldi B, Murphy-Beiner A, Murphy R, Baker-Jones M, Martell J, Nutt DJ, Carhart-Harris RL, Erritzoe D. Personality change in a trial of psilocybin therapy v. escitalopram treatment for depression. Psychol Med 2024; 54:178-192. [PMID: 37264814 PMCID: PMC10692311 DOI: 10.1017/s0033291723001514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's therapeutic action. METHODS In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up. RESULTS PT was associated with decreases in neuroticism (B = -0.63), introversion (B = -0.38), disagreeableness (B = -0.47), impulsivity (B = -0.40), and increases in absorption (B = 0.32), conscientiousness (B = 0.30), and openness (B = 0.23) at week 6, with neuroticism (B = -0.47) and disagreeableness (B = -0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism (B = -0.38), disagreeableness (B = -0.26), impulsivity (B = -0.35), and increases in openness (B = 0.28) at week 6, with neuroticism (B = -0.46) remaining decreased at month 6. No significant between-condition differences were observed. CONCLUSIONS Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT (v. ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.
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Affiliation(s)
- Brandon Weiss
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Induni Ginige
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Lu Shannon
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Ashleigh Murphy-Beiner
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Roberta Murphy
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Michelle Baker-Jones
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Jonny Martell
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - David J. Nutt
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Robin L. Carhart-Harris
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, CA, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
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11
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Delli Pizzi S, Chiacchiaretta P, Sestieri C, Ferretti A, Tullo MG, Della Penna S, Martinotti G, Onofrj M, Roseman L, Timmermann C, Nutt DJ, Carhart-Harris RL, Sensi SL. LSD-induced changes in the functional connectivity of distinct thalamic nuclei. Neuroimage 2023; 283:120414. [PMID: 37858906 DOI: 10.1016/j.neuroimage.2023.120414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
The role of the thalamus in mediating the effects of lysergic acid diethylamide (LSD) was recently proposed in a model of communication and corroborated by imaging studies. However, a detailed analysis of LSD effects on nuclei-resolved thalamocortical connectivity is still missing. Here, in a group of healthy volunteers, we evaluated whether LSD intake alters the thalamocortical coupling in a nucleus-specific manner. Structural and resting-state functional Magnetic Resonance Imaging (MRI) data were acquired in a placebo-controlled study on subjects exposed to acute LSD administration. Structural MRI was used to parcel the thalamus into its constituent nuclei based on individual anatomy. Nucleus-specific changes of resting-state functional MRI (rs-fMRI) connectivity were mapped using a seed-based approach. LSD intake selectively increased the thalamocortical functional connectivity (FC) of the ventral complex, pulvinar, and non-specific nuclei. Functional coupling was increased between these nuclei and sensory cortices that include the somatosensory and auditory networks. The ventral and pulvinar nuclei also exhibited increased FC with parts of the associative cortex that are dense in serotonin type 2A receptors. These areas are hyperactive and hyper-connected upon LSD intake. At subcortical levels, LSD increased the functional coupling among the thalamus's ventral, pulvinar, and non-specific nuclei, but decreased the striatal-thalamic connectivity. These findings unravel some LSD effects on the modulation of subcortical-cortical circuits and associated behavioral outputs.
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Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Molecular Neurology Unit, Center for Advanced Studies and Technology (CAST), University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Piero Chiacchiaretta
- Department of Innovative Technologies in Medicine and Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Carlo Sestieri
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University, Chieti-Pescara, Italy; UdA-TechLab, Research Center, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Maria Giulia Tullo
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Stefania Della Penna
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Leor Roseman
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christopher Timmermann
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David J Nutt
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom; Psychedelics Division, Neuroscape, Neurology, University of California San Francisco
| | - Stefano L Sensi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Molecular Neurology Unit, Center for Advanced Studies and Technology (CAST), University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University, Chieti-Pescara, Italy.
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12
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Nutt DJ, Peill JM, Weiss B, Godfrey K, Carhart-Harris RL, Erritzoe D. Psilocybin and Other Classic Psychedelics in Depression. Curr Top Behav Neurosci 2023. [PMID: 37955822 DOI: 10.1007/7854_2023_451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Psychedelic drugs such as psilocybin and ketamine are returning to clinical research and intervention across several disorders including the treatment of depression. This chapter focusses on psychedelics that specifically target the 5-HT2A receptor such as psilocybin and DMT. These produce plasma-concentration related psychological effects such as hallucinations and out of body experiences, insightful and emotional breakthroughs as well as mystical-type experiences. When coupled with psychological support, effects can produce a rapid improvement in mood among people with depression that can last for months. In this chapter, we summarise the scientific studies to date that explore the use of psychedelics in depressed individuals, highlighting key clinical, psychological and neuroimaging features of psychedelics that may account for their therapeutic effects. These include alterations in brain entropy that disrupt fixed negative ruminations, a period of post-treatment increased cognitive flexibility, and changes in self-referential psychological processes. Finally, we propose that the brain mechanisms underlying the therapeutic effect of serotonergic psychedelics might be distinct from those underlying classical serotonin reuptake-blocking antidepressants.
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Affiliation(s)
- D J Nutt
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK.
| | - J M Peill
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - B Weiss
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - K Godfrey
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - R L Carhart-Harris
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, University of California San Francisco, San Francisco, CA, USA
| | - D Erritzoe
- Centres for Neuropsychopharmacology & Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
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Bremler R, Katati N, Shergill P, Erritzoe D, Carhart-Harris RL. Case analysis of long-term negative psychological responses to psychedelics. Sci Rep 2023; 13:15998. [PMID: 37749109 PMCID: PMC10519946 DOI: 10.1038/s41598-023-41145-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023] Open
Abstract
Recent controversies have arisen regarding claims of uncritical positive regard and hype surrounding psychedelic drugs and their therapeutic potential. Criticisms have included that study designs and reporting styles bias positive over negative outcomes. The present study was motivated by a desire to address this alleged bias by intentionally focusing exclusively on negative outcomes, defined as self-perceived 'negative' psychological responses lasting for at least 72 h after psychedelic use. A strong justification for this selective focus was that it might improve our ability to capture otherwise missed cases of negative response, enabling us to validate their existence and better examine their nature, as well as possible causes, which could inspire risk-mitigation strategies. Via advertisements posted on social media, individuals were recruited who reported experiencing negative psychological responses to psychedelics (defined as classic psychedelics plus MDMA) lasting for greater than 72 h since using. Volunteers were directed to an online questionnaire requiring quantitative and qualitative input. A key second phase of this study involved reviewing all of the submitted cases, identifying the most severe-e.g., where new psychiatric diagnoses were made or pre-existing symptoms made worse post psychedelic-use-and inviting these individuals to participate in a semi-structured interview with two members of our research team, during which participant experiences and backgrounds were examined in greater depth. Based on the content of these interviews, a brief summary of each case was compiled, and an explorative thematic analysis was used to identify salient and consistent themes and infer common causes. 32 individuals fully completed an onboarding questionnaire (56% male, 53% < age 25); 37.5% of completers had a psychiatric diagnosis that emerged after their psychedelic experience, and anxiety symptoms arose or worsened in 87%. Twenty of the seemingly severer cases were invited to be interviewed; of these, 15 accepted an in-depth interview that lasted on average 60 min. This sample was 40% male, mean age = 31 ± 7. Five of the 15 (i.e., 33%) reported receiving new psychiatric diagnoses after psychedelic-use and all fifteen reported the occurrence or worsening of psychiatric symptoms post use, with a predominance of anxiety symptoms (93%). Distilling the content of the interviews suggested the following potential causal factors: unsafe or complex environments during or surrounding the experience, unpleasant acute experiences (classic psychedelics), prior psychological vulnerabilities, high- or unknown drug quantities and young age. The current exploratory findings corroborate the reality of mental health iatrogenesis via psychedelic-use but due to design limitations and sample size, cannot be used to infer on its prevalence. Based on interview reports, we can infer a common, albeit multifaceted, causal mechanism, namely the combining of a pro-plasticity drug-that was often 'over-dosed'-with adverse contextual conditions and/or special psychological vulnerability-either by young age or significant psychiatric history. Results should be interpreted with caution due to the small sample size and selective sample and study focus.
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Affiliation(s)
- Rebecka Bremler
- Centre for Psychedelic Research, Imperial College London, London, UK.
| | - Nancy Katati
- Centre for Psychedelic Research, Imperial College London, London, UK
| | | | - David Erritzoe
- Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, University of California San Francisco, San Francisco, USA
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14
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Zeifman RJ, Kettner H, Pagni BA, Mallard A, Roberts DE, Erritzoe D, Ross S, Carhart-Harris RL. Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences. Sci Rep 2023; 13:13645. [PMID: 37608057 PMCID: PMC10444769 DOI: 10.1038/s41598-023-40856-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023] Open
Abstract
Psilocybin and lysergic acid diethylamide (LSD) experiences can range from very positive to highly challenging (e.g., fear, grief, and paranoia). These challenging experiences contribute to hesitancy toward psychedelic-assisted psychotherapy among health care providers and patients. Co-use of 3,4-Methylenedioxy methamphetamine (MDMA) with psilocybin/LSD anecdotally reduces challenging experiences and enhances positive experiences associated with psilocybin/LSD. However, limited research has investigated the acute effects of co-use of MDMA and psilocybin/LSD. In a prospective convenience sample (N = 698) of individuals with plans to use psilocybin/LSD, we examined whether co-use of MDMA with psilocybin/LSD (n = 27) is associated with differences in challenging or positive experiences. Challenging experiences were measured using the Challenging Experiences Questionnaire and positive experiences were measured using the Mystical Experience Questionnaire and single-item measures of self-compassion, compassion, love, and gratitude. Potentially confounding variables were identified and included as covariates. Relative to psilocybin/LSD alone, co-use of psilocybin/LSD with a self-reported low (but not medium-high) dose of MDMA was associated with significantly less intense total challenging experiences, grief, and fear, as well as increased self-compassion, love and gratitude. Co-use of psilocybin/LSD and MDMA was not associated with differences in mystical-type experiences or compassion. Findings suggest co-use of MDMA with psilocybin/LSD may buffer against some aspects of challenging experiences and enhance certain positive experiences. Limitations include use of a convenience sample, small sample size, and non-experimental design. Additional studies (including controlled dose-response studies) that examine the effects and safety of co-administering MDMA with psilocybin/LSD (in healthy controls and clinical samples) are warranted and may assist the development of personalized treatments.
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Affiliation(s)
- Richard J Zeifman
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, 1 Park Avenue, New York, NY, 10016, USA.
