tag:theconversation.com,2011:/us/topics/psychedelics-research-59936/articlesPsychedelics research – The Conversation2023-10-02T12:27:51Ztag:theconversation.com,2011:article/2044422023-10-02T12:27:51Z2023-10-02T12:27:51ZPsychedelics plus psychotherapy can trigger rapid changes in the brain − new research at the level of neurons is untangling how<figure><img src="https://images.theconversation.com/files/549891/original/file-20230924-22-cjkf2k.jpg?ixlib=rb-1.1.0&rect=1516%2C67%2C5741%2C3842&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research hints at how psychedelics can trigger rapid, lasting change.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/psychedelic-drug-royalty-free-image/1306005226">wildpixel/iStock via Getty Images Plus</a></span></figcaption></figure><p>The <a href="https://www.verywellmind.com/what-is-brain-plasticity-2794886">human brain can change</a> – but usually only slowly and with great effort, such as when learning a new sport or foreign language, or recovering from a stroke. Learning new skills <a href="https://doi.org/10.1056/NEJMcibr1100496">correlates with changes in the brain</a>, as evidenced by neuroscience <a href="https://theconversation.com/cognitive-flexibility-is-essential-to-navigating-a-changing-world-new-research-in-mice-shows-how-your-brain-learns-new-rules-204259">research with animals</a> and functional brain scans in people. Presumably, if you master Calculus 1, something is now different in your brain. Furthermore, <a href="https://doi.org/10.1152/japplphysiol.00515.2006">motor neurons in the brain expand and contract</a> depending on how often they are exercised – a neuronal reflection of “use it or lose it.”</p>
<p>People may wish their brains could change faster – not just when learning new skills, but also when overcoming problems like anxiety, depression and addictions.</p>
<p>Clinicians and scientists know there are times the brain can make rapid, enduring changes. Most often, these <a href="https://doi.org/10.1016/S0079-6123(07)67012-5">occur in the context of traumatic experiences</a>, leaving an indelible imprint on the brain.</p>
<p>But positive experiences, which alter one’s life for the better, can occur equally as fast. Think of a <a href="https://doi.org/10.3389/fpsyg.2021.720579">spiritual awakening</a>, a <a href="https://doi.org/10.1177/0022167819892107">near-death experience</a> or a <a href="https://doi.org/10.1037/emo0000442">feeling of awe in nature</a>.</p>
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<a href="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a road splits in the woods, sun shines through green leafy trees" src="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A transformative experience can be like a fork in the road, changing the path you are on.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/germany-bavaria-franconia-spessart-track-in-forest-royalty-free-image/634474863">Westend61 via Getty Images</a></span>
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<p>Social scientists call events like these psychologically transformative experiences or <a href="https://doi.org/10.1177/0269881120959637">pivotal mental states</a>. For the rest of us, they’re forks in the road. Presumably, <a href="https://doi.org/10.1002/9781118591277.ch18">these positive experiences</a> quickly change some “wiring” in the brain. </p>
<p>How do these rapid, positive transformations happen? It seems the brain has a way to facilitate accelerated change. And here’s where it gets really interesting: Psychedelic-assisted psychotherapy appears to tap into this natural neural mechanism.</p>
<h2>Psychedelic-assisted psychotherapy</h2>
<p>Those who’ve had a psychedelic experience usually describe it as a mental journey that’s impossible to put into words. However, it can be conceptualized as an <a href="https://en.wikipedia.org/wiki/Psychedelic_experience">altered state of consciousness</a> with distortions of perception, modified sense of self and rapidly changing emotions. Presumably there is a relaxation of the higher brain control, which allows deeper brain thoughts and feelings to emerge into conscious awareness.</p>
