Dr. Robin Carhart-Harris, a leading researcher in the field of psychedelics, discusses the history, impact on the brain, and potential for treating mental health disorders. Clinical trials have shown that psilocybin can alleviate major depression in over 67% of patients. Psychedelics can reveal hidden aspects of the mind and be used in psychotherapy. Microdosing, taking small doses of psychedelics, has potential benefits but lacks compelling evidence. Psilocybin therapy increases communication between brain areas and promotes neuroplasticity. It shows promise in treating anorexia and fibromyalgia. The integration phase in psychedelic therapy is crucial for maximizing therapeutic outcomes. The use of psychedelics without hallucinations is being explored. The legal landscape surrounding psychedelics is unclear. MDMA therapy for PTSD may be approved by the FDA. Psilocybin therapy is in phase III clinical trials. Safeguards and standards are needed in psychedelic therapy. Various ways to support the podcast and Dr. Carhart-Harris's research are mentioned.
Dr. Robin Carhart-Harris
Dr. Robin Carhart-Harris, a distinguished professor of neurology and psychiatry at the University of California, San Francisco, is a leading researcher in the field of psychedelics and their effects on neural circuitry in the brain. His laboratory has conducted clinical trials demonstrating that appropriate dosages of psilocybin can alleviate major depression in over 67% of patients. This discussion explores the history of psychedelics, their impact on the brain, and their potential for treating mental health disorders. It also touches on the evolving legislation surrounding psychedelics for therapeutic use.
- Dr. Robin Carhart-Harris is a renowned researcher in the field of psychedelics and their effects on the brain.
- Clinical trials conducted by his laboratory have shown that psilocybin can effectively alleviate major depression in a significant percentage of patients.
- The discussion covers the history of psychedelics, their impact on neural circuitry, and their potential for treating mental health disorders.
- The conversation also explores the long-term effects of psychedelics and how they can rewire the brain.
- The evolving legislation surrounding psychedelics for therapeutic use is briefly mentioned.
The Brain-Body Contract
The Brain-Body Contract is a topic discussed by Dr. Robin Carhart-Harris, covering tools and science related to mental health, physical health, and performance. Key points include:
- The discussion offers new content not previously covered on the Huberman Lab podcast or elsewhere.
- Dr. Carhart-Harris mentions upcoming live events in Toronto and Chicago, where he will give a lecture and answer questions.
- Viewers can visit hubermanlab.com/tour and use the code "Huberman" for early ticket access.
Origin of the Word: “Psychedelics”; Pharmacology
Psychedelics, a class of drugs used in research for specific clinical conditions, were coined by Humphry Osmond to describe their psychological effects beyond mimicking psychotic symptoms. The word is derived from ancient Greek words meaning to reveal aspects of the psyche. It is valence nonspecific, working on the serotonin 2A receptor in the brain. The term is commonly used but may be overused and the nomenclature is still evolving.
Psychedelics & Revealing the Unconscious Mind, Psychotherapy
Psychedelics have the ability to reveal hidden aspects of the mind that are normally below conscious awareness. This includes repressed memories and painful experiences. Key points include:
- Psychedelics can uncover unconscious elements and bring them to conscious awareness.
- LSD and psilocybin are examples of psychedelics that can reveal repressed material.
- This action is unique to classic psychedelics and distinguishes them from other compounds.
- Understanding the biological mechanisms behind this action is an important area of research.
- Psychedelics can be used in psychotherapy to help individuals become aware of previously unknown aspects of themselves.
Microdosing
Microdosing refers to the use of small doses of classic psychedelics like LSD or psilocybin that have subtle psychedelic effects without inducing a noticeable altered state of consciousness. The goal of microdosing is to experience subtle changes in well-being and potentially improve certain aspects of cognition, particularly related to creative thinking. However, there is currently a lack of compelling evidence to support these claims.
