Hero

Videos

Slideshows

Articles

Podcasts

Poll

A study found that psilocybin-assisted meditation interventions alter the neural processes that underlie symptoms of social anxiety disorder (SAD) and may have complementary effects.

In the study, a qualitative systematic literature review, researchers aimed to address the limited efficacy of current first-line treatment for SAD by identifying the potential mechanisms used in a combination of psilocybin and mindfulness treatment to adjust the anomalous neural activity underlying SAD. Researchers followed Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines in a literature search on PubMed using separate search strings for psilocybin treatment and mindfulness meditation.

In the search string for psilocybin, researchers used the keywords “Psilocybin, LSD, Neural activation, brain imaging, nuclear, tomography, fMRI”; for the search string on mindfulness, they used “Mindfulness meditation, Neuronal Activity, Networks, Brain imaging, Tomography.” They selected 30 experimental studies that all had been published in a peer-reviewed journal, assessed the effects of psilocybin/lysergic acid diethylamide (LSD) or mindfulness meditation, and involved the performance of neuroimaging with fMRI.

The researchers analyzed these studies for the effects of combined psilocybin treatment and mindfulness meditation on brain activation and connectivity, biased attention toward social threats, heightened self-focused attention, negative self-perception, brain regions involved in low perceived emotional control, and brain regions involved in post-event rumination.

Their findings suggested a complementary effect of the combined treatments on the neurological mechanisms involved in SAD symptomatology: Psilocybin appears to cause acute disintegration of core neural networks, which are reintegrated in the post-acute phase, during which, the integration of mindfulness meditation exerts modulatory effects. The researchers suggested that this breaks the “vicious maintenance” of SAD by decreasing self-focused attention, while additional complementary effects of the treatments on frontoparietal control over the limbic cortex alter negative self-perception and emotional regulation.

The researchers concluded that the complementary effects of psilocybin and mindfulness meditation interventions may help patients with SAD experience unbiased perception of social situations by improving their control over attention allocation and facilitating regulation of negative self-referential processing and emotional control. They concluded that “future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who do not remit following conventional therapy.”

Don’t be afraid, ty to meditate—potential effects on neural activity and connectivity of psilocybin-assisted mindfulness-based intervention for social anxiety disorder: a systematic review

Treatments alter the neural processes underlying SAD symptoms.

Complementary Effects of Combined Alternative Treatments on Social Anxiety Disorder

In recent years, researchers have conducted an increasing number of clinical trials for psychedelic therapies for the treatment of several psychiatric conditions. However, few of those trials included individuals with physical and sensory disabilities. In response, Mintz et al

 provided 4 suggestions to help stimulate diversity inclusion in future research.

“We emphasize the need for extensive disability awareness training for those facilitating psychedelic therapies and encourage psychedelic researchers and therapists to exercise cultural humility toward individuals with physical and sensory disabilities,” wrote the authors.

Here are their recommendations for psychedelic research organizations.

1. Meet and exceed the basic requirements of relevant disability rights legislation.

Psychedelic research groups should strive to meet and exceed the basic requirements of the Americans with Disabilities Act Amendments of 2008, Section 504 of the Rehabilitation Act of 1973, and other legislation. By including experts in disability law on the team, current and future psychedelic therapy trials can strive to implement measures beyond what the law requires.

2. Engage in direct dialogue with individuals within disability communities about their thoughts and concerns related to psychedelic therapies

By speaking to members of the disability community, researchers can best assess what accommodations are needed. Those accommodations should then be considered across all phases of research.

For example, a recent psychedelic trial for depression, anxiety, and demoralization among men who were older and long-term AIDS survivors utilized the expertise of consultants, which benefited the overall study design, execution, and analysis.

3. Incorporate disability awareness into training programs for guides who facilitate psychedelic therapies.

“Disability inclusion requires ongoing work,” wrote the authors.