<p><a href="https://theconversation.com/psychedelic-medicine-is-on-its-way-but-its-not-doing-shrooms-with-your-shrink-heres-what-you-need-to-know-208568">Psychedelic-assisted psychotherapy</a> combines the <a href="https://theconversation.com/medication-can-help-you-make-the-most-of-therapy-a-psychologist-and-neuroscientist-explains-how-209200">psychology of talk therapy</a> with the power of a psychedelic experience. <a href="https://doi.org/10.1056/NEJMp2300936">Researchers have described cases</a> in which subjects report profound, personally transformative experiences after one six-hour session with the psychedelic substance psilocybin, taken in conjunction with psychotherapy. For example, <a href="https://nyulangone.org/news/single-dose-hallucinogenic-drug-psilocybin-relieves-anxiety-depression-patients-advanced-cancer">patients distressed about advancing cancer</a> have quickly experienced relief and an unexpected acceptance of the approaching end. How does this happen?</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="glowing green tendrils of a neuron against a black background" src="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Neuronal spines are the little bumps along the spreading branches of a neuron.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Dendriticspines.jpg">Patrick Pla via Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>Research suggests that <a href="https://theconversation.com/where-are-memories-stored-in-the-brain-new-research-suggests-they-may-be-in-the-connections-between-your-brain-cells-174578">new skills, memories</a> and attitudes are encoded in the brain by new connections between neurons – sort of like branches of trees growing toward each other. Neuroscientists even call the pattern of growth <a href="https://dictionary.apa.org/arborization">arborization</a>. </p>
<p>Researchers using a technique called <a href="https://doi.org/10.1038/nmeth818">two-photon microscopy</a> can observe this process in living cells by following the formation and regression of spines on the neurons. The spines are one half of the synapses that allow for communication between one neuron and another.</p>
<p>Scientists have thought that enduring spine formation could be established only with focused, repetitive mental energy. However, a lab at Yale recently documented <a href="https://doi.org/10.1016/j.neuron.2021.06.008">rapid spine formation in the frontal cortex of mice</a> after one dose of psilocybin. Researchers found that mice given the mushroom-derived drug had about a 10% increase in spine formation. These changes had occurred when examined one day after treatment and endured for over a month.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="diagram of little bumps along a neuron, enlarged at different scales" src="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=267&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=267&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=267&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=335&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=335&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=335&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Tiny spines along a neuron’s branches are a crucial part of how one neuron receives a message from another.</span>
<span class="attribution"><span class="source">Edmund S. Higgins</span></span>
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<h2>A mechanism for psychedelic-induced change</h2>
<p>Psychoactive molecules primarily change brain function through the receptors on the neural cells. The serotonin receptor 5HT, the one famously <a href="https://doi.org/10.1186/s13041-017-0306-y">tweaked by antidepressants</a>, comes in a variety of subtypes. Psychedelics such as DMT, the active chemical in the plant-based psychedelic <a href="https://www.britannica.com/science/ayahuasca">ayahuasca</a>, <a href="https://doi.org/10.1126/science.adf0435">stimulate a receptor cell type</a>, called 5-HT2A. This receptor also <a href="https://doi.org/10.1017/S0954579417001274">appears to mediate the hyperplastic states</a> when a brain is changing quickly.</p>
<p>These 5-HT2A receptors that DMT activates are not only on the neuron cell surface but also inside the neuron. It’s only the 5-HT2A receptor inside the cell that facilitates rapid change in neuronal structure. <a href="https://doi.org/10.1126/science.adg2989">Serotonin can’t get through the cell membrane</a>, which is why people don’t hallucinate when taking antidepressants like Prozac or Zoloft. The psychedelics, on the other hand, slip through the cell’s exterior and tweak the 5-HT2A receptor, stimulating dendritic growth and increased spine formation.</p>
<p>Here’s where this story all comes together. In addition to being the active ingredient in ayahuasca, <a href="https://doi.org/10.1038/s41598-019-45812-w">DMT is an endogenous molecule</a> synthesized naturally in mammalian brains. As such, human neurons are capable of producing their own “psychedelic” molecule, although likely in tiny quantities. It’s possible the brain uses its own endogenous DMT as a tool for change – as when forming dendritic spines on neurons – to encode pivotal mental states. And it’s possible psychedelic-assisted psychotherapy uses this naturally occurring neural mechanism to facilitate healing.</p>
<h2>A word of caution</h2>
