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Psychedelics and Perception*

Reviewing early research (1895-1975) on changes in visual perception

by Joshua Falcon, MA | Psychedelic Science Review | 6 Oct 2021

Psychedelic drugs have long been associated with temporary alterations in perception. These changes include, but are not limited to, auditory, visual, and sensory distortions or hallucinations, alterations in body image, and modifications in one’s sense of time. Although early studies are often overlooked due to recent advances in scientific methods and technologies, valuable research was conducted on the physiological changes that psychedelics produce at the visual, auditory, and sensory levels and how these are associated with phenomenological changes in perception.

In a recent review article, Aday et al. provide a novel synthesis of scientific literature drawn from the first era (1895-1975) of psychedelic research. While the early research was predominantly concerned with changes in visual perception, there was also research conducted on auditory processing, changes in body schema and tactile processing, and alterations in the perception of time. The following article summarizes Aday et. al.’s review of psychedelics’ effects on visual perception by drawing out some of its key findings and areas where further research is needed.

Physiological changes in vision

Upon reviewing the first era of studies, Aday et al. suggest that there remains a longstanding debate that has heretofore fallen by the wayside over whether psychedelic-induced changes in visual perception stem from alterations in the brain versus the peripheral eye. On the one hand, early animal studies from the 1950s and 1960s exhibited elevated levels of LSD found in the iris of monkeys. Additional research from this period found that LSD produced spontaneous firing in the sclera, visual cortices, and optic nerves of cats, leading some to hypothesize that changes in visual perception may stem from physiological changes in the retina and peripheral eye.

On the other hand, research conducted between the 1950s and 1970s suggests that changes in visual perception may instead stem from the brain insofar as studies on both blind individuals and in animal models exhibit neurological changes at the cortical and subcortical levels of the visual system.

Despite this era of research being technologically limited to electroencephalography (EEG), notable findings show that changes in cortical activity are more pronounced than changes in the lateral geniculate nucleus (LGN) under the effects of psychedelics. This hypothesis is not only thought to be consistent with contemporary claims which posit that the effects of psychedelics are primarily exerted through the 5-HT2A receptors, but it also lends credence to the idea that modifications in brain activity are more pertinent, robust, and dynamic than those located in the peripheral eye and the retina. Given certain discrepancies in the data, however, further research is needed on the brain versus peripheral eye debate as well as in other areas where discrepancies are found such as changes in alpha activity.

Changes in simple visual processing

The visual changes provoked by psychedelics are thought to stem from changes in elementary visual imagery (EVI), or changes in motion, form, and depth. In studies conducted during the 1950s with participants who had their eyes open, it was found that LSD changed perception in apparent horizon and apparent verticality, as well as elevations in low-level visual thresholds, while psilocybin contracted the perception of nearby visual space. These findings suggest that transformations in visual perception may ultimately be influenced by alterations in low-level visual processing; a point that appears to be at odds with recent studies, signaling the need for further research.

In studies from the 1940s where participants had their eyes closed, reports of geometric and kaleidoscopic patterns appearing in one’s visual field were reported and grouped together by researchers according to their phenomenological descriptions. These groupings included dynamic patterns such as tunnels, cobwebs, spiral designs, and cones to name a few.

Alterations in the perception of color can also be found in several of the first era of studies based on reports of increased color saturation or vividness. One study from the 1960s, in particular, found that LSD, psilocybin, and mescaline equally impaired color discrimination performance and suggested that each drug may affect the perception of different hues.

Complex visual imagery

Apart from changes in low-level visual perception, early studies also show that psychedelics tend to provoke intricate and evolving visionary experiences. Today’s researchers describe these changes in perception in terms of complex visual imagery (CVI), and individuals often describe these experiences as being dreamlike or vivid. Both anecdotal reports and self-experimental studies published during the first half of the twentieth century have long attested to the ability of psychedelics to produce these enduring, changing, and internal visions; however, these experiences prove difficult to quantify. Nevertheless, psychedelic experience reports are rife with references to internally experienced dynamic visions dating back to the early stages of psychedelic science. Although the nature of CVI has proved elusive, it is suggested that researchers should be on the lookout for cognitive factors that may be related to CVI, such as increases in creativity and metaphoric thinking.

The first era of research (1895-1975) into the effects of psychedelics on perception contains valuable findings that can be useful to researchers today. These include debates on how psychedelics produce physiological changes in the brain, the peripheral eye, and the retina to provoke changes in visual perception, as well as how alpha activity is affected by psychedelics.

Researchers during the mid-twentieth century found that psychedelics produced changes in low-level visual perception, increased vividness in color perception, as well alterations in the perception of certain hues. The significant visionary effects that are often produced by psychedelics were also investigated during the first era but proved difficult to quantify, signaling the need for contemporary research into the cognitive factors associated with the more profound and complex changes in visual perception.

Stay tuned for further articles in this series discussing changes in auditory and tactile processing, body schema, and time perception brought on by psychedelics.


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The First Era of Research
Reviewing early research (1895-1975) on changes in auditory perception

Psychedelic drugs have historically been recognized for their ability to produce changes in various aspects of perception. Upon examining early research conducted on psychedelics and changes in perception, Aday et al.’s recent review article synthesizes evidence drawn from the first era (1895-1975) of psychedelic research.

This article, Part 2, surveys a second portion of their review by examining the early evidence on psychedelics and changes in auditory perception. It highlights key findings drawn from the first era of research on psychedelics and changes in non-visual perception, while it also brings this evidence into conversation with contemporary studies where either resonances or discrepancies in the data exist.

Changes in auditory processing

Apart from investigating how psychedelics produce changes in the sphere of visual perception, researchers from the first era of psychedelic science also examined alterations in auditory perception. Behavioral studies conducted during the 1960s and 1970s, for example, found that LSD and other psychedelics reduced auditory sensitivity and led to increases in stimulus generalization. In contrast, other research conducted during this time period using animal models claimed that, in general, psychedelics produced fewer responses and reaction times overall, while they also appeared to have no effect on stimulus generalization. These observations of delayed reactions to auditory stimuli were also frequently reported across studies on psychedelics from the 1950s to the 1970s.

Around the same time, other experiments directed at studying the neural correlates of auditory alterations showed that mescaline, in a dose-dependent manner, increased the amplitude, latency, and peak area of the N1 and P1 auditory evoked potential (AEP) components in cats. Another notable study from 1971 compared how DMT and LSD differentially affect AEPs, suggesting that while LSD appeared to have no effect, peak DMT sessions showed a disappearance of AEP’s that tended to gradually resurface as the effects of DMT diminished. Aday et al. interpret the latter findings as being consistent with more recent studies on DMT, where individuals commonly report increased dissociation from their immediate surroundings.

Auditory hallucinations are another area of research investigated during the first era of psychedelic science; whereas some insisted on auditory hallucinations being common occurrences during psychedelic experiences, others considered them to be rare. Of the few early studies which quantitatively investigated the occurrence of auditory hallucinations, their frequency was considered to be uncommon. Instead of interpreting these changes in auditory perception as auditory hallucinations, some researchers during the 1930s and 1950s respectively suggested that these were perceptual distortions of objective stimuli. Aday et al. believe these results to resonate with contemporary studies wherein alterations in auditory perception have been examined.

Lastly, in undertaking investigations on the effects of music on psychedelic experiences, the first era of research produced several insights that would later be confirmed in more recent studies. In 1970, for instance, researchers suggested that music eased patients’ ability to “let go” during psychedelic therapy sessions, allowed patients to more fully explore their inner mental experiences, and reliably provoked intense emotions. Another study published in 1972 study showed that patients benefited more from the music they were most familiar with and that they also considered romantic and religious music as the most significant. In addition, it was discovered that music could, at times, “guide” the experience of the patient. These early insights on how music affects mental imagery and emotions during psychedelic experiences, and how these, in turn, are associated with increases in therapeutic value, have been validated in more recent studies, one of which was the subject of a Psychedelic Science Review article earlier this year.

Conclusions

The effects of psychedelics on perception have proven to be a longstanding area of interest to psychedelic researchers. This article summarized findings drawn from Aday et al.’s review of the first era of psychedelic research (1895-1975) and focused on the effects of psychedelics on auditory perception in particular. Behavioral studies predominantly from the 1960s and 1970s found divergent findings with regards to how psychedelics affect responses to auditory stimuli; however, they more reliably showed that there were delayed reactions to auditory stimuli across both animal and human models. Early investigations on the neural correlates of psychedelic-induced changes in auditory perception found increases in the amplitude, latency, and peak area of the N1 and P1 auditory evoked potential (AEP) components in cats. Other studies on the neural correlates of auditory changes during psychedelic states suggested that peak DMT experiences temporarily reduced AEP altogether, which can be seen as both anticipating and corroborating contemporary research on DMT.

While some first-era studies maintained opposing stances on the rarity of the phenomenon of auditory hallucinations, other investigations fell more in line with contemporary research which considers auditory hallucinations as pseudo hallucinations that stem from perceptual distortions of objective stimuli. Significant insights on the relationship between music and psychedelic experiences were also produced during the first era of psychedelic science, with many of these insights being validated by current research on music and psychedelic psychotherapy.

Stay tuned for further articles in this series discussing changes in tactile processing, body schema, and time perception brought on by psychedelics.

*From the articles (including references) here :
 
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7 fascinating psychedelics that are making a resurgence in scientific research

by Donovan Alexander | Interesting Engineering | Aug 14 2019

Scientists are now, more than ever, excited about the new research surrounding psychedelics.

Properly understanding psychedelics and the effects on the human mind and body has taken center stage in the research and medical community. Though psychedelics have always been a point of interest for scientists, new research pointing towards the use of these trippy drugs to treat depression and other forms of mental illness are making their rounds in the scientific community.

Even the popular psychedelic magic mushrooms have begun the process of decriminalization in certain areas in the United States.

Yet before even breaking into that exciting world of psychedelics and mental health we decided to take a hard look at what psychedelics are, how they are categorized, and what science says about the effects they have on the human brain.

Categorizing psychedelics

For the uninitiated psychedelic drugs are psychoactive drugs whose primary action is to alter the thought processes of the brain. These trippy drugs are thought to disable filters which lock or suppress signals related to everyday functions from reaching the conscious mind.

Some go on to describe these effects as mind-expanding, or consciousness expanding as your conscious mind becomes aware of things normally inaccessible to it. Psychedelic drugs are actually a subcategory of hallucinogens and can be broken down into three main categories.

RELATED: RESEARCH SHOWS PSYCHEDELIC DRUGS COULD HELP BRAINS HEAL

Let’s start with serotonergic or classical psychedelic drugs. These are the drugs you usually think about when discussing psychedelics with friends. Well, known drugs like LSD, DMT, and mescaline all fall into this category. These psychedelics will cause drastic changes in your sensory perception including visual and audible hallucinations.

Secondly, you have empathogens. These drugs make you feel good. Empathogens affect your neurons that release serotonin, giving the user the feeling of euphoria, love, and increased attentiveness and awareness. Nevertheless, you only experience mild forms of changes to perception.

Finally, you have dissociatives. These psychedelics create a dramatic sense of depersonalization and derealization, creating something that is literally out of this world. People who take dissociatives tend to disconnect from the world, their surroundings and even their bodies.

Now lets a look at some of the world’s most popular psychedelics.

LSD

You're probably very familiar with LSD as this psychedelic has reemerged in pop culture because of the raging micro-dosing trend currently taking hold of the Silicon Valley and the potential of the drug to become a means to treat mental health issues. Lysergic acid diethylamide was synthesized in 1938 by Albert Hofman but was not revisited until 1943 when he accidentally absorbed some through his skin.

LSD was a staple of the hippie movement, creative muse for much of pop culture, only to eventually become a Schedule I drug as a part of the Controlled Substances Act. LSD temporarily alters how our brain interacts with dopamine and serotonin causing hallucinations and euphoria.

LSD is nonaddictive and builds a sort of self-regulating tolerance almost immediately. An LSD high can last up to 12 hours. In controlled experiments, those who have taken LSD have shown increased levels of optimism, openness, creativity, and imagination.

Peyote

Another spiritual guide, peyote has been used by the Native Americans for years. The drug has been used during religious ceremonies. Though it is not chemically like LSD or psilocybin it has been known to produce a similar effect to both of the substances. Users have been described to feel deep introspection and the ability to dissociate from one’s self.