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.
| | - Hannes Kettner
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, University of California, San Francisco, USA
| | - Broc A Pagni
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, 1 Park Avenue, New York, NY, 10016, USA
| | - Austin Mallard
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, 1 Park Avenue, New York, NY, 10016, USA
| | - Daniel E Roberts
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, 1 Park Avenue, New York, NY, 10016, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Stephen Ross
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, 1 Park Avenue, New York, NY, 10016, USA
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, University of California, San Francisco, USA
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15
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Wall MB, Lam C, Ertl N, Kaelen M, Roseman L, Nutt DJ, Carhart-Harris RL. Increased low-frequency brain responses to music after psilocybin therapy for depression. J Affect Disord 2023; 333:321-330. [PMID: 37094657 DOI: 10.1016/j.jad.2023.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 03/27/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Psychedelic-assisted psychotherapy with psilocybin is an emerging therapy with great promise for depression, and modern psychedelic therapy (PT) methods incorporate music as a key element. Music is an effective emotional/hedonic stimulus that could also be useful in assessing changes in emotional responsiveness following PT. METHODS Brain responses to music were assessed before and after PT using functional Magnetic Resonance Imaging (fMRI) and ALFF (Amplitude of Low Frequency Fluctuations) analysis methods. Nineteen patients with treatment-resistant depression underwent two treatment sessions involving administration of psilocybin, with MRI data acquired one week prior and the day after completion of psilocybin dosing sessions. RESULTS Comparison of music-listening and resting-state scans revealed significantly greater ALFF in bilateral superior temporal cortex for the post-treatment music scan, and in the right ventral occipital lobe for the post-treatment resting-state scan. ROI analyses of these clusters revealed a significant effect of treatment in the superior temporal lobe for the music scan only. Voxelwise comparison of treatment effects showed relative increases for the music scan in the bilateral superior temporal lobes and supramarginal gyrus, and relative decreases in the medial frontal lobes for the resting-state scan. ALFF in these music-related clusters was significantly correlated with intensity of subjective effects felt during the dosing sessions. LIMITATIONS Open-label trial. Relatively small sample size. CONCLUSIONS These data suggest an effect of PT on the brain's response to music, implying an elevated responsiveness to music after psilocybin therapy that was related to subjective drug effects felt during dosing.
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Affiliation(s)
- Matthew B Wall
- Invicro London, Hammersmith Hospital, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK; Clinical Psychopharmacology Unit, University College London, UK.
| | - Cynthia Lam
- Division of Brain Sciences, Faculty of Medicine, Imperial College London, UK; Department of Clinical Neurosciences, University of Cambridge, UK
| | - Natalie Ertl
- Invicro London, Hammersmith Hospital, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK
| | - Mendel Kaelen
- Centre for Psychedelic Research, Imperial College London, UK
| | - Leor Roseman
- Centre for Psychedelic Research, Imperial College London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Imperial College London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, UK; Psychedelics Division - Neuroscape, University of California San Francisco, USA
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Weiss B, Erritzoe D, Giribaldi B, Nutt DJ, Carhart-Harris RL. A critical evaluation of QIDS-SR-16 using data from a trial of psilocybin therapy versus escitalopram treatment for depression. J Psychopharmacol 2023; 37:717-732. [PMID: 37122239 PMCID: PMC10350722 DOI: 10.1177/02698811231167848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND In a recent clinical trial examining the comparative efficacy of psilocybin therapy (PT) versus escitalopram treatment (ET) for major depressive disorder, 14 of 16 major efficacy outcome measures yielded results that favored PT, but the Quick Inventory of Depressive Symptomatology, Self-Report, 16 items (QIDS-SR16) did not. AIMS The present study aims to (1) rationally and psychometrically account for discrepant results between outcome measures and (2) to overcome psychometric problems particular to individual measures by re-examining between-condition differences in depressive response using all outcome measures at item-, facet-, and factor-levels of analysis. METHOD Four depression measures were compared on the basis of their validity for examining differences in depressive response between PT and ET conditions. RESULTS/OUTCOMES Possible reasons for discrepant findings on the QIDS-SR16 include its higher variance, imprecision due to compound items and whole-scale and unidimensional sum-scoring, vagueness in the phrasing of scoring options for items, and its lack of focus on a core depression factor. Reanalyzing the trial data at item-, facet-, and factor-levels yielded results suggestive of PT's superior efficacy in reducing depressed mood, anhedonia, and a core depression factor, along with specific symptoms such as sexual dysfunction. CONCLUSION/INTERPRETATION Our results raise concerns about the adequacy of the QIDS-SR16 for measuring depression, as well as the practice of relying on individual scales that tend not to capture the multidimensional structure or core of depression. Using an alternative approach that captures depression more granularly and comprehensively yielded specific insight into areas where PT therapy may be particularly useful to patients and clinicians.
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Affiliation(s)
- Brandon Weiss
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, CA, USA
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Delli Pizzi S, Chiacchiaretta P, Sestieri C, Ferretti A, Onofrj M, Della Penna S, Roseman L, Timmermann C, Nutt DJ, Carhart-Harris RL, Sensi SL. Spatial Correspondence of LSD-Induced Variations on Brain Functioning at Rest With Serotonin Receptor Expression. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:768-776. [PMID: 37003409 DOI: 10.1016/j.bpsc.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Lysergic acid diethylamide (LSD) is an atypical psychedelic compound that exerts its effects through pleiotropic actions, mainly involving 1A/2A serotoninergic (5-HT) receptor subtypes. However, the mechanisms by which LSD promotes a reorganization of the brain's functional activity and connectivity are still partially unknown. METHODS Our study analyzed resting-state functional magnetic resonance imaging data acquired from 15 healthy volunteers undergoing LSD single-dose intake. A voxelwise analysis investigated the alterations of the brain's intrinsic functional connectivity and local signal amplitude induced by LSD or by a placebo. Quantitative comparisons assessed the spatial overlap between these 2 indices of functional reorganization and the topography of receptor expression obtained from a publicly available collection of in vivo, whole-brain atlases. Finally, linear regression models explored the relationships between changes in resting-state functional magnetic resonance imaging and behavioral aspects of the psychedelic experience. RESULTS LSD elicited modifications of the cortical functional architecture that spatially overlapped with the distribution of serotoninergic receptors. Local signal amplitude and functional connectivity increased in regions belonging to the default mode and attention networks associated with high expression of 5-HT2A receptors. These functional changes correlate with the occurrence of simple and complex visual hallucinations. At the same time, a decrease in local signal amplitude and intrinsic connectivity was observed in limbic areas, which are dense with 5-HT1A receptors. CONCLUSIONS This study provides new insights into the neural processes underlying the brain network reconfiguration induced by LSD. It also identifies a topographical relationship between opposite effects on brain functioning and the spatial distribution of different 5-HT receptors.
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Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Molecular Neurology Unit, Center for Advanced Studies and Technology, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Piero Chiacchiaretta
- Department of Innovative Technologies in Medicine and Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology, University "G d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Carlo Sestieri
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Stefania Della Penna
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom
| | - Christopher Timmermann
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom
| | - David J Nutt
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom; Psychedelics Division-Neuroscape, Neurology, University of California San Francisco, San Francisco, California
| | - Stefano L Sensi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology, University "G d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy.
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18
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Luppi AI, Hansen JY, Adapa R, Carhart-Harris RL, Roseman L, Timmermann C, Golkowski D, Ranft A, Ilg R, Jordan D, Bonhomme V, Vanhaudenhuyse A, Demertzi A, Jaquet O, Bahri MA, Alnagger NL, Cardone P, Peattie AR, Manktelow AE, de Araujo DB, Sensi SL, Owen AM, Naci L, Menon DK, Misic B, Stamatakis EA. In vivo mapping of pharmacologically induced functional reorganization onto the human brain's neurotransmitter landscape. Sci Adv 2023; 9:eadf8332. [PMID: 37315149 PMCID: PMC10266734 DOI: 10.1126/sciadv.adf8332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/10/2023] [Indexed: 06/16/2023]
Abstract
To understand how pharmacological interventions can exert their powerful effects on brain function, we need to understand how they engage the brain's rich neurotransmitter landscape. Here, we bridge microscale molecular chemoarchitecture and pharmacologically induced macroscale functional reorganization, by relating the regional distribution of 19 neurotransmitter receptors and transporters obtained from positron emission tomography, and the regional changes in functional magnetic resonance imaging connectivity induced by 10 different mind-altering drugs: propofol, sevoflurane, ketamine, lysergic acid diethylamide (LSD), psilocybin, N,N-Dimethyltryptamine (DMT), ayahuasca, 3,4-methylenedioxymethamphetamine (MDMA), modafinil, and methylphenidate. Our results reveal a many-to-many mapping between psychoactive drugs' effects on brain function and multiple neurotransmitter systems. The effects of both anesthetics and psychedelics on brain function are organized along hierarchical gradients of brain structure and function. Last, we show that regional co-susceptibility to pharmacological interventions recapitulates co-susceptibility to disorder-induced structural alterations. Collectively, these results highlight rich statistical patterns relating molecular chemoarchitecture and drug-induced reorganization of the brain's functional architecture.