<p>In her essay collection “<a href="https://www.harpercollins.com/products/these-precious-days-ann-patchett?variant=40104586641442">These Precious Days</a>,” author Ann Patchett describes taking mushrooms with a friend who was <a href="https://theconversation.com/psychedelics-may-better-treat-depression-and-anxiety-symptoms-than-prescription-antidepressants-for-patients-with-advanced-cancer-201937">struggling with pancreatic cancer</a>. The friend had a mystical experience and came away feeling deeper connections to her family and friends. Patchett, on the other hand, said she spent eight hours “hacking up snakes in some pitch-black cauldron of lava at the center of the Earth.” It felt like death to her. </p>
<p>Psychedelics are powerful, and none of the classic psychedelic drugs, such as LSD, are approved yet for treatment. The U.S. Food and Drug Administration in 2019 did <a href="https://theconversation.com/fda-approves-promising-new-drug-called-esketamine-for-treatment-resistant-depression-111966">approve ketamine</a>, in conjunction with an antidepressant, to treat depression in adults. Psychedelic-assisted psychotherapy <a href="https://doi.org/10.1038/s41591-021-01336-3">with MDMA (often called ecstasy or molly) for PTSD</a> and <a href="https://doi.org/10.1056/NEJMoa2206443">psilocybin for depression</a> are in Phase 3 trials.</p><img src="https://counter.theconversation.com/content/204442/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr. Higgins is an unpaid member of the safety board for the Multidisciplinary Association for Psychedelic Studies (MAPA) for their phase 3 trials with MDMA for PTSD.</span></em></p>Change in the brain usually comes with plenty of effort over time. Neuroscientists are working to understand how psychedelic drugs provide a shortcut that seems to rely on existing brain systems.Edmund S. Higgins, Affiliate Associate Professor of Psychiatry & Family Medicine, Medical University of South CarolinaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2095912023-07-14T02:06:30Z2023-07-14T02:06:30ZKetamine injections for depression? A new study shows promise, but it’s one of many options<figure><img src="https://images.theconversation.com/files/537183/original/file-20230712-29-dtpug1.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Psychedelics like ketamine affect chemical messengers in the brain.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/abstract-brain-fractal-background-digital-illustration-2212346843">Shutterstock</a></span></figcaption></figure><p>Ketamine might be better known as a recreational drug or anaesthetic. But there’s growing evidence for its use for people with hard-to-treat depression.</p>
<p>An Australasian study <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/efficacy-and-safety-of-a-4week-course-of-repeated-subcutaneous-ketamine-injections-for-treatmentresistant-depression-kads-study-randomised-doubleblind-activecontrolled-trial/FDBAEC51F0891B57F5B04C572D13DA17">out today</a> showed some positive results for people with treatment-resistant depression when they had ketamine injections.</p>
<p>But we don’t know if these effects are sustained in the long term, and there are other ways of delivering ketamine. There are also other treatment options for this type of depression.</p>
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Read more:
<a href="https://theconversation.com/weekly-dose-anaesthetic-and-recreational-drug-ketamine-could-be-used-to-treat-depression-81468">Weekly Dose: anaesthetic and recreational drug ketamine could be used to treat depression</a>
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<h2>What is ketamine?</h2>
<p>Ketamine has been used as a powerful <a href="https://www.nature.com/articles/s41593-022-01203-5">general anaesthetic</a> for more than 50 years.</p>
<p>It’s also an <a href="https://www.ncbi.nlm.nih.gov/books/NBK470357/">illicit drug</a> of abuse and is considered a psychedelic. Psychedelics dramatically alter some neurotransmitters (chemical messengers) in the brain <a href="https://pubmed.ncbi.nlm.nih.gov/36280799/">to create</a> a profound change in perception, mood and anxiety.</p>
<p>In early animal studies, ketamine led to increase in levels of certain brain chemicals, such as dopamine, by <a href="https://www.nature.com/articles/mp2017190">up to 400%</a>. This led researchers to trial ketamine in humans to see what would happen in our brains.</p>
<p>Now, doses of ketamine (at those lower than used as an anaesthetic) are being used to help treatment-resistant depression. That’s when someone has tried at least two antidepressants and shows no improvement.</p>
<p>It is usually prescribed under strict conditions and observation that mitigate some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322816/">serious risks</a>, such as increased feelings about suicide in some people. So people need to be assessed and monitored not only during treatment, but afterwards.</p>
<p>But some clinicians have resisted using ketamine due to its potential to become a <a href="https://www.ranzcp.org/getmedia/75baa529-2b71-419f-993a-2ff64ede50fe/cm-use-of-ketamine-in-psychiatric-practice.pdf">drug of abuse</a>.</p>