Psilocybin

Another popular psychedelic, psilocybin or magic mushrooms are a group of fungi that have been used since prehistoric times as both an entheogen and hallucinogenic drug. Nevertheless, the substance exists in a wide range of genera with a little over 100 species in the genus.

The effect of psilocybin range from empathy, to euphoria, and altered thinking. Psilocybin is not chemically addictive or even represents a direct threat to your health. In fact, psilocybin is currently being researched to treat depression.

2C-B

Though it is less popular 2C-B is just as intriguing as some of the other psychedelics because of its unique properties. It was synthesized in 1974 by the famous Alexander Shulgin. The psychedelic creates euphoria, empathy, increased insight, brightened colors, and increased sexuality.

2C-B works on the serotonin receptors of the brain, blocking the 5-HT2C receptor which leads to the psychedelic effects. The psychedelic has been used to aid in the bonding between a therapist and their patient.

Salvia Divinorum

Salvia is one of the few psychedelics on this list that is not an illicit substance in the United States. Yet, it is one of the most potent naturally occurring psychedelics known to humankind. The psychedelic has been used for centuries by the Mazatec natives in South America.

Salvia bonds to only one of the receptors in the brain causing the dopamine in your brain to drop significantly. Some people who have smoked salvia had described a feeling of separation from the self.

DMT/Ayahuasca

DMT has grown in popularity over the years all thanks to Rick Strassman who gave it the nickname “the Spirit Molecule,” while Terence Mckenna studied the psychedelic in detail documenting the effects. It has been used for thousands of years for spiritual ceremonies that are still happening today.

DMT is considered to be one of the most powerful psychedelic drugs on earth causing in some case very literal out of this world trips.

MDMA

With two million pills being smuggled into the US every day, MDMA is a party drug for a reason. Yet, compared to the other substances on this list, MDMA is one of the more harmful drugs on this list. The drug was created in 1912 but was not explored until the 1970s by Alexander Shulgin in the field in of psychotherapy.

The drug dramatically affects your serotonin receptors creating a tremendous wave of euphoria which after 8-12 hours is followed by a comedown. Frequent use of MDMA has been said to cause permanent brain damage because of the drastic effects on serotonin. Even more so, MDMA on the black market is usually cut with other substances that can be life-threatening.

In our next psychedelic article, we will explore how some of these psychedelics are being used to treat mental health.

 
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Phase 2 clinical trials to begin using psilocybin to treat Major Depressive Disorder

By Barb Bauer | PSR | Sep 27 2019

Enrollment of study volunteers is expected to start within the next two months.

This fall, the Usona Institute will launch its phase 2 clinical trial studying the safety and efficacy of psilocybin for treating a condition known as major depressive disorder (MDD). Approximately 80 volunteers will be recruited to participate in the study that will take place in seven sites in the US (see below). The first sites are expected to begin enrolling volunteers in the next two months.

MDD (also known as clinical depression or simply depression) is a mood disorder characterized by persistent feelings of sadness and loss of interest. The condition affects how a person thinks, feels, and behaves and can lead to emotional and physical problems. People suffering from MDD not only have trouble with their normal day-to-day activities, but they may also feel that life isn’t worth living. Along with feeling sad and losing interest, symptoms of MDD may include angry outbursts, sleep disturbances, fatigue, anxiety, and frequent or recurring thoughts of death, thinking about suicide or attempting suicide.

The study site locations and principal investigators at each include:

- Johns Hopkins University (Roland Griffiths, Ph.D.)
- NYU School of Medicine (Stephen Ross, MD)
- University of California San Francisco (Josuha Woolley, MD, Ph.D.)
- Yale University (Gerard Sanacora, MD, Ph.D.)
- University of Wisconsin-Madison (Randall Brown, MD)
- Great Lakes Clinical Trials, Chicago (Rupal Trivedi, MD)
- Segal Trials, Miami (Rishi Kakar, MD)

More information, including what is involved in the clinical trial, who can qualify, and how to enroll is found at the website UsonaClinicalTrials.org.

Usona Institute is a 501(c)(3) nonprofit medical research organization (MRO) that conducts and supports pre-clinical and clinical research to further the understanding of the therapeutic effects of psilocybin and other consciousness-expanding medicines. The institute focuses on alleviating depression and anxiety in people for whom current medical treatments fall short in offering relief and a better quality of life.

 
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Psilocybin trial for Treatment Resistant Depression at University of Texas, Houston*

Medical Xpress | Oct 3 2019

Psilocybin, a psychedelic drug believed to help rewire the brain, is now being studied to relieve treatment-resistant depression at The University of Texas Health Science Center at Houston (UTHealth) as part of a global Phase II clinical trial.

"It is a medication that can change or alter perceptions, cognition, thinking, and how minds see the environment," said Sudhakar Selvaraj, MD, Ph.D., an assistant professor in the Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School at UTHealth. "This therapy, if it works, could help at least a portion of people get relief from their depression and get back to day-to-day life."

A 2012 study on the effects of psilocybin on the brain revealed that the drug may help create new circuits in the brain while potentially quieting others that may link to depression. Though the body will clear the drug in a matter of hours, the potential effects could last for several months or longer.

A previous study at Johns Hopkins University on the effects of the drug in cancer patients suggested that psilocybin therapy may lessen depressive symptoms. Psilocybin is broken down by the body to produce psilocin, which affects the serotonin system that regulates mood.

"It is not a drug that's given to someone and then you just wait and see what happens. The therapists guide the patients through the experience after the administration of the medication," Selvaraj said.

Participants in the double-blind study receive a single dose of the medication, either 25 mg, 10 mg or 1 mg. Neither the patient nor the study physician will know which dose participants are receiving. After taking the medication, patients are supervised by two therapists for eight hours in a specially designed, home-like, treatment room. Patients have preparation sessions with their therapists before the dosing day, and integration sessions afterwards.

Individuals participating in the trial will answer a questionnaire to measure depression symptoms the day before and the day after taking the single dose—and again one, three, six, nine and 12 weeks out.

Currently, psilocybin is a controlled Schedule 1 substance and is not approved in the U.S. to treat depression. However, the Food and Drug Administration has approved its use in this trial, and has designated this program of psilocybin therapy for treatment-resistant depression a Breakthrough Therapy.

To qualify, participants must be between the ages of 18 and 55 and have a diagnosis of treatment-resistant depression. Participants are being recruited in the Houston area.

*From the article here :
 
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RESEARCH INTO PSYCHEDELIC-ASSISTED THERAPY AND NEUROSCIENCE

Neuro Assessment & Development Center

Since 2006, the Third Wave of clinical research and therapeutic applications of psychedelics has been underway. Far from the recreational stigma, Psychedelics have evolved into an accepted treatment of significant issues. Microdosing has become an established method for dealing with ADHD, Depression, and Unlocking creativity. Anyone trapped by the old paradigms will be very surprised.

LSD versus placebo. Research investigating classic psychedelics as treatments for addiction was initiated in the first wave of classic psychedelic research in the mid twentieth-century, but was ultimately terminated as a result of misinformation, stigma, lack of funding, and legal proscription. For the most part, plant medicine and use of psychedelics is misrepresented. There is a taboo in society still. The outspoken work of Michael Pollan, Paul Stamets and many researchers has ushered us to the Third Wave, a tipping point where modern research and communication is informing the public. People are talking about the benefits, though often in corners and in whispers. Ancient and Sacred ceremonies by shamans have been part of every culture, though often demonized. This led to the First Wave of investigation and the discovery of LSD in 1938 by Albert Hoffman, a chemist working for a pharmaceutical company. The benefits evolved quickly and by the 1950's and 60's, the Scientific Method was applied to create the Second Wave. The clinical benefits of psychedelics were well established by research and clinical application was wide spread for those that suffered with Depression, Anxiety, PTSD, Addiction, and other debilitating conditions within major institutions and rehabilitaton centers. The research and clinical applications came to a crashing halt when recreational use and mind expansion efforts overtook clinical application. Psychologists such as Timothy Leary and Ram Dass at Harvard opened the floodgates with uncontrolled experimentation. Then the conservative Nixon-era shut down funding for research and created a negative stigma around these substances with false images and many exaggerations about deaths related to use. This scared the public and created the taboo. It is noted by many researchers that LSD and Psilocybin has no known lethal dosage level and is non-addictive.

It is noted that in the 60's, these drugs were classified as Schedule I, indicating they have a high potential for abuse, not currently accepted as a medical treatment, and lack safety even under the supervision of a doctor. We believe this is not correct and will be re-evaluated very soon. LSD and Psilocybin are about to enter Stage 3 Clinical Trials for Depression and Addicion, meaning that their status will have to change from Schedule I to Schedule III, with widespread clinical application around the corner. There needs to be an End to the Ban and a change in social thought. For further history and why these medicines have been demonized by government and pharmaceutical lobbies, the interested reader is referred to Michael Pollan's 2018 book How to Change your Mind. It likely will.

After remaining hidden for three decades, researchers began bringing Psychedelic Medicine out of the shadows in 2006. Griffiths' 2006 study, funded by NIH, opened the doors to legitimate study once again. Many researchers are now investigating the benefits in double-blind trials with major funding. As of 2018, 50 U.S. based researchers hold Class I drug licenses from the DEA to investigate the benefits of LSD, Psilocybin, MDMA, Ketamine, Ayahuasca, and many other substances. Although there is still a taboo amongst the majority when the word "Psychedelic" is said, we believe that like Cannabis, the majority will see the benefits of Psychedlics very soon and that it will be legalized and used in therapy, under the guidance and supervision of doctors. The data from research is very hard to argue with. The effectiveness of LSD and Psilocybin to treat Depression and Addiction in research trials has reached rates as high as 80%, without a return of symptoms for six months. There are no treatments (medications or therapies) that come close to the effective benefit. Government will resist and society will remember the stigma. Pharmaceuticals will fight against, because their expensive medications are not as effective. But the conversation has become universal and the benefits are undeniable. This is why large scale studies are beginning and reseachers are opening their vision to the world.

 
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New center at Johns Hopkins builds the case for psychedelic research*

by Tori Rodriguez, MA, LPC | Psychiatry Advisor | Nov 4 2019

Nearly 15 years after experts at Johns Hopkins University School of Medicine helped to reinvigorate research on the potential therapeutic effects of psychedelic substances, experts have launched the Center for Psychedelic and Consciousness Research, the first of its kind in the United States and the largest in the world. The center is fully funded by private donors, including The Steven and Alexandra Cohen Foundation and 4 philanthropists, who altogether contributed $17 million to cover operational expenses for the first 5 years.

Initial research on psychedelics that began in the 1950s and 1960s “abruptly ended in the early 1970s in response to unfavorable media coverage, resulting in misperceptions of risk and highly restrictive regulations,” according to the new Center’s website. Additionally, psilocybin was classified as a schedule I drug during the Nixon administration. However, researchers have subsequently demonstrated relatively low abuse potential and toxicity associated with the agent.

After obtaining regulatory approval in 2000 to reinitiate psychedelics studies, Johns Hopkins researchers published a landmark double-blind study in Psychopharmacology in 2006 showing positive, sustained effects of psilocybin on the attitudes and behavior of healthy volunteers. The study also demonstrated the safety of the substance when administered under well-controlled conditions. This “sparked a renewal of psychedelic research worldwide,” according to a press release announcing the new center. In the aftermath, a sizable body of research has demonstrated therapeutic benefits of psilocybin and other psychedelic substances, including ketamine, LSD, MDMA, ayahuasca, and ibogaine, some of which have long been used by indigenous cultures in medicine and spiritual practices.

Overall, results thus far support the efficacy of psychedelics in a wide range of conditions and populations, typically in combination with psychotherapy. For example, an open-label trial published in 2018 in Psychopharmacology examined the effects of psilocybin on treatment-resistant depression in 20 patients (6 female). Patients received 2 doses (10 and 25 mg) of the drug 7 days apart, along with psychological support at each session.

At weeks 1 and 5, significant reductions in depressive symptoms were noted. Many patients met criteria for response or remission at 5 weeks. In addition, results were sustained for months after the intervention. No serious adverse events were observed. Several other trials have also found improvements in depressive symptoms following psilocybin-assisted psychotherapy.