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Affiliation(s)
- Andrea I. Luppi
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Justine Y. Hansen
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Ram Adapa
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Robin L. Carhart-Harris
- Psychedelics Division - Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Leor Roseman
- Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Christopher Timmermann
- Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Daniel Golkowski
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, München, Germany
| | - Andreas Ranft
- School of Medicine, Department of Anesthesiology and Intensive Care, Technical University of Munich, Munich, Germany
| | - Rüdiger Ilg
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, München, Germany
- Department of Neurology, Asklepios Clinic, Bad Tölz, Germany
| | - Denis Jordan
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technical University Munich, München, Germany
- University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Vincent Bonhomme
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
| | - Audrey Vanhaudenhuyse
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Athena Demertzi
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liege, Liege, Belgium
| | - Oceane Jaquet
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Mohamed Ali Bahri
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liege, Liege, Belgium
| | - Naji L. N. Alnagger
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Paolo Cardone
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Alexander R. D. Peattie
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | | | - Stefano L. Sensi
- Department of Neuroscience and Imaging and Clinical Science, Center for Advanced Studies and Technology, Institute for Advanced Biomedical Technologies, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
- Institute for Memory Impairments and Neurological Disorders, University of California-Irvine, Irvine, CA, USA
| | - Adrian M. Owen
- Department of Psychology and Department of Physiology and Pharmacology, Western Institute for Neuroscience (WIN), Western University, London, ON, Canada
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - David K. Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Wolfon Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Bratislav Misic
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Emmanuel A. Stamatakis
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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19
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Singleton SP, Timmermann C, Luppi AI, Eckernäs E, Roseman L, Carhart-Harris RL, Kuceyeski A. Time-resolved network control analysis links reduced control energy under DMT with the serotonin 2a receptor, signal diversity, and subjective experience. bioRxiv 2023:2023.05.11.540409. [PMID: 37214949 PMCID: PMC10197635 DOI: 10.1101/2023.05.11.540409] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Psychedelics offer a profound window into the functioning of the human brain and mind through their robust acute effects on perception, subjective experience, and brain activity patterns. In recent work using a receptor-informed network control theory framework, we demonstrated that the serotonergic psychedelics lysergic acid diethylamide (LSD) and psilocybin flatten the brain's control energy landscape in a manner that covaries with more dynamic and entropic brain activity. Contrary to LSD and psilocybin, whose effects last for hours, the serotonergic psychedelic N,N-dimethyltryptamine (DMT) rapidly induces a profoundly immersive altered state of consciousness lasting less than 20 minutes, allowing for the entirety of the drug experience to be captured during a single resting-state fMRI scan. Using network control theory, which quantifies the amount of input necessary to drive transitions between functional brain states, we integrate brain structure and function to map the energy trajectories of 14 individuals undergoing fMRI during DMT and placebo. Consistent with previous work, we find that global control energy is reduced following injection with DMT compared to placebo. We additionally show longitudinal trajectories of global control energy correlate with longitudinal trajectories of EEG signal diversity (a measure of entropy) and subjective ratings of drug intensity. We interrogate these same relationships on a regional level and find that the spatial patterns of DMT's effects on these metrics are correlated with serotonin 2a receptor density (obtained from separately acquired PET data). Using receptor distribution and pharmacokinetic information, we were able to successfully recapitulate the effects of DMT on global control energy trajectories, demonstrating a proof-of-concept for the use of control models in predicting pharmacological intervention effects on brain dynamics.
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Affiliation(s)
| | - Christopher Timmermann
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | | | - Emma Eckernäs
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Leor Roseman
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California San Francisco, USA
| | - Amy Kuceyeski
- Department of Computational Biology, Cornell University, Ithaca, USA
- Department of Radiology, Weill Cornell Medicine, New York, USA
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20
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Zeifman RJ, Wagner AC, Monson CM, Carhart-Harris RL. How does psilocybin therapy work? An exploration of experiential avoidance as a putative mechanism of change. J Affect Disord 2023; 334:100-112. [PMID: 37146908 DOI: 10.1016/j.jad.2023.04.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Psilocybin therapy is receiving attention as a mental health intervention with transdiagnostic potential. In line with psychotherapeutic research, qualitative research has highlighted the role of reductions in experiential avoidance (and increases in connectedness) within psilocybin therapy. However, no quantitative research has examined experiential avoidance as a mechanism underlying psilocybin therapy's therapeutic effects. METHOD Data was used from a double-blind randomized controlled trial that compared psilocybin therapy (two 25 mg psilocybin session plus daily placebo for six weeks) with escitalopram (two 1 mg psilocybin sessions plus 10-20 mg daily escitalopram for six weeks) among individuals with major depressive disorder (N = 59). All participants received psychological support. Experiential avoidance, connectedness, and treatment outcomes were measured at pre-treatment and at a 6 week primary endpoint. Acute psilocybin experiences and psychological insight were also measured. RESULTS With psilocybin therapy, but not escitalopram, improvements in mental health outcomes (i.e., well-being, depression severity, suicidal ideation, and trait anxiety) occurred via reductions in experiential avoidance. Exploratory analyses suggested that improvements in mental health (except for suicidal ideation) via reduction in experiential avoidance were serially mediated through increases in connectedness. Additionally, experiences of ego dissolution and psychological insight predicted reductions in experiential avoidance following psilocybin therapy. LIMITATIONS Difficulties inferring temporal causality, maintaining blindness to condition, and reliance upon self-report. CONCLUSIONS These results provide support for the role of reduced experiential avoidance as a putative mechanism underlying psilocybin therapy's positive therapeutic outcomes. The present findings may help to tailor, refine, and optimize psilocybin therapy and its delivery.
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Affiliation(s)
- Richard J Zeifman
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada; Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK; NYU Langone Centre for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, USA.
| | - Anne C Wagner
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada; Remedy Institute, Toronto, Canada
| | - Candice M Monson
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK; Psychedelics Division, Neuroscape, University of California, San Francisco, USA
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21
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Affiliation(s)
- Jacob S Aday
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Robin L Carhart-Harris
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Joshua D Woolley
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Medical Center, San Francisco, California
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22
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Timmermann C, Roseman L, Haridas S, Rosas FE, Luan L, Kettner H, Martell J, Erritzoe D, Tagliazucchi E, Pallavicini C, Girn M, Alamia A, Leech R, Nutt DJ, Carhart-Harris RL. Human brain effects of DMT assessed via EEG-fMRI. Proc Natl Acad Sci U S A 2023; 120:e2218949120. [PMID: 36940333 PMCID: PMC10068756 DOI: 10.1073/pnas.2218949120] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Psychedelics have attracted medical interest, but their effects on human brain function are incompletely understood. In a comprehensive, within-subjects, placebo-controlled design, we acquired multimodal neuroimaging [i.e., EEG-fMRI (electroencephalography-functional MRI)] data to assess the effects of intravenous (IV) N,N-Dimethyltryptamine (DMT) on brain function in 20 healthy volunteers. Simultaneous EEG-fMRI was acquired prior to, during, and after a bolus IV administration of 20 mg DMT, and, separately, placebo. At dosages consistent with the present study, DMT, a serotonin 2A receptor (5-HT2AR) agonist, induces a deeply immersive and radically altered state of consciousness. DMT is thus a useful research tool for probing the neural correlates of conscious experience. Here, fMRI results revealed robust increases in global functional connectivity (GFC), network disintegration and desegregation, and a compression of the principal cortical gradient under DMT. GFC × subjective intensity maps correlated with independent positron emission tomography (PET)-derived 5-HT2AR maps, and both overlapped with meta-analytical data implying human-specific psychological functions. Changes in major EEG-measured neurophysiological properties correlated with specific changes in various fMRI metrics, enriching our understanding of the neural basis of DMT's effects. The present findings advance on previous work by confirming a predominant action of DMT-and likely other 5-HT2AR agonist psychedelics-on the brain's transmodal association pole, i.e., the neurodevelopmentally and evolutionarily recent cortex that is associated with species-specific psychological advancements, and high expression of 5-HT2A receptors.
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Affiliation(s)
- Christopher Timmermann
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Leor Roseman
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Sharad Haridas
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Fernando E Rosas
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
- Department of Informatics, University of Sussex, Brighton BN1 9RH, United Kingdom
- Centre for Complexity Science, Imperial College London, London SW7 2AZ, United Kingdom
- Center for Eudaimonia and Human Flourishing, University of Oxford, Oxford OX3 9BX, United Kingdom
| | - Lisa Luan
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Hannes Kettner
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Jonny Martell
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - David Erritzoe
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Enzo Tagliazucchi
- Departamento de Física, Latin American Brain Health Institute, Universidad Adolfo Ibanez, 3485 Santiago, Chile
- Universidad de Buenos Aires and Instituto de Física de Buenos Aires, 1428 Buenos Aires, Argentina
| | - Carla Pallavicini
- Universidad de Buenos Aires and Instituto de Física de Buenos Aires, 1428 Buenos Aires, Argentina
| | - Manesh Girn
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | | | - Robert Leech
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London WC2R 2LS, UK
| | - David J Nutt
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
| | - Robin L Carhart-Harris
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, W12 0NN London, UK
- Psychedelics Division - Neuroscape, Department of Neurology, University of California, San Francisco, CA 94143
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23
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Carhart-Harris RL, Chandaria S, Erritzoe DE, Gazzaley A, Girn M, Kettner H, Mediano PAM, Nutt DJ, Rosas FE, Roseman L, Timmermann C, Weiss B, Zeifman RJ, Friston KJ. Canalization and plasticity in psychopathology. Neuropharmacology 2023; 226:109398. [PMID: 36584883 DOI: 10.1016/j.neuropharm.2022.109398] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
This theoretical article revives a classical bridging construct, canalization, to describe a new model of a general factor of psychopathology. To achieve this, we have distinguished between two types of plasticity, an early one that we call 'TEMP' for 'Temperature or Entropy Mediated Plasticity', and another, we call 'canalization', which is close to Hebbian plasticity. These two forms of plasticity can be most easily distinguished by their relationship to 'precision' or inverse variance; TEMP relates to increased model variance or decreased precision, whereas the opposite is true for canalization. TEMP also subsumes increased learning rate, (Ising) temperature and entropy. Dictionary definitions of 'plasticity' describe it as the property of being easily shaped or molded; TEMP is the better match for this. Importantly, we propose that 'pathological' phenotypes develop via mechanisms of canalization or increased model precision, as a defensive response to adversity and associated distress or dysphoria. Our model states that canalization entrenches in psychopathology, narrowing the phenotypic state-space as the agent develops expertise in their pathology. We suggest that TEMP - combined with gently guiding psychological support - can counter canalization. We address questions of whether and when canalization is adaptive versus maladaptive, furnish our model with references to basic and human neuroscience, and offer concrete experiments and measures to test its main hypotheses and implications. This article is part of the Special Issue on "National Institutes of Health Psilocybin Research Speaker Series".