<p>Ketamine is also used to treat other mental health disorders such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8959757/">PTSD</a> (post-traumatic stress disorder).</p>
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Read more:
<a href="https://theconversation.com/hallucinations-in-the-movies-tend-to-be-about-chaos-violence-and-mental-distress-but-they-can-be-positive-too-204547">Hallucinations in the movies tend to be about chaos, violence and mental distress. But they can be positive too</a>
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<h2>How about this new study?</h2>
<p>The research involved <a href="https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12616001096448">multiple centres</a> across Australia and New Zealand and compared how well ketamine injected <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193034/">under the skin</a> compared with taking another drug in treating people with treatment-resistant depression.</p>
<p>The trial randomised the 184 study participants into different groups – some receiving ketamine, the rest the drug <a href="https://pubmed.ncbi.nlm.nih.gov/9258787/">midazolam</a>, twice a week over four weeks. Neither the study participants nor those assessing the results knew who had ketamine and who didn’t.</p>
<p>At the start of the study, all participants had a clinical depression score of at least 20 (moderate depression) using a particular scale known as the Montgomery-Asberg Depression Rating Scale.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Doctor in white coat putting hand on shoulder of patient" src="https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537220/original/file-20230713-25-gs9tri.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The study participants had moderate depression.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/doctor-psychiatrist-shakes-hands-encouragement-patient-2188082723">Shutterstock</a></span>
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<p>The researchers then looked for a score of less than 11, indicating a shift from a depression to remission.</p>
<p>After four weeks, there was a big difference between people treated with ketamine (19.6% in remission) compared with midazolam (2%). Another, less-strict way of measuring outcomes is to look for a halving of the depression score. This had an even bigger difference (29% compared with 4%). </p>
<p>However, four weeks after the treatment had ended, there was only limited sustained improvement in symptoms in the ketamine group. This suggests treatment may be needed over a longer period.</p>
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Read more:
<a href="https://theconversation.com/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">Do psychedelics really work to treat depression and PTSD? Here's what the evidence says</a>
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<h2>There are other options</h2>
<p>In the trial, ketamine was given via an injection under the skin, which is a low-cost and efficient option. But ketamine can also be delivered directly into the bloodstream via an intravenous drip. Neither of these two options are routinely available in Australia and New Zealand outside clinical trials.</p>
<p>A third option uses a <a href="https://www.nps.org.au/australian-prescriber/articles/esketamine-hydrochloride-for-treatment-resistant-depression">different form</a> of ketamine and comes in a <a href="https://www.spravato.com/">nasal spray</a> (approved for use in <a href="https://www.tga.gov.au/resources/auspmd/spravato">Australia</a> and New Zealand). </p>
<p>Each option delivers ketamine in different amounts, and research into how these work in practice, and how they compare, is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193034/">ongoing</a>.</p>
<p>There are also other drug and non-drug options for treatment-resistant depression. These include:</p>
<ul>
<li><p><a href="https://pubmed.ncbi.nlm.nih.gov/33834408/">transcranial magnetic stimulation</a>, which stimulates parts of the brain to improve mood</p></li>
<li><p><a href="https://www.ranzcp.org/events-learning/psychedelic-assisted-therapy">psilocybin</a>, another psychedelic drug that has just been given the go-ahead for use in Australia under strict conditions as part of <a href="https://theconversation.com/psychedelic-medicine-is-on-its-way-but-its-not-doing-shrooms-with-your-shrink-heres-what-you-need-to-know-208568">psychedelic-assisted therapy</a></p></li>
<li><p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429332/">psychotherapy</a> (talking therapy) such as cognitive behavioural therapy, <a href="https://www.psychologytoday.com/au/therapy-types/acceptance-and-commitment-therapy">acceptance and commitment therapy</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/29761488/">dialectical behaviour therapy</a></p></li>