 To ensure the best possible outcomes, training programs should include: discussion of disability rights history, the medical and social models of disability, the disability paradox, and the ethical issues arising from disability inclusion in psychedelic therapies, such as how to obtain informed consent, how to work with the caregivers of participants with disabilities in psychedelic therapies, and how to protect those with disabilities from harm and exploitation.

4. Demonstrate cultural humility toward people with disabilities.

Disability communities have experienced injustice from health care providers and researchers. It is paramount that individuals with disabilities are not seen as “guinea pigs” for experimentation. Additionally, the idea that these individuals need to be “cured” is ableist and wrong. To build trust with disability communities, researchers must be conscientious and transparent in their interactions.

Mintz et al asserted that “participants with physical and sensory disabilities should not merely be considered eligible but, also, actively recruited into psychedelic studies as both an intrinsic matter of justice and to expand the evidence base for treatments that will soon be broadly available.”

Do you have any recommendations for how mental health clinicians can incorporate disability inclusion into practice? Tell us about it: 

Physical disability and psychedelic therapies: an agenda for inclusive research and practice.

2. Anderson BT, Danforth A, Daroff PR, et al. 

Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: an open-label safety and feasibility pilot study.

How can psychedelic research incorporate disability inclusion into future work? 

4 Recommendations for Disability Inclusion in Psychedelic Therapy Research 

, and "several psychedelic compounds hold strong therapeutic potential for a wide array of mental health conditions." We want to know your thoughts on psychedelics and their role in psychiatric practice. 

We want to know more about your thoughts and experiences with psychedelics and clinical practice! Write to us at 

The Role of Psychedelics in Psychiatry: Helpful or Hoax? 

As part of a psychedelic revolution, careful research is underway to see how these compounds may benefit patients with psychiatric disorders. In this episode, Amir Inamdar MBBS, DNB (Psych), MFPM, shares insights and thoughts about the work being done and its potential to make a difference in patient care. 

Research is underway to make psychedelics agents a treatment option for psychiatric disorders.   

Here's to a Psychedelic Revolution

A study comparing the acute effects of lysergic acid diethylamide (LSD) and psilocybin in healthy participants found that the primary differences between the 2 are dose-, rather than substance-dependent.

In the study—a double-blind, randomized, placebo-controlled, crossover design—investigators evaluated 28 healthy individuals during 5 sessions, each 10 days apart and lasting 25 hours. In each session, participants were given LSD (100 and 200 µg), psilocybin (15 and 30 mg), or placebo, with outcome measures including self-rating scales for subjective and autonomic effects, adverse effects, and effect durations, plus plasma levels of brain-derived neurotrophic factor (BDNF), oxytocin, cortisol, prolactin, and pharmacokinetics.

Results showed that the 200 μg LSD dose received higher anxiety and ego-dissolution ratings, as well as control and cognition impairments, compared with the 100 μg LSD dose. The 200 μg LSD dose also significantly increased ratings of ineffability compared with the 30 mg dose of psilocybin. The investigators noted that both LSD doses demonstrated longer effect durations than the psilocybin doses, although both the LSD doses and the high psilocybin dose produced similar quantitative and qualitative subjective effects in the participants. Overall, investigators reported that these findings suggest that 20 mg psilocybin is equivalent to 100 μg LSD, and 30 mg psilocybin is equivalent to 150 μg LSD.

“The results in this publication continue to expand our knowledge of the differences between LSD and psilocybin with regard to their acute effects, similarities, and dose equivalence,” said Matthias Liechti, MD, professor of clinical pharmacology and internal medicine at University Hospital Basel, and principal investigator on the study, in a press release. “Although both substances are used as pharmacological tools, there are no modern studies investigating and directly comparing the acute effects of these substances within the same clinical study, using well-defined doses and validated psychometric tools.”

As there is a lack of contemporary clinical studies comparing the acute effects of LSD and psilocybin, the findings of this study can potentially help clinicians with dosing for psychiatric and neurologic disorders, designing trials, and evaluating these psychedelics for therapeutic utility in future research.