In a randomized, double-blind crossover trial published in 2016 in the Journal of Psychopharmacology, 51 patients with life-threatening cancer were treated with high-dose psilocybin and had substantial reductions in self- and clinician-rated depressed mood, anxiety, and death anxiety, as well as increased quality of life, optimism, and life meaning. At 6 months, clinically significant improvement in depressed mood and anxiety were sustained in approximately 80% of patients.

Numerous other studies have demonstrated the efficacy of psilocybin in combination with cognitive behavioral therapy for smoking cessation, psilocybin and LSD for alcohol use disorder, ayahuasca for treatment-resistant depression, ibogaine for opioid dependence, ketamine (alone and as a part of ketamine-assisted psychotherapy) for treatment-resistant depression, and MDMA-assisted psychotherapy for posttraumatic stress disorder and other conditions.

Limitations of psychedelics research include the inability to conduct blinded studies with these agents for both ethical and practical reasons. Thus, participants are aware of whether they have ingested a drug or not. Additionally, research is limited by the lack of objective measures of improvement.

“The investigation of hallucinogens as treatments may be endangered by grandiose descriptions of their effects and unquestioning acceptance of their value,” wrote Guy Goodwin, MD, senior research fellow at the University of Oxford, in a 2016 paper. He also cautions that the legalization of psychedelics for medical purposes, such as marijuana in many American states, could potentially lead to widespread recreational drug use.

*From the article here :
 
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Ease rules on research into psychedelic drugs, urges David Nutt

by Nicola Davis | The Guardian | 2 April 2020

Ex-government adviser says substances such as psilocybin could have medical value.

Restrictions on the use of psychedelic drugs in research should be relaxed to help find new treatments for conditions including mental health disorders, the former government adviser Prof David Nutt has said.

Nutt was sacked as chair of the advisory committee on the misuse of drugs in October 2009 over his views that ecstasy and LSD are less dangerous than alcohol.

He said the potential benefits of psychedelics – suggested from research in the 1950s and 60s – were failing to be properly explored because of draconian regulations imposed for political reasons.

While heroin and psilocybin (the active compound in magic mushrooms) are both class A drugs, only the latter is a “schedule 1” controlled drug – a category of drugs deemed to have no medical value.

“The implication is if you want to use psychedelics, you must be doing something wrong, even though it is research,” said Nutt.

He said the upshot was that research into drugs such as psilocybin involved an expensive and lengthy bureaucratic process to gain licences, and it was also difficult to gain ethical approval.

“You’ve got to get permissions, multiple permissions from the Home Office, and they include inspections,” he told the Guardian, adding that transporting such drugs required special couriers and extensive documentation, and higher levels of security were required than for other drugs that are more harmful.

“A lot of research isn’t done because people just can’t go through the rigmarole of getting the licence,” he added.

Despite the tight restrictions, some new research is being conducted, including by Nutt and his team who have conducted brain scans on people who are tripping on LSD.

Writing in the journal Cell, Nutt and colleagues outline evidence suggesting that psilocybin could be a powerful form of therapy for conditions ranging from depression to anorexia.

“Both the depression and tobacco smoking trials have shown that in some people psilocybin can produce clinical remission, in some cases persisting for years,” the team write, adding that they are now working on a trial comparing psilocybin with the antidepressant escitalopram in major depressive disorder.

Nutt and colleagues say that psychedelics are thought to produce such results by disrupting activity in the brain involved in habits of thought and behaviour, possibly by interacting with a receptor predominately found in the cerebral cortex of the brain called 5-HT2A.

They say that disruption can not only help individuals gain insights into their conditions during the trip but also provide a window of opportunity in the days that follow, while the participant is experiencing an “afterglow” and thinking differently, for them to engage better with psychotherapy.

However, the team note many questions remain, including how long a trip needs to last for benefits to be seen, whether so-called “microdosing” with the drugs – where levels are so low that there is no trip – could be beneficial, and why some patients relapse after psychedelic therapy.

In the meantime, with psychedelics legal in some parts of the world, the team are hoping to collect data on people’s experiences through an online survey.

Nutt cautioned against people using psychedelics for self-medication, noting that participants in trials were prepared for the trip, and the psychedelics were administered in the presence of therapists.

“Our depressed patients almost always have a very tough trip and we don’t think they’d be safe having a trip like that in the middle of a field or in their own bedroom without professional care,” he said, adding that the psychotherapy afterwards was also important to gain benefits.

Ultimately, said Nutt, the schedule 1 restrictions on psychedelics need to change. “We have been arguing for years there should be exemption for research,” he said. “That magic mushrooms can be alongside crack cocaine is absurd. But even worse is the putting it in schedule 1 so you can’t use psychedelics for research.”

 
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Medical University of South Carolina to launch new Psychedelic Research Center

by Adam Drury | Jan 7 2020

MUSC’s new Psychedelic Research Center will be at the center of major developments in psychiatric medicine.

Expanding access to legal cannabis and a surge of research into medical cannabis-based treatments have brought with them a renewed interest in the healing powers of another class of mind-altering substances: psychedelics. Cultural attitudes toward psychedelic drugs and experiences are shifting dramatically, and psychedelic-based treatments are rapidly gaining legitimacy among medical and health professionals.

But when it comes to evidence-based treatments, researchers have some catching up to do. Psychedelic compounds present myriad opportunities for major medical breakthroughs, but doctors and scientists need opportunities to study them. And The Medical University of South Carolina’s new Psychedelic Research Center, slated to open in mid-2021, will offer researchers exactly such a space to explore the vast medical and therapeutic potential of psychedelics.

MUSC partners with psychedelic studies association to launch research center


Despite rekindled interest in the ancient traditions of psychedelic medicine, tripping to heal remains a fringe concept for many health practitioners. But over the past couple of decades, more scientists have begun to investigate the effects of psychedelic compounds on psychiatric problems. Their work has produced a number of exciting and promising studies that point the way toward groundbreaking treatments for mental illness.

Indeed, one of those studies was conducted by Dr. Michael Mithoefer, a researcher in MUSC’s department of psychiatry and behavioral sciences who’s also spearheading the development of the new psychedelic research center. Mithoefer recently co-authored a study on using MDMA alongside psychotherapy to help veterans, firefighters and police officers overcome chronic PTSD.

Other studies have found that the use of psychedelics can help treat anxiety and depression, ween people off of addictions to nicotine, alcohol and opioids, and improve psychological well-being for people suffering from a range of mental health problems.

Beyond medical applications, the study of psychedelics could also revolutionize our understanding of the mind and human psychology.

To pursue all of these avenues of research, MUSC is partnering with the Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit research and educational organization working to develop “medical, legal and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana,” according to the group’s website.

With Dr. Mithoefer heading the project, MUSC and MAPS hope to bring the psychedelic research center online within 18 months.

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New research center will study MDMA, psilocybin and more

MUSC researcher in psychiatry and behavioral sciences Dr. Michael Mithoefer couldn’t conduct his research on MDMA and PTSD on the MUSC campus. But once the medical university’s new psychedelic research center comes online, Mithoefer and other researchers will be able to conduct clinical trials right on campus.

An on-campus research center will allow doctors and researchers to work together on larger studies involving more people. It will also give them the opportunity to study multiple psychedelic compounds. In addition to MDMA, MUSC’s new research center will investigate naturally occurring psychedelics like psilocybin, DMT and mescaline.

“I saw that we needed better treatments,” Mithoefer said of his early interest in finding new options for people with PTSD. “MDMA was used with therapy by maybe several thousand therapists and psychiatrists before it became illegal in 1985.”

Thirty years later, in 2015, the DEA approved large-scale studies of MDMA. And in August 2017, the FDA gave approval to MAPS, the same group partnering with MUSC to launch its new psychedelic research center, to conduct phase III clinical trials on treating PTSD with MDMA. Additionally, the FDA has designated MDMA as a potential breakthrough therapy.

All of that means that MUSC will be at the center of the clinical trials that could bring MDMA treatments to market. Medical ecstasy might not be far off. Indeed, it could be available for use in psychotherapy as early as 2021.

 
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World’s first textbook on psychedelic research

by David Wilder | Psychedelic Times | Jan 21 2020

Have you ever wondered where to find a reputable overview of psychedelic research? Maybe you’re a clinician with patients who would benefit from working with psychedelics and you want to read up on the latest research so you can feel confident implementing them into your practice. Or perhaps you are a well-seasoned psychonaut with an interest in learning about the scientific side of psychedelics. No matter your reasons for seeking out this information, look no further—the world’s first academic textbook covering this topic was published earlier this year.

Oliver Hovmand is a psychiatry resident in Denmark who decided to write Medical Psychedelics after realizing that although there have been plenty of psychedelic studies conducted over the past several decades, there has been an absence of academic textbooks available for people who want to study the existing body of psychedelic research. I spoke with Oliver about why having your own psychedelic experiences can help you to fully understand what has been reported in the research, about the factors that helped him decide which studies to include in his textbook, and about how he plans to keep the book updated moving forward.

Thanks for taking the time to speak with me today, Oliver. What is your background and how did you get interested in psychedelics?

After high school I went to medical school, which I finished two years ago. Now I have an internship in psychiatry in order to make it my specialty. I have been interested in psychedelics for the last four or five years, and I’m interested in non-ordinary states of mind and how we can achieve them. I got into a group that has an interest in psychedelics and then I tried them myself and found them really interesting. So I started to study the medical literature of psychedelics, which was beginning to develop back then. And I just kept developing more of an interest in them. Then back in medical school, I wrote my masters thesis on MDMA as a possible treatment for PTSD. There was a lot of media focus on that paper and that attention helped me realize that we sort of needed a textbook on psychedelics, which I decided I wanted to write.

That’s cool. I enjoyed reading your book. It’s the first academic textbook of this type?

Yes, that’s right.

Have you found that your experiences with psychedelics have benefitted you in any particular ways?

My experiences gave me a personal understanding of what I have read in the medical literature. It has been a lot easier trying to understand the literature now because of course a psychedelic experience is the kind of thing that you can’t understand until you try it.

That’s very true.

I think that if I hadn’t read the literature, I wouldn’t understand what it was talking about. Other than it has specific effects like raising your heart rate or something else along those lines. But I wouldn’t think that I would understand so much about it if I hadn’t tried psychedelics myself.

Personal experience with psychedelics can go a long way toward helping us understand them better. Is that what inspired you to write this book?

Well, I saw that there was a gap and I wanted to contribute, but I also wanted to write this book as a means for my personal growth because I wanted to know everything there was to know about psychedelics and I figured that this was a good way to educate myself. Then also I figured that if I ever wanted to go for a PhD, it would be a good jumping off point in terms of financing that goal.

In what way?

Well, because I think that writing this textbook has made me one of the people in the field who knows the most about them from a medical point of view, and that knowledge would make me more credible if I ever wanted to ask for funds.

That makes sense—it will probably go a long way to be the first person to have ever written an academic textbook on the topic.

I also felt that it was very important to write this book because I believe that during my career psychedelics will play a huge part in psychiatry. Right now there is a lot of evidence, but it is hard to find because it’s scattered throughout the medical journals and the Internet. I wanted to present the evidence as a textbook so that people could have access to the current body of research in one place, and I plan to update the textbook regularly to show how much the evidence is growing year by year.

That’s awesome. I really appreciate your work and I’m sure that I’m not alone. We do need to have a textbook on medical uses for psychedelics available for clinicians and researchers.

I think psychedelics will return to clinical practice in 5-10 years, and when that happens doctors and psychiatrists will need somewhere to learn about psychedelics and their medical use. I hope that in five years Medical Psychedelics will be the textbook to go to if you want to prepare yourself to use psychedelics in a medical practice.

The book focuses on a few different psychedelics—LSD, psilocybin, ayahuasca, DMT, MDMA, and ketamine. Why did you choose those specific substances to cover in the book?

Simply because those substances have been researched for clinical use. There are lots of other psychedelic substances but there hasn’t been any clinical research done on them. The only studies conducted on other psychedelics were safety studies and animal studies—there hasn’t really been any research into the therapeutic prospects of those drugs. So that’s why I chose to focus on the drugs that I did in the book.

So Medical Psychedelics is the first edition of what you hope to be multiple editions of the book?

Yeah, I plan to make an update in April.

Well that’s coming up mighty soon—are you actively working on that now?

Of course! I’m working on it as we speak.

What kind of updates are you planning to include in the next edition?

