Mental Health Psychedelics and OCD | +20 articles

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Cannabis reduces OCD symptoms by half in the short-term

by Washington State University | Neuroscience News | 21 Oct 2020

People with OCD reported a reduction in the symptoms within four hours of smoking cannabis, a new study reports.

People with obsessive-compulsive disorder, or OCD, report that the severity of their symptoms was reduced by about half within four hours of smoking cannabis, according to a Washington State University study.

The researchers analyzed data inputted into the Strainprint app by people who self-identified as having OCD, a condition characterized by intrusive, persistent thoughts and repetitive behaviors such as compulsively checking if a door is locked. After smoking cannabis, users with OCD reported it reduced their compulsions by 60%, intrusions, or unwanted thoughts, by 49% and anxiety by 52%.

The study, recently published in the Journal of Affective Disorders, also found that higher doses and cannabis with higher concentrations of CBD, or cannabidiol, were associated with larger reductions in compulsions.

“The results overall indicate that cannabis may have some beneficial short-term but not really long-term effects on obsessive-compulsive disorder,” said Carrie Cuttler, the study’s corresponding author and WSU assistant professor of psychology. “To me, the CBD findings are really promising because it is not intoxicating. This is an area of research that would really benefit from clinical trials looking at changes in compulsions, intrusions and anxiety with pure CBD.”

The WSU study drew from data of more than 1,800 cannabis sessions that 87 individuals logged into the Strainprint app over 31 months. The long time period allowed the researchers to assess whether users developed tolerance to cannabis, but those effects were mixed. As people continued to use cannabis, the associated reductions in intrusions became slightly smaller suggesting they were building tolerance, but the relationship between cannabis and reductions in compulsions and anxiety remained fairly constant.

Traditional treatments for obsessive-compulsive disorder include exposure and response prevention therapy where people’s irrational thoughts around their behaviors are directly challenged, and prescribing antidepressants called serotonin reuptake inhibitors to reduce symptoms. While these treatments have positive effects for many patients, they do not cure the disorder nor do they work well for every person with OCD.

“We’re trying to build knowledge about the relationship of cannabis use and OCD because it’s an area that is really understudied,” said Dakota Mauzay, a doctoral student in Cuttler’s lab and first author on the paper.

Aside from their own research, the researchers found only one other human study on the topic: a small clinical trial with 12 participants that revealed that there were reductions in OCD symptoms after cannabis use, but these were not much larger than the reductions associated with the placebo.

The WSU researchers noted that one of the limitations of their study was the inability to use a placebo control and an “expectancy effect” may play a role in the results, meaning when people expect to feel better from something they generally do. The data was also from a self-selected sample of cannabis users, and there was variability in the results which means that not everyone experienced the same reductions in symptoms after using cannabis.

This study points out that further research, particularly clinical trials on CBD, may reveal a therapeutic potential for people with OCD.

However, Cuttler said this analysis of user-provided information via the Strainprint app was especially valuable because it provides a large data set and the participants were using market cannabis in their home environment, as opposed to federally grown cannabis in a lab which may affect their responses. Strainprint’s app is intended to help users determine which types of cannabis work the best for them, but the company provided the WSU researchers free access to users’ anonymized data for research purposes.

Cuttler said this study points out that further research, particularly clinical trials on the cannabis constituent CBD, may reveal a therapeutic potential for people with OCD.

This is the fourth study Cuttler and her colleagues have conducted examining the effects of cannabis on various mental health conditions using the data provided by the app created by the Canadian company Strainprint. Others include studies on how cannabis impacts PTSD symptoms, reduces headache pain, and affects emotional well-being.

Cannabis Reduces OCD Symptoms by Half in the Short-Term - Neuroscience News

People with OCD reported a reduction in the symptoms within four hours of smoking cannabis, a new study reports.

neurosciencenews.com

 

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Safety, tolerability and efficacy of psilocybin in patients with OCD

Moreno, Wiegand, Taitano, Delgado

Obsessive-compulsive disorder (OCD) is a chronicand debilitating condition with a lifetime prevalence of 2% to 3%, which makes it the fourth most common psychiatric diagnosis and one with a very high disease burden. Furthermore, OCD is commonly complicated by the presence of comorbid delusions, suicidality, panic, substance abuse, depression, and interpersonal difficulties. Many patients with OCD delay or altogether avoid pursuing care, and of those who seek help, many remain unrecognized and untreated.

It is now well established that serotonin (5-HT) re-uptake inhibitors (SRIs), such as the selective serotonin re-uptake inhibitors (SSRIs) and clomipramine, are among the most effective pharmacologic treatments for OCD, although these treatments generally reduce symptoms by only 30% to 50%. Some SRI-treated patients who receive the 5-HT2 antagonist metergoline experience a resurgence of OCD symptoms. Supporting the central role of 5-HT in the efficacy of SRIs, drugs such as desipramine and bupropion, which may act primarily by blocking reuptake of norepinephrine and/or dopamine, are not effective treatments for OCD.

In spite of the greater efficacy of potent SRIs compared with other agents in the treatment of OCD, they are still suboptimal. The length of time required for improvement of patients undergoing treatment with SRIs is quite extensive, the rates of remission are minimal, and many patients considered responders have residual symptoms that continue to cause dysfunction and may increase vulnerability to complications and exacerbations. In addition to SRIs, other effective treatments include cognitive behavioral psychotherapy (CBT), combination of SRIs and CBT, and the use of polypharmacy. It is estimated that as many as 40% to 60% of those who are adequately treated will fail to respond to standard therapies. For these reasons, identifying new options for treatments has become a high priority.

There are several reported cases concerning the beneficial effects of psychedelic drugs (psilocybin and LSD) in patients with OCD and related disorders. For example, a 34-year-old man had suffered from OCD symptoms (checking and counting compulsions, performing actions a specific number of times, and a variety of other rituals) since age 14. However, he began using freeze-dried psilocybe mushrooms recreationally at age 18 and observed consistently that during the psilocybe mushroom intoxication, he was free of obsessions or compulsions. Repeated use induced tolerance to the psychedelic effects, but the subject continued to experience relief of his OCD symptoms despite thelack of a “high.” Chronic use of this psychedelic led to asymptomatic remission, which lasted for several months after discontinuing use.

Psilocybin, an indolealkylamine, is the main active compound of many species of the genus Psilocybe. Psilocybin binds potentlyas an agonist to the 5-HT1A, 5-HT2A, and 5-HT2C receptors. Behavioral pharmacology and electrophysiologic research show that agonist activity at 5-HT2 receptors strongly correlates with a stimulus effect in animals and a psychedelic effect in humans. Oral doses ranging from 8 to 20 mg or 100 to 315 μg/kg are considered safe and able to induce a quantifiable psychedelic experience that lasts, depending on the dose, from 3 to 8 hours.

Given a large first-pass metabolism in which psilocybin is converted primarily to psilocin, the latter may actually be responsible for the psychotropic effects observed after psilocybin administration. Given the large body of clinical data suggesting that pharmacologic potency in increasing synaptic 5-HT may underlie the therapeutic effects of some drugs in the treatment of OCD and the anecdotal reports of acute reduction in OCD symptoms with psychedelics, we hypothesized that agonist activity at 5-HT1A, 5-HT2A, and/or 5-HT2C receptors might underlie the efficacy of drug treatments for OCD. The present study sought to evaluate the safety, tolerability, and potential therapeutic effect of psilocybin administration in OCD patients who had failed to respondto at least one adequate treatment trial with SRI agents. Additionally, we sought to explore the relationship between the intensity of psychedelic experience and the severity of obsessions and compulsions during testing.

CONCLUSIONS

When administered in a supportive clinical environment, psilocybin appears to be safe and well tolerated. Psilocybin was associated with transient symptomatic reduction of OCD symptoms in subjects with treatment-resistant OCD.

These data result from a small proof-of-concept, phase I study designed to explore the safety for human consumption of 4 doses of psilocybin in a small sample of symptomatic OCD patients. The escalating dosing scheme was selected to allow exposure to increasingly higher doses only to individuals who had tolerated previous exposures. A smaller dose (VLD) was hypothesized to have negligible psychedelic effects and was introduce drandomly at any time after the first dose. Subjects experienced stronger than anticipated response to this dose and its clinical effects were also greater than anticipated. This response to VLD impedes the use of VLD as a placebo comparator, which clearly represents a major obstacle in our ability to explore clinical effects. Another methodological concern is the fact that the order of the doses was escalating, with the exception of VLD, which was inserted randomly and in double-blind fashion. This modified blind may have influenced expectations in both subjects and raters. Despite the obvious limitations from design and sample size, the data are suggestive of an acute benefit, worth exploring further.

Although we understand the psychedelic mechanism of action of psilocybin, it is not clear which specific receptors or pathways may mediate anti-obsessional responses. It may be possible for subjects to experience a decrease in symptoms by the mere artifact of mindset and setting, which are known to affect the psychedelic experi-ence in itself; by the contextual expectation of improvement; or just by the distracting psychedelic effects or a “pleasurable experience.” It should be noted that to someof the patients the exposure to a psychedelic agent was perceived as a stressful event; for others, testing represented a time without access to the usual distractions that help reduce their obsessions; and for most, the overnight stay in the hospital represented a significant stressor. Therefore, the setting was ideal not for reduction of stressand obsessions, but rather for safety and monitoring purposes. This issue may have introduced selection bias by allowing participation by only those subjects who tolerated travel and overnight hospitalization.

There was, however, no clear dose-response relationship to the change in YBOCS score and no correlation of YBOCS score reduction to the perceived psychedelic intensity based on HRS total score or intensity subscale score.

Although the intent of this study was not to conduct psychedelic-facilitated therapy during testing, five of the subjects readily described their experiences as very psychologically and spiritually enriching. Four subjects reported during HD profound positive transcendental experiences such as exploration of other planets, visiting past-life reincarnations, and interacting with deities. Most subjects reporting symptom reduction experienced a period of relief that extended beyond the pharmacologically expected life of the drug and beyond the 24-hour rating. This lingering effect, which extends clearly beyond the “high” or psychedelic state, raises a number of intriguing mechanistic questions. For example, does the effect result from a residual feeling of well-being due to the experience of temporary symptom distraction or “pleasure,” from the psychological insights described above, or from changes in working memory and attention as reported previously, or is the effect directly pharmacologically mediated? Although the explanation is highly speculative, if these are prolonged pharmacologic effects, they may be related to a rapid adaptive cascade ofevents such as postsynaptic 5-HT receptor down-regulation or early gene expression.

A large body of evidence supports the down-regulation of 5-HT2A receptors in response to psychedelic administration in animal models and human subjects. LSD has been reported to induce intracellular signal transduction changes that are different from endogenous 5-HT despite binding to the same receptor site. In fact, LSD is reported to decrease gene expression in rat brain after single-dose administration, while no changes in expression of 5-HT1A, 5-HT2A, or 5-HT2C were observed. These changes in gene expression, although reported with a similar compound rather than with psilocybin, may result in physiologic alterations that explain the delayed effect described above. It is also possible that the early changes in gene expression may be different after repeated administration of LSD or similar compounds, leading to the known down-regulation of 5-HT2A.

Ingestion of psilocybin and similar substances will facilitate subjects’ experiencing of altered states of consciousness and may lead to the development of powerful insights and profound existential and spiritual questions. Administration of these substances therefore should be approached with caution to minimize exposure to individuals who are vulnerable to psychosis or overvalued ideas. Researchers should carefully consider the subject’s mindset prior to exposure, address concerns developed during the psychedelic experience through careful debriefing, and secure a source of supportive continuity afterward. In spite of these concerns, given that OCD is associated with a great deal of human suffering and societal burden, and that treatment-resistant OCD represents a valid indication for irreversible brain surgery, it may be reasonable to consider psilocybin, with its potential benefit, a less burdensome alternative and one worth investigating further.

In summary, this study confirms and extends anecdotal reports of acute reduction in OCD symptoms with exposure to psilocybin. Given the chronicity and disease burden of OCD and the high rate of insufficient response to currently approved treatments, future studies involving traditional blinded, randomized, placebo-controlled methodology should explore the efficacy of and duration of therapeutic benefit from a more prolonged exposure to repeated doses of psilocybin in patients with OCD.

http://www.maps.org/research-archive/w3pb/2006/2006_Moreno_22868_1.pdf

 

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Can CBD treat obsessive-compulsive disorder?

Neuroscience News | June 3, 2019

Study provides evidence the endocannabinoid system plays a crucial role in obsessive-compulsive disorder (OCD). Using cannabinoid drugs have a positive impact in helping control behaviors associated with OCD.

The body’s endocannabinoid system, due to the critical role it plays in regulating neurotransmitter signaling, is an enticing target for drug development against disorders associated with anxiety, stress, and repetitive behaviors, such as obsessive-compulsive disorder (OCD). A comprehensive new review article that provides an overview of this complex system, endogenous and exogenous cannabinoids, results of animal studies and human trials to date, and recommendations for future directions is published in Cannabis and Cannabinoid Research.