Key points:
- Microdosing involves taking very small doses of psychedelics, such as 10 micrograms of LSD, below the threshold for inducing visual hallucinations.
- Microdosing is typically done on a semi-regular schedule, such as one day on, one day off or one day on, two days off.
- Conducting rigorous studies on microdosing is challenging due to practical and ethical considerations.
- A study in New Zealand showed preliminary positive findings but has not been published yet.
- A study at Imperial College used blinding techniques to investigate microdosing, but the results showed no significant difference between microdosing and placebo.
- Positive expectancy and the placebo response play a powerful role in driving therapeutic outcomes.
Psilocybin vs. Magic Mushroom Doses
Psilocybin vs. Magic Mushroom Doses:
- Psilocybin is the active compound in magic mushrooms.
- A gram of magic mushrooms contains approximately 10 milligrams of psilocybin.
- The exact equivalent dose of psilocybin in magic mushrooms is uncertain and requires further research.
- The approximate percentage of psilocybin in mushrooms is around 1% or slightly higher.
- Understanding the psilocybin content in mushrooms is important for ongoing trials and their results.
“Psychedelic-Therapy”, Music
Psychedelic therapy, a treatment for major depression, has shown remarkable results. The therapy involves the use of psychedelics in a controlled setting, with patients focusing on their inner experiences. Music is a crucial component of the therapy, creating a conducive environment. The emotional intensity of the experience is influenced by the presence of music, leading to better treatment outcomes.
Psychedelic Journey: “Trust, Let Go, Be Open”
The most profound aspect of the topic is the importance of "Trust, Let Go, Be Open" in psychedelic therapy.
Key points:
- Trust: The therapeutic rapport between the patient and therapist predicts the quality of the experience and therapeutic outcomes.
- Letting go: Surrendering and not resisting the effects of the psychedelic predicts response.
- Being open: Willingness to confront and be inquisitive during the experience facilitates positive outcomes.
- Difficult emotions: Struggles and negative emotions may arise in the early phase, but the latter half can be different.
Negative Emotions, Fear & Psychedelics
Psychedelic journeys often involve a struggle against the effects of the drugs, which can be frightening. This struggle is not related to specific sensations or memories, but rather the breaking down of normal consciousness. During this phase, people may feel like they are dying or losing their mind.
Key points:
- Negative emotions, particularly fear, are common during psychedelic drug use.
- Even knowledgeable individuals can experience intense fears while under the influence of these drugs.
- These fears are a predictable response to the drug's effects and are dose-dependent.
- Feeling like one is losing their mind or going insane is a fundamental aspect of psychedelic drug action.
Global Functional Connectivity, Serotonin 2A Receptor; Subjective Experiences
Psychedelics increase global functional connectivity in the brain, leading to enhanced communication between different brain areas that typically do not communicate with each other. This increased connectivity correlates with the subjective effects of the drugs, such as auditory and visual hallucinations and changes in thinking patterns. The activation of serotonin 2A receptors is believed to be responsible for this increased connectivity. Studies using psilocybin, LSD, and DMT have all shown similar effects. The exact regions of the brain most affected are still debated. The increased connectivity and subjective experiences occur in parallel and influence each other, with a circular causality between the two. This understanding challenges the notion that the brain solely causes subjective experiences and highlights the interaction between mind and brain. Subjective experience is a distinct phenomenon but is connected to the biological level.
Pharmacology: Therapeutics without Psychedelic Effects; SSRIs
The possibility of developing therapeutic drugs for depression without psychedelic effects is being explored in the scientific community. This involves modifying psychedelics like psilocybin and MDMA to have therapeutic applications without hallucinations. Some laboratories are working on this approach, which has both supporters and critics. Pharmaceutical companies are interested in these drugs as they could potentially cure depression without causing hallucinations.