<li><p>changing some lifestyle factors, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164235/">such as diet</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/28110494/">exercise</a>, or <a href="https://pubmed.ncbi.nlm.nih.gov/32985916/">practising mindfulness</a> meditation.</p></li>
</ul>
<h2>In a nutshell</h2>
<p>Serious consequences of depression include <a href="https://theconversation.com/suicide-rates-are-rising-with-or-without-13-reasons-why-lets-use-it-as-a-chance-to-talk-116434">suicide</a> or a lifetime of anguish. This latest research shows promising outcomes for people whose symptoms are harder to treat. But this option is not yet widely available outside a clinical trial. Only the ketamine nasal spray has been approved for use in Australia and New Zealand.</p>
<p>There are also other treatments. So if your existing treatment is not working for you, discuss this with your doctor who will explain what else is available.</p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. Beyond Blue provides the free resource <a href="https://www.beyondblue.org.au/docs/default-source/resources/bl0556-what-works-for-depression-booklet_acc.pdf?sfvrsn=fe1646eb_2">A guide to what works for depression</a>.</em></p><img src="https://counter.theconversation.com/content/209591/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Musker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>This latest research provides hope for people whose symptoms are harder to treat.Michael Musker, Enterprise Fellow (Senior Research Fellow/Senior Lecturer), University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2085682023-06-29T06:54:42Z2023-06-29T06:54:42ZPsychedelic medicine is on its way. But it’s not ‘doing shrooms with your shrink’. Here’s what you need to know<figure><img src="https://images.theconversation.com/files/534483/original/file-20230628-7269-u63go1.jpg?ixlib=rb-1.1.0&rect=1%2C0%2C997%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/focus-on-female-psychiatrist-writing-information-2160876067">Shutterstock</a></span></figcaption></figure><p>Many people in Australia, including psychiatrists, were <a href="https://theconversation.com/the-tga-has-approved-certain-psychedelic-treatments-the-response-from-experts-is-mixed-199290">surprised</a> when earlier this year the medicines regulator <a href="https://www.tga.gov.au/news/blog/understanding-changes-mdma-and-psilocybin-access">down-scheduled</a> MDMA, known colloquially as ecstasy, and psilocybin, from magic mushrooms.</p>
<p>This means that under certain circumstances from July 1, <a href="https://www.tga.gov.au/sites/default/files/2023-03/change-classification-mdma-psilocybin-enable-prescribing-authorised-psychiatrists_.pdf">authorised psychiatrists</a> will be able to prescribe MDMA to treat post-traumatic stress disorder and psilocybin to treat depression that has not responded to other treatments. Patients must also undergo psychotherapy (talking therapy). </p>
<p>It all sounds very certain but it’s not really.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-post-traumatic-stress-disorder-11135">Explainer: what is post-traumatic stress disorder?</a>
</strong>
</em>
</p>
<hr>
<h2>Beware the hype</h2>
<p>The Therapeutic Goods Administration decision has left a lot of <a href="https://theconversation.com/the-tga-has-approved-certain-psychedelic-treatments-the-response-from-experts-is-mixed-199290">questions unanswered</a> about how the new scheme will be implemented and operated, both effectively and safely.</p>
<p>There are a small number of countries where psychedelic-assisted therapies are used outside clinical trials – in a very limited manner. However, this is the first time a national government has altered the way these substances are formally classified.</p>
<p>So the world is watching closely how “psychedelic-assisted therapy”, as it’s officially called, is rolled out in Australia.</p>
<p>It’s a hot topic, with much <a href="https://www.abc.net.au/radio/programs/pm/australia-to-allow-psychiatric-treatment-with-psychedelics/102526508">public interest</a>. But for researchers, there are concerns the hype is getting way ahead of the research.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-tga-has-approved-certain-psychedelic-treatments-the-response-from-experts-is-mixed-199290">The TGA has approved certain psychedelic treatments: the response from experts is mixed</a>
</strong>
</em>
</p>
<hr>
<h2>The first steps</h2>
<p>The Royal Australian and New Zealand College of Psychiatrists this week <a href="https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression">released guidance</a> to their members about how this would work in practice.</p>