“LSD and psilocybin have recently become promising candidates for the treatment of various psychiatric and neurologic disorders, and thus a deeper understanding of their differential subjective effects in humans is needed,” said Miri Halperin Wernli, PhD, MindMed executive president, in a press release. “This study brings us one step closer to maximizing the therapeutic potential of these molecules, by providing valuable dose-finding context and enabling more direct comparisons when interpreting clinical results.”

MindMed announces publication of study comparing the acute effects of lysergic acid diethylamide and psilocybin in healthy subjects

. Cision PR Newswire. News release. March 2, 2022. Accessed March 3, 2022.

Direct comparison of the acute effects of lysergic acid diethylamide and psilocybin in a double-blind placebo-controlled study in healthy subjects

Drug comparison has significant implications for dose- and substance-dependence.

Research Identifies Key Differences Between LSD and Psilocybin

Over the past several years, we have witnessed a psychedelic renaissance, and a growing body of evidence suggests that several psychedelic compounds hold strong therapeutic potential for a wide array of mental health conditions.

Once dismissed as dangerous and having little therapeutic potential, 

 are gaining mainstream acceptance. Research data continue to demonstrate that, on the whole, these medicines are not only safe, but mostly well tolerated. Although more research is needed to better understand safety, especially in the context of at-risk conditions, these favorable safety profiles are enabling deeper exploration of these medicines.

The term psychedelic was coined in the 1950s by psychiatrist Humphry Osmond, MD, and it literally means “mind-manifesting.” This class of drugs produces changes in perception, thought, and mood with minimal disorientation or confusion. Unlike alcohol, 

, and barbiturates, psychedelics do not lead to a slowing of cognitive processes or an acceleration of cognition as seen with 

Several US states and cities are in the process of legalizing or decriminalizing psychedelics like 

, 3,4-methylenedioxymethamphetamine (MDMA), lysergic acid diethylamide (LSD), and others for therapeutic or recreational purposes. In 2020, the Oregon Ballot Measure 109 was passed,

 allowing licensed service providers to administer psilocybin products to individuals 21 years and older and making Oregon the first state to legalize psilocybin. The drug will not be available commercially or for home-based use, as strict regulations are in place to ensure psilocybin will be used only under the supervision of trained facilitators. This was a major milestone in psychedelic medicine, as it opened the door for more widespread access to 

The US Food and Drug Administration (FDA) has also shown interest in prioritizing the approval of certain psychedelic drugs. Both psilocybin- assisted psychotherapy for 

 (MDD) and treatment-resistant depression,

as well as MDMA-assisted psychotherapy for 

 have received the breakthrough therapy designation from the FDA to fast-track the approval process because of the growing clinical evidence demonstrating substantial improvement over currently available therapies.

The growing research results continue to confirm that psychedelic medicines are not only safe, but well tolerated by the majority of recipients. A psilocybin study found that cases of mental health complications following a psychedelic are rare (<0.1%) even in vulnerable populations (<0.2%), and rarer still with proper screening.

, LSD, psilocybin, and mescaline. It found no evidence of increased rates of mental health problems; in fact, it demonstrated psychedelic use was associated with reduced psychological distress and suicidality.

 Additionally, results of studies examining psychedelic substance use patterns in humans as well as self-administration in animals suggest that classic psychedelics possess little or no abuse liability and may even be antiaddictive.

Results of other studies suggest psychedelics may have protective effects when it comes to mental illness in general. Pooling more than 190,000 adults, researchers evaluated the relationship of classic psychedelic use and psychological distress and suicidality. They found that lifetime psychedelic use was associated with significantly reduced odds of past-month psychological distress, past-year 

, past-year suicidal planning, and past-year suicide attempt.

 This offers new insight into the potential promise of psychedelics in helping to prevent suicide.

More research is still needed to fully understand safety, especially in the context of at-risk conditions and mechanisms of action. However, the favorable safety profiles are opening doors for deeper exploration of these medicines.

, the psychedelic treatment closest to receiving FDA approval, is currently undergoing phase 3 clinical trials in patients with PTSD.