Key points:
- Movement to develop drugs for depression without psychedelic effects
- Modifying psychedelics like psilocybin and MDMA for therapeutic applications
- Laboratories working on this approach, with both supporters and critics
- Pharmaceutical companies interested in these drugs for potential depression cure without hallucinations.
Psilocybin & Depression; Long-Term Effects: Connectivity & Neuroplasticity
Psilocybin therapy for depression has shown promising results in increasing communication between neurons and promoting neuroplasticity. During the psychedelic experience, there is a significant increase in connectivity and communication between brain areas. The effects of increased connectivity and structural brain changes after the drug wears off are still unclear and require further research. Psilocybin can induce a decrease in modularity, or increased connectivity, in the brain, both immediately after the experience and weeks later. The magnitude of this change correlates with symptom improvement. The increased cross-talk between brain modules during and after the trip is strongly associated with positive therapeutic outcomes. Psilocybin may decrease modularity in the brain, leading to an opening up of the mind. Macro doses in a controlled setting have shown more significant improvements in well-being compared to microdosing.
Psilocybin Therapy & Anorexia
Psilocybin therapy for anorexia shows promise in alleviating obsessive thoughts about food and improving willingness to consume healthier amounts of food. Patients also experience weight improvement at long-term follow-up. The ongoing trial offers hope for treating this deadly psychiatric illness.
Integration Phase & Psychedelic-Therapy; Meditation
The integration phase in psychedelic therapy involves re-integrating experiences and insights into daily life, and can be optimized through daily conversations with therapists, journaling, and reflection. This phase is essential for maximizing therapeutic outcomes and has shown impressive relief from depression. Integration is an ongoing process that requires continuous effort. Psychedelic therapy can aid in processing and integrating traumatic experiences, but individuals must take responsibility for their own ongoing practice. Incorporating elements of spiritual practice and mindfulness can complement psychedelic therapy. Psychedelics provide a space for awareness without reactivity and grant access to a better version of oneself. The acceptance of psychedelics in scientific and medical communities is evolving.
First-Time Psychedelic Use, “Entropic Brain Effect”, Neuroplasticity, Cognition
The most profound aspect of the topic of First-Time Psychedelic Use, “Entropic Brain Effect”, Neuroplasticity, Cognition is that a study on first-time psychedelic use found significant improvements in psychological well-being and observed an increase in the informational complexity of ongoing brain activity, known as the "entropic brain effect." The study also showed anatomical changes in the brain's microstructure, indicating neuroplasticity. Here are the key points:
- Study on first-time psychedelic use compared psilocybin therapy to escitalopram for depression.
- Small doses of psilocybin were given to standardize psychotherapy.
- The study involved middle-aged healthy volunteers, not typical student population.
- Participants were given a placebo dose of psilocybin before receiving a 25 milligram dose.
- Significant improvements in psychological well-being were observed.
- The "entropic brain effect" was observed, indicating an increase in complexity of brain activity.
- MRI scans showed changes in white matter tracts, suggesting increased communication between brain regions.
- Anatomical changes in brain microstructure were found, indicating neuroplasticity.
- The changes in brain anatomy were similar to those observed in a healthy brain during neurodevelopment.
- The study did not find correlations between brain changes and psychological outcomes, possibly due to small sample size.
- Overall, the findings suggest that psychedelics may have a positive impact on brain plasticity and cognition.
Fibromyalgia & Psychedelic Treatment; MDMA Therapy & “Inner Healer”
Summary: Psilocybin therapy shows promise in treating fibromyalgia, a condition characterized by chronic pain, by exploring the connection between trauma and inflammation. The use of psychedelics, specifically MDMA, in therapy allows for profound experiences and empathy development. The concept of the "inner healer" in psychedelic therapy is debated but offers a deeper understanding of the therapeutic process.
- Psilocybin therapy is being explored as a treatment for fibromyalgia, a condition characterized by chronic pain.
- The study aims to understand the potential benefits of psilocybin in alleviating fibromyalgia symptoms.