The article entitled “The Endocannabinoid System: A New Treatment Target for Obsessive Compulsive Disorder?” was co-authored by Reilly Kayser, MD, Ivar Snorrasson, PhD, Margaret Haney, PhD, and H. Blair Simpson, MD, PhD, Columbia University Vagelos College of Physicians and Surgeons, and Francis Lee, MD, PhD, Weill Cornell Medical College, (New York, NY). The researchers present evidence that links the endocannabinoid system to the pathology underlying OCD. They also explore the potential for targeting this system to relieve symptoms of OCD and related disorders such as anxiety, tic, and impulse control disorders. The review includes an extensive overview of cannabinoids made by the body, and exogenous cannabinoids, including phytocannabinoids found in the marijuana plant and purified and synthetic cannabinoids.

Based on both animal study data showing anti-anxiety and anti-compulsive effects of cannabinoid agents and on preliminary human clinical trial data, the authors suggest that continued pharmaceutical development is warranted. Which cannabinoid agents to test and how to measure their effects will be among the important questions to consider in designing future studies.

“Is there a place for cannabinoid-based medicines in psychiatry? Evidence from animal and human studies points to the endocannabinoid system as an important regulator of emotionality, but how can we exploit this knowledge for therapy? This review article offers a critical assessment of the evidence, focused on obsessive-compulsive disorder, and clues to future research,” says Editor-in-Chief Daniele Piomelli, PhD, University of California-Irvine, School of Medicine.

Can cannabinoids help treat obsessive-compulsive disorder? - Neuroscience News

Study provides further evidence the endocannabinoid system plays a crucial role in obsessive-compulsive disorder (OCD). Using cannabinoid drugs have a positive impact in helping control behaviors associated with OCD.

neurosciencenews.com

 

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Psilocybin mushroom extract more effective in reducing OCD symptoms than pure psilocybin

by Barb Bauer | PSR | Jul 10 2019

The "entourage effect" is a phenomenon most often discussed in the field of medical cannabis. The term refers to the synergistic interaction of two or more different molecules when those molecules are co-administered, such as upon consuming a natural extract or an engineered formulation of components. However, anecdotal and experimental evidence exists showing that the entourage effect is also at work with the compounds found in magic mushrooms and the secretions of some species of toads. One study from 2009 published in Bioscience, Biotechnology, and Biochemistry presents data supporting the entourage effect in magic mushrooms. Specifically, scientists studied the effects of pure psilocybin versus an extract from magic mushrooms on a mouse model of obsessive-compulsive disorder (OCD).

"Marble-Burying Behavior"

Marble-Burying Behavior (MBB) in mice and rats is used as an animal model for the study of OCD. The accuracy of the model has faced some criticism in the scientific world. This is primarily because OCD and generalized anxiety disorder have symptoms that overlap and the causes of these conditions are unknown. As a result, it can be difficult to determine which condition the treatment is affecting. Researchers and other experts in the area of OCD believe that at a high level, some of the results from MBB studies are relevant to understanding OCD. However, they caution that MBB may not be useful when it comes down to evaluating the effectiveness of anti-compulsive drugs.

Psilocybin Mushroom Extract is more effective than psilocybin alone

In this study, the research team compared the effects of an extract from Psilocybe argentipes to pure psilocybin using MBB and 5-week old male mice. The results of the study showed that the same dose of the mushroom extract and pure psilocybin were effective in reducing marble-burying behavior. But even more interesting was the finding that the Psilocybin Mushroom Extract was more effective at the same dose in reducing the behavior than pure psilocybin alone. A dose of 0.1 to 1.0 g/kg was significant in reducing the number of buried marbles without affecting the overall locomotor activity of the mice.

Also of interest is that the data for P. argentipes showed an inverted bell curve for the relationship between the dose level and the number of marbles the mice buried. The authors note that this is an unusual result. Many chemicals show a proportional relationship in the marble-burying test, meaning higher doses reduce the number of marbles buried as well as the locomotor activity of the mice. The authors sum up the overall study results by saying:

"These findings suggest that inhibition of marble-burying behavior by P. argentipes is due to the involvement of a variety of psychoactive substances."

The importance of the entourage effect

When it comes to studying magic mushroom compounds, the majority of researchers are focusing on psilocybin and psilocin. Of course, these two compounds are important to the psychedelic mushroom experience and are worthy of study and understanding them. However, the entourage effect dictates the overall outcome —how all the active compounds in magic mushrooms work together and with receptors to produce the effect for the user. The few scientific studies, such as this one, offer a brief and tantalizing glimpse into the impact of the entourage effect on psychedelic drug therapy. The entourage effect offers a wide-open area of study for the curious researcher.

*From the article here :

Psilocybin Mushroom Extract More Effective Than Pure Psilocybin in Reducing OCD Symptoms in Mice

This study provides more evidence for the entourage effect in magic mushrooms.

psychedelicreview.com

 

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Can psychedelics cure OCD?

by Adam Strauss | Huffington Post | 14 Dec 2017

Whatever shirt I put on was somehow wrong. It didn't fit right, or there was a small stain: either way I was making a mistake. But the next shirt was even worse, and now the anxiety was, too. I'd spend hours compulsively putting on and taking off shirts, frantically trying to find one that felt right. Once I did finally leave the apartment, I had to decide which side of the street to walk down, where to sit on the subway: even the most trivial choices were freighted with terrible significance, and I lived in constant dread of making the wrong one.

My diagnosis was obsesssive-compulsive disorder, and like many with OCD, my condition was termed "treatment-resistant OCD." Prozac, Paxil, Zoloft, Xanax, Luvox, Lamictal, Lexapro and Effexor had all failed to halt my steady slide. Ditto twice-weekly therapy sessions, yoga, meditation, acupuncture, herbal remedies. Inch by inch, the need to make the perfect decision swallowed relationships, career and everything else Id once cared about until I was spending weeks on end holed up in my apartment.

So when I read that University of Arizona researchers had found psilocybin, the psychoactive compound in hallucinogenic mushrooms, could alleviate symptoms of severe, treatment-resistant OCD, I figured I didn't have much to lose by trying shrooms.

Roughly 2% of the population has OCD, which studies show can be as debilitating as schizophrenia in its impact on everyday functioning; one in seven OCD sufferers eventually attempts suicide. About half of OCD patients don't respond to medication, and those who do almost always still suffer from significant symptoms. The last truly novel OCD drug was Prozac, and after decades of R&D dead ends, the pharmaceutical industry has given up searching for the next one. The situation is so bleak that psychosurgery, in which parts of the brain are permanently destroyed, is an accepted OCD treatment, even though it is only moderately effective and can cause severe cognitive impairment and even paralysis.

Yet despite this desperate need for better treatments, in the years since I read that psilocybin study, there has been no further investigation of psilocybin for OCD.

Psilocybin, along with LSD and most other psychedelics, was classified in 1970 as a Schedule I drug, defined as having high risk of abuse and addiction and no medical use. While this was perhaps an understandable reaction to the excesses of the Woodstock era, the reality, as a large population study recently concluded, is that "psychedelics are not known to harm the brain or other body organs or to cause addiction." Another recent study found that people who have used psychedelics actually had significantly reduced risk of severe psychological problems compared to those who have never tried these drugs.

As for medical use, a growing body of recent research suggests psychedelics have a capacity for rapidly effecting lasting, positive change that science simply has not found elsewhere. For example, NYU investigators report that after a single dose of psilocybin, cancer patients "almost uniformly experienced a dramatic reduction in existential anxiety and depression... and the changes lasted a year or more and in some cases were permanent." Johns Hopkins researchers found that psilocybin enabled 80% of long-term smokers to quit, more than double the rate of the most effective current treatments. University of New Mexico researchers reported that a single psilocybin dose dramatically reduced drinking among alcoholics throughout their study's eight month follow up period. Psychedelics have also shown tremendous promise in treating severe depression and PTSD.

Given such singularly promising results, why isn't there more research under way into the potential therapeutic use of psychedelics?

In a word, money. Virtually all drug development is financed by two sources: pharmaceutical firms and government agencies. The former have little interest in medications that cant be patented, and the latter are squeamish about drugs still officially deemed a dire menace. So all funding has come from a handful non-profit organizations, foremost among them MAPS, which backed the OCD study that inspired my own quest. While MAPS continues to fund groundbreaking research on psychedelic-assisted therapy for conditions such as PTSD and end-of-life anxiety, their annual budget is around $4 million; in comparison, last year Pfizer spent over $200 million just to advertise Cialis.

Thanks in part to psychedelics, I am not only able to leave the house, I am well enough to share my story in the form of a monologue called The Mushroom Cure, currently playing at the Theatre 80 in New York.

https://www.huffingtonpost.com/entry...b0c863d4004453​

 

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Man opens up about his experience treating OCD with magic mushrooms

by Michelle Soriano | Rebel Circus

Adam Strauss is a writer, comic, and performer, and the creator of the off-broadway show “The Mushroom Cure.” On April 23, Strauss spoke to Vice about his experience treating his mental health issues with — gasp — magic mushrooms. He was in his 20s when he first started noticing symptoms of Obsessive Compulsive Disorder (OCD), and was in desperate need of help. As a result, he turned to psychedelics.

After recognizing his symptoms, Strauss turned to different things for help. He tried therapy, yoga, meditation, and, of course, medication—but nothing worked. Then, he stumbled upon a “small proof-of-concept study online about the impact of psilocybin—the active, psychedelic ingredient in magic mushrooms—on OCD,” Vice reports.

After looking into the study, Strauss was determined to embark on a new chapter in life— one of experimentation. After dabbling with magic mushrooms, as suggested by the study, Strauss noticed something big: He was, slowly but surely, curing himself of OCD.

That said, there still isn’t enough science behind using psilocybin for OCD. Still, Strauss was inspired to share his personal experience with others. Enter the off-broadway show, “The Mushroom Cure."

In a post for The Huffington Post, Strauss explains how he used to live in constant dread. "Whatever shirt I put on was somehow wrong,” he says. "It didn’t fit right, or there was a small stain—either way I was making a mistake. But the next shirt was even worse—and now the anxiety was too."

Strauss notes how his condition was initially deemed “treatment-resistant”— meaning that no medication could help him. "Inch by inch, the need to make the perfect decision swallowed relationships, career and everything else I’d once cared about until I was spending weeks on end holed up in my apartment,” he writes. By the time he stumbled on the study about shrooms, Strauss figured he didn’t have much to lose.

Strauss goes on to note how psilocybin and LSD, along with most other psychedelics, were classified in 1970 as a Schedule I drug, defined as having high risk of abuse and addiction—and no medical use. However, this is not necessarily true.

"While this was perhaps an understandable reaction to the excesses of the Woodstock era, the reality, as a large population study recently concluded, is that 'psychedelics are not known to harm the brain or other body organs or to cause addiction,’” Strauss explains. "Another recent study found that people who’ve used psychedelics actually had significantly reduced risk of severe psychological problems compared to those who’ve never tried these drugs."

As for medical use, research indicates psychedelics have the ability to affect people in a positive way. This, Strauss notes in his piece, is something that “science simply hasn’t found elsewhere.” From helping cancer patients dealing with existential anxiety to treating severe depression and PTSD, psychedelics have shown — and continue to show — great promise in treating certain conditions.

So, why isn’t there more research on the matter? "In a word: money,” Strauss writes. "Virtually all drug development is financed by two sources: pharmaceutical firms and government agencies. The former have little interest in medications that can’t be patented, and the latter are squeamish about drugs still officially deemed a dire menace."

As a result, all funding into the matter has to come from non-profit organizations. The biggest among them? The Multidisciplinary Association for Psychedelic Studies (MAPS), which backed the OCD post that Strauss first stumbled upon.

"While MAPS continues to fund groundbreaking research on psychedelic-assisted therapy for conditions such as PTSD and end-of-life anxiety, their annual budget is around $4 million; in comparison, last year Pfizer spent over $200 million just to advertise Cialis,” Strauss explains.

Today, Strauss is a different, healthier man— and it’s all thanks to psychedelics. "While there may be more urgent challenges facing humanity (war, hunger, climate change—take your pick) I believe there’s no other area where so little can change so much: with psychedelic research, right now every dollar really does make a difference,” he notes.

Strauss points out that “we’re barely scratching the surface on what may be one of the most effective treatments there is for mental illness." He adds: "I also believe that problems like war, hunger, and climate change are far more likely to be solved if we avail ourselves of the empathy and compassion that are often the fruit of psychedelic experience."

Even though there has been an increase in use of psychiatric medications, mental health issues are currently the leading cause of disability in the U.S. overall, they afflict one in four adults each year. For many, their condition is fatal and leads to suicide.