I’m planning to include all the clinical research that has been published during the last year, which is about 10 or 15 studies. And I will also be removing some unnecessary text from the first edition—making some passages shorter, that sort of thing. Concerning the MDMA chapter, a meta-analysis of MDMA studies was published earlier this year, so that will make its way to the MDMA chapter in the next edition.

What do you think is your target audience for the book? Who would be most interested in reading it?

I think the audience for this book consists of people like us, who are just generally interested in psychedelics. The average guy who is interested in psychedelics and wants to learn some more, but also people who think it’s helpful to speak about psychedelics from a scientific standpoint and maybe not as much from a spiritual or recreational standpoint.

So your book is really for someone who wants to have an evidence-based argument about psychedelics rather than a recreational or spiritual argument. Personally I think there are also valid arguments for those use cases, but I’m also in favor of having strong scientific evidence to back up any type of pro-psychedelic argument.

Yes, and also I think this book is good for psychologists and medical professionals working in psychiatry who have seen the evidence from the mainstream news sources and really want to dive into the evidence and learn more.

Well, I think what you’ve put together with the first edition of Medical Psychedelics is a great start, and I can definitely see where it would come in handy for anyone who wants to learn more about the clinical uses of psychedelics. Thanks for your time today, Oliver.

My pleasure. Thank you for talking with me.

 
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Understanding drug potency and its importance in psychedelic research

by Barb Bauer | Psychedelic Science Review | 21 March 2020

Understanding the potency of the compounds in nature’s cocktails is essential for formulating effective doses.

The potency of drugs is becoming a more frequent topic in studying novel naturally occurring compounds. When creating formulations from nature’s chemical cocktails, scientists need an understanding of more than just the effects each compound has. They also need to know how much of each they need to get the desired results from a formulation. The amounts depend, in part, on each compound’s potency.

Reading psychedelic studies can be challenging. Things get complicated at the molecular level. There are physiological pathways, acronyms, and measuring tiny quantities. Breaking down some of the concepts of drug potency helps with understanding when reading these studies. Here are some of the basics of drug potency.

What does drug potency mean?

The discipline of pharmacology defines potency as follows:

"An expression of the activity of a drug, in terms of the concentration or amount needed to produce a defined effect; an imprecise term that should always be further defined."

The acronym EC50 quantifies the potency of a compound. It stands for half the maximal effective concentration. The EC50 of a compound tells how much of it is needed to give the response that is halfway between the baseline measurement and the maximum effect for a given exposure time.

In other words, EC50 measures 50% of the compound’s maximal response. Another way to look at it is that a drug with high potency causes a strong effect at a low dose. Thus, the lower the EC50, the more potent the drug. The EC50 is the most common measure used in agonist/stimulation assays.

For example, below is the EC50 for three psychedelic compounds at the 5-HT2A receptor. Notice the high potency of LSD compared to the other compounds.

- LSD = 9.8 nM (rat)3
- Psilocin = 2,300 nM (rat)4
- Psilocybin = 3,480 nM (human)5

Conversely, IC50 stands for half the maximal inhibitory concentration. This value measures the potency of an antagonist compound.

Other factors influencing potency

Another concept in pharmacology, known as efficacy, influences drug potency. Efficacy is defined as,

"…the degree to which different agonists produce varying responses, even when occupying the same proportion of receptors."

Scientists measure efficacy using the quantity called Emax. As discussed earlier, EC50 measures 50% of the drug’s maximal response. Emax measures the maximum response of the drug.

The image below illustrates the relationship between potency and efficacy.

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These dose-response curves show the relationship between potency and efficacy.
The higher the potency of the drug, the steeper the curve and the more it shifts to
the left (i.e., a steeper curve corresponds to a lower dose at 50% response). Therefore,
Curve A shows higher potency than Curve B. Also, curves A and B have similar efficacy
(Emax), but A is more potent. For comparison, Curve C shows a drug with lower potency
and efficacy.


Drugs can have high potency but low efficacy and vice versa. Ideally, the most desirable situation is a drug that strikes the ideal balance of these and other variables
depending on the application, route of administration, etc. The metabolism, absorption, and excretion rate also play significant roles in the efficacy of drugs.

But high potency isn’t always a good thing. For example, if a drug is potent in a variety of tissues in the body, it can cause undesirable and sometimes dangerous side effects.

The potency of compounds is critical for making effective formulations

The potency of all the compounds in magic mushrooms, for example, should be tested on the full spectrum of serotonin receptors. Potency is just one part of elucidating the mechanisms of the entourage effect in naturally occurring compounds. Harnessing the entourage effect allows researchers to make formulations that preserve the benefits of nature’s cocktails while also having pharma’s precise dosing.

 
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Human 5-hydroxytryptamine (serotonin) receptor 2A

The serotonin receptors, and their importance in psychedelic research

by Barb Bauer | Psychedelic Science Review | 2 December 2019

Serotonin receptors play many roles in addition to the psychedelic effect.

The growing interest in psychedelic drug research is bringing serotonin receptors to the forefront of interest for scientists as well as laypeople. There is much more to understanding serotonin receptors and psychedelics than just the well-known 5-HT2A receptor that is known to elicit the psychedelic effect.

PSR has published articles discussing how the entourage effect observed with cannabis compounds may also be at work with psychedelics. Because the entourage effect of psychedelics may involve more than 5-HT2A and the different compounds found in naturally occurring organisms like psychedelic mushrooms, it is helpful to look at the whole family of serotonin receptors for a better understanding.

Keep in mind the common thread that connects serotonin receptors and psychedelics. Not only do serotonin receptors have a high affinity for the neurotransmitter serotonin, but the chemical structure of many psychedelics is similar to serotonin. For example, Figure 1 shows the chemical structure of serotonin along with three psychedelic compounds. Therefore, understanding how serotonin receptors work is critical to understanding how psychedelic compounds work.

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Figure 1: The chemical structures of serotonin, psilocybin, DMT, and LSD. Note the indoleamine structure in serotonin that is also present in the psychedelic
compounds. This similarity is one reason some psychedelics have an affinity for serotonin receptors.


Serotonin receptors are G Protein-Coupled Receptors

Serotonin receptors belong to a family known as GPCRs or G protein-coupled receptors. GPCRs are membrane proteins that are responsible for mediating most of the cellular responses to hormones and neurotransmitters. They are also involved in vision, smell, and taste.

GPCRs have a basic form consisting of seven membrane-spanning alpha-helices (Figure 2). The helices are separated by alternating sections of the receptor that form intracellular and extracellular loops. Although GPCRs share many similarities, each is unique in terms of the signaling pathways they use, other receptors with which they interact, and the regulatory processes they support.

GPCR.png

Figure 2: A cartoon representation of the basic structure of a GPCR receptor
showing the seven protein helices that span the cell membrane.


The importance of Allosteric Modulation

Researchers studying drug development often use GPCRs in conjunction with small molecules called allosteric modulators. These molecules do not bind to the primary binding site (aka the orthosteric site) on GPCRs, but rather an alternate binding site (the allosteric site). When this binding occurs, the receptor changes conformation (i.e. changes shape). This changes how the GPCR interacts with a different molecule (also called a ligand) at the orthosteric site.

An allosteric modulator comes in handy, for example, when binding a ligand directly to the orthosteric site causes unwanted side effects. Positive allosteric modulators (PAMs) increase the response of the receptor and negative allosteric modulators (NAMs) reduce responsiveness. There are also neutral allosteric modulators that bind to the allosteric site but have no effect on binding at the orthosteric site. These neutral allosteric molecules can be used when researchers want to block the allosteric site.

Getting to know the 14 serotonin receptors

Here is a list of the known serotonin GPCRs along with some general information about each one.

5-HT1A – This was the first serotonin receptor cloned and characterized by researchers. It is found densely populating the limbic areas in the brain, particularly in the hippocampus, lateral septum, cortices, and the dorsal and median raphe nuclei. The levels of 5-HT1A binding sites are almost non-existent in the cerebellum and basal ganglia. The 5-HT1A receptor may have roles in anxiety, the action of selective serotonin reuptake inhibitor (SSRI) drugs, schizophrenia, Parkinson’s disease, addiction, protection against ischemic brain damage.

5-HT1B – This receptor is found at high levels in the basal ganglia and low levels in the cerebral cortex, hypothalamus, amygdala, and dorsal horn of the spinal cord. Within neurons in the brain, 5-HT1B receptors are found on axon terminals. This receptor is being studied for its roles in aggression, learning, memory, addiction, and in the action of SSRI drugs.

5-HT1D – Compared to the rat and mouse, the expression of this receptor appears limited in humans. It has been detected in the trigeminal fibers in the spinal trigeminal tract and the brainstem in the human brain. The biggest claim to fame for 5-HT1D is its role as a target for the antimigraine drug sumatriptan and subsequent triptan drugs.

5-HT1E – This is an intriguing serotonin receptor because although it is expressed in humans and Guinea pigs, it has not been detected in rats or mice—these rodents don’t even have a gene for it. Another interesting feature is that 5-HT1E and 5-HT1B share approximately 60% of the DNA that codes for their transmembrane helices but the receptors retain distinct pharmacological properties. 5-HT1E is thought to be important for cognition and memory processes due to its abundant presence in the hippocampus, frontal cortex, and olfactory bulb, all key brain areas for these functions.

5-HT1F – Like 5-HT1D, this receptor is studied primarily for its importance in migraine therapies. 5-HT1F has the added advantage of being a target for newer migraine drugs that have fewer side effects (e.g., coronary vasoconstriction) than drugs like sumatriptan. Using radioactive sumatriptan in post mortem human brains, researchers have found expression of 5-HT1F in the globus pallidus, substantia nigra (brainstem), and the spinal cord.

5-HT2A – In 1988, Vollenweider et al. were the first to publish data indicating that the 5-HT2A receptor was the key site for the action of hallucinogenic drugs in humans.6 This receptor is found in high levels across many species in the forebrain, particularly the cortices, caudate nucleus, nucleus accumbens, olfactory tubercle, and hippocampus. In peripheral areas of the body 5-HT2A receptors are found in cardiovascular and smooth muscle tissues. In addition to eliciting hallucinogenic effects, 5-HT2A is of great interest to researchers studying antipsychotic drugs.

5-HT2B – This receptor has the distinction of being the only serotonin receptor that is necessary for life. The primary function of 5-HT2B is coordinating the proper formation of critical structures in the brain and heart during development. 5-HT2B Knockout mice, which don’t have the gene for 5-HT2B, are lethal and display severe embryonic defects. In mammals, 5-HT2B is expressed primarily in the liver, kidneys, fundus of the stomach, and gut. There is a moderate expression in the lungs and cardiovascular tissues. Interestingly, there is only weak, limited expression in the brain. Scientists study 5-HT2B because it may have important roles in drug abuse and hearing loss.

5-HT2C – There is considerable interest in studying the 5-HT2C receptor for several reasons. It is believed to play a role in drug abuse, the action of SSRIs, and obesity. Also, 5-HT2C is highly expressed in the amygdala, the area of the brain that mediates feelings of anxiety. According to leading psychedelic researcher Dr. David Nichols, all known psychedelics are agonists at 5-HT2A and -HT2C.7 Other areas of the brain with a high density of 5-HT2C include choroid plexus, cortex, basal ganglia, thalamus, and hippocampus.

5-HT3 – Unique among the serotonin receptors is 5-HT3. It is the only serotonin receptor that is not a GPCR. 5-HT3 is a ligand-gated ion channel.3 This means that when it is activated by agonist binding, channels open allowing ions (such as sodium, potassium, and calcium) to flow in and out of the cell. With neuron cells, this ion flow causes an excitatory response. These receptors are found in both the central (CNS) and peripheral nervous systems (PNS), both pre- and postsynaptically (i.e., the receptor both sends and receives signals). The 5-HT3 receptor is most notably studied for treating nausea and vomiting and irritable bowel syndrome (IBS).

5-HT4 – In the human CNS, this receptor is expressed in the basal ganglia, cortex, hippocampus, and subtantia nigra. In the PNS, 5-HT4 is particularly important in gastrointestinal function. Similar to 5-HT3, therapeutic drugs target 5-HT4 for treating constipation and constipation-predominant IBS. Interestingly, 5-HT4 specific agonists can enhance learning and memory in animal models.