 The study included 90 patients with severe, chronic PTSD from a variety of different causes (eg, abuse, combat, sexual trauma). It is worth mentioning that this was a treatment-resistant group, meaning patients had suffered with PTSD for an average of 14 years without relief. All participants completed a 12-week treatment program composed of 3 full-day sessions, during which they received either MDMA or a placebo, plus weekly nondrug psychotherapy sessions. No serious adverse effects were detected beyond transient, mild symptoms during drug treatment such as nausea or sweating. No increases in suicide risk or potential for abuse were noted in the MDMA group relative to placebo. Two months after treatment, 67% of the MDMA cohort no longer qualified for PTSD diagnosis, compared with 32% of the placebo group. In addition, 88% of those in the MDMA group experienced a clinically significant reduction in symptoms (

MDMA is unique in its ability to promote acceptance of and empathy for self and others. In addition to elevating oxytocin levels, MDMA stimulates the release of the monoamines serotonin, norepinephrine, and dopamine, resulting in improved mood and increased sociability.

 Brain imaging after administration of MDMA shows there is decreased amygdala activation and reduced fear response,

 allowing the patient to emotionally engage in therapy without becoming overwhelmed by anxiety or difficult emotions. The combination of medication plus psychotherapy represents a new frontier for the FDA, with unique challenges to be addressed such as therapeutic approaches and therapist training.

Psilocybin, the main psychoactive component of “magic mushrooms,” is currently in phase 2 clinical trials for MDD. As a classic psychedelic, it is an agonist of serotonergic 5-HT2A receptors in the brain,

 which are particularly abundant in the cortex and regions associated with cognitive functions and social interactions.

 Stimulation of this receptor has been directly linked to cognitive flexibility, enhanced imagination, and creative thinking.

In pivotal study results, 71% of individuals with MDD who received 2 doses of psilocybin were treatment responders, and half of the participants entered remission (

 Some follow-up studies after therapy, although small, have shown lasting benefits.

Psychedelic medicine is forging ahead as a promising new treatment paradigm, in which psychedelics, paired with psychotherapy, have the potential to treat various mental health conditions. Preliminary findings show successful results for these treatments, with significant clinical improvements and few—if any—serious adverse effects. The emerging results likely have implications for future psychiatric research, education, and policy—and most importantly, they are poised to offer new therapeutic options and improve the lives of those we serve.

 is a board-certified psychiatrist and Chief Medical Officer of Novamind. He is the co-founder of Cedar Psychiatry and serves as the Medical Director for the Center for Change, a leading eating disorders center. Dr Robison   previously served as a coordinating investigator for the MAPS-sponsored MDMA-assisted psychotherapy study of eating disorders.

1. Oregon psilocybin services. Oregon Health Authority. Accessed December 5, 2021. 

https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/Pages/Oregon-Psilocybin-Services.aspx

2. COMPASS Pathways receives FDA breakthrough therapy designation for psilocybin therapy for treatment-resistant depression. News release. COMPASS Pathways; October 23, 2018. Accessed December 5, 2021. 

https://compasspathways.com/compass-pathways-receives-fda-breakthrough-therapy-designation-for-psilocybin-therapy-for-treatment-resistant-depression

3. Brooks M. FDA grants psilocybin second breakthrough therapy designation. News release. Medscape Medical News; November 25, 2019. Accessed December 5, 2021. 

https://www.medscape.com/viewarticle/921789

4. FDA grants Breakthrough Therapy designation for MDMA-assisted psychotherapy for PTSD, agrees on special protocol assessment for phase 3 Trials. News release. Multidisciplinary Association for Psychedelic Studies; August 26, 2017. Accessed December 5, 2021. 

https://maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials

5. Studerus E, Kometer M, Hasler F, Vollenweider FX. 

Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies.

Psychedelics and mental health: a population study.

Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans.

8. Hendricks PS, Thorne CB, Clark CB, et al. 

Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population.

9. Mitchell JM, Bogenschutz M, Lilienstein A, et al. 

MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study.

