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Replication and extension of a model predicting response to psilocybin

Abstract

BACKGROUND:

Recent research demonstrated the potential of psychedelic drugs as treatment for depression and death-related anxiety and as an enhancement for well-being. While generally positive, responses to psychedelic drugs can vary according to traits, setting, and mental state (set) before and during ingestion. Most earlier models explain minimal response variation, primarily related to dosage and trust, but a recent study found that states of surrender and preoccupation at the time of ingestion explained substantial variance in mystical and adverse psilocybin experiences.

OBJECTIVES:

The current study sought to replicate the previous model, extend the model with additional predictors, and examine the role of mystical experience on positive change.

METHOD:

A hierarchical regression model was created with crowdsourced retrospective data from 183 individuals who had self-administered psilocybin in the past year. Scales explored mental states before, during, and after psilocybin ingestion, relying on open-ended memory prompts at each juncture to trigger recollections. Controlled drug administration was not employed.

RESULTS:

This study replicated the previous model, finding a state of surrender before ingestion a key predictor of optimal experience and preoccupation a key predictor of adverse experience. Additional predictors added to the explanatory power for optimal and adverse experience. The model supported the importance of mystical experiences to long-term change.

CONCLUSION:

Mental states of surrender or preoccupation at the time of ingestion explain variance in mystical or adverse psilocybin experiences, and mystical experiences relate to long-term positive change. The capacity to recognize this optimal preparatory mental state may benefit therapeutic use of psilocybin in clinical settings.

Russ, S. L., Carhart-Harris, R. L., Maruyama, G., & Elliott, M. S. (2019). Replication and extension of a model predicting response to psilocybin. Psychopharmacology, 1-10., 10.1007/s00213-019-05279-z
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Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial.

Abstract

Serotonergic psychedelics are emerging as potential antidepressant therapeutic tools, as suggested in a recent randomized controlled trial with ayahuasca for treatment-resistant depression. Preclinical and clinical studies have suggested that serum brain-derived neurotrophic factor (BDNF) levels increase after treatment with serotoninergic antidepressants, but the exact role of BDNF as a biomarker for diagnostic and treatment of major depression is still poorly understood. Here we investigated serum BDNF levels in healthy controls (N = 45) and patients with treatment-resistant depression (N = 28) before (baseline) and 48 h after (D2) a single dose of ayahuasca or placebo. In our sample, baseline serum BDNF levels did not predict major depression and the clinical characteristics of the patients did not predict their BDNF levels. However, at baseline, serum cortisol was a predictor of serum BDNF levels, where lower levels of serum BDNF were detected in a subgroup of subjects with hypocortisolemia. Moreover, at baseline we found a negative correlation between BDNF and serum cortisol in volunteers with eucortisolemia. After treatment (D2) we observed higher BDNF levels in both patients and controls that ingested ayahuasca (N = 35) when compared to placebo (N = 34). Furthermore, at D2 just patients treated with ayahuasca (N = 14), and not with placebo (N = 14), presented a significant negative correlation between serum BDNF levels and depressive symptoms. This is the first double-blind randomized placebo-controlled clinical trial that explored the modulation of BDNF in response to a psychedelic in patients with depression. The results suggest a potential link between the observed antidepressant effects of ayahuasca and changes in serum BDNF, which contributes to the emerging view of using psychedelics as an antidepressant. This trial is registered at http://clinicaltrials.gov (NCT02914769).

Almeida, R. N., Galvão, A. C. D. M., Da Silva, F. S., Silva, E. A. D. S., Palhano-Fontes, F., Maia-de-Oliveira, J. P., … & Galvão-Coelho, N. (2019). Modulation of serum brain-derived neurotrophic factor by a single dose of ayahuasca: observation from a randomized controlled trial. Frontiers in psychology10, 1234., https://doi.org/10.3389/fpsyg.2019.01234
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Acute subjective and behavioral effects of microdoses of LSD in healthy human volunteers