- Dr. Robin Carhart-Harris cautions against assuming that all cases of fibromyalgia are rooted in buried trauma.
- Initial results of the study using psilocybin therapy have been promising.
- MDMA therapy involves dialogue and empathic connection between individuals, unlike classic psychedelic therapy.
- The use of psychedelics in therapy allows for profound experiences and empathy development.
- The concept of the "inner healer" in psychedelic therapy involves feeling connected to others and experiencing love and beauty.
- Critics argue that the "inner healer" concept may bias the therapeutic process, but skeptics do not capture the full picture.
Placebo Response & Psychedelic Therapy
The therapeutic effects of psilocybin therapy cannot be solely attributed to a placebo response, as pre-trial expectancy predicted response to escitalopram but not to psilocybin therapy. The exact mechanism of action for psilocybin therapy is still unknown, but it may involve increased global connectivity in the brain.
LSD & Psychedelic-Therapy, Micro-Dose
The lack of attention towards LSD in psychedelic therapy trials may be due to the duration of the LSD trip and the stigma associated with it. Psilocybin studies were easier to conduct because other researchers had already established a precedent. However, there have been promising results with LSD in brain imaging studies. The term "microdose" can be misleading, as the effective psychedelic dose of LSD is actually in the microgram range, and a macrodose of LSD can also be measured in micrograms.
- LSD has received less attention in psychedelic therapy trials due to its longer duration and associated stigma.
- Psilocybin studies were easier to conduct because of previous research.
- Promising results have been seen with LSD in brain imaging studies.
- The term "microdose" can be misleading as the effective dose of LSD is in the microgram range.
- A macrodose of LSD can also be measured in micrograms.
The duration of LSD trips makes it impractical for clinical trials, as participants would need to remain in the lab for eight hours post-dose. This is considered excessive, especially for low doses. The duration of an LSD trip can range from 8 to 15 hours, with higher doses potentially lasting longer.
- The long duration of LSD trips makes it impractical for clinical trials.
- Participants would need to remain in the lab for eight hours post-dose, which is excessive.
- The duration of an LSD trip can range from 8 to 15 hours, potentially longer with higher doses.
The duration of psychedelic experiences, including LSD, poses practical challenges in psychedelic therapy. Larger doses result in longer experiences, which can be burdensome for both patients and therapists. MDMA experiences are shorter, lasting about 4 to 6 hours, and sometimes a booster dose is administered.
- Larger doses of psychedelics result in longer experiences, posing challenges for patients and therapists.
- The duration of psychedelic experiences needs to be considered in the real-world context of therapy.
- MDMA experiences are shorter, lasting about 4 to 6 hours, with the possibility of a booster dose.
The use of LSD and psychedelic therapy, particularly microdosing, is discussed. The potential for abridging the psychedelic experience to make it shorter and less expensive while still achieving therapeutic outcomes is explored.
- The potential for abridging the psychedelic experience to make it shorter and less expensive is discussed.
- Microdosing is mentioned as a method of using LSD in psychedelic therapy.
- The goal is to achieve therapeutic outcomes while minimizing duration and cost.
Combination Psilocybin-MDMA Therapy
Combination psilocybin-MDMA therapy, also known as a "hippy flip," involves the use of both psilocybin and MDMA. This therapy offers a more precise and personalized approach to mental health treatment by combining the therapeutic effects of both substances. The combination allows individuals to go inward and address key issues in a safe and trusting environment. However, it is important to acknowledge that psychedelic experiences can have both positive and challenging aspects.
DMT “Rocketship” & Serotonin 2A Receptors; Ibogaine
DMT, or dimethyltryptamine, is a powerful psychedelic drug that induces a brief but intense trip. It is being studied for its potential therapeutic effects, particularly in combination with ibogaine, a long-lasting psychedelic. The Veterans Solutions Initiative in Mexico, in collaboration with Stanford and other laboratories, is evaluating the neural changes associated with this combination therapy for veterans.