"Whether psychedelics can meaningfully change this grim picture is still an open question,” Strauss concludes. "But in the face of so much unrelieved suffering, it’s one that’s clearly worth answering. Sometimes the right choice is clear."

Man Opens Up About His Experience Treating OCD With Magic Mushrooms

Recently, writer and comic Adam Strauss spoke to Vice about his experience treating his mental health issues with magic mushrooms.

www.rebelcircus.com

 

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People with OCD have six times higher levels of the protein, Imood

Queen Mary University of London | Neuroscience News | 21 April 2020

People with OCD have six times higher Immuno-moodulin (Imood) expression than those without the disorder.

Blocking Imood, with the aid of an antibody, reduced OCD-like behaviors in mouse models within a couple of days following treatment.

Scientists at Queen Mary University of London and the University of Roehampton, London, have discovered that patients suffering from obsessive-compulsive disorder (OCD) have increased levels of a protein called Immuno-moodulin (Imood) in their lymphocytes, a type of immune cell.

The findings have led the researchers to file a patent application for the antibody and they are now working with a drug company to develop a potential treatment for human patients.

Mice with high levels of this protein were also found to exhibit behaviours that are characteristic of anxiety and stress, such as digging and excessive grooming.

When the researchers treated the mice with an antibody that neutralised Imood, the animals’ anxiety levels reduced.

The findings have led the researchers to file a patent application for the antibody and they are now working with a drug company to develop a potential treatment for human patients.

“There is mounting evidence that the immune system plays an important role in mental disorders,” said Professor Fulvio D’Acquisto, a professor of immunology at the University of Roehampton and honorary professor of Immunopharmacology at Queen Mary University of London, who led the research. “And in fact people with auto-immune diseases are known to have higher than average rates of mental health disorders such as anxiety, depression and OCD. Our findings overturn a lot of the conventional thinking about mental health disorders being solely caused by the central nervous system.”

Professor D’Acquisto, whose findings are published in the journal Brain Behavior and Immunity, first identified Imood by chance while studying a different protein called Annexin-A1 and the role it plays in autoimmune diseases such as multiple sclerosis and lupus.

He had created transgenic mice to over-express this protein in their T-cells, one of the main cells responsible for the development of autoimmune diseases, but found the mice showed more anxiety than normal. When he and his team analysed the genes expressed in the animals’ T-cells, they discovered one gene in particular was especially active. The protein produced from this gene was what they eventually named Immuno-moodulin, or Imood.

When the anxious mice were given an antibody that blocked Imood, their behaviour returned to normal in a couple of days.

The researchers tested the immune cells from 23 patients with OCD and 20 healthy volunteers. They found Imood expression was around six times higher in the OCD patients.

Other recent research by scientists elsewhere have also found the same protein may also play a role in Attention-Deficit/Hyperactivity Disorder.

Professor D’Acquisto believes Imood does not directly regulate brain functions in a classical way, for example by changing the levels of chemical signals in neurons. Instead, it may influence genes in brain cells that have been linked to mental disorders like OCD.

“This is work we still have to do to understand the role of Imood,” he said. “We also want to do more work with larger samples of patients to see if we can replicate what we saw in the small number we looked at in our study.”

In the meantime, Professor D’Acquisto and Dr Dianne Cooper, a Senior Lecturer at Queen Mary University of London, are working with the biopharmaceutical company UCB to develop antibodies against Imood that can be used in humans and to understand how this could be used to treat patients with mental disorders.

“It is early still, but the discovery of antibodies – instead of the classical chemical drugs – for the treatment of mental disorders could radically change the life of these patients as we foresee a reduced chance of side effects,” he said. Professor D’Acquisto estimates it could take up to five years before a treatment can be taken to clinical trials.

Antibodies could provide new treatment for OCD - Neuroscience News

People with OCD have six times higher Immuno-moodulin (Imood) expression that those without the disorder. Blocking Imood with the aid of an antibody reduced OCD-like behaviors in mouse models within a couple of days following treatment.

neurosciencenews.com

 

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Scientists to investigate psilocybin's impact on OCD

by Chris Moore | 1 Jun 2020

British researchers are researching whether psilocybin can provide a unique, safe treatment for this condition.

A British charity has raised over $69,000 to fund new clinical trials exploring whether psilocybin can help treat symptoms of obsessive compulsive disorder (OCD).

Last month, a new charity called Orchard launched a crowdfunding campaign to raise money for research into psilocybin as an OCD treatment. By May 15, just one week after it launched, the campaign met its initial goal of £50,000. The campaign is now working towards a stretch goal of £80,000, and has currently secured nearly £56,000 in donations.

The campaign will fund a new series of clinical trials that will be conducted by Professor David Nutt, director of the Neuropsychopharmacology Unit at the Division of Brain Sciences at Imperial College London. Professor Nutt and his team have already conducted research finding that psilocybin can be used as a fast-acting antidepressant. For the new study, researchers will administer either a low dose of psilocybin (10 mg) or a placebo to patients suffering from OCD.

Although psilocybin remains illegal in the UK, the researchers will be able to source legal psilocybin from the UK Home Office, as researchers have already demonstrated that this natural medicine is one of the world’s safest drugs. The researchers will be using psilocybin created by a pharmaceutical company, since it is difficult to determine the exact dose of psilocybin that a natural mushroom contains.

OCD, which affects over 2 percent of the population, can cause intrusive, recurrent, and disturbing thoughts. This disorder is popularly characterized by excessive hand washing, but most commonly involves intrusive thoughts, often about terrifying or taboo subjects. The ongoing coronavirus pandemic has increased obsessive fears over contamination for many of these patients, leading to hours of compulsive cleaning or other behavior every day. Around 60 percent of OCD patients in the UK are also suffering from depression, and 1 in 7 attempts suicide.

Orchard was founded by Nick Sireau, a social entrepreneur who has been suffering with this disorder for over 30 years. Sireau told VT that he “spent years trying to access treatment, having different forms of psychological treatment... and going on different medications.” But these traditional treatments proved ineffective at treating his symptoms, and Sireau “became an advocate for new treatments for OCD as many of us OCD sufferers do not respond to existing treatments."

"I have never taken magic mushrooms to treat my OCD, although I heard anecdotally from people who have used this successfully,” Sireau continued. “Furthermore, a small study in 2006 by the University of Arizona showed that psilocybin could help with OCD symptoms. As a charity, we are not encouraging OCD patients to go out and try magic mushrooms. Instead, we are funding a scientific feasibility study to see whether psilocybin — the active ingredient in magic mushrooms — can help with OCD at a low dose.”

Professor Nutt told VT that he doubts “a complete cure for everyone with OCD will ever be found, because OCD is multi-faceted and has many genetic, environmental, neurological, biochemical, and other causes.” For this reason, Nutt helped found Orchard “to accelerate the development of many new and better treatments for OCD. We are starting with psilocybin and we will then go on to work on other potential treatments."

Other than the limited trial conducted in Arizona, there has been no research on the effects of psilocybin on OCD patients. Other studies have found that this natural psychedelic can help break addictions, quell anxiety, and reduce depression, however. Dozens of new studies are currently researching if psilocybin can help treat brain injuries, chronic pain, eating disorders, and other issues, and the US government is currently working towards legalizing psilocybin-assisted therapy.

UK Researchers Raise Nearly $70,000 to Research Psilocybin's Impact on OCD

The coronavirus pandemic is making life harder for OCD patients, but British researchers are researching whether psilocybin can provide a unique, safe treatment for this condition.

merryjane.com

 

[mr peabody]

Can psilocybin treat OCD?*

by Rich Haridy | New Atlas | 23 Jul 2020

A new review from neuroethicist Eddie Jacobs, and published in the Journal of Psychedelic Studies, is suggesting psilocybin may have great potential as a treatment for obsessive-compulsive disorder (OCD). Jacobs, from King’s College London and the University of Oxford, says it is surprising how little focus has been on the therapeutic potential of psilocybin in treating OCD, and he points to a number of new clinical trials that are finally exploring this promising treatment.

The ongoing psychedelic science renaissance has delivered a number of remarkable breakthroughs in recent years. From the incredible results seen in MDMA-assisted psychotherapy trials for PTSD, to the equally potent data coming from psilocybin psychotherapy for major depression, we will inevitably see psychedelic medicine finally become a legal therapy within the next few years.

Psilocybin, a natural psychedelic compound found in magic mushrooms, has been granted Breakthrough Status designation by the FDA on two occasions in recent years for treatment-resistant depression and major depressive disorder. The Breakthrough Therapy status is an indication early clinical evidence is strong and clinically meaningful. Alongside depression, psilocybin therapy is also seen to be effective in helping terminal cancer patients deal with end of life anxiety.

How can psilocybin help OCD?

OCD is the fourth most common mental illness, after depression, substance abuse and specific phobias. Affecting more than 2 percent of people at some point in their life, OCD can be profoundly distressing and disruptive.

Eddie Jacobs’ interest in psilocybin for OCD arose when he discovered how little research attention had been directed at this particular therapeutic outcome. He suggests that, although much excitement surrounds the results of psilocybin therapy for conditions such as depression and anxiety, the treatment should hypothetically also be effective for OCD.

"... psychedelics can interrupt rigidly repeating patterns of thought and behavior that people want to escape, but struggle to" -Eddie Jacobs

“OCD seems to perfectly encapsulate the sorts of maladaptive processes that we know – from clinical and experimental trials, and anecdotal report – psychedelics can interrupt rigidly repeating patterns of thought and behavior that people want to escape, but struggle to,” says Jacobs in an email to New Atlas.

Jacobs’ new review article set out to fill a gap in our body of knowledge, effectively summarizing what we know about OCD and psilocybin therapy, while also offering an outline of what research has been done up till now.

“There are reports from back in the first age of psychedelic therapy that suggested OCD symptoms were amenable to this sort of treatment,” says Jacobs. “Frustratingly, a lot of the research from those days doesn't match up to modern standards of rigor, so we're probably best to consider them clues pointing in a direction, rather than firm evidence in and of themselves. The other evidence for psilocybin in OCD – case reports and (quite a lot!) of anecdotal reports, are the same.”

Alongside these anecdotal reports and case studies there are several strong mechanistic hypotheses to explain how psilocybin could be useful in treating OCD. One of those hypotheses, for example, relates to a large-scale interconnected collection of brain regions, known as the default mode network (DMN).

The DMN is essentially the state of our brain when we are at rest, not sleeping, but instead the “default” mode of brain connectivity when we are not performing active tasks. DMN activity is linked with self-reflection and daydreaming, and dysfunction in one’s DMN has been associated with depression and anxiety.

Psilocybin has been found to serve a little like a reset button for a dysfunctional DMN. Imaging studies have revealed a single dose of psilocybin can temporarily disintegrate resting state networks such as the DMN. And many researchers hypothesize this pharmacological action plays a part in the positive therapeutic outcomes seen in psilocybin therapy.

Jacobs suggests there is some evidence dysfunctional DMN activity plays a role in OCD by enhancing self-referential cognitive processing. And it is reasonable to hypothesize psilocybin could help “reset” this dysfunction in OCD patients.

“The disruption and reintegration ‘reset’ in DMN activity that is seen with psilocybin may, in OCD patients, allow the easing of an overly strong, top-down filtering bias, thereby re-establishing normal responsiveness towards the environment,” explains Jacobs in the published review.

The one modern clinical trial

To date there has only been one clinical investigation of psilocybin for OCD, conducted in the early days of the psychedelic science renaissance by Francisco Moreno and colleagues at the University of Arizona. The study, published in 2006, recruited nine OCD patients classified with moderate to severe symptoms.

Each patient was administered three doses of psilocybin, separated a week apart, with each dose escalating in potency. As well as establishing a safety profile for administering the psychedelic in this type of cohort, the study was primarily looking at whether the treatment offers short-term relief from severe OCD symptoms in the 24-hour period following a dose.

The results found all patients displayed some kind of symptomatic relief from their OCD symptoms in the 24-hour period following a treatment. The long-term effects were less impressive, but still relevant, with two subjects reporting relief for up to a week, and one patient remarkably showing sustained remission from OCD symptoms at a six-month follow-up.

“OCD is currently not very well treated; even when our current approaches work, there's still significant residual symptoms,” says Jacobs, in reference to the Moreno study. “Considering that context, and considering the Moreno study wanted to confirm an effect over the course of 24 hours following treatment, having a patient in remission six months later is pretty impressive.”

Moreno and his University of Arizona team are currently running a more rigorous, placebo-controlled trial investigating the effects of psilocybin on OCD. The trial involves eight weekly psilocybin doses, accompanied by comprehensive neuroimaging, and a long follow-up to measure any sustained effects six months later.

The drug, the therapy, or both?

An interesting question raised by Moreno’s work is whether psilocybin treatments need to be embedded within a larger therapeutic program. Most of the advanced clinical trial work investigating psilocybin for depression and anxiety incorporates one or two active drug sessions into a longer program involving preparatory psychotherapy and follow-up integration therapy. All up, a clinical treatment for psychedelic-assisted psychotherapy can last up to three months.