Abstract

Background
Numerous anecdotal reports suggest that repeated use of very low doses of lysergic acid diethylamide (LSD), known as “microdosing,” improves mood and cognitive function. These effects are consistent both with the known actions of LSD on serotonin receptors, and with limited evidence that higher doses of LSD (100-200 μg) positively bias emotion processing. Yet, the effects of such sub-threshold doses of LSD have not been tested in a controlled laboratory setting. As a first step, we examined the effects of single very low doses of LSD (0 – 26μg) on mood and behavior in healthy volunteers under double-blind conditions.
Methods
Healthy young adults (N=20) attended four laboratory sessions during which they received placebo, 6.5μg, 13μg, or 26μg LSD in randomized order at one-week intervals. During expected peak drug effect, they completed mood questionnaires and behavioral tasks assessing emotion processing and cognition. Cardiovascular measures and body temperature were also assessed.
Results
LSD produced dose-related subjective effects across the three doses (6.5μg, 13μg, or 26μg). At the highest dose the drug also increased ratings of “vigor” and slightly decreased positivity ratings of images with positive emotional content. Other mood measures, cognition, and physiological measures were unaffected.
Conclusions
Single “microdoses” of LSD produced orderly dose-related subjective effects in healthy volunteers. These findings indicate that a threshold dose of 13μg of LSD might be used safely in an investigation of repeated administrations. It remains to be determined whether the drug improves mood or cognition in individuals with symptoms of depression.
Bershad, A. K., Schepers, S. T., Bremmer, M. P., Lee, R., & de Wit, H. (2019). Acute subjective and behavioral effects of microdoses of LSD in healthy human volunteers. Biological Psychiatry., https://doi.org/10.1016/j.biopsych.2019.05.019
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Acute Subjective and Behavioral Effects of Microdoses of Lysergic Acid Diethylamide in Healthy Human Volunteers

Abstract

BACKGROUND:

Numerous anecdotal reports suggest that repeated use of very low doses of lysergic acid diethylamide (LSD), known as microdosing, improves mood and cognitive function. These effects are consistent both with the known actions of LSD on serotonin receptors and with limited evidence that higher doses of LSD (100-200 μg) positively bias emotion processing. Yet, the effects of such subthreshold doses of LSD have not been tested in a controlled laboratory setting. As a first step, we examined the effects of single very low doses of LSD (0-26 μg) on mood and behavior in healthy volunteers under double-blind conditions.

METHODS:

Healthy young adults (N = 20) attended 4 laboratory sessions during which they received 0 (placebo), 6.5, 13, or 26 μg of LSD in randomized order at 1-week intervals. During expected peak drug effect, they completed mood questionnaires and behavioral tasks assessing emotion processing and cognition. Cardiovascular measures and body temperature were also assessed.

RESULTS:

LSD produced dose-related subjective effects across the 3 doses (6.5, 13, and 26 μg). At the highest dose, the drug also increased ratings of vigor and slightly decreased positivity ratings of images with positive emotional content. Other mood measures, cognition, and physiological measures were unaffected.

CONCLUSIONS:

Single microdoses of LSD produced orderly dose-related subjective effects in healthy volunteers. These findings indicate that a threshold dose of 13 μg of LSD might be used safely in an investigation of repeated administrations. It remains to be determined whether the drug improves mood or cognition in individuals with symptoms of depression.

Bershad, A. K., Schepers, S. T., Bremmer, M. P., Lee, R., & de Wit, H. (2019). Acute subjective and behavioral effects of microdoses of LSD in healthy human volunteers. Biological Psychiatry., 10.1016/j.biopsych.2019.05.019
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‘Never drop without your significant other, cause that way lies ruin’: The boundary work of couples who use MDMA together.