5-HT5A – Of the two receptors in the 5-HT5 family, only 5-HT5A has been described in humans (it is also present in rodents). The receptor is expressed broadly but has high densities in the olfactory bulb, neocortex, and medial habenula. The expression of 5-HT5A mRNA (the code for making proteins) in human brain sections was found primarily in the cerebral cortex, hippocampus, cerebellum, various layers of the neocortex. These findings correlate with the concept of 5-HT5A involvement in higher cortical and limbic functions. 5-HT5 is perhaps the least studied serotonin receptor family and not much is known about their function. These receptors may have a role in controlling circadian rhythms, mood, and cognitive functions. From this, it has been proposed that agonist drugs may be useful in treating sleep disturbances and schizophrenia.

5-HT5B – To date, this receptor is only found in rodents. It appears that 5-HT2B is receiving less research attention that its 5A counterpart. See 5-HT5A for more information on the 5-HT5 receptor family.

5-HT6 – This receptor is found almost exclusively in the CNS in mammals. The highest concentrations of 5-HT6 are in the striatum, nucleus accumbens, cortex, olfactory tubercle, hippocampus, thalamus, amygdala, hypothalamus, and cerebellum. Because it is primarily confined to the CNS, scientists suspect 5-HT6 functions in higher cognitive processes. Research on this receptor is constrained due to the lack of selective agonists.

5-HT7 – This is the most recently identified serotonin receptor. In the human CNS, the receptor is expressed in the hypothalamus, thalamus, hippocampus, and cortex. In the human PNS, it is found in blood vessels (where it causes relaxation of the smooth muscle) and the smooth muscle of the colon (where, interestingly, it doesn’t seem to be involved in muscle relaxation). Again, the lack of selective agonists for this receptor has constrained research efforts. The difficulty in identifying receptor-specific agonists is compounded by agonists having a high affinity for 5-HT7 also having high agonist activity for 5-HT1A and other receptors. Despite these drawbacks, researchers believe 5-HT7 is involved in regulating sleep, circadian rhythms, and mood.

Continuing research on serotonin receptors

It is clear that there are still many mysteries surrounding the structure and function of serotonin receptors. Further research into their structure, function, and allosteric modulators would help in understanding how psychedelic drugs work, including the influence of the entourage effect. From this, researchers could make formulations with precise amounts of specific compounds. Scientists have only started to scratch the surface to reveal the capabilities and potential of psychedelic compounds.

 
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LSD "off-switch" developed by psychedelic pharmaceutical company

by Rich Haridy | New Atlas | 26 April 2020

Psychedelic pharmaceutical company MindMed has announced the development of a novel compound designed to stop the effects of an LSD experience. The compound is claimed to function as an “off-switch” for LSD, allowing clinicians a way to make psychedelic therapy sessions safer if patients become uncomfortable.

The new announcement comes several weeks after MindMed revealed the signing of an exclusive, multi-year contract with the Liechti Lab, a psychedelic research lab headed by Matthias Liechti at the University of Basel in Switzerland.

"The innovative and original work of the Liechti Laboratory is a treasure trove of novel data on LSD,” says JR Rahn, co-CEO of MindMed. “We are just at the beginning of several significant discoveries that have the potential to further the application of psychedelics as therapeutic medicines.”

MindMed says it has filed a patent application for “a neutralizer technology intended to shorten and stop the effects of an LSD trip during a therapy session.”

It is unclear exactly what this LSD neutralizing compound actually is. New Atlas contacted Matthias Liechti directly for clarification to ask if there were any pre-existing published research offering insights into how this proposed compound works. Liechti said the research is ongoing, and could not supply specific details.

“I can say that we have a planned program exploring the use of a range of compounds to be used to treat negative acute experiences with hallucinogens to increase their clinical safe use,” Liechti responded to New Atlas in an email. “Classically, such treatments included benzodiazepines or haloperidol. Ketanserin has so far been used to investigate the mechanism of action of psychedelic substances.”

Ketanserin is a compound most recently used by psychedelic researchers in studies to block the subjective and neural effects of LSD. Ketanserin, clinically used as an antihypertensive drug, is thought to disrupt the effects of LSD by blocking serotonin 2A receptors in the brain. Liechti did not offer any indication as to whether this novel new compound works to block the effects of LSD in similar ways, however, he did offer insights into the general purposes and goals of the research.

“The novel concept is to reduce the duration of action and the effect intensity of a psychedelic in high doses, for example, in cases where panic develops or in overdoses and after the hallucinogen has been ingested,” writes Liechti to New Atlas. “The rapidity of the effect will depend on the specifics of the formulation that is being tested and developed.”

MindMed claims the development of an effective LSD-neutralizing compound would greatly amplify the safety profile of psychedelic therapy. As LSD’s effects can often last eight to 12 hours, the clinical potential of the drug would be limited. MindMed believes if there were a compound that could stop the subjective effects of LSD it may allow for broader clinical uses.

Other collaborative psychedelic science projects ongoing between MindMed and the Liechti Lab include a currently underway Phase 2 trial testing high-dose LSD as treatment for anxiety, and a soon to start Phase 2 trial testing LSD microdoses for adult ADHD.

 
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Dr. Harry L. Williams squirts LSD into the mouth of Carl Curt Pfeiffer, M.D., Ph.D.

The 50-year psychedelic research hiatus and its relevance today

by Mans Bergkvist | Psychedelics Daily | 4 May 2020

The psychedelic renaissance (i.e. the resurgence of scientific research into psychedelic substances) concerns evaluating substances such as LSD and psilocybin in the treatment of mental illness such as depression, anxiety and PTSD. Preliminary small-scale studies yielded impressive results and psilocybin-assisted psychotherapy was recently designated a breakthrough therapy by the FDA.

Western medicine once showed great interest in these substances, as they constituted a major and promising field of study, starting late in the 1940s and lasting until the early 1970s. Although still in the infancy of the field, by 1963, one thousand research papers had been published.

By 1968, NIMH had spent $30 million on intramural psychedelics research programs (Asher, 1975). Despite the massive interest, the research almost dried up almost completely in the early 1970s.

Some 50 years later, this hiatus in research is about to end as the research is gaining pace. Still, a persistent misconception lingers on, as prohibition is invariably being blamed for the hiatus of research. As students in the theory of science will testify — correlation doesn’t necessarily equal causation.

The misconceptions are partly illustrated by recent claims that the NIMH stopped funding research with LSD in 1968 because LSD was made illegal at that time (Nutt et al., 2020). Furthermore, in Dr. Nutts way of arguing, the UN narcotic conventions may constitute “the worst censorship of scientific research ever.” and even compared them to the Catholic Church banning Copernicus writings in 1616 and threatening him with death, should he not desist in his research.

This text details why the common perception of why the research dried up is (mostly) false and why the topic still holds relevance.

The ‘truth is rarely pure and never simple’ (in the words of Oscar Wilde).

The first class of antipsychotic drugs (such as Chlorpromazine) were developed in the early 1950s. Such drugs fit like a hand in a glove into a system relying on statistical methods and replicable results. The psychedelics on the other hand offered all but replicable results/experiences that could be forced into the same system of classification.

In essence, psychedelics represented a paradigm that did not allow them to be included in the medical framework. Surely, enabling experiences involving religious and mystical elements did not reduce the clash of paradigms?

The development of antipsychotic drugs partly catapulted society into the future by leaving behind some medieval treatments of mental illness.

For the first time, efficient psychopharmacological treatments against illnesses involving hallucinations and delusions were being utilised. Promoting psychedelics in this context must have been laborious as they (appeared to) prompt just such effects.

Coupled with that, the antipsychotic drugs required merely one pill to take effect, while the ‘psychedelic approach’ required sessions lasting upwards of 10 hours with assistance from a team of medical professionals. This made it a time-consuming and expensive practice.

The 1960s witnessed the “Thalidomide catastrophe” erupting, induced by mothers using a new sedative drug, causing their offspring to suffer birth defects as a result. This brought the medical community and society at large to realise that drugs could potentially have such adverse effects. Coincidentally, medical findings indicated that the offspring of LSD users were at serious risk of contracting chromosome damages. The findings have been disproved since, but deterred many researchers at the time from pursuing research, and sensational news coverage aggravated the situation.

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Swedish newspapers reported in 1968 on how ‘yet another Thalidomide catastrophe’ erupted, as a mother with a history of LSD usage gives birth to a deformed child. Contemporary Swedish articles described scientific agreement that LSD provokes leukemia, tumours and ‘mongoloidism.’

As a response to the Thalidomide catastrophe, the U.S introduced a legion of regulations in the field of clinical drug research (Turner, 2012) to ensure that drugs administered to humans were safe and had proven efficacy.

The experimentation of Thalidomide on humans prior to clinical evaluation was made possible due to a regulatory loophole that enabled substances to be subject to “investigational use by experts qualified by scientific training and experience to investigate the safety of drugs."

The initial experimental phase of psychedelic research is partly in debt to this particular loophole in making research possible, despite the lack of documented safety and efficacy. Upon enforcing the regulations, a range of improper research practices decreased. However, these adjustments, unfortunately turned out to severely impair psychedelic research.

The golden standard of clinical drug research — randomized controlled trial (RCT), became standardised. The standard was targeted at taking the direct biological actions of drugs into account for evaluation. All other factors constituted biases to be eliminated. RCT however, is fundamentally incompatible with the psychedelic treatment. LSD is perceived as lacking inherent therapeutic effects, but rather displaying therapeutic effects through its ‘extra-pharmacological’ effects (the experiences) it exerts.

Besides, the RCT model assumes that neither the research subjects nor the researchers are able to determine if the drug or placebo has been administered. Naturally, this constitutes a major challenge with regards to psychedelics. The researchers tried adjusting in accordance with the new regulations, but in doing so, renounced established methods that had proved to be effective. This paved way for the research to produce mediocre results, aggravating already dwindling scientific interest into psychedelics. Ensuing discussions on appropriate methodology in the research protocols pitted researchers against each other.

In 1963, the aforementioned regulations had caused scientists who wished to conduct research with LSD to be forced to provide data on its chemistry and manufacturing details to the FDA.

However, Sandoz was reluctant to share such proprietary and patented data. When required by the FDA, the company only provided very limited animal toxicity data to prove safety. Sandoz never conducted trials to properly assess the safety and efficacy of LSD. In the 1950s, Sandoz ignored FDAs request to submit an application that would constitute a first step towards the formal registration of LSD as an approved drug.

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Unpublished documents indicate that Sandoz applied to have LSD registered in Sweden, but later withdrew their application.

More than a decade later, the NIMH could not allow LSD to indefinitely remain in limbo, without the goal of it being an approved drug.

Practically, the limbo violated the new regulations as well. This contributed to NIMH shutting down their intramural (inhouse) human research with LSD in 1968. At this point, it had only included limited trials, with poor design, lacked controls and randomisation. In 1975, NIMH shut down the extramural research grants (funding of external clinical trials) into human research with LSD. This event has been linked with the revelation of the highly controversial ‘MKULTRA’ program that NIMH may have wanted to distance itself from.

Psychedelics were of little interest to pharmaceutical companies as the intervention seemed to treat illness, rather than alleviate symptoms. Consequently, the financial imperatives were lacking; fully recovered patients would not require continued medication. The patent for LSD expired in the 1960s, certainly making it even less appealing for pharmaceutical companies at that point in time.

It is important to note that the early research was indeed promising by its contemporary standards, but the methodological discrepancies are too severe to be overlooked by modern standards. The old data cannot be used in regulatory decision making as the results are neither reliable nor valid.

Regarding earlier statements on the role of prohibition in the curtailment of research, it cannot be completely ruled out that this played some role.

But, most importantly, researchers at the time were unable to comply with regulations in the field of drug evaluations and the actions of Sandoz exacerbated the situation. The actions of the US government in the 1960s with regards to medical research have been largely misunderstood as their actions are not at all as reactionary or repressive as they often are represented as being.

The UN’s Convention of Psychotropic Substances (CPS) of 1971 placed psychedelics in Schedule 1 (high potential for abuse and without acknowledged medicinal value). This was prompted by widespread abuse and the fact that science still had failed at determining their efficacy and safety as therapeutic interventions.

Modern population studies however have failed to find evidence that the use of psychedelics constitutes an independent risk factor for mental health problems (Johansen & Krebs, 2015).

The preamble of CPS speaks of how: “the use of psychotropic substances for medical and scientific purposes is indispensable and […] their availability for such purposes should not be unduly restricted.”