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Affiliation(s)
- R L Carhart-Harris
- Psychedelics Division - Neuroscape, Department of Neurology, University of California, San Francisco, USA; Centre for Psychedelic Research, Imperial College London, UK.
| | - S Chandaria
- Centre for Psychedelic Research, Imperial College London, UK; Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK; Institute of Philosophy, School of Advanced Study, University of London, UK
| | - D E Erritzoe
- Centre for Psychedelic Research, Imperial College London, UK; CNWL-Imperial Psychopharmacology and Psychedelic Research Clinic (CIPPRS), UK
| | - A Gazzaley
- Psychedelics Division - Neuroscape, Department of Neurology, University of California, San Francisco, USA
| | - M Girn
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - H Kettner
- Psychedelics Division - Neuroscape, Department of Neurology, University of California, San Francisco, USA; Centre for Psychedelic Research, Imperial College London, UK
| | - P A M Mediano
- Department of Computing, Imperial College London, London, UK; Department of Psychology, University of Cambridge, UK
| | - D J Nutt
- Centre for Psychedelic Research, Imperial College London, UK
| | - F E Rosas
- Centre for Psychedelic Research, Imperial College London, UK; Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK; Department of Informatics, University of Sussex, UK; Centre for Complexity Science, Imperial College London, UK
| | - L Roseman
- Centre for Psychedelic Research, Imperial College London, UK; CNWL-Imperial Psychopharmacology and Psychedelic Research Clinic (CIPPRS), UK
| | - C Timmermann
- Centre for Psychedelic Research, Imperial College London, UK; CNWL-Imperial Psychopharmacology and Psychedelic Research Clinic (CIPPRS), UK
| | - B Weiss
- Centre for Psychedelic Research, Imperial College London, UK; CNWL-Imperial Psychopharmacology and Psychedelic Research Clinic (CIPPRS), UK
| | - R J Zeifman
- Centre for Psychedelic Research, Imperial College London, UK; NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, USA
| | - K J Friston
- Wellcome Centre for Human Neuroimaging, University College London, UK
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24
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Carhart-Harris RL. Translational Challenges in Psychedelic Medicine. N Engl J Med 2023; 388:476-477. [PMID: 36724336 DOI: 10.1056/nejmcibr2213109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Robin L Carhart-Harris
- From the Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, and the Centre for Psychedelic Research, Imperial College London, London
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25
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Luppi AI, Vohryzek J, Kringelbach ML, Mediano PAM, Craig MM, Adapa R, Carhart-Harris RL, Roseman L, Pappas I, Peattie ARD, Manktelow AE, Sahakian BJ, Finoia P, Williams GB, Allanson J, Pickard JD, Menon DK, Atasoy S, Stamatakis EA. Distributed harmonic patterns of structure-function dependence orchestrate human consciousness. Commun Biol 2023; 6:117. [PMID: 36709401 PMCID: PMC9884288 DOI: 10.1038/s42003-023-04474-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/11/2023] [Indexed: 01/29/2023] Open
Abstract
A central question in neuroscience is how consciousness arises from the dynamic interplay of brain structure and function. Here we decompose functional MRI signals from pathological and pharmacologically-induced perturbations of consciousness into distributed patterns of structure-function dependence across scales: the harmonic modes of the human structural connectome. We show that structure-function coupling is a generalisable indicator of consciousness that is under bi-directional neuromodulatory control. We find increased structure-function coupling across scales during loss of consciousness, whether due to anaesthesia or brain injury, capable of discriminating between behaviourally indistinguishable sub-categories of brain-injured patients, tracking the presence of covert consciousness. The opposite harmonic signature characterises the altered state induced by LSD or ketamine, reflecting psychedelic-induced decoupling of brain function from structure and correlating with physiological and subjective scores. Overall, connectome harmonic decomposition reveals how neuromodulation and the network architecture of the human connectome jointly shape consciousness and distributed functional activation across scales.
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Affiliation(s)
- Andrea I. Luppi
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, CB2 1SB UK
| | - Jakub Vohryzek
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, OX3 7JX UK ,grid.7048.b0000 0001 1956 2722Center for Music in the Brain, Aarhus University, Aarhus, Denmark ,grid.5612.00000 0001 2172 2676Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08005 Spain
| | - Morten L. Kringelbach
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, OX3 7JX UK ,grid.7048.b0000 0001 1956 2722Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Pedro A. M. Mediano
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, CB2 3EB UK ,grid.7445.20000 0001 2113 8111Department of Computing, Imperial College London, London, W12 0NN UK
| | - Michael M. Craig
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Ram Adapa
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Robin L. Carhart-Harris
- grid.7445.20000 0001 2113 8111Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, W12 0NN UK ,grid.266102.10000 0001 2297 6811Psychedelics Division - Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA 94143 USA
| | - Leor Roseman
- grid.7445.20000 0001 2113 8111Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, W12 0NN UK
| | - Ioannis Pappas
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.42505.360000 0001 2156 6853Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033 USA
| | - Alexander R. D. Peattie
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Anne E. Manktelow
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Barbara J. Sahakian
- grid.5335.00000000121885934Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Psychiatry, MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB UK
| | - Paola Finoia
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Guy B. Williams
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Judith Allanson
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.120073.70000 0004 0622 5016Department of Neurosciences, Cambridge University Hospitals NHS Foundation, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
| | - John D. Pickard
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK
| | - David K. Menon
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK
| | - Selen Atasoy
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, OX3 7JX UK ,grid.7048.b0000 0001 1956 2722Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Emmanuel A. Stamatakis
- grid.5335.00000000121885934Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK
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26
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Forstmann M, Kettner HS, Sagioglou C, Irvine A, Gandy S, Carhart-Harris RL, Luke D. Among psychedelic-experienced users, only past use of psilocybin reliably predicts nature relatedness. J Psychopharmacol 2023; 37:93-106. [PMID: 36601974 PMCID: PMC9834326 DOI: 10.1177/02698811221146356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Past research reports a positive relationship between experience with classic serotonergic psychedelics and nature relatedness (NR). However, these studies typically do not distinguish between different psychedelic compounds, which have a unique psychopharmacology and may be used in specific contexts and with different intentions. Likewise, it is not clear whether these findings can be attributed to substance use per se or unrelated variables that differentiate psychedelic users from nonusers. AIMS The present study was designed to determine the relative degree to which lifetime experience with different psychedelic substances is predictive of self-reported NR among psychedelic-experienced users. METHODS We conducted a combined reanalysis of five independent datasets (N = 3817). Using standard and regularized regression analyses, we tested the relationship between degree of experience with various psychedelic substances (binary and continuous) and NR, both within a subsample of psychedelic-experienced participants as well as the complete sample including psychedelic-naïve participants. RESULTS/OUTCOMES Among people experienced with psychedelics, only past use of psilocybin (versus LSD, mescaline, Salvia divinorum, ketamine, and ibogaine) was a reliable predictor of NR and its subdimensions. Weaker, less reliable results were obtained for the pharmacologically similar N,N-dimethyltryptamine (DMT). Results replicate when including psychedelic-naïve participants. In addition, among people exclusively experience with psilocybin, use frequency positively predicted NR. CONCLUSIONS/INTERPRETATION Results suggest that experience with psilocybin is the only reliable (and strongest) predictor of NR. Future research should focus on psilocybin when investigating effects of psychedelic on NR and determine whether pharmacological attributes or differences in user expectations/use settings are responsible for this observation.
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Affiliation(s)
- Matthias Forstmann
- University of Zurich, Zurich, Switzerland,Matthias Forstmann, Department of Psychology, University of Zurich, Binzmühlestrasse 14, Zurich 8050, Switzerland.
| | - Hannes S Kettner
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, USA,Centre for Psychedelic Research, Imperial College London, London, UK
| | | | | | - Sam Gandy
- Centre for Psychedelic Research, Imperial College London, London, UK
| | | | - David Luke
- Centre for Psychedelic Research, Imperial College London, London, UK,University of Greenwich, London, UK
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Spriggs MJ, Giribaldi B, Lyons T, Rosas FE, Kärtner LS, Buchborn T, Douglass HM, Roseman L, Timmermann C, Erritzoe D, Nutt DJ, Carhart-Harris RL. Body mass index (BMI) does not predict responses to psilocybin. J Psychopharmacol 2023; 37:107-116. [PMID: 36373934 PMCID: PMC9834321 DOI: 10.1177/02698811221131994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psilocybin is a serotonin type 2A (5-HT2A) receptor agonist and naturally occurring psychedelic. 5-HT2A receptor density is known to be associated with body mass index (BMI), however, the impact of this on psilocybin therapy has not been explored. While body weight-adjusted dosing is widely used, this imposes a practical and financial strain on the scalability of psychedelic therapy. This gap between evidence and practice is caused by the absence of studies clarifying the relationship between BMI, the acute psychedelic experience and long-term psychological outcomes. METHOD Data were pooled across three studies using a fixed 25 mg dose of psilocybin delivered in a therapeutic context to assess whether BMI predicts characteristics of the acute experience and changes in well-being 2 weeks later. Supplementing frequentist analysis with Bayes Factors has enabled for conclusions to be drawn regarding the null hypothesis. RESULTS Results support the null hypothesis that BMI does not predict overall intensity of the altered state, mystical experiences, perceptual changes or emotional breakthroughs during the acute experience. There was weak evidence for greater 'dread of ego dissolution' in participants with lower BMI, however, further analysis suggested BMI did not meaningfully add to the combination of the other covariates (age, sex and study). While mystical-type experiences and emotional breakthroughs were strong predictors of improvements in well-being, BMI was not. CONCLUSIONS These findings have important implications for our understanding of pharmacological and extra-pharmacological contributors to psychedelic-assisted therapy and for the standardization of a fixed therapeutic dose in psychedelic-assisted therapy.
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Affiliation(s)
- Meg J Spriggs
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,Meg J Spriggs, Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, 2nd floor, Commonwealth Building, Hammersmith Campus 160 Du Cane Road, London, London W12 0NN, UK.
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Taylor Lyons
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,Centre for Complexity Science, Imperial College London, UK
| | - Laura S Kärtner
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tobias Buchborn
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,Institute for Psychopharmacology, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hannah M Douglass
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Leor Roseman
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Christopher Timmermann
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,CNWL-Imperial Psychopharmacology & Psychedelic Research Clinic, St. Charles Hospital, CNWL NHS Foundation Trust, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK,Psychedelics Division, Neuroscape, University of California San Francisco, USA
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28
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Kanen JW, Luo Q, Rostami Kandroodi M, Cardinal RN, Robbins TW, Nutt DJ, Carhart-Harris RL, den Ouden HEM. Effect of lysergic acid diethylamide (LSD) on reinforcement learning in humans. Psychol Med 2022; 53:1-12. [PMID: 36411719 PMCID: PMC10600934 DOI: 10.1017/s0033291722002963] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The non-selective serotonin 2A (5-HT2A) receptor agonist lysergic acid diethylamide (LSD) holds promise as a treatment for some psychiatric disorders. Psychedelic drugs such as LSD have been suggested to have therapeutic actions through their effects on learning. The behavioural effects of LSD in humans, however, remain incompletely understood. Here we examined how LSD affects probabilistic reversal learning (PRL) in healthy humans. METHODS Healthy volunteers received intravenous LSD (75 μg in 10 mL saline) or placebo (10 mL saline) in a within-subjects design and completed a PRL task. Participants had to learn through trial and error which of three stimuli was rewarded most of the time, and these contingencies switched in a reversal phase. Computational models of reinforcement learning (RL) were fitted to the behavioural data to assess how LSD affected the updating ('learning rates') and deployment of value representations ('reinforcement sensitivity') during choice, as well as 'stimulus stickiness' (choice repetition irrespective of reinforcement history). RESULTS Raw data measures assessing sensitivity to immediate feedback ('win-stay' and 'lose-shift' probabilities) were unaffected, whereas LSD increased the impact of the strength of initial learning on perseveration. Computational modelling revealed that the most pronounced effect of LSD was the enhancement of the reward learning rate. The punishment learning rate was also elevated. Stimulus stickiness was decreased by LSD, reflecting heightened exploration. Reinforcement sensitivity differed by phase. CONCLUSIONS Increased RL rates suggest LSD induced a state of heightened plasticity. These results indicate a potential mechanism through which revision of maladaptive associations could occur in the clinical application of LSD.