The Moreno research notably divorces a psilocybin session from any broad psychotherapy program. This implies the sole pharmacological effect of a few psilocybin doses is enough to generate broadly beneficial outcomes. Jacobs suggests psilocybin most likely does confer some degree of intrinsic pharmacological effect, but the current research also affirms the benefits are indeed amplified when integrated into a larger psychotherapeutic program.

"... there is an 'afterglow' period following a psychedelic session, and an enhanced level of psychological and neurological flexibility" -Eddie Jacobs

“My sense is that, in general, psilocybin therapy is enhanced by placing it within a wider psychotherapeutic program: it's well established now that there is an 'afterglow' period following a psychedelic session, where there is an enhanced level of psychological and neurological flexibility,” Jacobs tells New Atlas. “I suspect that in most conditions, this period of malleability is a powerful opportunity to make positive changes, which therapy can help.”

However, Jacobs also notes this does not mean administering psilocybin outside of psychotherapeutic structures would be useless. He says the ideal methods for administering psychedelic therapies have yet to be determined, and there may be some conditions that benefit from shorter therapies.

“… a long program of therapy is expensive to administer, and there may be some conditions for which this is a nice extra, rather than a necessity,” says Jacobs. “Perhaps OCD is one of these – you see a good deal of reports of people successfully self-medicating their OCD by microdosing Psilocybe mushrooms. OCD doesn't tend to respond to placebos as much as other conditions, so it seems plausible that the treatment effect is real, and comes about by physiological, rather than psychological, processes.”

Looking forward

Moreno’s current clinical trial is not the only one investigating psilocybin’s potential for OCD. A similar Yale University clinical trial is underway looking primarily at the short-term effects of a single psilocybin dose on acute OCD symptoms. A UK organization called Orchard is also currently raising funds to conduct a psilocybin/OCD trial in association with a psychedelic research team from Imperial College London.

Ultimately, while all the signs promisingly suggest psilocybin therapy could be an effective treatment for OCD, the research is not quite there yet. And despite the explosion of progress in psychedelic science over the past decade, there are still huge hurdles slowing research down. Legal restrictions inhibit easy access to the psychedelic compounds; political and social taboos still frustrate academic processes and study approvals; and the inability to easily profit from these old, off-patent compounds mean big pharmaceutical companies have no interest in paying for novel studies.

So, while we may be seeing some incredible and innovative studies demonstrating novel therapeutic uses for psychedelic drugs, there are still a number of research questions that need to be answered. Not the least of which is exactly how psychedelic therapy works, and what are the best techniques to optimize its outcomes.

“We're still a long, long way from determining how psilocybin (therapy) works,” says Jacobs. “There are a lot of dials to adjust that we have good reason to believe influence treatment success: e.g., dosage, number of sessions and space between them, style of therapy during and around the sessions. Frustratingly, the obstacles put in the way of psychedelic research mean it's going to be a long time while we tune these dials to get the best effect.”

*From the article here :

Psilocybin & OCD: Can psychedelics treat obsessive compulsive disorder?

A new review from neuroethicist Eddie Jacobs, and published in the Journal of Psychedelic Studies, is suggesting psilocybin may have great potential as a treatment for obsessive-compulsive disorder (OCD). Jacobs, from King’s College London and the University of Oxford, says it is surprising how…

newatlas.com

 

[mr peabody]

Subjects report reduced symptoms of OCD following inhalation of herbal cannabis

by NORML | 15 Oct 2020

The inhalation of herbal cannabis is associated with temporary reductions in symptoms of obsessive-compulsive disorder (OCD), according to data published in the Journal of Affective Disorders.

A team of investigators affiliated with Washington State University analyzed data from 87 subjects who self-identified as suffering from OCD. Study participants used a smartphone application to track the severity of their symptoms immediately before and shortly following their use of cannabis over a 31-month period.

Authors reported: “Using a large dataset of medical cannabis users self-medicating for symptoms of OCD, we found that for the vast majority of cannabis use sessions individuals reported reductions in intrusions [unwanted thoughts or impulses], compulsions, and anxiety. … Results indicated that after inhaling cannabis, ratings of intrusions were reduced by 49 percent, compulsions by 60 percent, and anxiety by 52 percent.” Decreases in compulsive behavior were most closely associated with the consumption of cannabis containing higher concentrations of CBD.

Subjects’ baseline severity ratings for anxiety declined over the course of the study. Baseline ratings for other symptoms, however, were unchanged – indicating that cannabis’ impact on OCD-related intrusions and compulsions was likely short-lived.

Authors concluded: “Results from the present study indicate that inhaled cannabis may acutely reduce symptoms of OCD. While the symptom severity ratings were reduced by approximately 50 to 60 percent from immediately before to after cannabis use, there was evidence that cannabis-associated reductions in intrusions may diminish over time. Collectively these results indicate that cannabis may have short-term, but not long-term beneficial effects on symptoms of OCD.”

Commenting on the study’s findings, NORML’s Deputy Director Paul Armentano said: “Few studies have assessed the potential efficacy of cannabis for the mitigation of symptoms of OCD. As such, these findings, though somewhat limited by the study’s design, indicate that cannabis – and, in particular, varieties high in CBD – holds promise as a therapeutic option for OCD patients and should be furthered examined in more rigorously designed controlled setting.”

The abstract of study, “Acute effects of cannabis on symptoms of obsessive-compulsive disorder” appears online here.

Study: Subjects Report Reduced Symptoms of Obsessive-Compulsive Disorder Following Cannabis Inhalation - NORML

“Using a large dataset of medical cannabis users self-medicating for symptoms of OCD, we found that for the vast majority of cannabis use sessions individuals reported reductions in intrusions, compulsions, and anxiety."

norml.org

 

[mr peabody]

Study suggests that cannabis can reduce OCD symptoms by half in short term

by Jahnavi Gupta | Asian News International | 25 Oct 2020

A new Washington State University study suggests that people with obsessive-compulsive disorder, or OCD, report that the severity of their symptoms was reduced by about half within four hours of smoking cannabis.

A new Washington State University study suggests that people with obsessive-compulsive disorder, or OCD, report that the severity of their symptoms was reduced by about half within four hours of smoking cannabis.

The researchers analysed data inputted into the Strainprint app by people who self-identified as having OCD, a condition characterised by intrusive, persistent thoughts and repetitive behaviours such as compulsively checking if a door is locked. After smoking cannabis, users with OCD reported it reduced their compulsions by 60%, intrusions, or unwanted thoughts, by 49% and anxiety by 52 per cent.

The study, recently published in the Journal of Affective Disorders, also found that higher doses and cannabis with higher concentrations of CBD, or cannabidiol, were associated with larger reductions in compulsions.

“The results overall indicate that cannabis may have some beneficial short-term but not really long-term effects on obsessive-compulsive disorder,” said Carrie Cuttler, the study’s corresponding author and WSU assistant professor of psychology. “To me, the CBD findings are really promising because it is not intoxicating. This is an area of research that would really benefit from clinical trials looking at changes in compulsions, intrusions and anxiety with pure CBD.”

The WSU study drew from data of more than 1,800 cannabis sessions that 87 individuals logged into the Strainprint app over 31 months. The long time period allowed the researchers to assess whether users developed tolerance to cannabis, but those effects were mixed. As people continued to use cannabis, the associated reductions in intrusions became slightly smaller suggesting they were building tolerance, but the relationship between cannabis and reductions in compulsions and anxiety remained fairly constant.

Traditional treatments for obsessive-compulsive disorder include exposure and response prevention therapy where people’s irrational thoughts around their behaviours are directly challenged, and prescribing antidepressants called serotonin reuptake inhibitors to reduce symptoms. While these treatments have positive effects for many patients, they do not cure the disorder nor do they work well for every person with OCD.

“We’re trying to build knowledge about the relationship of cannabis use and OCD because it’s an area that is really understudied,” said Dakota Mauzay, a doctoral student in Cuttler’s lab and first author on the paper.

Aside from their own research, the researchers found only one other human study on the topic: a small clinical trial with 12 participants that revealed that there were reductions in OCD symptoms after cannabis use, but these were not much larger than the reductions associated with the placebo.

The WSU researchers noted that one of the limitations of their study was the inability to use a placebo control and an “expectancy effect” may play a role in the results, meaning when people expect to feel better from something they generally do. The data was also from a self-selected sample of cannabis users, and there was variability in the results which means that not everyone experienced the same reductions in symptoms after using cannabis.

However, Cuttler said this analysis of user-provided information via the Strainprint app was especially valuable because it provides a large data set and the participants were using market cannabis in their home environment, as opposed to federally grown cannabis in a lab which may affect their responses. Strainprint’s app is intended to help users determine which types of cannabis work the best for them, but the company provided the WSU researchers free access to users’ anonymized data for research purposes.

Cuttler said this study points out that further research, particularly clinical trials on the cannabis constituent CBD, may reveal a therapeutic potential for people with OCD.

This is the fourth study Cuttler and her colleagues have conducted examining the effects of cannabis on various mental health conditions using the data provided by the app created by the Canadian company Strainprint. Others include studies on how cannabis impacts PTSD symptoms, reduces headache pain and affects emotional well-being.

Study suggests that cannabis can reduce OCD symptoms by half in short term

A new Washington State University study suggests that people with obsessive-compulsive disorder, or OCD, report that the severity of their symptoms was reduced by about half within four hours of smoking cannabis.

www.hindustantimes.com

 

[mr peabody]

Cognitive Behavioral Therapy found to normalize brain abnormality in OCD patients

UCLA | Medical Xpress | 14 Oct 2020

UCLA scientists and colleagues studying the effects of cognitive behavioral therapy (CBT) discovered an abnormality in the brains of people with obsessive compulsive disorder (OCD) that may help to predict who is most likely to respond to CBT. Researchers used functional MRI scans to obtain a measure called hemodynamic response function (HRF), which is a marker of how blood flows to certain tissues in the brain.

Researchers found abnormalities in the HRF in patients with OCD before treatment in brain areas including a region called the caudate that appeared to normalize after four weeks of CBT. This finding did not hold true for people who did not receive CBT but were scanned twice separated by four weeks.

OCD is a disabling and relatively common psychiatric disorder that affects about 1 in 40 people in their lifetime. Certain abnormalities in brain function and structure are known to exist in OCD, but it is not understood how activity of the brain cells called neurons is linked to blood flow in the brains of those with OCD. CBT is a first-line treatment for OCD but does work for all patients.

OCD patients' pre-treatment HRF patterns in the caudate were able to predict their response to CBT, on an individual patient level, with high accuracy. With future studies confirming this, the finding may help doctors better decide who should and should not receive CBT as a first-line treatment for OCD.

Furthermore, abnormalities in how neural activity is linked to blood flow, called neurovascular coupling, could be related to the symptoms people with OCD experience and could be a target for future treatments.

The research is published in the journal Brain Imaging and Behavior.

Cognitive behavioral therapy normalizes brain abnormality in OCD patients

UCLA scientists and colleagues studying the effects of cognitive behavioral therapy (CBT) discovered an abnormality in the brains of people with obsessive compulsive disorder (OCD) that may help to predict who is most likely to respond to CBT. Researchers used functional MRI scans to obtain a...

medicalxpress.com

 

[mr peabody]

Psilocybin and OCD

An interview with Dr. Francisco Moreno and Dr. Brian Bayze | College of Medicine Tucson

Obsessive Compulsive Disorder (OCD) is a psychiatric disorder in which people have obsessive thoughts and fears that cause them to act compulsively. Due to its unique symptoms, the stigma associated with OCD can make it difficult for people to be open about their diagnosis and ask for help. However, recent research by Dr. Francisco Moreno, Professor of Psychiatry at the University of Arizona, and his team, is emphasizing a new way to manage the symptoms of OCD, with the use of psilocybin.

1. How can OCD effect an adult’s day to day life?

OCD is a common and often debilitating mental health disorder characterized by recurring unwanted thoughts/images/urges that often result in compensatory repetitive compulsive behaviors. Obsessions and compulsions are many times senseless and distressing. Their daily impact can be severely burdensome and often results in significant interpersonal, psychosocial, and occupational impairments. Individuals may have extreme difficulty with day-to-day tasks including leaving their home, driving, grocery shopping, interacting with others, or meeting familial or vocational demands. In turn, individuals with OCD often describe comorbid symptoms of depression and may be at an increased risk of suicide. Current approaches to treatment, usually including a specific form of cognitive-behavioral therapy known as Exposure Response Prevention, and or serotonin reuptake inhibiting (SRI) drugs, although helpful, rarely provide full relief of symptoms.