Despite that CPS stipulates the importance of research being conducted with such substances, it currently acts impeding on research by creating obstacles through making special permits a requirement.

It still remains fully possible to conduct such research though.

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CPS may not ever have been taken into effect, should Sweden not have exerted great diplomatic pressure on the US, as its pharmaceutical industry heavily opposed the treaty. Depicted is Bror Rexed signing CPS on behalf of Sweden.

Not only didn’t prohibition singlehandedly end research or ban it from being conducted, but a complete legalisation may actually cause a backlash to the research, and science still “has a lot to learn about the immense power and potential risk of these molecules, not to mention the consequences of unrestricted use.” (Pollan, 2019).

The need for contemporary research is pressing and the field of psychedelic science will face challenges such as:

- Designing appropriate clinical drug trial evaluation protocols that resolve the issue of double-blinding and how to account for the ‘extra-pharmacological’ effects of LSD and similar psychedelics.

- The substances will likely not carry an appeal to pharmaceutical companies. This is an issue that must properly be addressed as pharmaceutical companies are ordinarily the driving force behind drug development and marketing.

- The field of psychiatry and medicine at large must study the distinct characteristics of these extraordinary pharmacological agents to investigate whatever possible treatment modalities they have to offer. When entertaining this notion, such investigations may unveil anomalies in the medical paradigm to such extent that a scientific model crisis ensues in the Kuhnian sense of the word.

The path forward must consider all facts at hand and build on honesty, not only with regard to potential medical findings and adverse reactions. Cherry picking, even in the field of historiography, is unlikely to be fruitful in the long run for the growing field of research into the therapeutic potentials of psychedelics.

Let us give psychedelics an honest chance by facing the actual challenges at hand — humankind and the world at large are in desperate need of what these curious compounds purportedly have to offer.

 
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Decoding the Tripping Brain

by Diana Kwon | The Scientist

Scientists are beginning to unravel the mechanisms behind the therapeutic effects of psychedelic drugs.

Lying in a room at Imperial College London, surrounded by low lighting and music, Kirk experienced a vivid recollection of visiting his sick mother before she passed away. “I used to go and see my mum in the hospital quite a lot,” recalls Kirk, a middle-aged computer technician who lives in London. “And a lot of the time she’d be asleep... but she’d always sense I was there, and after about five minutes she’d wake up, and we’d interact. I kind of went through that again—but it was a kind of letting go.”

Kirk choked up slightly while retelling his experience. “It’s still a little bit emotional,” he says. “The thing I realized was that I didn’t want to let go. I wanted to hold on to the grief, because that was the only connection I had with my mum.”

While this may sound like an ordinary therapy session, it was not what you would typically expect. Kirk was experiencing the effects of a 25-mg dose of psilocybin—the active ingredient in psychedelic “magic” mushrooms—which he had ingested as part of a 2015 clinical trial investigating the drug’s therapeutic potential.

After his mother died, Kirk says, he "fell into a deep, dark pit of grief.” Despite antidepressants and regular sessions with a therapist, his condition was not improving. “I was stuck in it for years,” he recalls. So when he heard Imperial College London was recruiting participants for an upcoming trial studying the impact of psilocybin on depression, Kirk decided to sign up.

The study, led by psychologist and neuroscientist Robin Carhart-Harris as part of the Beckley/Imperial Research Program, enrolled 12 patients with varying stages of treatment-resistant depression. Each participant took part in two guided treatment sessions, first with a low dose (10 mg) of psilocybin in pill form, then a high dose (25 mg) one week later. During each psychedelic session, subjects were closely monitored by at least one psychiatrist and an accompanying counselor or psychologist. “The guides help provide a safe space for the patient to have their experience,” Carhart-Harris explains.

In addition to the deeply emotional encounter with his deceased mother, Kirk also recalls "moments of absolute joy and pleasure” during his sessions. He remembers having a vision of the Hindu deity Ganesh (the “remover of obstacles”) and feeling an altered sense of self and his surroundings. “Your mind is always chattering and observing things,” Kirk says. “And that was all shut down. For me, there was a feeling of new space.”

Experiences like Kirk’s are common among people who have participated in a psychedelic session. Reports consistently include feeling intense emotions, having mystical experiences, and entering a dreamlike state. Many also articulate a dissolving sense of a bounded self, coupled with a feeling of increased connectedness with others and the rest of the world.

When Carhart-Harris and his team assessed their study’s participants three months after treatment, they found that most of the participants showed reduced depressive symptoms, with 5 of the 12 in complete remission—including Kirk. It’s now been two years since he received psilocybin therapy, and he says that he has not needed antidepressants or therapy since. “I got a new positivity that I didn’t have for some time,” he says.

These results are preliminary—the study tested a small sample size with no control group. But other recent trials, including some that were larger and included controls, have revealed additional therapeutic benefits. Last December, for example, two randomized placebo-controlled clinical trials of psilocybin in terminal cancer patients (51 and 29 patients, respectively) found that giving participants psilocybin in guided sessions could substantially decrease depression and anxiety—an improvement that persisted for at least six months after treatment. In smaller pilot studies, psilocybin has also shown success in treating addiction. In two small trials, one involving smokers and the other alcoholics, most participants remained abstinent for months after treatment with the psychedelic.

A number of early studies have also reported evidence that other psychedelics, primarily lysergic acid diethylamide (LSD), have similar effects. Roland Griffiths, a psychiatry professor at Johns Hopkins University, describes the effects of psychedelics as a sort of 'reverse PTSD.' "With PTSD, there is some discrete, traumatic event that produces some alteration in neurology and perception that produces psychological dysregulation going forward,” he says. "In a similar but opposite way, treatment with psychedelic is a discrete event that occurs to which people attribute positive changes that endure into the future.” While scientists are only beginning to understand the mechanisms behind these effects, what they’ve found so far already tells quite a compelling story.

Most psychedelics researchers believe that the session itself—the profound experiences individuals have during a trip—is key to the drugs’ therapeutic effects. But whether this is a cause or consequence of underlying neurobiological effects is still unclear. Studies show that psychedelics disrupt established networks in the brain, potentially allowing new connections to form. Recent work has also begun to reveal that these drugs’ effects—such as promoting neuroplasticity and reducing inflammation—are exerted through the serotonin 2A receptor.

“It’s very exciting that we seem to be at a threshold of establishing the neurobiological basis for the range of effects that psychedelics have, and specifically, the therapeutic range of action,” says Charles Grob, a psychiatry professor at Harbor-UCLA Medical Center who conducted a pilot study of psilocybin for terminal cancer patients that was published in 2011. “I think there is growing knowledge and appreciation that this work can be conducted responsibly and safely, and that it has the quite compelling potential to offer us very new and exciting treatment models.”

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The tripping brain

While on psychedelics, people commonly experience ego dissolution, a loss of the sense of a separate self, and an enhanced feeling of connectedness with the outside world. Recent neuroimaging studies have revealed that the intensity of this experience correlates with changes in brain activity, primarily in the default mode network (DMN)—a system of brain regions that is more active at rest than during tasks, and that is thought to be involved in, among other things, processing information related to the self.

To understand what happens in the brain during a trip, Carhart-Harris and colleagues have been dosing healthy participants with psychedelics and scanning their brains using functional magnetic resonance imaging (fMRI) to measure cerebral blood flow, a proxy measure of neural activity. In 2012, for example, the researchers found that, following an intravenous injection of 2 mg of psilocybin, 15 subjects displayed an overall decrease in cerebral blood flow as well as decreased connectivity between the posterior cingulate cortex and the medial prefrontal cortex, two hubs of the default mode network.

Follow-up studies using both fMRI and magnetoencephalography (MEG)—a technique to detect the tiny magnetic fields generated by electrical activity in the brain—on subjects dosed with LSD have revealed similar effects. This work also revealed a correlation between decreased connectivity in the default mode network and subjective ratings of ego dissolution.

"But while the two psychedelic drugs share signature psychological effects,” Carhart-Harris notes, “they differ in the potency and in their kinetics. The psilocybin trip is shorter, and for that reason is more manageable than an LSD trip.”

Researchers have found similar neurological effects during meditation—another altered state of mind associated with psychological well-being. Expert meditators also show an acute reduction in the activity of the default mode network. Conversely, an increase in activity and connectivity in this network has been found in some individuals with depression. “In some ways, it kind of makes sense that psilocybin, which brings people very powerfully into the present moment, would be more similar to meditation than it would be to depression,” says Griffiths. “In other words, people are riveted with interest in the present moment and what’s happening here and now, rather than in the future or in the past.” Griffiths and his colleagues at Johns Hopkins are currently conducting a neuroimaging experiment probing the brains of expert meditators on psychedelic trips.

Using MEG, Carhart-Harris and colleagues have also discovered that psilocybin and LSD alter neural oscillations, rhythmic brain activity linked to various perceptual and cognitive functions, across the default mode network. Individuals under the influence of these drugs experience a drop in so-called alpha rhythms, oscillations in the range of around 8 to 13 hertz, that correlate with their reports of ego dissolution. “When you plot out what rhythms contribute to the brain’s overall oscillatory activity, you get this huge peak in the alpha band—this really prominent frequency that, in some ways, sort of dominates the rhythmicity of the brain,” Carhart-Harris explains. “It’s a really curious rhythm, because it’s more prominent in humans than in any other species, and its prominence increases as we develop into adulthood. I see it as a kind of signature of high-level consciousness that adult humans have.”

In contrast to the decrease in activity and connectivity within the DMN, imaging studies have revealed an increase in functional links between normally discrete brain networks during a trip, and such activity also correlates with reports of ego-dissolution. Together with findings of changes in the default mode network and reduced alpha rhythms, these results are contributing to a hypothesis that the brain becomes “entropic”—more disordered, fluid, and unpredictable—during psychedelic use, disrupting certain pathways while allowing for new connections to be made. “What’s been consistently found is that the brain or the mind during psychedelic states is in a different state of consciousness, and this is also reflected in how the brain is behaving,” says Rainer Krähenmann, a psychiatrist and researcher at the University of Zurich. "But more research is needed to understand just what these changes mean. I would not say that we can reduce it to certain areas or certain mechanisms,” Krähenmann says. “The brain is still too complex to really understand what’s going on.”

And of course, the biggest question that remains is how these neurological changes might be therapeutic. In a soon-to-be published study, Carhart-Harris and his colleagues found that changes in the connectivity of the default mode network predicted how well patients would do after psilocybin treatment, but the results are preliminary. “We know that there’s fascinating things happening acutely in terms of these changes in the synchronization across brain areas,” says Matthew Johnson, a behavioral pharmacologist at Johns Hopkins. “But the really tantalizing possibilities that a number of groups, including ours, are looking at is whether those types of changes persist and are related to long-standing clinical benefits.”

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Mind-bending molecules

All the classic psychedelic drugs—psilocybin, LSD, and DMT, the active component in ayahuasca—activate serotonin 2A (5-HT2A) receptors, which are distributed throughout the brain. In all likelihood, this receptor plays a key role in the drugs’ effects. Krähenmann and his colleagues in Zurich have discovered that ketanserin, a 5-HT2A receptor antagonist, blocks LSD’s psychedelic properties, and prevents individuals from entering a dreamlike state or attributing personal relevance to the experience.

Other research groups have found that, in rodent brains, DOI, a highly potent and selective 5-HT2A receptor agonist, can modify the expression of brain-derived neurotrophic factor (BDNF)—a protein that, among other things, regulates neuronal survival, differentiation, and synaptic plasticity. This has led some scientists to hypothesize that, through this pathway, psychedelics may enhance neuroplasticity, the ability to form new neuronal connections in the brain. “We’re still working on that and trying to figure out what is so special about the receptor and where it is involved,” says Katrin Preller, a postdoc studying psychedelics at the University of Zurich. “But it seems like this combination of serotonin 2A receptors and BDNF leads to a kind of different organizational state in the brain that leads to what people experience under the influence of psychedelics.”

This serotonin receptor isn’t limited to the central nervous system. Work by Charles Nichols, a pharmacology professor at Louisiana State University, has revealed that 5-HT2A receptor agonists can reduce inflammation throughout the body. Nichols and his former postdoc Bangning Yu stumbled upon this discovery by accident, while testing the effects of DOI on smooth muscle cells from rat aortas. When they added this drug to the rodent cells in culture, it blocked the effects of tumor necrosis factor-alpha (TNF-α), a key inflammatory cytokine.