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Affiliation(s)
- Jonathan W. Kanen
- Department of Psychology, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Qiang Luo
- National Clinical Research Center for Aging and Medicine at Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433, China
- Center for Computational Psychiatry, Ministry of Education-Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Human Phenome Institute, Fudan University, Shanghai, 200032, China
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200241, China
| | - Mojtaba Rostami Kandroodi
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Rudolf N. Cardinal
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - David J. Nutt
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin L. Carhart-Harris
- Neuroscape Psychedelics Division, University of California San Francisco, San Francisco, California, USA
| | - Hanneke E. M. den Ouden
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Singleton SP, Luppi AI, Carhart-Harris RL, Cruzat J, Roseman L, Nutt DJ, Deco G, Kringelbach ML, Stamatakis EA, Kuceyeski A. Receptor-informed network control theory links LSD and psilocybin to a flattening of the brain's control energy landscape. Nat Commun 2022; 13:5812. [PMID: 36192411 PMCID: PMC9530221 DOI: 10.1038/s41467-022-33578-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
Psychedelics including lysergic acid diethylamide (LSD) and psilocybin temporarily alter subjective experience through their neurochemical effects. Serotonin 2a (5-HT2a) receptor agonism by these compounds is associated with more diverse (entropic) brain activity. We postulate that this increase in entropy may arise in part from a flattening of the brain's control energy landscape, which can be observed using network control theory to quantify the energy required to transition between recurrent brain states. Using brain states derived from existing functional magnetic resonance imaging (fMRI) datasets, we show that LSD and psilocybin reduce control energy required for brain state transitions compared to placebo. Furthermore, across individuals, reduction in control energy correlates with more frequent state transitions and increased entropy of brain state dynamics. Through network control analysis that incorporates the spatial distribution of 5-HT2a receptors (obtained from publicly available positron emission tomography (PET) data under non-drug conditions), we demonstrate an association between the 5-HT2a receptor and reduced control energy. Our findings provide evidence that 5-HT2a receptor agonist compounds allow for more facile state transitions and more temporally diverse brain activity. More broadly, we demonstrate that receptor-informed network control theory can model the impact of neuropharmacological manipulation on brain activity dynamics.
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Affiliation(s)
- S Parker Singleton
- Department of Computational Biology, Cornell University, Ithaca, NY, USA.
| | - Andrea I Luppi
- Division of Anesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, UK.,Psychedelics Division, Neuroscape, University of California San Francisco, San Francisco, CA, USA
| | - Josephine Cruzat
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile.,Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona, Spain
| | - Leor Roseman
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, UK
| | - David J Nutt
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona, Spain.,Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, Barcelona, Spain.,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,School of Psychological Sciences, Monash University, Melbourne, Clayton, VIC, Australia
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford, UK.,Center of Music in the Brain (MIB), Clinical Medicine, Aarhus University, Aarhus, Denmark.,Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Emmanuel A Stamatakis
- Division of Anesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Amy Kuceyeski
- Department of Computational Biology, Cornell University, Ithaca, NY, USA.,Department of Radiology, Weill Cornell Medicine, New York, NY, USA
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30
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Rajpal H, Mediano PAM, Rosas FE, Timmermann CB, Brugger S, Muthukumaraswamy S, Seth AK, Bor D, Carhart-Harris RL, Jensen HJ. Psychedelics and schizophrenia: Distinct alterations to Bayesian inference. Neuroimage 2022; 263:119624. [PMID: 36108798 DOI: 10.1016/j.neuroimage.2022.119624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/11/2022] [Accepted: 09/10/2022] [Indexed: 11/28/2022] Open
Abstract
Schizophrenia and states induced by certain psychotomimetic drugs may share some physiological and phenomenological properties, but they differ in fundamental ways: one is a crippling chronic mental disease, while the others are temporary, pharmacologically-induced states presently being explored as treatments for mental illnesses. Building towards a deeper understanding of these different alterations of normal consciousness, here we compare the changes in neural dynamics induced by LSD and ketamine (in healthy volunteers) against those associated with schizophrenia, as observed in resting-state M/EEG recordings. While both conditions exhibit increased neural signal diversity, our findings reveal that this is accompanied by an increased transfer entropy from the front to the back of the brain in schizophrenia, versus an overall reduction under the two drugs. Furthermore, we show that these effects can be reproduced via different alterations of standard Bayesian inference applied on a computational model based on the predictive processing framework. In particular, the effects observed under the drugs are modelled as a reduction of the precision of the priors, while the effects of schizophrenia correspond to an increased precision of sensory information. These findings shed new light on the similarities and differences between schizophrenia and two psychotomimetic drug states, and have potential implications for the study of consciousness and future mental health treatments.
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Affiliation(s)
- Hardik Rajpal
- Centre for Complexity Science, Imperial College London, South Kensington, London, United Kingdom; Department of Mathematics, Imperial College London, South Kensington, London, United Kingdom; Public Policy Program, The Alan Turing Institute, London, United Kingdom.
| | - Pedro A M Mediano
- Department of Computing, Imperial College London, South Kensington, London, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, Queen Mary University of London, London, United Kingdom.
| | - Fernando E Rosas
- Centre for Complexity Science, Imperial College London, South Kensington, London, United Kingdom; Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom; Data Science Institute, Imperial College London, London, United Kingdom; Department of Informatics, University of Sussex, Brighton, United Kingdom
| | - Christopher B Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stefan Brugger
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, United Kingdom; Centre for Academic Mental Health, Bristol Medical School, University of Bristol, United Kingdom
| | | | - Anil K Seth
- School of Engineering and Informatics, University of Sussex, United Kingdom; CIFAR Program on Brain, Mind, and Consciousness, Toronto, Canada
| | - Daniel Bor
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, Queen Mary University of London, London, United Kingdom
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom; Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, US
| | - Henrik J Jensen
- Centre for Complexity Science, Imperial College London, South Kensington, London, United Kingdom; Department of Mathematics, Imperial College London, South Kensington, London, United Kingdom; Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan
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31
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Mediano PAM, Rosas FE, Luppi AI, Jensen HJ, Seth AK, Barrett AB, Carhart-Harris RL, Bor D. Greater than the parts: a review of the information decomposition approach to causal emergence. Philos Trans A Math Phys Eng Sci 2022; 380:20210246. [PMID: 35599558 PMCID: PMC9125226 DOI: 10.1098/rsta.2021.0246] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/07/2022] [Indexed: 05/28/2023]
Abstract
Emergence is a profound subject that straddles many scientific disciplines, including the formation of galaxies and how consciousness arises from the collective activity of neurons. Despite the broad interest that exists on this concept, the study of emergence has suffered from a lack of formalisms that could be used to guide discussions and advance theories. Here, we summarize, elaborate on, and extend a recent formal theory of causal emergence based on information decomposition, which is quantifiable and amenable to empirical testing. This theory relates emergence with information about a system's temporal evolution that cannot be obtained from the parts of the system separately. This article provides an accessible but rigorous introduction to the framework, discussing the merits of the approach in various scenarios of interest. We also discuss several interpretation issues and potential misunderstandings, while highlighting the distinctive benefits of this formalism. This article is part of the theme issue 'Emergent phenomena in complex physical and socio-technical systems: from cells to societies'.
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Affiliation(s)
- Pedro A M Mediano
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychology, Queen Mary University of London, London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Imperial College London, London, UK
- Data Science Institute, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
| | - Andrea I Luppi
- University Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - Henrik J Jensen
- Centre for Complexity Science, Imperial College London, London, UK
- Department of Mathematics, Imperial College London, London, UK
- Institute of Innovative Research, Tokyo Institute of Technology Tokyo, Japan
| | - Anil K Seth
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
- CIFAR Program on Brain, Mind, and Consciousness, Toronto, Canada
| | - Adam B Barrett
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
- The Data Intensive Science Centre, Department of Informatics, University of Sussex, Brighton, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, CA, USA
| | - Daniel Bor
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychology, Queen Mary University of London, London, UK
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32
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Peill JM, Trinci KE, Kettner H, Mertens LJ, Roseman L, Timmermann C, Rosas FE, Lyons T, Carhart-Harris RL. Validation of the Psychological Insight Scale: A new scale to assess psychological insight following a psychedelic experience. J Psychopharmacol 2022; 36:31-45. [PMID: 34983255 PMCID: PMC8801624 DOI: 10.1177/02698811211066709] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As their name suggests, 'psychedelic' (mind-revealing) compounds are thought to catalyse processes of psychological insight; however, few satisfactory scales exist to sample this. This study sought to develop a new scale to measure psychological insight after a psychedelic experience: the Psychological Insight Scale (PIS). METHODS The PIS is a six- to seven-item questionnaire that enquires about psychological insight after a psychedelic experience (PIS-6) and accompanied behavioural changes (PIS item 7). In total, 886 participants took part in a study in which the PIS and other questionnaires were completed in a prospective fashion in relation to a planned psychedelic experience. For validation purposes, data from 279 participants were analysed from a non-specific 'global psychedelic survey' study. RESULTS Principal components analysis of PIS scores revealed a principal component explaining 73.57% of the variance, which displayed high internal consistency at multiple timepoints throughout the study (average Cronbach's α = 0.94). Criterion validity was confirmed using the global psychedelic survey study, and convergent validity was confirmed via the Therapeutic-Realizations Scale. Furthermore, PIS scores significantly mediated the relationship between emotional breakthrough and long-term well-being. CONCLUSION The PIS is complementary to current subjective measures used in psychedelic studies, most of which are completed in relation to the acute experience. Insight - as measured by the PIS - was found to be a key mediator of long-term psychological outcomes following a psychedelic experience. Future research may investigate how insight varies throughout a psychedelic process, its underlying neurobiology and how it impacts behaviour and mental health.