2. What is psilocybin?

Psilocybin is a naturally occurring psychedelic (meaning mind-manifesting) compound that is produced by over 200 different species of “magic” mushroom, most within the genus Psilocybe. Anthropological research indicates that these mushrooms have been used by several indigenous cultures and societies for millennia. Psilocybin is chemically and structurally very similar to our own neurotransmitter, Serotonin, and interacts with the same receptors in the body and brain. When consumed in high doses—either in the form of mushrooms or as purely synthetic—psilocybin is capable of manifesting deeply altered states of consciousness. These experiences often include changes in broad aspects of sensation/perception, heightened emotional awareness, visual/auditory phenomena, and altered perceptions of self, identity, and reality. Some individuals may describe components of a “Mystical Experience” characterized by an often ineffable sense of boundless unity, an expansive sense of awe, feelings of immense gratitude, and transcendence of time and space. Recent research has shown that individuals often rate such an experience as one of the most meaningful events of their lives, similar in significance to the birth of a child or death of a parent. At times these experiences can be anxiety provoking and significantly uncomfortable for those consuming the drug. The mindset and setting in which the drug is utilized is believed to impact the type of experience people have.

3. Has psilocybin been prescribed for a mental health diagnosis?

Psilocybin has never been “prescribed” for a mental health condition, per se. However, in the 1950s and 1960s, a number of early research studies suggested that psilocybin (and similar compounds) was safe and may have broad potential therapeutic benefits on a number of mental health conditions, including depression and addiction. More recent research with psilocybin has shown similar broad therapeutic potential, but it is obvious that any clinical application requires well-designed extensive clinical research trials. Early preliminary clinical research with psilocybin has shown promising beneficial effects on OCD, major depression, and the anxiety/depression associated with terminal illness. The FDA has granted “breakthrough therapy” designation for psilocybin in both treatment-resistant depression as well as major depressive disorder. A breakthrough therapy designation is for a drug that treats a serious or life-threatening condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement on clinically significant outcomes over available therapies. Ongoing and future clinical trials will further evaluate psilocybin’s therapeutic potential in treating these and other indications.

4. How can psilocybin ease OCD symptoms?

There are multiple potential mechanisms by which treatment with psilocybin may help with the symptoms of OCD. Psilocybin interacts with different serotonin receptors in the brain, including those which seem to regulate certain brain regions of individuals with OCD. Treatment with multiple doses of psilocybin may change the binding activity of serotonin receptors such that symptoms are reduced. Psilocybin may also alleviate concerns with doubt and rumination, these are key elements underlying obsessions which may be measured through assessment of a specific brainwave pattern—known as error related negativity (ERN)—that increased in individuals with symptomatic OCD. Recent research has shown that psilocybin alters functional connectivity between and within different brain regions. One particular network of brain structures known as the Default Mode Network (DMN) is highly involved in self-referential thinking and has been shown to have increased connectivity and activity in individuals with OCD. Treatment with psilocybin may dramatically change and reset functional connectivity with DMN structures leading to reduced OCD symptoms. Psychological openness observed in the context of a psychedelic experience has been studied extensively and it is believed to facilitate the development of insights and attitudes that often are sought through the psychotherapy process. Finally, subjective transformative experiences—including, perhaps a “Mystical Experience”—within the psychedelic experience itself may contribute to improved wellness, decreased stress, and improved OCD symptoms. Risks may exist also with the use of psilocybin and other psychedelic agents, which may complicate the mental health of individuals. Hence, it is important to ensure that screening limits the risk to individuals considered at risk for complications.

5. What do you want our society to know about your study of using psilocybin to help with an OCD diagnosis?

It is not often in the field of psychiatry that we find a treatment that may immediately and significantly change an individual’s symptoms that have been present for years. Treatment with psilocybin, when done in an interpersonally supportive setting with a well-prepared individual, is not only safe but may result in rapid and significant reductions in overall OCD symptoms and a general improvement in overall quality of life. Psilocybin represents a paradigm shift in the treatment approach to OCD as well as other mental health conditions including depression and addiction. If psilocybin shows to be safe and effective in current trials, it may advance our ability to develop new therapies to best serve people suffering from OCD.

Psilocybin and OCD | The Department of Psychiatry, University of Arizona Health Sciences

psychiatry.arizona.edu

 

[mr peabody]

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How I ease my OCD and anxiety with psychedelics

by Amanda Gelender | Psychedelic Exploration | 10 Mar 2020

I have struggled with OCD and anxiety for about 25 years. My OCD has shapeshifted over time, camouflaging into each phase of my life, but the themes have remained pretty consistent through the years. At this point in my life, my OCD could perhaps best be described as primarily obsessional meaning that while I have compulsions, obsessive and intrusive thought loops are the most debilitating aspects of my condition. At times, OCD fear loops have been so overwhelming that entire parts of my life shut down - for example, I stopped driving for years because I couldn’t shake the terrifying fear that I would accidentally hurt someone.

I have been fortunate enough to work with many different healing modalities throughout my life, including talk therapy, community support networks, acupuncture, medications (many!), cannabis, peer-support group therapy, physical movement, nature, and creative practices. I have also worked extensively with psychedelics to manage my OCD, anxiety, and depression. While I don’t seek or expect a “cure” to my mental health challenges, LSD and psychedelic mushrooms are life changing tools to work through my fears and come to peace with myself, facilitating some of the most transformational healing work of my life.

Working with psychedelics to support folks with OCD and anxiety is a topic of deep interest to me both personally and professionally: In addition to my own experiences, my work is to facilitate legal psychedelic sessions with psilocybin mushroom truffles. I’m not a doctor or therapist, I facilitate experiences as someone with extensive experience with psychedelics and a love for creating the conditions for others to benefit from them the way I have. Many of the people who reach out for sessions experience anxiety and/or OCD, so I’m frequently in conversation with folks about whether psychedelics may be helpful tools to support them.

There are still many open questions about how and why psychedelics impact people the way they do - this is not merely a scientific inquiry, it is also political, philosophical, cultural, and spiritual. In this age of crumbling drug prohibition, western science is trying to catch up to what indigenous people have known for centuries about the healing potential of entheogenic plant medicine. Researchers have only begun to scratch the surface on psychedelic applications for OCD and anxiety, but the results so far are very promising. I’m confident that in the coming years, psychedelic medicine will become mainstream treatment for a broad range of mental and physical health challenges. We just have to keep our focus on access and decriminalization, being wary of how these incredibly powerful tools may be co-opted under capitalism and a for-profit medical system.

In a neurological context, the current working theory about classic psychedelics and the brain is that it temporarily quiets down the “default mode network,” a part of the brain that filters and communicates information between various regions. So when the default mode network goes off duty during a psychedelic trip, parts of the brain can communicate that don’t usually talk to each other and new neural connections form. We suddenly have unfiltered access to a slew of information, memories, and feelings that are often difficult to tap into in our standard state of consciousness. It can help us feel what some call “ego dissolution,” a sensation that changes how we see ourselves, which research has linked to the positive benefits of psychedelics.

But what does this mean on a practical level? Well, it’s different for everyone. I have found that in the psychedelic state it’s easier to go past the mind and work through trauma in my body. I can release control and explore my deepest fears and traumas at the root of my anxieties. I can hold myself with compassion and feel through repressed emotions, tapping into a sense of universal oneness and spiritual connection. I can feel tremendous joy, sorrow, rage, euphoria, and humility, a powerful emotional catharsis that cleans my pipes. In the time after a trip, there is often a window of neuroplasticity that can particularly support folks with depression and anxiety - it often feels a bit easier to try new things and shake up old habits. I feel more present and aware of what I want. I feel re-energized, appreciative, and grounded. Ideas, fresh perspectives, and creativity comes more easily. My connections and community work deepens. All of these shifts help ease the daily struggle of anxiety.

Of course when we ask a question like, “How can psychedelics help relieve anxiety?” we have to remember the context in which we attempt to heal: Racialized capitalism. We live under political systems that exacerbate and facilitate trauma and perpetual anxiety, particularly for Black and Brown people. It’s very hard to heal yourself in an environment that continues to inflict harm. So we have to remember that while mental health challenges can feel like individual plights, they are often not so much personal pathologies as they are natural ways of responding to our environment. While psychedelics are incredibly powerful tools for exploration and healing, to truly address the roots of mental health crises, our focus must always be on systemic level change.

From what I have witnessed with clients, people heal differently with these tools and it can change over time. Some folks have a radical shift after a trip, others may have a more subtle shift or may not resonate with this modality at this point in their life. A trip that facilitates a strong sense of interconnectedness with the universe (ego “death” or dissolution) can support folks who struggle with depression and anxiety. But in my experience, ego dissolution isn’t a prerequisite for substantial healing with psychedelics. I like to remind clients that the wisdom from psychedelic sessions can come in many forms: Just because there may not be a stark, immediate shift after a trip doesn’t mean that important work isn’t being done. Rather than a silver bullet, I view psychedelic sessions as powerful steps on a healing and growth path. Each trip I shed another layer and go deeper - it’s a process that can take time.

So while my work with psychedelics hasn’t eradicated my OCD or anxiety symptoms, the volume has turned down, and I have renewed mental, emotional, and spiritual fortitude to traverse challenges when they arise. A great example is my writing - OCD would want to block me from publishing this piece (“Have I checked it enough times to see if I said something incorrect? Will I accidentally cause damage with what I share?”...) but I move through the fear and publish anyway. It’s not that those voices aren’t there, it’s that they don’t drive and control my life the way they used to. In working with psychedelics through the years, I’ve become less fear-based. I feel more aligned and at peace with the natural ebb and flow of things.

I have also found that psychedelics work well in partnership with other healing modalities. People who have healing practices in place before their trip often have an easier time integrating the lessons from psychedelic journeys. By the same token, psychedelics can enhance existing practices, helping people go deeper and unlock new levels in talk therapy, meditation, and artistic expression, for instance.

Trip tips for folks with OCD & anxiety

The many unknowns of a psychedelic journey can be the perfect catalyst for worry, particularly for those of us with a proclivity towards looping, catastrophizing, and worst-case scenarios. It’s completely normal to be scared before a psychedelic journey - I was certainly terrified before my first psychedelic trip and I’m so grateful to have had thorough preparation and a supportive person there with me to help me feel safe in my exploration.

A wide range of experiences are possible in a psychedelic journey and even healing trips can sometimes feel scary or even traumatic. In my experience, going through these dark places in psychedelic journeying can still bring great positivity, but only if the container around the trip is supportive. This is supported by research which found that the majority of people who have had challenging psychedelic mushroom experiences still said they were “‘meaningful’ or ‘worthwhile,’ with half of these positive responses claiming it as one of the most valuable experiences in their life.”

To set yourself up for a safe and transformational session, it’s always wise to follow basic prep guidelines - access the medicine from a trusted and safe source (testing the substance if necessary), know a good starting dose, check how medications may affect your trip, prepare and feel as centered as possible before the journey (set), arrange for a safe and nourishing space (setting), have a person with you for support (sitter or guide), and allot time to process in the days following the session (integration).

I actually think that a healthy mix of nervousness and excitement before a trip is a good thing: It demonstrates that you have reverence for how powerful a psychedelic teacher is and that it has the potential to significantly shift your life. But of course it’s best not to go into a trip feeling too anxious, so practice grounding yourself before the journey. And if you’re really struggling the days leading up to the trip - don’t push it. Check in with yourself and see if you want to postpone your trip or start with a lower dose.

It’s also important to note that psychedelics aren’t for everyone and it can shift depending on what you’re going through. For instance, I don’t go on full dose trips when I am in a depressive crisis, a particularly bad OCD episode, or when I’m very stressed or overworked. I’ve found that these trips can be unnecessarily challenging or even temporarily damaging, so I wait until I feel a bit more stable to have a session.

After your trip, be kind to yourself and take time to process in whatever ways feel most natural to you. It can be particularly helpful to write, draw, rest, and be in nature in the days following your journey. It’s normal to feel many things after a trip so let the changes unfold over time and don’t rush to make sense of everything. Be patient if changes don’t come right away and remember that for those of us who struggle with anxiety and OCD, just the act of releasing control and taking the leap into the psychedelic journey is a huge achievement.

How I Ease my OCD and Anxiety with Psychedelics — Psychedelic Exploration

By Amanda Gelender

psychedelicexploration.com

 

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Magic mushrooms reduce OCD symptoms, study*

by Eric Dolan | Psypost | 29 Mar 2021

Approximately 2.3% of adults will suffer from symptoms of Obsessive-Compulsive Disorder at some point in their life. The disorder is characterized by intrusive, persistent thoughts and compulsive behaviors and a substantial number of people don’t respond well to standard treatments.

A report recently published in the Journal of Psychoactive Drugs presents the case of a 30-year-old man who showed clinically significant reductions in treatment-resistant OCD symptoms after consuming psilocybin-containing mushrooms, more commonly known as “magic” mushrooms.