Key points:
- DMT is a classic psychedelic that directly stimulates the serotonin 2A receptor.
- DMT is less potent than psilocybin but can produce intense effects when given in standard doses.
- DMT and 5-methoxy DMT are often smoked or vaped for clinical purposes.
- DMT and 5-MeO have different effects, with 5-MeO reliably inducing ego dissolution and a loss of self-identity, while DMT is more visually stimulating.
“Ego Dissolution”, Cocaine vs. Psychedelics; Relapses
Ego dissolution is the temporary elimination of the concept of self and the boundaries between oneself and the external world. It can lead to a sense of belonging and connection. Serotonin 2A activation is believed to cause ego dissolution.
Key points:
- Ego dissolution is the temporary loss of one's sense of self.
- Psychedelics induce ego dissolution, while cocaine inflates the ego.
- Psychedelics target receptors in the cortex, leading to ego dissolution and a more capacious headspace.
- Ego dissolution during a trip is temporary and can lead to relapses, especially in individuals with chronic depression.
- Psychedelics have shown promise in treating mental health conditions, but their illegal status limits access to treatment.
Psychedelics & Legal Landscape; Decriminalization
The legal landscape surrounding psychedelics is currently unclear, with ongoing clinical trials for therapeutic use and illegal recreational markets. Psilocybin mushrooms are illegal but may be decriminalized in some places like Oakland. However, this does not mean they are fully legal. Head shops in Oakland openly sell mushrooms, but may still face shutdowns. A church in Oakland claims religious rights to sell psychedelics, but the legitimacy of their case is questionable.
MDMA, Trauma & Clinical Trials; Future Regulatory (FDA) Approval?
The potential future regulatory approval of MDMA as a medicine for the treatment of post-traumatic stress disorder (PTSD) is discussed. Phase III clinical trials have shown promising results with high remission rates for trauma. The Multidisciplinary Association for Psychedelic Studies (MAPS) is filing data for FDA approval. If approved, MDMA therapy could be legally prescribed and available as early as next year. The administration and regulation of MDMA therapy are being considered, with the involvement of MAPS and the FDA. Licensed and certified providers, such as clinical psychologists, may be eligible to administer the treatment, but a physician must be present or readily available due to potential cardiac issues. The source and purity of MDMA for medical use would need to be carefully regulated.
Psilocybin & Current Clinical Trials
Psilocybin therapy for treatment-resistant depression is currently in phase III clinical trials conducted by Compass, with an estimated completion date of 2026. MDMA therapy is ahead of psilocybin in terms of clinical trials. However, there are numerous psychedelic research centers globally exploring various indications, including anorexia, fibromyalgia syndrome, methamphetamine use disorder, Parkinson's disease, chronic lower back pain, bipolar disorder, and OCD. These investigator-led studies are expected to report positive results, contributing to the growing body of research on psychedelics for mental health. The process of licensing and approval for psychedelic therapies is slow, but there is growing interest and support for psychedelic studies due to their potential therapeutic benefits. This shift in perception reflects a more open-minded approach towards psychedelic therapy and the potential evolution of the human species.
Mental Health & Psychedelic Treatment, Safeguards, Paradigm Shift
The science of psychedelics for mental health and the need for safeguards and standards in psychedelic therapy is discussed. The field has faced scandals and bad practices, but can learn from past experiences. Current treatments for mental health have not significantly improved since the 1950s. Dr. Robin Carhart-Harris discusses the potential paradigm shift in mental health treatment through psychedelic therapy. He emphasizes the value of understanding psychedelic therapy as a different approach and supports multiple treatment options. Combining psychedelic therapy with other treatments can lead to improvements in mental and physical health outcomes. The clinical applications and potential underlying mechanisms of psychedelics for mental health are also discussed, with an emphasis on caution and attribution when interpreting results.
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