<p>As researchers in this field, we helped develop these guidelines. They cover topics such as patients’ suitability for this therapy, and how to administer and monitor it.</p>
<p>The guidelines also stress the importance of patient safety and appropriate training for prescribers, and advocates for continued research.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1673359318408650753"}"></div></p>
<h2>What does this mean for patients?</h2>
<p>This has several implications for potential patients: </p>
<ul>
<li><p>their existing psychiatrist may not be authorised to prescribe these psychedelics. So patients will have to ask their psychiatrist or GP for a referral to one who is</p></li>
<li><p>the psychiatrist authorised to prescribe these psychedelics will need to assess whether the therapy is suitable for each individual patient. This involves a detailed and comprehensive assessment. If the treatment is suitable, several sessions of further assessment and therapy are required before the actual dosing session</p></li>
<li><p>patients will be informed of what to expect before, during and after treatment, and need to give consent to proceed. We also recommend psychiatrists tell patients this therapy is not guaranteed to work, and provide patients with a clear account of the risks and possible negative side effects of psychedelic medications.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/psychedelics-how-they-act-on-the-brain-to-relieve-depression-183320">Psychedelics: how they act on the brain to relieve depression</a>
</strong>
</em>
</p>
<hr>
<h2>Expectations are high, but clear evidence is lacking</h2>
<p>Despite a growing <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">body of evidence</a>, psychedelic-assisted therapies are in their infancy.</p>
<p>In a time when demand for mental health services <a href="https://theconversation.com/a-bigger-budget-for-mental-health-services-wont-necessarily-improve-australias-mental-health-160767">far outstrips supply</a>, exaggerated promises about the effectiveness of these drugs, before the research results are in, has many researchers worried. Patient expectations remain high but good clear evidence is still lacking.</p>
<p>Australian research is just getting under way and so far most psychedelic research has been done overseas. Yes, early findings have been <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">quite promising</a>, but numbers are small, long-term follow-ups sparse, and potential risks and dangers still need to be explored.</p>
<p>Destigmatising these drugs has allowed us to begin our research, but sensationalising their effectiveness has the potential to disappoint and even harm patients because we really don’t know enough about how they work and who is suitable for this treatment.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Older man, sitting on sofa, palms together, with therapist taking notes" src="https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534487/original/file-20230628-19-xd13tl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">We still don’t know who is suitable for this treatment.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/psychology-depression-elderly-asian-adult-man-2100727735">Shutterstock</a></span>
</figcaption>
</figure>
<p>Psychedelic-assisted therapy is no miracle cure. Espousing the benefits without a thorough examination of the risks and limitations is not only a misrepresentation of the science, it is arguably unethical.</p>
<p>Very few psychiatrists have had much experience in this fascinating but challenging field. We still have a lot to learn about the use of psychedelic medicines to treat psychiatric illness.</p>
<p>Undue haste in translating psychedelic-assisted therapy conducted in clinical trials to community clinics could affect how well these treatments work and their safety. Outside clinical trials, patients will also need to shoulder the <a href="https://theconversation.com/the-tricky-economics-of-subsidising-psychedelics-for-mental-health-therapy-201462">cost</a> of this therapy, raising equity issues.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-tricky-economics-of-subsidising-psychedelics-for-mental-health-therapy-201462">The tricky economics of subsidising psychedelics for mental health therapy</a>
</strong>
</em>
</p>
<hr>
<h2>There’s potential for harm</h2>
<p>Psychedelic-assisted therapy is not simply “doing shrooms with your shrink”.</p>
<p>There is potential for psychedelic substances to cause fear, panic or cause psychological damage if given to susceptible and vulnerable people who have been inadequately screened or assessed.</p>
<p>Paranoia, traumatisation, worsening depression, and even suicidal behaviour, among other <a href="https://pubmed.ncbi.nlm.nih.gov/36988924/">serious</a> <a href="https://pubmed.ncbi.nlm.nih.gov/36453037/">side-effects</a>, <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">have been observed</a> in some cases.</p>