The man had suffered from disabling symptoms even after treatment with a variety of medications, including antidepressants, nonsteroidal anti-inflammatory drugs, and ketamine. He was undergoing treatment at a clinic when he decided to take psychedelic mushrooms.

The patient told medical professionals that he had consumed about 2 grams of dried mushrooms while at home. A friend was present to watch over him. The man did not report experiencing hallucinations, but did experience a sense of disassociation for about an hour. During this hour, his OCD symptoms completely disappeared. Despite being warned of the dangers of consuming the mushrooms, he continued to consume them about once every two weeks.

Prior to consuming psilocybin, the patient scored 35 on the Yale-Brown Obsessive Compulsive Scale Test, indicating that he was suffering from “extreme” symptoms. Six months after consuming psilocybin, the patient’s score on the test had dropped down to 13, indicating that he was suffering from “mild” symptoms.

“His obsessive thoughts and compulsions had significantly been reduced, as well as the rumination, worry and anxiety, and checking behavior,” the clinicians wrote in their case report. “He is now able to perform most of his daily tasks and work without interruptions, meaningfully improving his wellbeing and quality of life. The patient continues his treatment, while consuming the psilocybin-containing mushrooms as a therapeutic adjuvant.”

There has been growing interest in psilocybin, but scientists have only just begun to examine whether psilocybin can aid the treatment of OCD.

A study published in 2006 found that psilocybin was associated with transient reductions in OCD symptoms. But the study was only meant as a first step — and only examined 9 participants.

Researchers at Yale University and the Heffter Research Institute are currently conducting a randomized, placebo-controlled study to examine the effects of psilocybin on OCD.

“These and future studies will determine if psilocybin and other psychoactive compounds of psilocybin- containing mushrooms are clinically effective and safe for the treatment of OCD,” the clinicians wrote.

The report, “Long-term Amelioration of OCD Symptoms in a Patient with Chronic Consumption of Psilocybin-containing Mushrooms,“ was authored by Agustin Lugo-Radillo and Jorge Luis Cortes-Lopez.

*From the article here :

Case report: Consumption of psilocybin-containing mushrooms results in amelioration of OCD symptoms

Approximately 2.3% of adults will suffer from symptoms of Obsessive-Compulsive Disorder at some point in their life. The disorder is characterized by ...

www.psypost.org

 

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Neuropsychopharmacologist David Nutt

Psychedelics for Obsessive-Compulsive Disorder

by Nate Seltenrich | Project CBD | 22 Mar 2021

Why is psilocybin helpful for treating mood disorders? Is it the drug alone acting on the brain, or is it the subjective experience engendered by the magic mushroom extract?

The latest wave of psychedelic research has led to many significant breakthroughs in a short span of time. Yet this complex and mysterious field remains in relative infancy, with a number of key subjects still poorly understood. Among these, perhaps no question is more central – nor of more interest to modern pharmaceutical companies – than that of the therapeutic value of the psychedelic experience.

What is it about psychedelics that seems to make them so useful for helping to treat depression, addiction, and other mental health disorders? Is it the drug alone, acting physiologically on the brain, or is it the lived, subjective response engendered by the drug?

New research into the treatment of obsessive-compulsive disorder (OCD) with psilocybin, the active ingredient in magic mushrooms, may help to unravel this riddle.

Hard to let go

Three studies are currently investigating the use of psilocybin to reduce symptoms of OCD, a condition that has otherwise received relatively little attention in psychedelic research to date. Although the studies employ different treatment protocols, their combined evidence could prove pivotal in helping researchers better understand the therapeutic mechanism of psychedelic drugs.

That’s because OCD is generally characterized by a failure to surrender or release control – exactly what a full psychedelic experience typically demands. “People with OCD are trying to control their experience in a way that becomes very, very counter-productive, and very painful,” says Adam Strauss, a Los Angeles-based comedian who used psychedelics to overcome OCD. “OCD is really a disorder of control.”

Strauss chronicled his experience in the award-winning one-man stage show The Mushroom Cure. “For me,” he explains, “the experience of surrendering, of not trying to change my internal experience, not trying to get rid of the thoughts, not trying to get rid of the sensations, seems like the key factor in psychedelic healing. It’s that subjective experience of letting go and surrendering and allowing.”

While Strauss experimented with and achieved some benefit from low and moderate doses, he found that higher doses, particularly of psilocybin mushrooms, were most effective at teaching him to “let go” – and thus offered the most therapeutic value. “It’s hard for me to imagine having the outcomes I’ve had without those experiences that seem so essential,” he said.

A pioneering study

Strauss first got the idea to treat his OCD with psychedelics from a pioneering 2006 study in the Journal of Clinical Psychiatry. Nine patients were administered psilocybin up to four times each, at doses ranging from “very low” to “frankly hallucinogenic.” Not only did all nine show immediate improvement in OCD symptoms following at least one of the testing sessions, but the drug was also proven safe and well-tolerated. (Interestingly, and contrary to Strauss’ subsequent experience, the researchers did not find dose size to have a significant effect on outcomes.)

To this day, that study stands as the only of the modern era to investigate the use of psilocybin to treat OCD. But within the next couple of years, it will be joined by at least three more. One of these is being led by University of Arizona professor of psychiatry Francisco Moreno, the same researcher who directed the groundbreaking and now highly cited 2006 study.

Launched in October 2017, Moreno’s new study – this time with 15 subjects – has been on hold since early 2020 due to the coronavirus pandemic. But it should be restarting soon, Moreno reported in an email. “We have people who are ready to go and my hope is that we will start dosing this Spring if COVID restrictions match our institutional requirements and our ability to do this consistent with the customary settings and presence of two sitters in the room for extended periods of time,” he wrote.

To gain greater insight into how physiological changes in the brain and subjective psychedelic experience may be associated with therapeutic benefit for OCD following low and high doses of psilocybin, Moreno’s team will analyze both brain scans and patient responses to a variety of standardized questionnaires, including the 5-Dimensional Altered States of Consciousness Rating Scale and the Mystical Experience Questionnaire.

This should allow the researchers to determine if any improvements in OCD symptoms observed up to six months after the last dose are more closely aligned with patients’ experience of the drug or with specific aspects of brain activity following treatment. The study should be complete by the end of 2021, Moreno said.

High-dose therapy

Meanwhile on the other side of the country, a second, larger study with 30 participants is underway at Yale University – and not far behind. Principal investigator Benjamin Kelmendi, an assistant professor of psychiatry, said the study has already resumed after a nine-month pause for COVID and is now enrolling subjects, with a projected completion date of early 2022.

Like Moreno’s study, Kelmendi’s will measure the effects of psilocybin – in this case just a single, high dose – in both objective and subjective terms, and then compare those effects to clinical outcomes for OCD. This will permit the researchers to determine whether, across the study population, degree of improvement is more accurately predicted by changes in brain connectivity as measured by fMRI, or by self-reported subjective experience.

Another way in which the two studies are alike (and distinct from most other recent and ongoing studies investigating psychedelics as treatments for mental health disorders like addiction and depression) is that they won’t include any form of talk therapy. Instead, as in Moreno’s first, pilot study, any beneficial effect will be directly attributable to the pharmacology of the drug and the changes it causes in the brain, the psychedelic experience it precipitates, or some combination of the two.

That’s not the case with the third concurrent study into psilocybin and OCD, being led by renowned psychedelic researcher David Nutt at Imperial College London’s Centre for Psychedelic Research. Nutt’s new study will pair a moderate dose of psilocybin – low enough that it is not expected to provoke a traditional psychedelic experience – with a form of talk therapy widely used for OCD called Acceptance and Commitment Therapy. This therapy will not take place under the influence of the drug, but rather after its most direct effects have worn off, during “integration” of the treatment, Nutt said in an email.

A big challenge

In an online talk discussing the new study last May, Nutt acknowledged that based on findings from his previous research into the treatment of depression with psilocybin, he would expect that higher, more psychedelic doses would be more effective at treating OCD – with the subjective experience playing at least a partial role.

“It’s a big challenge to take a trip, or something you’ve never had before, and possibly go somewhere that could be very dark and unpleasant, but the depressed people have agreed to do it,” Nutt said in the talk. “They’ve often been very anxious about it, but when they’ve done it, they’ve usually come back and said, ‘Wow, that was tough, but I’m glad I did it.’”

Nevertheless, Nutt and his collaborators decided not to offer a high dose this time around after determining early on that members of the OCD patient population weren’t interested. “They made it clear that they would not accept a ‘full’ dose,” Nutt confirmed in an email to Project CBD.

So the research team pivoted to a slightly different model of treatment, one in which subjects will “still be in control” throughout the entire process. Ideally, they will also be primed by the drug on some level to be more receptive to targeted therapy immediately afterward, Nutt said in the video: “We call it psychedelic-enhanced psychotherapy.”

Recruitment for the full study begins in April 2021.

Acceptance & surrender

Adam Strauss believes his own healing was enabled by higher doses and powerful subjective experiences, but he still sees the potential for significant therapeutic value in moderate doses paired with Acceptance and Commitment Therapy. ACT is a form of cognitive behavioral therapy that he underwent for years, without much success – until he combined his hard-earned knowledge of its key principles with self-directed use of psychedelics.

“I wasn’t actually able to do that sort of acceptance and surrender until I began using psychedelics,” he said. “A lot of my key experiences on psychedelics were me basically doing these ACT techniques while I was tripping.”

Though the Imperial College study’s smaller dose is not expected to produce a full psychedelic experience in patients, the researchers will still measure subjective responses to psilocybin through questionnaires, allowing them to correlate perceived effect with therapeutic benefit.

But beyond the specific findings of any single study, looking at all three studies together could yield the greatest insight into the treatment of OCD with psychedelics and the larger question of the therapeutic value of “the trip.” Are high-dose or high-effect experiences that involve “letting go” truly better for treating OCD in the long term? Or is a moderate, controlled trip followed by talk therapy just as effective – or more so?

With drug companies already obsessed over the prospect of developing trip-free (or at least bad-trip-free) psychedelics, the issue is more than just academic. For better or worse, it has major implications for fledgling efforts to commercialize and medicalize psychedelic drugs. If these three studies go as planned, in another year or so we may have a better idea about whether the psychedelic experience will be viewed as a feature or a bug by the medical establishment.

Psychedelics for Obsessive-Compulsive Disorder | Project CBD

Psychedelic treatments for OCD may yield insights into whether therapeutic benefits are caused by the drug alone, acting physiologically on the brain, or are they caused by the lived, subjective response engendered by the drug?

www.projectcbd.org

 

[mr peabody]

Although strongly acting mutations have been hypothesized to exist in OCD,
statistically reliable evidence has been difficult to obtain. I

Gene discovery may hold key to better therapies for OCD

Columbia University | Neuroscience News | 28 Jun 2021

Summary: A new study links a distinct pattern of genetic mutations with OCD in humans.

In the first analysis of its kind, researchers at Columbia University Vagelos College of Physicians and Surgeons and several other institutions have linked distinct patterns of genetic mutations with obsessive-compulsive disorder (OCD) in humans.

The work, published online June 28 in Nature Neuroscience, confirms the validity of targeting specific genes to develop new OCD treatments and points toward novel avenues for studying this often debilitating condition.

OCD, which affects 1% to 2% of the population, often runs in families and genes are known to play a large role in determining who develops the disease. However, the identity of many OCD genes remains unknown.

“Many neurological diseases are influenced by strongly acting mutations which can cause disease by themselves,” says David Goldstein, PhD, director of the Institute for Genomic Medicine at Columbia and a senior author on the new paper. “These mutations are individually very rare but important to find because they can provide a starting point for the development of therapeutics that target precise underlying causes of disease.”

Although strongly acting mutations have been hypothesized to exist in OCD, statistically reliable evidence has been difficult to obtain.

Most previous studies on the genetics of OCD have used a “candidate gene” approach, in which researchers focus on plausible genes that might be involved in pathogenesis and look for genetic signatures of risk. Although that approach has had some successes, it can lead to challenges in statistical interpretation and can miss unexpected genes. As a result, both funding agencies and the pharmaceutical industry increasingly focus on genome-wide analyses that can securely implicate genes in disease risk.

“The solution to the problem is to study all the genes in the genome at the same time and ask whether any of them have significant evidence of influencing risk. That had not been done yet at scale in OCD,” says Goldstein.

In collaboration with Gerald Nestadt, MBBCh, a psychiatrist at Johns Hopkins University with access to a cohort of OCD patients, Goldstein’s team took this genome wide approach, which uses high-throughput sequencing and computational biology techniques to identify relevant genes anywhere in the genome.

The investigators looked at genes that encode protein using whole exome sequencing in more than 1,300 OCD patients and compared them to similarly large control groups. The multi-institution collaboration also included scientists from the University of North Carolina at Chapel Hill, the David Geffen School of Medicine in Los Angeles, Harvard Medical School, and SUNY Downstate Medical Center in Brooklyn.