Abstract

MDMA has a variety of pro-social effects, such as increased friendliness and heightened empathy, yet there is a distinct lack of research examining how these effects might intertwine with a romantic relationship. This article seeks to compensate for this absence and explore heterosexual couples’ use of MDMA through the lens of the boundaries they construct around these experiences. Three couple interviews, two diary interviews and eight written diaries about couples’ MDMA practices were analysed. Douglas’ (2001) and Stenner’s (2013) work around order, disorder and what lies at the threshold between the two are employed here. This conceptual approach allows us to see what happens at the border of MDMA experiences as crucial to their constitution. Two main themes are identified in the data. First, MDMA use was boundaried from daily life both temporally and corporeally: the drug was tied to particular times in people’s lives as well as the performance of rituals which engaged the material world and reenchanted everyday spaces and selves. Secondly, other people are excluded from MDMA experiences to varying degrees in order to preserve the emotionally intense space for the couple alone. This paper claims that MDMA use forms part of a spectrum of relationship ‘work’ practices; a unique kind of ‘date night’ that revitalises couples’ connection. Hence, MDMA should be recognised as transforming couple as well as individual practices. Finally, it is suggested that harm reduction initiatives could distinguish more ‘messy’ forms of emotional harm and engage with users’ language of ‘specialness’ to limit negative impacts of MDMA use.
Anderson, K., Reavey, P., & Boden, Z. (2019). ‘Never drop without your significant other, cause that way lies ruin’: The boundary work of couples who use MDMA together. International Journal of Drug Policy71, 10-18., https://doi.org/10.1016/j.drugpo.2019.05.004
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'Never drop without your significant other, cause that way lies ruin': The boundary work of couples who use MDMA together.

Abstract

MDMA has a variety of pro-social effects, such as increased friendliness and heightened empathy, yet there is a distinct lack of research examining how these effects might intertwine with a romantic relationship. This article seeks to compensate for this absence and explore heterosexual couples’ use of MDMA through the lens of the boundaries they construct around these experiences. Three couple interviews, two diary interviews and eight written diaries about couples’ MDMA practices were analysed. Douglas’ (2001) and Stenner’s (2013) work around order, disorder and what lies at the threshold between the two are employed here. This conceptual approach allows us to see what happens at the border of MDMA experiences as crucial to their constitution. Two main themes are identified in the data. First, MDMA use was boundaried from daily life both temporally and corporeally: the drug was tied to particular times in people’s lives as well as the performance of rituals which engaged the material world and reenchanted everyday spaces and selves. Secondly, other people are excluded from MDMA experiences to varying degrees in order to preserve the emotionally intense space for the couple alone. This paper claims that MDMA use forms part of a spectrum of relationship ‘work’ practices; a unique kind of ‘date night’ that revitalises couples’ connection. Hence, MDMA should be recognised as transforming couple as well as individual practices. Finally, it is suggested that harm reduction initiatives could distinguish more ‘messy’ forms of emotional harm and engage with users’ language of ‘specialness’ to limit negative impacts of MDMA use.
Anderson, K., Reavey, P., & Boden, Z. (2019). ‘Never drop without your significant other, cause that way lies ruin’: The boundary work of couples who use MDMA together. International Journal of Drug Policy71, 10-18., https://doi.org/10.1016/j.drugpo.2019.05.004
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Psychedelic drugs-a new era in 
psychiatry?


Abstract

This article covers the renaissance of classical psychedelic drugs such as psilocybin and LSD plus 3,4-methylene dioxymethamphetamine (MDMA-ecstasy) in psychiatric research. These drugs were used quite extensively before they became prohibited. This ban had little impact on recreational use, but effectively stopped research and clinical treatments, which up to that point had looked very promising in several areas of psychiatry. In the past decade a number of groups have been working to re-evaluate the utility of these substances in medicine. So far highly promising preliminary data have been produced with psilocybin in anxiety, depression, smoking, alcoholism, and with MDMA for post-traumatic stress disorder (PTSD) and alcoholism. These findings have led to the European Medicines Agency approving psilocybin for a phase 3 study in treatment-resistant depression and the Food and Drug Administration for PTSD with MDMA. Both trials should read out in 2020, and if the results are positive we are likely to see these medicines approved for clinical practice soon afterwards.

Nutt, D. (2019). Psychedelic drugs—a new era in psychiatry?. Dialogues in clinical neuroscience21(2), 139., https://dx.doi.org/10.31887%2FDCNS.2019.21.2%2Fdnutt
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Motives and side-effects of microdosing with psychedelics among users

Abstract

BACKGROUND:

Microdosing with psychedelics has gained considerable media attention where it is portrayed as a performance enhancer, especially popular on the work floor. While reports are in general positive, scientific evidence about potential negative effects is lacking aside from the prevalence and motives for use. The present study addressed this gap by surveying psychedelic users about their experience with microdosing including their dosing schedule, motivation, and potential experienced negative effects.

METHODS:

An online questionnaire was launched on several websites and fora between March and July 2018. Respondents who had consented, were 18 years of age or older, and had experience with microdosing were included in the analyses.