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Affiliation(s)
- Joseph M Peill
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Katie E Trinci
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Clinical Psychopharmacology Unit, Division of Psychology and Language Sciences, University College London, London, UK
| | - Hannes Kettner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Lea J Mertens
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Leor Roseman
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Christopher Timmermann
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Fernando E Rosas
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Data Science Institute, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
| | - Taylor Lyons
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, University of California San Francisco, San Francisco, CA, USA
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33
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Kuc J, Kettner H, Rosas F, Erritzoe D, Haijen E, Kaelen M, Nutt D, Carhart-Harris RL. Psychedelic experience dose-dependently modulated by cannabis: results of a prospective online survey. Psychopharmacology (Berl) 2022; 239:1425-1440. [PMID: 34734314 PMCID: PMC9110465 DOI: 10.1007/s00213-021-05999-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
RATIONALE Classic psychedelics are currently being studied as novel treatments for a range of psychiatric disorders. However, research on how psychedelics interact with other psychoactive substances remains scarce. OBJECTIVES The current study aimed to explore the subjective effects of psychedelics when used alongside cannabis. METHODS Participants (n = 321) completed a set of online surveys at 2 time points: 7 days before, and 1 day after a planned experience with a serotonergic psychedelic. The collected data included demographics, environmental factors (so-called setting) and five validated questionnaires: Mystical Experience Questionnaire (MEQ), visual subscales of Altered States of Consciousness Questionnaire (ASC-Vis), Challenging Experience Questionnaire (CEQ), Ego Dissolution Inventory (EDI) and Emotional Breakthrough Inventory (EBI). Participants were grouped according to whether they had reported using no cannabis (n = 195) or low (n = 53), medium (n = 45) or high (n = 28) dose, directly concomitant with the psychedelic. Multivariate analysis of covariance (MANCOVA) and contrasts was used to analyse differences in subjective effects between groups while controlling for potential confounding contextual 'setting' variables. RESULTS The simultaneous use of cannabis together with classic serotonergic psychedelics was associated with more intense psychedelic experience across a range of measures: a linear relationship was found between dose and MEQ, ASC-Vis and EDI scores, while a quadratic relationship was found for CEQ scores. No relationship was found between the dose of cannabis and the EBI. CONCLUSIONS Results imply a possible interaction between the cannabis and psychedelic on acute subjective experiences; however, design limitations hamper our ability to draw firm inferences on directions of causality and the clinical implications of any such interactions.
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Affiliation(s)
- Joanna Kuc
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN, UK.
| | - Hannes Kettner
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - Fernando Rosas
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - David Erritzoe
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - Eline Haijen
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - Mendel Kaelen
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - David Nutt
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
| | - Robin L. Carhart-Harris
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, W12 0NN UK
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Carhart-Harris RL, Wagner AC, Agrawal M, Kettner H, Rosenbaum JF, Gazzaley A, Nutt DJ, Erritzoe D. Can pragmatic research, real-world data and digital technologies aid the development of psychedelic medicine? J Psychopharmacol 2022; 36:6-11. [PMID: 33888025 PMCID: PMC8801625 DOI: 10.1177/02698811211008567] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Favourable regulatory assessments, liberal policy changes, new research centres and substantial commercial investment signal that psychedelic therapy is making a major comeback. Positive findings from modern trials are catalysing developments, but it is questionable whether current confirmatory trials are sufficient for advancing our understanding of safety and best practice. Here we suggest supplementing traditional confirmatory trials with pragmatic trials, real-world data initiatives and digital health solutions to better support the discovery of optimal and personalised treatment protocols and parameters. These recommendations are intended to help support the development of safe, effective and cost-efficient psychedelic therapy, which, given its history, is vulnerable to excesses of hype and regulation.
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Affiliation(s)
- Robin L Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, London, UK,Robin L Carhart-Harris, Centre for Psychedelic Research, Imperial College London, Burlington Danes Building, London W12 0NN, UK.
| | - Anne C Wagner
- Remedy, Toronto, Canada,Department of Psychology, Ryerson University, Toronto, Canada
| | - Manish Agrawal
- Maryland Oncology and Hematology, Rockville, USA,Aquilino Cancer Center, Rockville, USA
| | - Hannes Kettner
- Centre for Psychedelic Research, Imperial College London, London, UK
| | | | - Adam Gazzaley
- Neuroscape, Department of Neurology, Physiology and Psychiatry, University of California San Francisco, San Francisco, USA
| | - David J Nutt
- Centre for Psychedelic Research, Imperial College London, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Imperial College London, London, UK
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Abstract
Healthful behaviours such as maintaining a balanced diet, being physically active and refraining from smoking have major impacts on the risk of developing cancer, diabetes, cardiovascular diseases and other serious conditions. The burden of the so-called 'lifestyle diseases'-in personal suffering, premature mortality and public health costs-is considerable. Consequently, interventions designed to promote healthy behaviours are increasingly being studied, e.g., using psychobiological models of behavioural regulation and change. In this article, we explore the notion that psychedelic substances such as psilocybin could be used to assist in promoting positive lifestyle change conducive to good overall health. Psilocybin has a low toxicity, is non-addictive and has been shown to predict favourable changes in patients with depression, anxiety and other conditions marked by rigid behavioural patterns, including substance (mis)use. While it is still early days for modern psychedelic science, research is advancing fast and results are promising. Here we describe psychedelics' proposed mechanisms of action and research findings pertinent to health behaviour change science, hoping to generate discussion and new research hypotheses linking the two areas. Therapeutic models including psychedelic experiences and common behaviour change methods (e.g., Cognitive Behaviour Therapy, Motivational Interviewing) are already being tested for addiction and eating disorders. We believe this research may soon be extended to help promote improved diet, exercise, nature exposure and also mindfulness or stress reduction practices, all of which can contribute to physical and psychological health and well-being.
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Affiliation(s)
- Pedro J Teixeira
- CIPER - Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal,The Synthesis Institute B.V, Amsterdam, The Netherlands,Pedro J Teixeira, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada 1499-002, Portugal.
| | - Matthew W Johnson
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, USA
| | | | | | - David Erritzoe
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannah Douglass
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannes Kettner
- Imperial College London Psychedelic Research Group, London, UK
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36
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Weiss B, Nygart V, Pommerencke LM, Carhart-Harris RL, Erritzoe D. Examining Psychedelic-Induced Changes in Social Functioning and Connectedness in a Naturalistic Online Sample Using the Five-Factor Model of Personality. Front Psychol 2021; 12:749788. [PMID: 34899488 PMCID: PMC8655335 DOI: 10.3389/fpsyg.2021.749788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
The present study examines prospective changes in personality traits relevant to social functioning as well as perceived social connectedness in relation to the naturalistic use of psychedelic compounds in an online volunteer sample. The study also examined the degree to which demographic characteristics, social setting, baseline personality, and acute subjective factors (e.g., emotional breakthrough experiences) influenced trajectories of personality and perceived social connectedness. Participants recruited online completed self-report measures of personality and social connectedness at three timepoints (baseline, 2weeks post-experience, 4weeks post-experience). Linear mixed models were used to examine changes in outcomes and the moderation of these outcomes by covariates. The most substantive changes were reductions in the personality domains Neuroticism, and increases in Agreeableness and social connectedness. Notably, reductions in Neuroticism and increases in Agreeableness covaried over time, which may be suggestive of common processes involving emotion regulation. Preliminary evidence was found for a specific effect on a component of Agreeableness involving a critical and quarrelsome interpersonal style. Although moderation by demographic characteristics, social setting, baseline personality, and acute factors generally found limited support, baseline standing on Neuroticism, perspective taking, and social connectedness showed tentative signs of amplifying adaptive effects on each trait, respectively. Our findings hold implications for the potential use of psychedelics for treating interpersonal elements of personality pathology as well as loneliness.
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Affiliation(s)
- Brandon Weiss
- Psychedelic Research Group, Division of Psychiatry, Department of Brain Sciences Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Lis Marie Pommerencke
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Robin L. Carhart-Harris
- Psychedelic Research Group, Division of Psychiatry, Department of Brain Sciences Department of Medicine, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - David Erritzoe
- Psychedelic Research Group, Division of Psychiatry, Department of Brain Sciences Department of Medicine, Imperial College London, London, United Kingdom
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Abstract
Can the use of psychedelic drugs induce lasting changes in metaphysical beliefs? While it is popularly believed that they can, this question has never been formally tested. Here we exploited a large sample derived from prospective online surveying to determine whether and how beliefs concerning the nature of reality, consciousness, and free-will, change after psychedelic use. Results revealed significant shifts away from 'physicalist' or 'materialist' views, and towards panpsychism and fatalism, post use. With the exception of fatalism, these changes endured for at least 6 months, and were positively correlated with the extent of past psychedelic-use and improved mental-health outcomes. Path modelling suggested that the belief-shifts were moderated by impressionability at baseline and mediated by perceived emotional synchrony with others during the psychedelic experience. The observed belief-shifts post-psychedelic-use were consolidated by data from an independent controlled clinical trial. Together, these findings imply that psychedelic-use may causally influence metaphysical beliefs-shifting them away from 'hard materialism'. We discuss whether these apparent effects are contextually independent.
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Affiliation(s)
- Christopher Timmermann
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK.