10. Hysek CM, Schmid Y, Simmler LD, et al. 

MDMA enhances emotional empathy and prosocial behavior.

11. Bedi G, Phan KL, Angstadt M, de Wit H. 

Effects of MDMA on sociability and neural response to social threat and social reward.

3,4-methylenedioxymethamphetamine (MDMA) impairs the extinction and reconsolidation of fear memory in rats. 

13. Tylš F, Páleníček T, Horáček J. 

Psilocybin—summary of knowledge and new perspectives. 

14. Celada P, Puig M, Amargós-Bosch M, et al. 

The therapeutic role of 5-HT1A and 5-HT2A receptors in depression.

Psychedelic drugs: neurobiology and potential for treatment of psychiatric disorders.

16. Davis AK, Barrett FS, May DG, et al. 

Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial.

 2021;78(5):481-489. Published correction appears in 

17. Carhart-Harris RL, Bolstridge M, Day CMJ, et al. 

Psilocybin with psychological support for treatment-resistant depression: six-month follow-up.

18. Agin-Liebes GI, Malone T, Yalch MM, et al. 

Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer.

Psychedelics and the Future of Psychiatry

My wife and I do not watch much TV, but we almost always watch CBS Sunday Morning. I am not sure that the show this past Sunday, which had 2 segments on posttraumatic stress disorder (PTSD) and veterans, was a follow-up to the just passed Veterans Day, but it sure seemed that way.

This show’s cover story was on “New hope in treating PTSD with psychedelic drugs.”

 It focused on a veteran of 2 tours in Iraq, who had been struggling with severe PTSD for about a dozen years. Treatment as usual was not helping, as is often the case with PTSD, especially when there is moral injury involved. In his case, he felt strong guilt about being unable to rescue, but only being able to watch, another fellow soldier burn to death from an explosive device.

He then heard of a US Food and Drug Administration therapeutic breakthrough trial on psychedelics for treating PTSD and was able to enroll. The treatment was MDMA, aka ecstasy, with the crucial complement of psychotherapy. After 3 sessions, his symptoms dissipated and have continued to do so.

Later in the show, there was a report about a woman who had found 2 Army uniforms in a dumpster. Finding that unusual, she wanted to find the owner, but only had the last name of McKenzie on a jacket. Eventually, she found out they were from a veteran who had served twice in Afghanistan, developed PTSD, and then died from suicide in 2018. She decided to make the 1000 mile drive to his wife and teenage son to deliver them in person. The son was overwhelmed and felt that she returned more than the uniforms. She returned hope for the future. If only the father could have tried a psychedelic.

Hopefully, the outstanding results and protocols will continue to pan out in this new paradigm.

is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues relate to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of

1. CBS Sunday Morning. New hope in treating PTSD with psychedelic drugs. YouTube. November 14, 2021. Accessed November 16, 2021. 

https://www.youtube.com/watch?v=rMBRgBFp7TI

Psychedelics: returning hope to veterans with PTSD. 

Psychedelics Providing Hope for Veterans and Others

Alexander Somjen discusses the fragmented psychedelic industry, regulatory frameworks, and potential commercial success. 

Here's why psychedelics might be a valuable addition to mental health treatment. 

Emerging Psychedelic Therapies

Following a financially successful weekend opening, what might the movie 

 mean for our mental health? Most important may be the movie’s statement that whoever economically controls the psychedelic “spice” controls the future world. Then we add the confluence with the resurgence of interest in psychedelics, layered upon the common desire of humankind to take various mind altering substances.

What has led to the current second coming of psychedelics after they began to be criminalized not long after the novel 

 was published in 1965? From the psychiatric perspective, it seems to be the need to obtain more effective and safer medications after a couple of decades of stagnant psychopharmacology. This second era is illustrated by the article, “Shrooms! Shamans! Kosher LSD! Why Los Angeles Is Suddenly Tripping Out” in 

, the psychedelic “spice” enhances various mind expanding functions, but apparently not our prior counterculture search for a loving spiritual awakening. Approved updated research on current psychedelics has shown that with proper dosage, set, and setting, there is unique promise for treating various difficult mental conditions. Moreover, lower and micro dosage is found to have nonpsychedelic benefits, including calmness, creativity, and, yes, maybe even enhanced connectivity.