“It was completely unexpected,” Nichols recalls. "The effects were so bewildering," he says, "that they repeated the experiment twice to convince themselves that the results were correct." Before publishing the findings in 2008, they tested a few other 5-HT2A receptor agonists, including LSD, and found consistent anti-inflammatory effects, though none of the drugs’ effects were as strong as DOI’s. “Most of the psychedelics I have tested are about as potent as a corticosteroid at their target, but there’s something very unique about DOI that makes it much more potent,” Nichols says. “That’s one of the mysteries I’m trying to solve.”

After seeing the effect these drugs could have in cells, Nichols and his team moved on to whole animals. When they treated mouse models of system-wide inflammation with DOI, they found potent anti-inflammatory effects throughout the rodents’ bodies, with the strongest effects in the small intestine and a section of the main cardiac artery known as the aortic arch. “I think that’s really when it felt that we were onto something big, when we saw it in the whole animal,” Nichols says.

The group is now focused on testing DOI as a potential therapeutic for inflammatory diseases. In a 2015 study, they reported that DOI could block the development of asthma in a mouse model of the condition, and last December, the team received a patent to use DOI for four indications: asthma, Crohn’s disease, rheumatoid arthritis, and irritable bowel syndrome. They are now working to move the treatment into clinical trials. "The benefit of using DOI for these conditions," Nichols says, "is that because of its potency, only small amounts will be required—far below the amounts required to produce psychedelic effects."

In addition to opening the door to a new class of diseases that could benefit from psychedelics-inspired therapy, Nichols’s work suggests “that there may be some enduring changes that are mediated through anti-inflammatory effects,” Griffiths says. Recent studies suggest that inflammation may play a role in a number of psychological disorders, including depression and addiction.

“If somebody has neuroinflammation and that’s causing depression, and something like psilocybin makes it better through the subjective experience but the brain is still inflamed, it’s going to fall back into the depressed rut,” Nichols says. "But if psilocybin is also treating the inflammation," he adds, “it won’t have that rut to fall back into.”

If it turns out that psychedelics do have anti-inflammatory effects in the brain, the drugs’ therapeutic uses could be even broader than scientists now envision. “In terms of neurodegenerative disease, every one of these disorders is mediated by inflammatory cytokines,” says Juan Sanchez-Ramos, a neuroscientist at the University of South Florida who in 2013 reported that small doses of psilocybin could promote neurogenesis in the mouse hippocampus. “That’s why I think, with Alzheimer’s, for example, if you attenuate the inflammation, it could help slow the progression of the disease.”

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Research revival

Although researchers have only recently started to test psychedelics’ effects in controlled clinical trials, evidence that these drugs could help treat conditions such as depression and terminal cancer–related anxiety has existed since the middle of the 20th century. Despite promising results, the counterculture that emerged around LSD use led to the criminalization of it and other psychedelics in 1966. Since 1970, almost all of these compounds have been Schedule I controlled substances, which imposes strict prohibitions on their use, even in research.

“If the drug war hadn’t started, and we didn’t have this demonization of psychedelics, we’d know a lot more about what makes people happy, sad, depressed,” says David Nichols, a professor emeritus of pharmacology at Purdue University and a pioneering psychedelics researcher (also the father of Charles Nichols). “That’s the tragedy—that none of that has happened because the research basically died in 1970.”

Now, psychedelics research is slowly starting to regain ground, though it’s still not easy to win federal funding for these studies. But with support from private organizations such the Heffter Research Institute and MAPS, scientists have begun to probe the mechanisms underlying the drugs’ psychological effects and the enduring changes they can bring about. The answers to these mysteries may help scientists gain insight into what happens to the brain in disease, and perhaps learn more about the nature of consciousness itself.

“There are many different questions to ask, and in some ways, the therapeutic ones are among the most mundane,” says Griffiths. “Our understanding is so primitive that I think it’s important that we not be so naive as to think that our current technologies are going to be able to unravel the many, many subtleties that account for some of these kinds of sustained effects. That’s why the study of psychedelics is such an interesting, important, and rich field of investigation for neuroscience.”

 
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Scientists explain how psychedelic drugs can lead people to lose their sense of self

by Rajvi Desai | The Swaddle | 2 Jun 2020

People who use psychedelic drugs — psychoactive substances that produce profoundly altered states of consciousness — often report a loss of sense of self and dissolution of their ego, also called ‘ego-death.’ They report their sense of “I,” usually distinct from the rest of the world, disintegrating when they trip on psychedelic drugs, such as magic mushrooms or LSD. For the longest time, scientists have attempted to trace the process of this ego dissolution in the brain, often having ended up with anecdotal or observational evidence. Now, a new first-of-its-kind study evaluating the effect of psilocybin (magic mushrooms) on the human brain reveals a possible neurotransmitter pathway that could hold the answer.

Previous theories suggest people who are tripping on psychedelics have elevated levels of neurotransmitter glutamate in the part of the brain that is believed to be linked to self-awareness. This hypothesis, however, had not been tested in humans until now. Scientists from the Maastricht University in the Netherlands conducted a double-blind, controlled trial with 60 participants using magnetic resonance imaging (MRI), to monitor their glutamate levels while they tripped on magic mushrooms.

The study, published in the journal Neuropsychopharmacology, shows people who had negative experiences of their ego death had higher levels of glutamate in their pre-frontal cortex, which is responsible for personality expression, social behavior, and decision-making. People who had positive experiences with the disintegration of their ego had lower levels of glutamate in the hippocampus, the part of the brain that’s involved in the formation of memories, and is associated with emotions and self-esteem. This fluctuation in glutamate — considered one of the most common neurotransmitters in the brain — could explain the loss of autobiographical information (and loss of personal identity) that previous research has established accompanies the use of psychedelics.

While these findings have taken scientists one step closer to establishing a proven connection between glutamate and ego-death, they don’t yet show exactly how this process of ego death comes about. While further investigation into the phenomenon of psychedelics-induced ego death is needed, scientists stress that the findings chart a way forward into researching the therapeutic effects of psychedelics. Charting the effects of reality-altering psychedelics could help better understand mental health issues that are characterized by distortions of self-perception, such as depression.

Drugs like ketamine and MDMA have already been tapped to treat drug-resistant depression and post-traumatic stress disorder, respectively. With further research into how the brain perceives altered realities caused by drugs, scientists believe they can better understand, and therefore treat, altered realities caused by mental health issues.

 
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How psychedelic drug psilocybin works on brain

Johns Hopkins Medicine | Science Daily | 5 Jun 2020

To see how psychedelics impact the claustrum, a mysterious region of the brain believed to control the ego, researchers compared the brain scans of people after they took psilocybin with their scans after taking a placebo.

Perhaps no region of the brain is more fittingly named than the claustrum, taken from the Latin word for "hidden or shut away." The claustrum is an extremely thin sheet of neurons deep within the cortex, yet it reaches out to every other region of the brain. Its true purpose remains "hidden away" as well, with researchers speculating about many functions. For example, Francis Crick of DNA-discovery fame believed that the claustrum is the seat of consciousness, responsible for awareness and sense of self.

What is known is that this region contains a large number of receptors targeted by psychedelic drugs such as LSD or psilocybin. To see what happens in the claustrum when people are on psychedelics, Johns Hopkins Medicine researchers compared the brain scans of people after they took psilocybin with their scans after taking a placebo.

Their findings were published online on May 23, 2020, in the journal NeuroImage.

The scans after psilocybin use showed that the claustrum was less active, meaning the area of the brain believed responsible for setting attention and switching tasks is turned down when on the drug. The researchers say that this ties in with what people report as typical effects of psychedelic drugs, including feelings of being connected to everything and reduced senses of self or ego.

"Our findings move us one step closer to understanding mechanisms underlying how psilocybin works in the brain," says Frederick Barrett, Ph.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and a member of the school's Center for Psychedelic and Consciousness Research. "This will hopefully enable us to better understand why it's an effective therapy for certain psychiatric disorders, which might help us tailor therapies to help people more."

Because of its deep-rooted location in the brain, the claustrum has been difficult to access and study. Last year, Barrett and his colleagues at the University of Maryland, Baltimore, developed a method to detect brain activity in the claustrum using functional magnetic resonance imaging (fMRI).

For this new study, the researchers used fMRI with 15 people and observed the claustrum brain region after the participants took either psilocybin or a placebo. They found that psilocybin reduced neural activity in the claustrum by 15% to 30%. This lowered activity also appeared to be associated with stronger subjective effects of the drug, such as emotional and mystical experiences. The researchers also found that psilocybin changed the way that the claustrum communicated with brain regions involved in hearing, attention, decision-making and remembering.

With the highly detailed imaging of the claustrum provided by fMRI, the researchers next hope to look at the mysterious brain region in people with certain psychiatric disorders such as depression and substance use disorder. The goal of these experiments will be to see what roles, if any, the claustrum plays in these conditions. The researchers also plan to observe the claustrum's activity when under the influence of other psychedelics, such as salvinorin A, a psychedelic derived from a Mexican plant.

 
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Barbara Bauer, MS

Why are Crystal Structures important in psychedelic research?

by Barb Bauer, MS | Psychedelic Science Review | 20 Dec 2019

Crystal Structures help researchers understand changes at the molecular level that affect the physical properties of compounds.

X-ray crystallography is a technique that scientists use to figure out the three-dimensional structure of organic, inorganic, or biological material. It’s similar to having a microscope that operates at an atomic level. Crystallography is used in several scientific disciplines, including material science, physics, chemistry, molecular biology, and biochemistry. Scientists use crystal structures to study and develop drugs (especially antibiotics and cancer drugs), polymers, and textiles, to name a few.

The process works by first purifying and concentrating the compound. The compound is then crystallized and exposed to a beam of X-rays. The beam is diffracted (bent) by the compound, creating a pattern of spots that are analyzed. The analysis gives information on the size of the repeating unit that forms the crystal and how the crystals are packed together. The data also allows calculating the electron density of the crystals.

Crystal Structures of psychedelic compounds

In 2019, researchers solved the crystal structure of fumarate salt forms of the psychedelic compounds:

MiPT – N-Methyl-N-isopropyltryptamine
4-HO-DPT – 4-hydroxy-N,N-dipropyltryptamine
4-AcO-DMT – 4-acetoxy-N,N-dimethyltryptamine
4-HO-MiPT – 4-hydroxy-N-methyl-N-isopropyltryptamine

These new crystalline forms could be used to modulate the effects of each compound in a drug formulation (i.e., the entourage effect). Also, determining the crystal structures of psychedelic compounds is essential to understanding their physical properties and for probing their activity at receptors by using modeling studies.

Protein crystallization is critical for understanding receptors

Scientists also use crystallography to understand the structure and function of larger molecules like proteins (e.g., enzymes, receptors, structural proteins) and nucleic acids (e.g., DNA and RNA).

For example, the 2012 Nobel Prize in chemistry was awarded to two scientists who used X-ray crystallography to see a receptor in action. The scientists captured the moment when a G protein-coupled receptor (GPCR) transferred a signal from the outside of a cell to the inside. The signal was initiated by a hormone binding to the receptor in the cell membrane. In other words, they caught the receptor in its active state. This is a groundbreaking discovery because it provides critical information that can be used in drug development. Discoveries about GPCRs are particularly important for psychedelic research because the serotonin receptors (except for 5-HT3) belong to the GPCR family.

Another excellent example is a 2017 study that reported the crystal structure of LSD bound to the human serotonin 5-HT2B receptor. This work allowed the researchers to propose explanations for the receptor binding, kinetics, stereochemistry, and signaling of LSD at human serotonin receptors. In a 2018 interview with ALIUS, chemist and psychedelics expert Dr. David Nichols described the importance of the crystal structure solved in this study in understanding the long-lasting effects of LSD. Dr. Nichols noted how the crystal structure indicated a ‘lid’ or loop in the receptor:

"In the x-ray crystal structure of LSD in the 5-HT2B receptor, that loop could be seen laying over LSD within the receptor, and Leucine 209 [an amino acid in the receptor] sort of wedged down between the LSD molecule and the receptor. In essence, EL2 [extracellular loop 2] was able to ‘lock’ LSD into the receptor."

In the same interview, Dr. Nichols also explained the importance of crystal structures of compounds in work he did with NBOMe (N-benzyl methoxy) compounds. He said that the crystal structure,

"…gave us an idea of how the side chain of the NBOMe compounds must bind to the receptor."