| | - Hannes Kettner
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Chris Letheby
- Department of Philosophy, The University of Western Australia, Perth, Australia
- Department of Philosophy, The University of Adelaide, Adelaide, Australia
| | - Leor Roseman
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Fernando E Rosas
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Data Science Institute, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, USA
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Luppi AI, Mediano PAM, Rosas FE, Harrison DJ, Carhart-Harris RL, Bor D, Stamatakis EA. What it is like to be a bit: an integrated information decomposition account of emergent mental phenomena. Neurosci Conscious 2021; 2021:niab027. [PMID: 34804593 PMCID: PMC8600547 DOI: 10.1093/nc/niab027] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/24/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023] Open
Abstract
A central question in neuroscience concerns the relationship between consciousness and its physical substrate. Here, we argue that a richer characterization of consciousness can be obtained by viewing it as constituted of distinct information-theoretic elements. In other words, we propose a shift from quantification of consciousness-viewed as integrated information-to its decomposition. Through this approach, termed Integrated Information Decomposition (ΦID), we lay out a formal argument that whether the consciousness of a given system is an emergent phenomenon depends on its information-theoretic composition-providing a principled answer to the long-standing dispute on the relationship between consciousness and emergence. Furthermore, we show that two organisms may attain the same amount of integrated information, yet differ in their information-theoretic composition. Building on ΦID's revised understanding of integrated information, termed ΦR, we also introduce the notion of ΦR-ing ratio to quantify how efficiently an entity uses information for conscious processing. A combination of ΦR and ΦR-ing ratio may provide an important way to compare the neural basis of different aspects of consciousness. Decomposition of consciousness enables us to identify qualitatively different 'modes of consciousness', establishing a common space for mapping the phenomenology of different conscious states. We outline both theoretical and empirical avenues to carry out such mapping between phenomenology and information-theoretic modes, starting from a central feature of everyday consciousness: selfhood. Overall, ΦID yields rich new ways to explore the relationship between information, consciousness, and its emergence from neural dynamics.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge CB2 1SB, UK
| | - Pedro A M Mediano
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Fernando E Rosas
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, UK
- Data Science Institute, Imperial College London, London SW7 2AZ, UK
- Centre for Complexity Science, Imperial College London, London SW7 2AZ, UK
| | - David J Harrison
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge CB2 1SB, UK
- Department of History and Philosophy of Science, University of Cambridge, Cambridge CB2 3RH, UK
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, UK
| | - Daniel Bor
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
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Spriggs MJ, Douglass HM, Park RJ, Read T, Danby JL, de Magalhães FJC, Alderton KL, Williams TM, Blemings A, Lafrance A, Nicholls DE, Erritzoe D, Nutt DJ, Carhart-Harris RL. Study Protocol for "Psilocybin as a Treatment for Anorexia Nervosa: A Pilot Study". Front Psychiatry 2021; 12:735523. [PMID: 34744825 PMCID: PMC8563607 DOI: 10.3389/fpsyt.2021.735523] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Anorexia nervosa (AN) is a serious and life-threatening psychiatric condition. With a paucity of approved treatments, there is a desperate need for novel treatment avenues to be explored. Here, we present (1) an overview of the ways through which Public Patient Involvement (PPI) has informed a trial of psilocybin-assisted therapy for AN and (2) a protocol for a pilot study of psilocybin-assisted therapy in AN currently underway at Imperial College London. The study aims to assess the feasibility, brain mechanisms and preliminary outcomes of treating anorexia nervosa with psilocybin. Methods: (1) PPI: Across two online focus groups, eleven individuals with lived experience of AN were presented with an overview of the protocol. Their feedback not only identified solutions to possible barriers for future participants, but also helped the research team to better understand the concept of "recovery" from the perspective of those with lived experience. (2) Protocol: Twenty female participants [21-65 years old, body mass index (BMI) 15 kg/m2 or above] will receive three oral doses of psilocybin (up to 25 mg) over a 6-week period delivered in a therapeutic environment and enveloped by psychological preparation and integration. We will work with participant support networks (care teams and an identified support person) throughout and there will be an extended remote follow-up period of 12 months. Our two-fold primary outcomes are (1) psychopathology (Eating Disorder Examination) across the 6-month follow-up and (2) readiness and motivation to engage in recovery (Readiness and Motivation Questionnaire) across the 6-week trial period. Neurophysiological outcome measures will be: (1) functional magnetic resonance imaging (fMRI) brain changes from baseline to 6-week endpoint and (2) post-acute changes in electroencephalography (EEG) activity, including an electrophysiological marker of neuronal plasticity. Discussion: The results of this pilot study will not only shed light on the acceptability, brain mechanisms, and impression of the potential efficacy of psilocybin as an adjunct treatment for AN but will be essential in shaping a subsequent Randomised Control Trial (RCT) that would test this treatment against a suitable control condition. Clinical Trial Registration: identifier: NCT04505189.
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Affiliation(s)
- Meg J. Spriggs
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Hannah M. Douglass
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Rebecca J. Park
- OxBREaD Research Group, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Tim Read
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Jennifer L. Danby
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | | | - Kirsty L. Alderton
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Tim M. Williams
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Allan Blemings
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Adele Lafrance
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - Dasha E. Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - David J. Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
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40
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Mans K, Kettner H, Erritzoe D, Haijen ECHM, Kaelen M, Carhart-Harris RL. Sustained, Multifaceted Improvements in Mental Well-Being Following Psychedelic Experiences in a Prospective Opportunity Sample. Front Psychiatry 2021; 12:647909. [PMID: 34267683 PMCID: PMC8277190 DOI: 10.3389/fpsyt.2021.647909] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/31/2021] [Indexed: 12/20/2022] Open
Abstract
In the last 15 years, psychedelic substances, such as LSD and psilocybin, have regained legitimacy in clinical research. In the general population as well as across various psychiatric populations, mental well-being has been found to significantly improve after a psychedelic experience. Mental well-being has large socioeconomic relevance, but it is a complex, multifaceted construct. In this naturalistic observational study, a comprehensive approach was taken to assessing well-being before and after a taking a psychedelic compound to induce a "psychedelic experience." Fourteen measures of well-being related constructs were included in order to examine the breadth and specificity of change in well-being. This change was then analysed to examine clusters of measures changing together. Survey data was collected from volunteers that intended to take a psychedelic. Four key time points were analysed: 1 week before and 2 weeks, 4 weeks, and 2 years after the experience (N = 654, N = 315, N = 212, and N = 64, respectively). Change on the included measures was found to cluster into three factors which we labelled: 1) "Being well", 2) "Staying well," and 3) "Spirituality." Repeated Measures Multivariate Analysis of Variance revealed all but the spirituality factor to be improved in the weeks following the psychedelic experience. Additional Mixed model analyses revealed selective increases in Being Well and Staying Well (but not Spirituality) that remained statistically significant up to 2 years post-experience, albeit with high attrition rates. Post-hoc examination suggested that attrition was not due to differential acute experiences or mental-health changes in those who dropped out vs. those who did not. These findings suggest that psychedelics can have a broad, robust and sustained positive impact on mental well-being in those that have a prior intention to use a psychedelic compound. Public policy implications are discussed.
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Affiliation(s)
- Keri Mans
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
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41
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Borissova A, Ferguson B, Wall MB, Morgan CJA, Carhart-Harris RL, Bolstridge M, Bloomfield MAP, Williams TM, Feilding A, Murphy K, Tyacke RJ, Erritzoe D, Stewart L, Wolff K, Nutt D, Curran HV, Lawn W. Acute effects of MDMA on trust, cooperative behaviour and empathy: A double-blind, placebo-controlled experiment. J Psychopharmacol 2021; 35:547-555. [PMID: 32538252 PMCID: PMC8155732 DOI: 10.1177/0269881120926673] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND 3,4-Methylenedioxymethamphetamine (MDMA) is being actively researched as an adjunct to psychotherapy. It may be beneficial to trust, empathy and cooperative behaviour due to its acute prosocial effects. AIM To test (a) the acute effects of MDMA on measures of empathy, trust and cooperative behaviour, and (b) subacute changes in mood three days after MDMA administration. METHODS Twenty-five participants (n=7 female), participated in this double-blind, repeated-measures, placebo-controlled experiment. Participants attended two acute sessions, one week apart. Each acute session was followed by a subacute session three days later. Participants received placebo (100 mg ascorbic acid) during one acute session, and MDMA (100 mg MDMA-HCl) at the other, with order counterbalanced. Participants completed the following tasks assessing prosocial behaviour: a trust investment task, a trustworthy face rating task, an empathic stories task, a public project game, a dictator game and an ultimatum game. Participants reported subjective effects. Blood was taken pre-drug, 2 and 4 hours post-drug, and tested for plasma MDMA levels. RESULTS MDMA acutely increased self-reported 'closeness to others' and 'euphoria' and increased plasma concentrations of MDMA. MDMA did not significantly change task-based empathy, trust or cooperative behaviour. Using Bayesian analyses, we found evidence that MDMA and placebo did not differ in their effects on empathy and cooperative behaviour. MDMA did not significantly change subacute mood and this was supported by our Bayesian analyses. CONCLUSION Despite augmentation in plasma MDMA levels and subjective drug effects, we found no increase in prosocial behaviour in a laboratory setting.
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Affiliation(s)
- Anna Borissova
- Clinical Psychopharmacology Unit,
UCL, London, UK,NIHR University College London
Hospitals Biomedical Research Centre, University College Hospital, London,
UK,Anna Borissova, UCL Clinical
Psychopharmacology Unit, 1-19 Torrington Place, London, WC1E 6HB, UK
| | - Bart Ferguson
- UMC Utrecht Brain Center,
University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthew B Wall
- Clinical Psychopharmacology Unit,
UCL, London, UK,Invicro London, London, UK,Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK
| | - Celia JA Morgan
- Psychopharmacology and Addiction
Research Centre, University of Exeter, Exeter, UK
| | - Robin L Carhart-Harris
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK,Centre for Psychedelic Research,
Department of Psychiatry, Imperial College London, London, UK
| | - Mark Bolstridge
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK
| | - Michael AP Bloomfield
- Clinical Psychopharmacology Unit,
UCL, London, UK,NIHR University College London
Hospitals Biomedical Research Centre, University College Hospital, London,
UK,Translational Psychiatry Research
Group, Research Department of Mental Health Neuroscience, Division of
Psychiatry University College London, London, UK,The Traumatic Stress Clinic, St
Pancras Hospital, Camden and Islington NHS Foundation Trust, London,
UK,National Hospital for Neurology
and Neurosurgery, London, UK
| | - Tim M Williams
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK
| | | | - Kevin Murphy
- Cardiff University Brain
Research Imaging Centre, Cardiff, UK
| | - Robin J Tyacke
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK
| | - David Erritzoe
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK,Centre for Psychedelic Research,
Department of Psychiatry, Imperial College London, London, UK
| | | | - Kim Wolff
- School of Biomedical Sciences,
King’s College London, London, UK
| | - David Nutt
- Neuropsychopharmacology Unit,
Centre for Psychiatry, Imperial College London, London, UK
| | | | - Will Lawn
- Clinical Psychopharmacology Unit,
UCL, London, UK
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Szigeti B, Kartner L, Blemings A, Rosas F, Feilding A, Nutt DJ, Carhart-Harris RL, Erritzoe D. Self-blinding citizen science to explore psychedelic microdosing. eLife 2021; 10:e62878. [PMID: 33648632 PMCID: PMC7925122 DOI: 10.7554/elife.62878] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022] Open
Abstract
Microdosing is the practice of regularly using low doses of psychedelic drugs. Anecdotal reports suggest that microdosing enhances well-being and cognition; however, such accounts are potentially biased by the placebo effect. This study used a 'self-blinding' citizen science initiative, where participants were given online instructions on how to incorporate placebo control into their microdosing routine without clinical supervision. The study was completed by 191 participants, making it the largest placebo-controlled trial on psychedelics to-date. All psychological outcomes improved significantly from baseline to after the 4 weeks long dose period for the microdose group; however, the placebo group also improved and no significant between-groups differences were observed. Acute (emotional state, drug intensity, mood, energy, and creativity) and post-acute (anxiety) scales showed small, but significant microdose vs. placebo differences; however, these results can be explained by participants breaking blind. The findings suggest that anecdotal benefits of microdosing can be explained by the placebo effect.