The analysis showed a strong correlation between OCD and rare mutations, particularly in a gene called SLITRK5 that had been previously linked to OCD in candidate-gene studies.

Goldstein expects that the new data on SLITRK5 will encourage pharmaceutical companies and translational researchers to develop drugs that target this gene.

The study also identified a specific pattern of variation in other genes. “When you look at genes that do not tolerate variation in the human population, those are the genes most likely to cause disease, and with OCD, we see an overall increased burden of damaging mutations in those genes compared to controls,” Goldstein says. “That’s telling us that there are more OCD genes to be found and where to find them.”

For patients suffering from OCD and their doctors, new treatments can’t come too soon. OCD causes uncontrollable, recurring thought patterns and behaviors that interfere with patients’ daily lives.

“OCD is a disabling disorder that is twice as common as schizophrenia,” says H. Blair Simpson, MD, PhD, professor of psychiatry at Columbia University.

Gene Discovery May Hold Key to Better Therapies for Ocd - Neuroscience News

A new study links a distinct pattern of genetic mutations with OCD in humans.

neurosciencenews.com

 

[mr peabody]

What's it like treating OCD with psychedelics?*

by Jesse Hicks | VICE | 5 Apr 2018

Adam Strauss was trying to choose a shirt to wear—not a project that had ever before given him any trouble. He was in his twenties and his girlfriend had moved out a few weeks earlier, so maybe he was just feeling extra self-conscious about his appearance. Somehow, though, the anxious pursuit of the perfect shirt had become consuming. This one, with its wide collar, he thought, put too much of his chest on display. The next fit well but wasn't his color; he looked jaundiced. If he didn't choose, he was going to be late.

One more try, he told himself, then it was time to go. This one looked good—maybe too good. He needed to get out of his head, collect some real-world data. What if he wore his two favorite shirts, compared the number of spontaneous compliments he received on each, then bought ten identical copies of the winner? That'd be the perfect way to choose, right?

In his off-Broadway one-man show, The Mushroom Cure, playing now in New York City and opening soon in Berkeley, California, Strauss recounts how this almost-everyday moment of indecision later flowered into paralyzing obsessive-compulsive disorder. Over the course of years, he talked to specialists, went to therapy, tweaked his medication. He went to a 12-step meeting for people with OCD. He tried alternative treatments: yoga (two years), meditation (five years), acupuncture, hypnotherapy, homeopathy.

“Anything that anyone mentioned that I found online that offered some sort of hope, I tried. Because it was out of control,” Strauss says. The shirt trick, for example, worked until with washing and wearing the ten identical copies started to become unique. Then his mind returned to the ceaseless litany of considerations he had to navigate to make the perfect choice. And choices were everywhere, from picking a shirt to deciding which bagel to order for breakfast to finding the best side of the street to walk down. He ended up zigzagging, trying to balance sunshine on one side with trees on the other. “It was debilitating,” he says. “It was difficult to function, really in any domain of my life.”

One day, deep in the results of a Google search for “OCD cures,” he stumbled upon a small proof-of concept study published in 2006. Nine people who'd previously failed to respond to more conventional treatments for OCD received psilocybin, the active ingredient in magic mushrooms, in a controlled hospital environment. The researchers wanted to test anecdotal reports that psilocybin had benefited OCD patients. One man, for example, used shrooms for years, developing a tolerance that kept him from getting high, but it still quelled his OCD. The study bore out those stories, finding that most participants saw their symptoms temporarily reduced.

“I read this study in absolute desperation,” Strauss says. “I had very little experience with psychedelics, but my attitude was sort of, 'Well, I really don't have anything to lose at this point.'” That's the jumping off point for The Mushroom Cure. It's not a spoiler to tell you that Strauss's informal self-experimentation worked—it's right there in the title, after all. But it wasn't as simple as just scarfing a handful of mushrooms and becoming a different person. First, there were the practical considerations.

At the time, Strauss says, it was hard to get shrooms in New York City. In a bit of coincidence, Strauss had recently met a woman who’d inadvertently used psychedelics to help treat her depression. Instead of shrooms, though, she’d used readily available cacti—the kind you can sometimes even find at Home Depot—that contained not psilocybin but a potent psychedelic called mescaline.

The most famous mescaline-containing cactus is peyote, which is used in legally protected Native American religious rituals; outside of those practices, peyote is a Schedule I drug. Other cacti, though, also contain mescaline. So Strauss’s first psychedelic experience was with a cactus. Or it would have been, but he was also taking Lexapro, a prescription drug used for treating anxiety and depression. It’s a selective serotonin reuptake inhibitor (SSRI), meaning it helps maintain higher levels of serotonin in the brain. That elevates mood, but SSRIs can dampen the effects of psychedelics for some people. That’s exactly what happened with Strauss—the magic cactus didn’t work.

But he didn’t give up; in fact, he went off his SSRI to pursue his experiment. “The idea was that psychedelics could cure my OCD,” Strauss says. The hypothesis was based on anecdotes and a single, small study of one psychedelic, but he was committed to it. He went off his prescription medication to try the cactus; he experimented with research chemicals delivered from China. He spaced out his trips, but admits it was a pretty ad-hoc approach. “Basically I did it in not a very intelligent way,” he says. “I was really driven by desperation. I was doing a lot of different drugs. It wasn't a very well-controlled experiment to say the least.”

Nonetheless, the drugs kept showing him glimpses of a different person he could become. Often he got short-term relief from his OCD symptoms, so he kept trying: new settings, new doses, new drugs. He also happened to be working at a time when psychedelics were undergoing a renaissance in medicine, so he drew on research showing they have potential to treat depression, anxiety, and post-traumatic stress disorder. He still hadn't had shrooms, but that seemed less important. “The key thing, it seemed to me,” he says, “wasn't mushrooms, but the psychedelic experience.” (When he finally did get shrooms—a particularly potent strain called the penis envy mushroom—he wound up calling 911 for help answering his most burning existential questions.)

What the psychedelic experience offered him was a new, deeper understanding of something he'd only grasped intellectually before: acceptance. Growing up, he'd received mental health diagnoses that included depression and generalized anxiety disorder; he took medication and went to therapy. Later, a therapist treating his OCD told him that he'd have to accept the anxiety produced by his intrusive thoughts. Every decision, Strauss explains, would make him anxious, but committing to an action made it go away. The relief, though, was only temporary—the anxiety would soon build, demanding he reverse his original choice. “Of course,” he says, “life is constant decision-making, so I'd get paralyzed.”

The cycle of anxious decision-making could only be broken if he, as his therapist had advised, stopped trying to avoid feeling anxious. He had to accept that feeling, uncomfortable as it was. And that proved very difficult. “I understood this intellectually,” he says, “but acceptance is a fascinating thing. It's not really an intellectual thing. I think of it as more of a visceral thing. Or a spiritual practice.”

Psychedelics helped him grasp acceptance as more than a concept. “It was only while using psychedelics that I had the actual visceral experience of acceptance,” he says. His obsessive thoughts would arrive as usual, but he didn't feel beholden to them. They were separate from him, placed at a remove. He could just let them be there. “I found that when I did that,” he says, “they didn't necessarily go away, but they didn't have the same power over me.” Recent research has shed light on what users of psychedelics intuited long ago: Tripping can profoundly affect the way we see ourselves, by producing an “ego-dissolution” that lets us step outside the models we use to navigate everyday reality. It can produce a detachment from all the thoughts and fears we call the “self.”

It took a long time, but with practice, Strauss was able to feel that same detachment when he wasn't tripping. Therapy exposed him to the concept of acceptance, psychedelics brought him to a visceral understanding of it, and with diligent effort he made it work for him. He's not “cured,” he says, but he's had a pretty remarkable recovery, thanks to his idiosyncratic, self-directed course of psychedelic therapy.

The drugs weren't a panacea as much as a tool. Studies of psychedelic-assisted therapy begin from a similar premise, and they’ve shown that ecstasy could improve therapy by making people more open. In early studies, it’s been used alongside therapy to treat PTSD and eating disorders. At least one adventurous DIYer has combined MDMA with couples therapy.

“I don't think it would have happened without psychedelics,” Strauss says, “but I also don't think psychedelics would have been sufficient in and of themselves.” Even Timothy Leary eventually realized you can't just give people potent, mind-expanding drugs and assume they'll come out better on the other side. They need a supportive, respectful environment.

Recent research supports this view, with studies showing how psychedelics in conjunction with therapy can provide real benefits for patients with depression, anxiety, and post-traumatic stress disorder, among others. Based on his own experience, Strauss would like to see more of that kind of study, and laments that it's so expensive to do that work. (MAPS, which funded the original study that sent Strauss on his odyssey, is also sponsoring his show.)

Beyond encouraging more research, though, Strauss says that what he most wants to convey to audiences is the sense of wonder he still has about his journey through psychedelics. Paralyzed with OCD, he took a desperate—if relatively informed—gamble and experimented on himself, along the way confronting some of his deepest and most persistent fears. And basically, it worked. “The story itself,” he says, “is pretty amazing.”

*From the article here :

Shrooms Helped Tame This Man's Obsessive Thoughts

This guy treated his OCD with psychedelics and then wrote a play about it.

www.vice.com

 

[mr peabody]

How I ease my OCD and anxiety with psychedelics

by Amanda Gelender | Psychedelic Exploration | 10 Mar 2020

I have struggled with OCD and anxiety for about 25 years. My OCD has shapeshifted over time, camouflaging into each phase of my life, but the themes have remained pretty consistent through the years. At this point in my life, my OCD could perhaps best be described as primarily obsessional meaning that while I have compulsions, obsessive and intrusive thought loops are the most debilitating aspects of my condition. At times, OCD fear loops have been so overwhelming that entire parts of my life shut down - for example, I stopped driving for years because I couldn’t shake the terrifying fear that I would accidentally hurt someone.

I have been fortunate enough to work with many different healing modalities throughout my life, including talk therapy, community support networks, acupuncture, medications (many!), cannabis, peer-support group therapy, physical movement, nature, and creative practices. I have also worked extensively with psychedelics to manage my OCD, anxiety, and depression. While I don’t seek or expect a “cure” to my mental health challenges, LSD and psychedelic mushrooms are life changing tools to work through my fears and come to peace with myself, facilitating some of the most transformational healing work of my life.

Working with psychedelics to support folks with OCD and anxiety is a topic of deep interest to me both personally and professionally: In addition to my own experiences, my work is to facilitate legal psychedelic sessions with psilocybin mushroom truffles. I’m not a doctor or therapist, I facilitate experiences as someone with extensive experience with psychedelics and a love for creating the conditions for others to benefit from them the way I have. Many of the people who reach out for sessions experience anxiety and/or OCD, so I’m frequently in conversation with folks about whether psychedelics may be helpful tools to support them.

There are still many open questions about how and why psychedelics impact people the way they do - this is not merely a scientific inquiry, it is also political, philosophical, cultural, and spiritual. In this age of crumbling drug prohibition, western science is trying to catch up to what indigenous people have known for centuries about the healing potential of entheogenic plant medicine. Researchers have only begun to scratch the surface on psychedelic applications for OCD and anxiety, but the results so far are very promising. I’m confident that in the coming years, psychedelic medicine will become mainstream treatment for a broad range of mental and physical health challenges. We just have to keep our focus on access and decriminalization, being wary of how these incredibly powerful tools may be co-opted under capitalism and a for-profit medical system.

In a neurological context, the current working theory about classic psychedelics and the brain is that it temporarily quiets down the “default mode network,” a part of the brain that filters and communicates information between various regions. So when the default mode network goes off duty during a psychedelic trip, parts of the brain can communicate that don’t usually talk to each other and new neural connections form. We suddenly have unfiltered access to a slew of information, memories, and feelings that are often difficult to tap into in our standard state of consciousness. It can help us feel what some call “ego dissolution,” a sensation that changes how we see ourselves, which research has linked to the positive benefits of psychedelics. Below is an image of brain scans depicting the neural connections with psilocybin (image b) and a placebo (image a):

But what does this mean on a practical level? Well, it’s different for everyone. I have found that in the psychedelic state it’s easier to go past the mind and work through trauma in my body. I can release control and explore my deepest fears and traumas at the root of my anxieties. I can hold myself with compassion and feel through repressed emotions, tapping into a sense of universal oneness and spiritual connection. I can feel tremendous joy, sorrow, rage, euphoria, and humility, a powerful emotional catharsis that cleans my pipes. In the time after a trip, there is often a window of neuroplasticity that can particularly support folks with depression and anxiety - it often feels a bit easier to try new things and shake up old habits. I feel more present and aware of what I want. I feel re-energized, appreciative, and grounded. Ideas, fresh perspectives, and creativity comes more easily. My connections and community work deepens. All of these shifts help ease the daily struggle of anxiety.