<p>So we need ongoing monitoring of outcomes, including adverse events.</p>
<p>We also know psychedelic substances render patients particularly vulnerable. Boundary issues and safeguards are vital considerations for patient safety, particularly when patients are under the influence of the psychedelic drug. For instance, it is important to discuss and agree with patients beforehand about the nature and timing of any touch during treatment sessions, so any touch is appropriate and done with full informed consent.</p>
<h2>An exciting prospect</h2>
<p>Despite the potential harms, we remain excited at the prospect of psychedelic-assisted therapy becoming an established treatment to help a select group of patients.</p>
<p>But we want to do this in a safe, controlled and sustainable manner.</p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/208568/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nigel Strauss is a psychiatrist and senior consultant with St Vincent’s Hospital Melbourne, an investigator on several psychedelic clinical trials, is on the scientific advisory board of the European Mind Foundation, and is the medical director of the Millswyn Clinic in Melbourne, a private psychiatric clinic. He has made his own philanthropic donation to Monash University for a trial of MDMA assisted psychotherapy for PTSD. The trials he's involved in have not personally received any funding.</span></em></p><p class="fine-print"><em><span>Colleen Loo receives research grant funding from the Australian NHMRC and MRFF. </span></em></p><p class="fine-print"><em><span>David Jonathan Castle has received grant monies for research from Servier, Boehringer Ingelheim; travel support and honoraria for talks and consultancy from Servier, Seqirus, Lundbeck, Mindcafe, Psychscene, Inside Practice. He is a founder of the Optimal Health Program (OHP) and holds 50% of the IP for OHP; and is part owner (5%) of Clarity Healthcare. He is an unpaid Chair of an Advisory Board of Psychae, an Australian not-for-profit institute specialising in psychedelic medicines research. He is a member of the Royal Australian and New Zealand College of Psychiatrists Psychedelic Assisted Therapy Working Group. He does not knowingly have stocks or shares in any pharmaceutical company.</span></em></p><p class="fine-print"><em><span>Steve Kisely was the first author of the report commissioned by the Therapeutic Goods Administration on the possible clinical benefits of MDMA and psilocybin. </span></em></p>From July 1, authorised psychiatrists will be able to prescribe MDMA and psilocybin in some circumstances. Here’s what we’re excited and concerned about.Nigel Strauss, Psychiatrist and Clinical Associate at The Centre of Mental Health, Swinburne University of TechnologyColleen Loo, Professor of Psychiatry, UNSW & Black Dog Institute, UNSW SydneyDavid Jonathan Castle, Chair of Psychiatry, The University of MelbourneSteve Kisely, Professor, School of Medicine, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1915022022-09-29T10:46:12Z2022-09-29T10:46:12ZPsychedelics researchers balance trippyness with scientific rigor after history of legal and cultural controversy – podcast<figure><img src="https://images.theconversation.com/files/487143/original/file-20220928-14-qtv0t5.jpeg?ixlib=rb-1.1.0&rect=1%2C14%2C888%2C654&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Psychedelic experiences are deeply tied to mystical and counterculture ideas that are often at odds with science.</span> <span class="attribution"><a class="source" href="https://deepdreamgenerator.com/ddream/d96rfaftcg1">Daniel Merino, DeepDream</a></span></figcaption></figure><p>As research into psychedelics and their medical uses <a href="https://theconversation.com/psychedelic-drugs-how-to-tell-good-research-from-bad-189923">makes a comeback</a>, scientists are having to deal with the legacy – both scientific and social – of a 40-year nearly total freeze on psychedelics research. </p>
<p>In this episode of “<a href="https://theconversation.com/uk/topics/the-conversation-weekly-98901">The Conversation Weekly</a>” podcast, we speak with three experts about the early rise and fall of psychedelics in Western science and culture, how the mystical and often vague language of the ‘60s and '70s still pervades research today and what it’s like to actually run clinical trials using psilocybin.</p>
<iframe src="https://embed.acast.com/60087127b9687759d637bade/633489593c8dea0013c02a83" frameborder="0" width="100%" height="190px"></iframe>