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Affiliation(s)
- Balázs Szigeti
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Laura Kartner
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Allan Blemings
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Fernando Rosas
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Data Science Institute, Imperial College LondonLondonUnited Kingdom
- Center for Complexity Science, Imperial College LondonLondonUnited Kingdom
| | | | - David J Nutt
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Centre for Psychiatry, Imperial College LondonLondonUnited Kingdom
| | | | - David Erritzoe
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Centre for Psychiatry, Imperial College LondonLondonUnited Kingdom
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43
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Luppi AI, Carhart-Harris RL, Roseman L, Pappas I, Menon DK, Stamatakis EA. LSD alters dynamic integration and segregation in the human brain. Neuroimage 2021; 227:117653. [PMID: 33338615 PMCID: PMC7896102 DOI: 10.1016/j.neuroimage.2020.117653] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023] Open
Abstract
Investigating changes in brain function induced by mind-altering substances such as LSD is a powerful method for interrogating and understanding how mind interfaces with brain, by connecting novel psychological phenomena with their neurobiological correlates. LSD is known to increase measures of brain complexity, potentially reflecting a neurobiological correlate of the especially rich phenomenological content of psychedelic-induced experiences. Yet although the subjective stream of consciousness is a constant ebb and flow, no studies to date have investigated how LSD influences the dynamics of functional connectivity in the human brain. Focusing on the two fundamental network properties of integration and segregation, here we combined graph theory and dynamic functional connectivity from resting-state functional MRI to examine time-resolved effects of LSD on brain networks properties and subjective experiences. Our main finding is that the effects of LSD on brain function and subjective experience are non-uniform in time: LSD makes globally segregated sub-states of dynamic functional connectivity more complex, and weakens the relationship between functional and anatomical connectivity. On a regional level, LSD reduces functional connectivity of the anterior medial prefrontal cortex, specifically during states of high segregation. Time-specific effects were correlated with different aspects of subjective experiences; in particular, ego dissolution was predicted by increased small-world organisation during a state of high global integration. These results reveal a more nuanced, temporally-specific picture of altered brain connectivity and complexity under psychedelics than has previously been reported.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, United Kingdom.
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, United Kingdom
| | - Leor Roseman
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, United Kingdom
| | - Ioannis Pappas
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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Kaertner LS, Steinborn MB, Kettner H, Spriggs MJ, Roseman L, Buchborn T, Balaet M, Timmermann C, Erritzoe D, Carhart-Harris RL. Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing. Sci Rep 2021; 11:1941. [PMID: 33479342 PMCID: PMC7820236 DOI: 10.1038/s41598-021-81446-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022] Open
Abstract
Psychedelic microdosing describes the ingestion of near-threshold perceptible doses of classic psychedelic substances. Anecdotal reports and observational studies suggest that microdosing may promote positive mood and well-being, but recent placebo-controlled studies failed to find compelling evidence for this. The present study collected web-based mental health and related data using a prospective (before, during and after) design. Individuals planning a weekly microdosing regimen completed surveys at strategic timepoints, spanning a core four-week test period. Eighty-one participants completed the primary study endpoint. Results revealed increased self-reported psychological well-being, emotional stability and reductions in state anxiety and depressive symptoms at the four-week primary endpoint, plus increases in psychological resilience, social connectedness, agreeableness, nature relatedness and aspects of psychological flexibility. However, positive expectancy scores at baseline predicted subsequent improvements in well-being, suggestive of a significant placebo response. This study highlights a role for positive expectancy in predicting positive outcomes following psychedelic microdosing and cautions against zealous inferences on its putative therapeutic value.
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Affiliation(s)
- L S Kaertner
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK.
| | - M B Steinborn
- Departmant of Psychology, Julius-Maximilans-University Würzburg, Würzburg, Germany
| | - H Kettner
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - M J Spriggs
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - L Roseman
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - T Buchborn
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - M Balaet
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, London, UK
| | - C Timmermann
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - D Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - R L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
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Rosas FE, Mediano PAM, Jensen HJ, Seth AK, Barrett AB, Carhart-Harris RL, Bor D. Reconciling emergences: An information-theoretic approach to identify causal emergence in multivariate data. PLoS Comput Biol 2020; 16:e1008289. [PMID: 33347467 PMCID: PMC7833221 DOI: 10.1371/journal.pcbi.1008289] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/25/2021] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
The broad concept of emergence is instrumental in various of the most challenging open scientific questions-yet, few quantitative theories of what constitutes emergent phenomena have been proposed. This article introduces a formal theory of causal emergence in multivariate systems, which studies the relationship between the dynamics of parts of a system and macroscopic features of interest. Our theory provides a quantitative definition of downward causation, and introduces a complementary modality of emergent behaviour-which we refer to as causal decoupling. Moreover, the theory allows practical criteria that can be efficiently calculated in large systems, making our framework applicable in a range of scenarios of practical interest. We illustrate our findings in a number of case studies, including Conway's Game of Life, Reynolds' flocking model, and neural activity as measured by electrocorticography.
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Affiliation(s)
- Fernando E. Rosas
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London SW7 2DD, UK
- Data Science Institute, Imperial College London, London SW7 2AZ, UK
- Center for Complexity Science, Imperial College London, London SW7 2AZ, UK
| | | | - Henrik J. Jensen
- Center for Complexity Science, Imperial College London, London SW7 2AZ, UK
- Department of Mathematics, Imperial College London, London SW7 2AZ, UK
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8502, Japan
| | - Anil K. Seth
- Sackler Centre for Consciousness Science, Department of Informatics, University of Sussex, Brighton BN1 9QJ, UK
- CIFAR Program on Brain, Mind, and Consciousness, Toronto M5G 1M1, Canada
| | - Adam B. Barrett
- Sackler Centre for Consciousness Science, Department of Informatics, University of Sussex, Brighton BN1 9QJ, UK
- The Data Intensive Science Centre, Department of Informatics, University of Sussex, Brighton BN1 9QJ, UK
| | - Robin L. Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London SW7 2DD, UK
| | - Daniel Bor
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
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Abstract
Psychedelic drugs are potent modulators of conscious states and therefore powerful tools for investigating their neurobiology. N,N, Dimethyltryptamine (DMT) can rapidly induce an extremely immersive state of consciousness characterized by vivid and elaborate visual imagery. Here, we investigated the electrophysiological correlates of the DMT-induced altered state from a pool of participants receiving DMT and (separately) placebo (saline) while instructed to keep their eyes closed. Consistent with our hypotheses, results revealed a spatio-temporal pattern of cortical activation (i.e. travelling waves) similar to that elicited by visual stimulation. Moreover, the typical top-down alpha-band rhythms of closed-eyes rest were significantly decreased, while the bottom-up forward wave was significantly increased. These results support a recent model proposing that psychedelics reduce the 'precision-weighting of priors', thus altering the balance of top-down versus bottom-up information passing. The robust hypothesis-confirming nature of these findings imply the discovery of an important mechanistic principle underpinning psychedelic-induced altered states.
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Affiliation(s)
| | - Christopher Timmermann
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Faculty of Medicine, Imperial CollegeLondonUnited Kingdom
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College LondonLondonUnited Kingdom
| | - David J Nutt
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College LondonLondonUnited Kingdom
| | - Rufin VanRullen
- Cerco, CNRS Université de ToulouseToulouseFrance
- Artificial and Natural Intelligence Toulouse Institute (ANITI)ToulouseFrance
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College LondonLondonUnited Kingdom
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Zeifman RJ, Wagner AC, Watts R, Kettner H, Mertens LJ, Carhart-Harris RL. Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation. Front Psychiatry 2020; 11:782. [PMID: 32903724 PMCID: PMC7438781 DOI: 10.3389/fpsyt.2020.00782] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 07/22/2020] [Indexed: 12/23/2022] Open
Abstract
Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2-weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.
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Affiliation(s)
- Richard J. Zeifman
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Ros Watts
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Hannes Kettner
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Lea J. Mertens
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Molecular Neuroimaging, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| | - Robin L. Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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Girn M, Mills C, Roseman L, Carhart-Harris RL, Christoff K. Updating the dynamic framework of thought: Creativity and psychedelics. Neuroimage 2020; 213:116726. [DOI: 10.1016/j.neuroimage.2020.116726] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/03/2020] [Accepted: 03/07/2020] [Indexed: 01/29/2023] Open
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Family N, Maillet EL, Williams LTJ, Krediet E, Carhart-Harris RL, Williams TM, Nichols CD, Goble DJ, Raz S. Safety, tolerability, pharmacokinetics, and pharmacodynamics of low dose lysergic acid diethylamide (LSD) in healthy older volunteers. Psychopharmacology (Berl) 2020; 237:841-853. [PMID: 31853557 PMCID: PMC7036065 DOI: 10.1007/s00213-019-05417-7] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 11/27/2019] [Indexed: 12/20/2022]
Abstract
Research has shown that psychedelics, such as lysergic acid diethylamide (LSD), have profound anti-inflammatory properties mediated by 5-HT2A receptor signaling, supporting their evaluation as a therapeutic for neuroinflammation associated with neurodegenerative disease. OBJECTIVE This study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamics of orally repeated administration of 5 μg, 10 μg, and 20 μg LSD in older healthy individuals. In the current paper, we present safety, tolerability, pharmacokinetics, and pharmacodynamic measures that relate to safety, tolerability, and dose response. METHODS This was a phase 1 double-blind, placebo-controlled, randomized study. Volunteers were randomly assigned to 1 of 4 dose groups (5 μg, 10 μg, 20 μg LSD, and placebo), and received their assigned dose on six occasions (i.e., every 4 days). RESULTS Forty-eight older healthy volunteers (mean age = 62.9 years) received placebo (n = 12), 5 μg (n = 12), 10 μg (n = 12), or 20 μg (n = 12) LSD. LSD plasma levels were undetectable for the 5 μg group and peak blood plasma levels for the 10 μg and 20 μg groups occurred at 30 min. LSD was well tolerated, and the frequency of adverse events was no higher than for placebo. Assessments of cognition, balance, and proprioception revealed no impairment. CONCLUSIONS Our results suggest safety and tolerability of orally administered 5 μg, 10 μg, and 20 μg LSD every fourth day over a 21-day period and support further clinical development of LSD for the treatment and prevention of Alzheimer's disease (AD).
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Affiliation(s)
| | | | | | | | | | | | - Charles D Nichols
- Department of Pharmacology and Experimental Therapeutics, LSU Health Sciences Center, New Orleans, LA, USA
| | | | - Shlomi Raz
- Eleusis Benefit Corporation, New York, NY, USA
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