It is clear that crystal structures are essential for helping researchers ‘see’ what’s going on at a molecular level. This gives them a better understanding of how receptors and compounds look and act in nature.

Crystal Structures and the Entourage Effect

It is important to remember that small changes at the molecular level can translate into significant changes in effect when it comes to drugs. Therefore, working with compounds at the molecular level is essential for unraveling the mysteries of how drugs work and how other compounds affect them.

Crystal structures can never fully explain the interaction of drugs on receptors. However, the information scientists obtain from these studies helps to clarify some aspects of their structure, interaction, and function. These small discoveries add up, resulting in a clearer understanding of complex biochemical processes and pathways.

 
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Imaging psilocybin's actions in the brain*

Genetic Engineering & Biotechnology News | 8 Jun 2020

The psychedelic drug, psilocybin, which is present in a number of species of mushroom, is particularly interesting to scientists as it may have potential use in the treatment of a variety of neuropsychiatric disorders. However, the mechanism by which the chemical works in the brain isn’t well understood. Scientists at Johns Hopkins University School of Medicine now report on brain imaging studies in human volunteers that have shown how psilocybin alters signaling in a somewhat enigmatic region of the brain known as the claustrum, which is derived from the Latin word for “hidden” or “shut away.”

“Our findings move us one step closer to understanding mechanisms underlying how psilocybin works in the brain,” said Frederick Barrett, PhD, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and a member of the school’s Center for Psychedelic and Consciousness Research. “This will hopefully enable us to better understand why it’s an effective therapy for certain psychiatric disorders, which might help us tailor therapies to help people more.”

Barrett and colleagues reported their findings in NeuroImage, in a paper titled, “Psilocybin acutely alters the functional connectivity of the claustrum with brain networks that support perception, memory, and attention.”

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The claustrum is an extremely thin sheet of neurons deep within the cortex, yet it reaches out to every other region of the brain. Its true purpose also remains “hidden away,” with researchers speculating about many functions. Francis Crick, for example, believed the claustrum to be the seat of consciousness, responsible for awareness and sense of self.

What is known is that this region contains a large number of receptors targeted by psychedelic drugs such as LSD or psilocybin, a chemical that acts as a serotonin 2a (5-HT2A) receptor partial agonist. Psilocybin alters sensory perception, but it may have long-term therapeutic value in treating a range of neuropsychiatric disorders, without the adverse reactions associated with current medication, the team noted. “Understanding how psilocybin alters large-scale brain networks may reveal mechanisms of therapeutic effects and shed light on new therapeutic targets for many mental disorders. The effects of psilocybin are largely achieved through its action as a partial agonist of the serotonin 2a (5-HT2A) receptor which likely modulates glutamatergic signaling across a range of cortical and subcortical afferents.”

Because of its deep-seated location in the brain, the claustrum has been difficult to access and study. Last year, however, Barrett and his colleagues at the University of Maryland, Baltimore, developed a method to detect brain activity in the claustrum using functional magnetic resonance imaging (fMRI). To see what happened in the claustrum when people were given the psychedelic, the Johns Hopkins Medicine researchers compared the brain scans of 15 healthy volunteers both before, and after they took psilocybin, or a placebo. The participants all received psychological support before, during, and after drug administration and scanning procedures, consistent with guidelines for the safe administration of psilocybin in a research context.

The scans indicated that psilocybin reduced neural activity in the claustrum by 15–30%, suggesting that the area of the brain that is believed to be responsible for setting attention and switching tasks is turned down in response to the drug. “Psilocybin reduced measures of activity (variance and amplitude of low-frequency fluctuations) of both left and right claustrum during the acute effects of psilocybin, and led to alterations in both left and right claustrum connectivity with brain networks that support sensory and cognitive processes,” the researchers wrote. "This ties in with what people report as typical effects of psychedelic drugs, including feelings of being connected to everything and reduced senses of self or ego."

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Lowered activity in the claustrum also appeared to be associated with stronger subjective effects of the drug, such as emotional and mystical experiences. The researchers in addition found that psilocybin changed the way that the claustrum communicated with brain regions involved in hearing, attention, decision-making, and remembering.

The authors acknowledged that their study did have a number of limitations, and suggested future directions for research, noting that reductions in the volume of the claustrum have been reported in depression and schizophrenia. “The current report utilizes a pharmacological intervention to provide empirical evidence for a significant role of 5-HT2A signaling in claustrum function, provides evidence for the potential effects of psilocybin on claustrum activity and connectivity, and highlights the need for additional efforts to further explore the potential role of the claustrum in both the subjective and therapeutic effects of psilocybin,” they concluded.

With the highly detailed imaging of the claustrum provided by fMRI, the researchers next hope to further investigate this brain region in people with certain psychiatric disorders such as depression and substance use disorder. Their aim will be to see what roles, if any, the claustrum plays in these conditions. The researchers also plan to observe the claustrum’s activity when under the influence of other psychedelics, such as salvinorin A, a psychedelic derived from a Mexican plant.

*From the article here :
 
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Ease restrictions on medical psychedelics to aid research, experts say

by Ian Sample | The Guardian | 26 Jul 2020

Psilocybin may be safe for treating depression but research is stymied by government controls.

Potential treatments for severe depression, addiction and other mental health disorders are being held up by excessive restrictions on psilocybin, the active ingredient in magic mushrooms, scientists and politicians have said.

Clinical trials suggest that psilocybin may be a safe and effective medicine for patients with certain psychiatric illnesses who do not respond to talking therapies, antidepressants and other drugs. But researchers say their work is being stymied by the government placing the strictest possible controls on the chemical compound.

In a report published on Monday, the Adam Smith Institute, a free market thinktank, and the Conservative drug policy reform group, urge ministers to order a review of psilocybin and remove the obstacles faced by researchers.

Under Home Office regulations, psilocybin is classified as a schedule 1 drug, along with raw opium, LSD, ecstasy and cannabis, and is not considered a medicinal compound. "While clinical trials are allowed under licence, obtaining one takes more time and money than many researchers can afford," the authors say.

The report calls on government to make psilocybin a schedule 2 drug, a move that would dramatically cut the cost and time taken to obtain a licence and remove the stigma surrounding research into the drug.

Jo Neill, a co-author on the report and professor of psychopharmacology at Manchester University, said: “Patients are losing out because it’s taking an awful lot longer and it’s costing a lot more money to get the research evidence we need to have psilocybin approved for use. And there are patients dying in the meantime, there are people killing themselves."

“There are people who would be doing this research who aren’t because they can’t afford it and they know it’s going to take them a year to get the licence. They cannot wait that long. If psilocybin were rescheduled, all the universities would have a programme on this. It’s very frustrating.”


Early trials suggest that one or two doses of psilocybin can lead to an immediate improvement in anxiety and depression, but such trials are often prohibitively expensive. Neill, who is also chair of the medical psychedelics working group for the nonprofit DrugScience, said one trial cost £20,000 because six separate licences at £3,000 each were needed to cover everything from manufacture to dispensing the drug.

“We have a huge unmet medical need in psychiatry,” she said. “There are a lot of good treatments on the NHS, lots of talking therapy, and antidepressants work for some people. But there’s a huge amount of people who are just not being treated. We need to heal people and these drugs are healing.”

David Nutt, professor of neuropsychopharmacology at Imperial College London, who was not involved in the report, said schedule 1 licenses cost thousands of pounds and took a year or more to get.

“Most universities won’t pay for them so research is stymied,” he said. “Schedule 1 status serves no role in stopping recreational use as there has never been diversion from a research lab to street use. Heroin and fentanyl – two much more sought-after drugs – are schedule 2, so I say let us store our psilocybin alongside them. It will be perfectly safe and much easier as all universities and hospitals are given schedule 2 status free as a right.”

Crispin Blunt, the Tory MP for Reigate and chair of the Conservative drug policy reform group, said the schedule 1 classification "led to a scientific blackout lasting nigh on 50 years, that precluded new treatments, and with them, the prospect of a better life for millions.”

A Home Office spokesperson said: “We need to strike the right balance between enabling legitimate research to take place in a secure environment while ensuring that harmful drugs are not misused and do not get into the hands of criminals. The current classification of psilocybin under schedule 1 does not prevent research or clinical trials under a Home Office licence.”

 
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Beneficial synergy: Teaming psilocybin with mindfulness meditation

by Emma Stone, MA, PhD | Psychedelic Science Review | 6 Aug 2020

A double-blind study reveals that mindfulness meditation practice may amplify the positive effects of psilocybin while reducing the likelihood of a bad trip.

Set and setting are both acknowledged to shape one’s experience of psychedelic medicine profoundly. Set refers to an individual’s expectation of the experience, their personality, and current mood. Setting, on the other hand, speaks to the physical and social environment in which the experience takes place.

Armed with this knowledge, a team of researchers recently set out to explore the effects of a 5-day mindfulness meditation retreat combined with a psychedelic experience. The double-blinded placebo-controlled study, which was published in the October 2019 issue of Nature Scientific Reports, revealed some fascinating findings.

Meditation and psilocybin: Parallel pathways to self-dissolution?

Throughout history, both meditation and psilocybin have offered gateways to self-transcendence, non-dual awareness, mystical awareness, and personal change. Both meditation and psychedelic experiences offer the potential for beneficial therapeutic outcomes, such as prosocial behavior and the alleviation of depression, stress, and anxiety. Despite the similarities that both meditation and psychedelics may induce in one’s sense of self, these two experiences have never been systematically investigated.

While psychedelic experiences that induce self-dissolution occur at relatively high rates (up to 60 percent), profound states of selflessness occur more infrequently during meditation and are usually confined to long-term meditators. However, the self-dissolution induced by psychedelic experience can also be accompanied by severe anxiety and a groundswell of emotion. Smigielski et al. hypothesized that a mindfulness meditation practice teamed with psychedelic experience could lead to greater changes than mindfulness meditation alone and reduce the likelihood of ‘a bad trip.’

Mindfulness meditation represents a specific type of meditation. Simply put, it is “nonjudgemental attention to present-moment experiences.” Smigielski et al. describe it as “a temporary state of intentional self-regulation of attention to foster greater awareness of one’s sensations, emotions, and thoughts with a non-judgmental attitude.”

The study

Thirty-nine expert Buddhist meditation practitioners were recruited for a five-day mindfulness meditation retreat. Two-thirds of the participants had never experienced psychedelics before, and one-third had experienced limited previous exposure. On the fourth day of the retreat, 19 participants received a placebo capsule, and 20 received a psilocybin capsule in a double-blind manner. The psilocybin dose within the capsule was calculated based on the individual’s weight and contained 315 micrograms of psilocybin per kilogram of body weight.

The researchers evaluated the spectrum and extent of change in consciousness, the loss of cognitive control and anxiety, and the level of mystical-type experience using a range of tools. These tools included the Freiburg Mindfulness Inventory, the Meditation Depth Questionnaire, the Toronto Mindfulness Scale, the 5-Dimensional Altered States of Consciousness rating scale (5D-ASC) which is designed to quantify both positive and negative forms of ego dissolution, and the M-scale which assesses external and internal aspects of mystical experience.

After four months had elapsed, participants completed the Life Changes Inventory, Revised (LCI-R) questionnaire, which evaluates changes in attitudes and behaviors. Each participant additionally designated a closely-related person to complete a third-person LCI-R questionnaire concerning the participant. Finally, the researchers asked the participants how personally meaningful the experience was, and whether they had perceived any enduring changes in their behavior or attitudes in themselves.

The findings

The outcome of the research offers some compelling findings. The combination of psilocybin and mindfulness meditation produced markedly more pronounced alterations of consciousness than mindfulness meditation alone. The alterations that were more profoundly experienced included a sense of unity, spiritual experience, blissfulness, insightfulness, disembodiment, complex imagery, audiovisual synesthesia, and changed meanings of precepts.

Those who received the psilocybin capsule also noted a deeper sense of self-dissolution than those who received the placebo. Nineteen out of the 20 participants who received psilocybin met the criteria for having had an intense mystical experience, compared with 3 out of 10 participants in the placebo group. While the depth of mindfulness meditation increased throughout the retreat, the participants who received psilocybin were able to deepen their mindfulness meditation practice significantly. Ultimately, the evidence suggests that incorporating mindfulness meditation into psychedelic experiences may positively shape the experience.

 
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