RESULTS:

In total, 1116 of the respondents were either currently microdosing (79.5%) or microdosed in the past (20.5%). Lysergic acid diethylamide (10 mcg) and psilocybin (0.5 g) were the most commonly used psychedelics with a microdosing frequency between 2 and 4 times per week. The majority of users, however, were oblivious about the consumed dose. Performance enhancement was the main motive to microdose (37%). The most reported negative effects were of psychological nature and occurred acutely while under the influence.

CONCLUSION:

In line with media reports and anecdotes, the majority of our respondents microdosed to enhance performance. Negative effects occurred mostly acutely after substance consumption. However, the main reason to have stopped microdosing was that it was not effective. Future experimental placebo-controlled studies are needed to test whether performance enhancement can be quantified and to assess potential negative effects after longer term microdosing.

Hutten, N. R., Mason, N. L., Dolder, P. C., & Kuypers, K. P. (2019). Motives and side-effects of microdosing with psychedelics among users. International Journal of Neuropsychopharmacology., 10.1093/ijnp/pyz029

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Psychedelic-assisted therapies: The past, and the need to move forward responsibly.

Abstract

Recent clinical studies illustrate that psychedelics such as LSD and psilocybin may represent much-needed new treatment options for mood disorders and alcohol and other drug use disorders. More clinical studies are required to confirm the safety and efficacy of psychedelic-assisted therapies, but the cultural stigma that has surrounded psychedelics since the 1960s has hindered research. This problem is amplified in Australia. There has been a complete absence of research into psychedelic therapies, and Australian-based research advocates claim to have encountered a number of barriers. In this commentary, we provide a brief account of the historical stigma associated with psychedelics, and an overview of the contemporary context of research into psychedelic-assisted therapies, including the purported barriers to research in Australia. In light of the complex history of psychedelics, we identify a number of pressing questions relating to the social and legal context that need to be addressed so that clinical studies can proceed. Research is needed to address such questions so that the nature and extent of purported barriers to clinical studies with psychedelics can be properly elucidated, and strategies developed – with practitioners, patients, families and other stakeholders – to responsibly address these barriers. This is important because it will enable Australian researchers to contribute robust evidence about the possible efficacy and safety of psychedelic therapies, and to facilitate local expertise needed to implement psychedelic-assisted therapies, should they prove efficacious.
Gardner, J., Carter, A., O’Brien, K., & Seear, K. (2019). Psychedelic-assisted therapies: The past, and the need to move forward responsibly. International Journal of Drug Policy70, 94-98., https://doi.org/10.1016/j.drugpo.2019.05.019
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Dynamical exploration of the repertoire of brain networks at rest is modulated by psilocybin

Abstract

Growing evidence from the dynamical analysis of functional neuroimaging data suggests that brain function can be understood as the exploration of a repertoire of metastable connectivity patterns (‘functional brain networks’), which potentially underlie different mental processes. The present study characterizes how the brain’s dynamical exploration of resting-state networks is rapidly modulated by intravenous infusion of psilocybin, a tryptamine psychedelic found in “magic mushrooms”. We employed a data-driven approach to characterize recurrent functional connectivity patterns by focusing on the leading eigenvector of BOLD phase coherence at single-TR resolution. Recurrent BOLD phase-locking patterns (PL states) were assessed and statistically compared pre- and post-infusion of psilocybin in terms of their probability of occurrence and transition profiles. Results were validated using a placebo session. Recurrent BOLD PL states revealed high spatial overlap with canonical resting-state networks. Notably, a PL state forming a frontoparietal subsystem was strongly destabilized after psilocybin injection, with a concomitant increase in the probability of occurrence of another PL state characterized by global BOLD phase coherence. These findings provide evidence of network-specific neuromodulation by psilocybin and represent one of the first attempts at bridging molecular pharmacodynamics and whole-brain network dynamics.

Lord, L. D., Expert, P., Atasoy, S., Roseman, L., Rapuano, K., Lambiotte, R., … & Cabral, J. (2019). Dynamical exploration of the repertoire of brain networks at rest is modulated by psilocybin. NeuroImage199, 127-142., 10.1016/j.neuroimage.2019.05.060

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