Ketamine, an anesthetic that was found from recent off label trials to be uniquely helpful for clinical depression, seems to be a transitional psychedelic product. Different this time, too, is investor funding for such endeavors, but perhaps as we have now seen in both medicine and the movie, this is the kind of business control over health care ethics that we may have to be wariest about.

The mental health promise is surely here, but so is the peril.

1. Kiefer P. Shrooms! Shamans! Kosher LSD! Why Los Angeles is suddenly tripping out. 

October 21, 2021. Accessed October 25, 2021. 

https://www.lamag.com/citythinkblog/shrooms-shamans-kosher-lsd-why-los-angeles-is-suddenly-tripping-out/

What does the movie Dune say about our society’s current relationship with psychedelics? 

Dune and the Second Coming of Psychedelics in the United States

, a wholly owned subsidiary developing Salvinorin A (SalA) to treat a variety of mental health disorders. SalA, a unique non-nitrogenous agonist of the kappa-opioid receptor (KOR), is derived from Salvia divinorum.

SalA has a complex pharmacological profile. It is an atypical KOR agonist, and its mechanism of action (MoA) shows no interaction at the 5-HT2A serotonin receptor—the main molecular target for hallucinogens like psilocybin.

“Due to SalA’s short psychedelic effect, it will be an attractive option for those who would like psychedelic treatment but are unwilling or unable to participate in longer sessions,” said Glenn Short, CEO of Revixia. “The shorter experience will allow for more practical administration and monitoring, which may even make it possible to attend psychotherapy sessions on the same day.”

Salvia divinorum has been traditionally used by the Mazatec people in Oaxaca, Mexico for a variety of illnesses, such as diarrhea, headaches, and rheumatism, as well as for palliative care. It also has potential use with treatment-resistant depression (TRD), substance use disorder (SUD), and pain.

Published reports suggest potential benefits of Salvia divinorum in the treatment of TRD. One doctor reported on 7 patients with TRD who described relief from depressive symptoms with 

triweekly oral consumption of salvia leaves

. Several patients reported lasting benefits from their use of salvia, with significantly reduced scores on quantitative measures of depression. Patients also reported benefits like mood enhancement, increased feelings of relaxation, and increased self-awareness.

"While SalA has until now been understudied, its unique MoA may allow for combination with SSRIs, potentially giving patients a better chance in beating depression," Srinivas Rao, CSO and cofounder of atai Life Sciences, said to the press. “We’re thrilled to be pursuing SalA and progressing research, as we strive for new treatments.”

Revixia’s product will be paired with a digital therapeutic developed by atai company, Introspect Digital Therapeutics. The company hopes this pairing will streamline preparation, integration, and continued patient engagement.

“In exploring SalA, Revixia aims to develop a product with a differentiated pharmacological and treatment effect. Considering the significance of prior evidence in humans in parallel with the substantial unmet need in TRD, we believe Revixia has high commercial potential and an increased probability of success in the clinic,” Florian Brand, CEO and cofounder of atai Life Sciences, said. “SalA is a great product candidate that magnificently matches the criteria we strive for, with recognized synergies across the atai platform.”

Clinical trials are expected to begin in the second half of 2022.

1. atai Life Sciences. atai launches Revixia Life Sciences to develop Salvinorin A for a variety of mental health conditions. News release. August 12, 2021. Accessed August 13, 2021. 

https://ir.atai.life/news-releases/news-release-details/atai-launches-revixia-life-sciences-develop-salvinorin-variety

2. Hanes KR. Salvia divinorum: clinical and research potential. 

A kappa-opioid receptor with psychedelic effects, this potential agent for treatment-resistant depression and other disorders will be paired with a digital therapeutic for maximum efficacy.

Psychedelics