Of course when we ask a question like, “How can psychedelics help relieve anxiety?” we have to remember the context in which we attempt to heal: Racialized capitalism. We live under political systems that exacerbate and facilitate trauma and perpetual anxiety, particularly for Black and Brown people. It’s very hard to heal yourself in an environment that continues to inflict harm. So we have to remember that while mental health challenges can feel like individual plights, they are often not so much personal pathologies as they are natural ways of responding to our environment. While psychedelics are incredibly powerful tools for exploration and healing, to truly address the roots of mental health crises, our focus must always be on systemic level change.

From what I have witnessed with clients, people heal differently with these tools and it can change over time. Some folks have a radical shift after a trip, others may have a more subtle shift or may not resonate with this modality at this point in their life. A trip that facilitates a strong sense of interconnectedness with the universe (ego “death” or dissolution) can support folks who struggle with depression and anxiety. But in my experience, ego dissolution isn’t a prerequisite for substantial healing with psychedelics. I like to remind clients that the wisdom from psychedelic sessions can come in many forms: Just because there may not be a stark, immediate shift after a trip doesn’t mean that important work isn’t being done. Rather than a silver bullet, I view psychedelic sessions as powerful steps on a healing and growth path. Each trip I shed another layer and go deeper - it’s a process that can take time.

So while my work with psychedelics hasn’t eradicated my OCD or anxiety symptoms, the volume has turned down, and I have renewed mental, emotional, and spiritual fortitude to traverse challenges when they arise. A great example is my writing - OCD would want to block me from publishing this piece (“Have I checked it enough times to see if I said something incorrect? Will I accidentally cause damage with what I share?”...) but I move through the fear and publish anyway. It’s not that those voices aren’t there, it’s that they don’t drive and control my life the way they used to. In working with psychedelics through the years, I’ve become less fear-based. I feel more aligned and at peace with the natural ebb and flow of things.

I have also found that psychedelics work well in partnership with other healing modalities. People who have healing practices in place before their trip often have an easier time integrating the lessons from psychedelic journeys. By the same token, psychedelics can enhance existing practices, helping people go deeper and unlock new levels in talk therapy, meditation, and artistic expression, for instance.

Trip tips for those with OCD & anxiety

The many unknowns of a psychedelic journey can be the perfect catalyst for worry, particularly for those of us with a proclivity towards looping, catastrophizing, and worst-case scenarios. It’s completely normal to be scared before a psychedelic journey - I was certainly terrified before my first psychedelic trip and I’m so grateful to have had thorough preparation and a supportive person there with me to help me feel safe in my exploration.

A wide range of experiences are possible in a psychedelic journey and even healing trips can sometimes feel scary or even traumatic. In my experience, going through these dark places in psychedelic journeying can still bring great positivity, but only if the container around the trip is supportive. This is supported by research which found that the majority of people who have had challenging psychedelic mushroom experiences still said they were “‘meaningful’ or ‘worthwhile,’ with half of these positive responses claiming it as one of the most valuable experiences in their life.”

To set yourself up for a safe and transformational session, it’s always wise to follow basic prep guidelines - access the medicine from a trusted and safe source (testing the substance if necessary), know a good starting dose, check how medications may affect your trip, prepare and feel as centered as possible before the journey (set), arrange for a safe and nourishing space (setting), have a person with you for support (sitter or guide), and allot time to process in the days following the session (integration).

I actually think that a healthy mix of nervousness and excitement before a trip is a good thing: It demonstrates that you have reverence for how powerful a psychedelic teacher is and that it has the potential to significantly shift your life. But of course it’s best not to go into a trip feeling too anxious, so practice grounding yourself before the journey. And if you’re really struggling the days leading up to the trip - don’t push it. Check in with yourself and see if you want to postpone your trip or start with a lower dose.

It’s also important to note that psychedelics aren’t for everyone and it can shift depending on what you’re going through. For instance, I don’t go on full dose trips when I am in a depressive crisis, a particularly bad OCD episode, or when I’m very stressed or overworked. I’ve found that these trips can be unnecessarily challenging or even temporarily damaging, so I wait until I feel a bit more stable to have a session.

After your trip, be kind to yourself and take time to process in whatever ways feel most natural to you. It can be particularly helpful to write, draw, rest, and be in nature in the days following your journey. It’s normal to feel many things after a trip so let the changes unfold over time and don’t rush to make sense of everything. Be patient if changes don’t come right away and remember that for those of us who struggle with anxiety and OCD, just the act of releasing control and taking the leap into the psychedelic journey is a huge achievement.

How I Ease my OCD and Anxiety with Psychedelics — Psychedelic Exploration

By Amanda Gelender

psychedelicexploration.com

 

[mr peabody]

Psychedelics for Obsessive-Compulsive Disorder

Why is psilocybin helpful for treating mood disorders? Is it the drug alone acting on the brain, or is it the subjective experience?

by Nate Seltenrich | PROJECT CBD | 22 Mar 2021

The latest wave of psychedelic research has led to many significant breakthroughs in a short span of time. Yet this complex and mysterious field remains in relative infancy, with a number of key subjects still poorly understood. Among these, perhaps no question is more central – nor of more interest to modern pharmaceutical companies – than that of the therapeutic value of the psychedelic experience.

What is it about psychedelics that seems to make them so useful for helping to treat depression, addiction, and other mental health disorders? Is it the drug alone, acting physiologically on the brain, or is it the lived, subjective response engendered by the drug?

New research into the treatment of obsessive-compulsive disorder (OCD) with psilocybin, the active ingredient in magic mushrooms, may help to unravel this riddle.

Hard to let go

Three studies are currently investigating the use of psilocybin to reduce symptoms of OCD, a condition that has otherwise received relatively little attention in psychedelic research to date. Although the studies employ different treatment protocols, their combined evidence could prove pivotal in helping researchers better understand the therapeutic mechanism of psychedelic drugs.

That’s because OCD is generally characterized by a failure to surrender or release control – exactly what a full psychedelic experience typically demands. “People with OCD are trying to control their experience in a way that becomes very, very counter-productive, and very painful,” says Adam Strauss, a New York-based comedian who used psychedelics to overcome OCD. “OCD is really a disorder of control.”

Strauss chronicled his experience in the award-winning one-man stage show The Mushroom Cure. “For me,” he explains, “the experience of surrendering, of not trying to change my internal experience, not trying to get rid of the thoughts, not trying to get rid of the sensations, seems like the key factor in psychedelic healing. It’s that subjective experience of letting go and surrendering and allowing.”

While Strauss experimented with and achieved some benefit from low and moderate doses, he found that higher doses, particularly of psilocybin mushrooms, were most effective at teaching him to “let go” – and thus offered the most therapeutic value. “It’s hard for me to imagine having the outcomes I’ve had without those experiences that seem so essential,” he said.

A pioneering study

Strauss first got the idea to treat his OCD with psychedelics from a pioneering 2006 study in the Journal of Clinical Psychiatry. Nine patients were administered psilocybin up to four times each, at doses ranging from “very low” to “frankly hallucinogenic.” Not only did all nine show immediate improvement in OCD symptoms following at least one of the testing sessions, but the drug was also proven safe and well-tolerated. (Interestingly, and contrary to Strauss’ subsequent experience, the researchers did not find dose size to have a significant effect on outcomes.)

To this day, that study stands as the only of the modern era to investigate the use of psilocybin to treat OCD. But within the next couple of years, it will be joined by at least three more. One of these is being led by University of Arizona professor of psychiatry Francisco Moreno, the same researcher who directed the groundbreaking and now highly cited 2006 study.

Launched in October 2017, Moreno’s new study – this time with 15 subjects – has been on hold since early 2020 due to the coronavirus pandemic. But it should be restarting soon, Moreno reported in an email. “We have people who are ready to go and my hope is that we will start dosing this Spring if COVID restrictions match our institutional requirements and our ability to do this consistent with the customary settings and presence of two sitters in the room for extended periods of time,” he wrote.

To gain greater insight into how physiological changes in the brain and subjective psychedelic experience may be associated with therapeutic benefit for OCD following low and high doses of psilocybin, Moreno’s team will analyze both brain scans and patient responses to a variety of standardized questionnaires, including the 5-Dimensional Altered States of Consciousness Rating Scale and the Mystical Experience Questionnaire.

This should allow the researchers to determine if any improvements in OCD symptoms observed up to six months after the last dose are more closely aligned with patients’ experience of the drug or with specific aspects of brain activity following treatment. The study should be complete by the end of 2021, Moreno said.

High-dose therapy

Meanwhile on the other side of the country, a second, larger study with 30 participants is underway at Yale University – and not far behind. Principal investigator Benjamin Kelmendi, an assistant professor of psychiatry, said the study has already resumed after a nine-month pause for COVID and is now enrolling subjects, with a projected completion date of early 2022.

Like Moreno’s study, Kelmendi’s will measure the effects of psilocybin – in this case just a single, high dose – in both objective and subjective terms, and then compare those effects to clinical outcomes for OCD. This will permit the researchers to determine whether, across the study population, degree of improvement is more accurately predicted by changes in brain connectivity as measured by fMRI, or by self-reported subjective experience.

Another way in which the two studies are alike (and distinct from most other recent and ongoing studies investigating psychedelics as treatments for mental health disorders like addiction and depression) is that they won’t include any form of talk therapy. Instead, as in Moreno’s first, pilot study, any beneficial effect will be directly attributable to the pharmacology of the drug and the changes it causes in the brain, the psychedelic experience it precipitates, or some combination of the two.

That’s not the case with the third concurrent study into psilocybin and OCD, being led by renowned psychedelic researcher David Nutt at Imperial College London’s Centre for Psychedelic Research. Nutt’s new study will pair a moderate dose of psilocybin – low enough that it is not expected to provoke a traditional psychedelic experience – with a form of talk therapy widely used for OCD called Acceptance and Commitment Therapy. This therapy will not take place under the influence of the drug, but rather after its most direct effects have worn off, during “integration” of the treatment, Nutt said in an email.

A big challenge

In an online talk discussing the new study last May, Nutt acknowledged that based on findings from his previous research into the treatment of depression with psilocybin, he would expect that higher, more psychedelic doses would be more effective at treating OCD – with the subjective experience playing at least a partial role.

“It’s a big challenge to take a trip, or something you’ve never had before, and possibly go somewhere that could be very dark and unpleasant, but the depressed people have agreed to do it,” Nutt said in the talk. “They’ve often been very anxious about it, but when they’ve done it, they’ve usually come back and said, ‘Wow, that was tough, but I’m glad I did it.’”

Nevertheless, Nutt and his collaborators decided not to offer a high dose this time around after determining early on that members of the OCD patient population weren’t interested. “They made it clear that they would not accept a ‘full’ dose,” Nutt confirmed in an email to Project CBD.

So the research team pivoted to a slightly different model of treatment, one in which subjects will “still be in control” throughout the entire process. Ideally, they will also be primed by the drug on some level to be more receptive to targeted therapy immediately afterward, Nutt said in the video: “We call it psychedelic-enhanced psychotherapy.”

Recruitment for the full study started in April 2021.

Acceptance & surrender

Adam Strauss believes his own healing was enabled by higher doses and powerful subjective experiences, but he still sees the potential for significant therapeutic value in moderate doses paired with Acceptance and Commitment Therapy. ACT is a form of cognitive behavioral therapy that he underwent for years, without much success – until he combined his hard-earned knowledge of its key principles with self-directed use of psychedelics.

“I wasn’t actually able to do that sort of acceptance and surrender until I began using psychedelics,” he said. “A lot of my key experiences on psychedelics were me basically doing these ACT techniques while I was tripping.”

Though the Imperial College study’s smaller dose is not expected to produce a full psychedelic experience in patients, the researchers will still measure subjective responses to psilocybin through questionnaires, allowing them to correlate perceived effect with therapeutic benefit.

But beyond the specific findings of any single study, looking at all three studies together could yield the greatest insight into the treatment of OCD with psychedelics and the larger question of the therapeutic value of “the trip.” Are high-dose or high-effect experiences that involve “letting go” truly better for treating OCD in the long term? Or is a moderate, controlled trip followed by talk therapy just as effective – or more so?

With drug companies already obsessed over the prospect of developing trip-free (or at least bad-trip-free) psychedelics, the issue is more than just academic. For better or worse, it has major implications for fledgling efforts to commercialize and medicalize psychedelic drugs. If these three studies go as planned, in another year or so we may have a better idea about whether the psychedelic experience will be viewed as a feature or a bug by the medical establishment.
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Nate Seltenrich, an independent science journalist based in the San Francisco Bay Area, covers a wide range of subjects including environmental health, neuroscience, and pharmacology.

Psychedelics for Obsessive-Compulsive Disorder | Project CBD

Psychedelic treatments for OCD may yield insights into whether therapeutic benefits are caused by the drug alone, acting physiologically on the brain, or are they caused by the lived, subjective response engendered by the drug?

www.projectcbd.org