<p><iframe id="tc-infographic-561" class="tc-infographic" height="100" src="https://cdn.theconversation.com/infographics/561/4fbbd099d631750693d02bac632430b71b37cd5f/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>According to a poll done in the summer of 2022, nearly <a href="https://today.yougov.com/topics/society/articles-reports/2022/07/28/one-in-four-americans-have-tried-psychedelic-drugs">30% of U.S. residents have tried at least one psychedelic drug</a> in their lifetime. Whether from personal experience, hearing about the experiences of friends or widespread depictions in the media, many people will have either tried to describe a psychedelic trip or heard someone else describe one. The language commonly used in these descriptions is, for lack of a better word, often quite trippy. </p>
<p>“A key function of the ego is to identify differentiation,” says <a href="https://scholar.google.com/citations?user=7_MD_w0AAAAJ&hl=en&oi=sra">Robin Carhart-Harris</a>, a neurologist and psychologist at the University of California, San Francisco, and one of the world’s leading psychedelics researchers. “And when that function breaks down, it’s replaced with a sense of de-differentiation, a sense of unity, like everything is interconnected in a web of relationships. That’s not nothingness, it’s sort of everythingness.” </p>
<p>Many psychedelics researchers use an approach called “the mystical framework” to assess psychedelic experiences. Researchers who use this framework <a href="https://www.trippingly.net/lsd-studies/2018/5/22/the-mystical-experience-questionaire-30-questions">give participants in psychedelics studies a survey</a> as a way to define and categorize the experience. The survey asks participants to rate how strongly they felt certain phenomena during their trip, including feelings like the “certainty of encounter with ultimate reality (in the sense of being able to 'know’ and ‘see’ what is really real at some point during your experience).”</p>
<p>But some researchers, such as <a href="https://scholar.google.com/citations?user=kw2savEAAAAJ&hl=en&oi=ao">Josjan Zijlmans</a>, at Vrije Universiteit Amsterdam in the Netherlands, think the mystical framework poses some problems. </p>
<p>“I think the experience that people are trying to describe is very valuable, but calling it mystical is a misnomer,” Zijlmans says, “because mysticism in general is associated with many vague and supernatural concepts, which I think shouldn’t be part of this sort of scientific endeavor.” </p>
<p>According to Zijlmans, there is no reason researchers couldn’t come up with more precise language to define psychedelic experiences. However, this language, and psychedelics generally, have a long contentious history when it comes to associations with spiritual and counterculture ideas – as well as scientific ones. </p>
<p>“There was an enthusiasm for psychedelics in the ‘20s and '30s, but it never really captured a lot of attention,” explains <a href="https://scholar.google.com/citations?user=2iChS8UAAAAJ&hl=en&oi=ao">Wayne Hall</a>, a professor of health and behavioral sciences at the University of Queensland in Australia. “Back then, you didn’t need an ethics committee to approve research. You didn’t need a clinical trial protocol. You just tried out the drugs on your patients to see if they worked.”</p>
<p>Early enthusiasm and experimentation produced some far-out ideas and strong advocates, such as <a href="https://psychology.fas.harvard.edu/people/timothy-leary">the Harvard psychologist Timothy Leary</a> and others. But during the '60s and '70s, the attitude toward psychedelics changed. </p>
<p>“There was the fear that you might end up like Timothy Leary. If these drugs could do this to a Harvard professor, what might they do to you?” says Hall. “If you want a promising career, then you’d be wise to stay away from these drugs.” As a result of this shift – and strong government pushback against the use of psychedelics recreationally as well as medically – research almost stopped entirely from the '70s to the early 2000s.</p>
<p>Today, psychedelics research is undergoing a resurgence. Listen to the full episode to find out how the legacy of the '60s and '70s, though fading, is still influencing the world of psychedelics today, for better or worse. </p>
<p>This episode was produced by Mend Mariwany, with sound design by Eloise Stevens. The executive producer was Gemma Ware. Our theme music is by Neeta Sarl. </p>
<p>You can find us on Twitter <a href="https://twitter.com/TC_Audio">@TC_Audio</a>, on Instagram at <a href="https://www.instagram.com/theconversationdotcom/?hl=en">theconversationdotcom</a> or <a href="mailto:podcast@theconversation.com">via email</a>. You can also sign up to The Conversation’s <a href="https://theconversation.com/newsletter">free daily email here</a>. A <a href="https://theconversation.com/psychedelic-research-balancing-trippyness-with-a-new-scientific-rigor-the-conversation-weekly-podcast-transcript-192640">transcript of this episode is available here</a>. </p>
<p>You can listen to “The Conversation Weekly” via any of the apps listed above, download it directly via our <a href="https://feeds.acast.com/public/shows/60087127b9687759d637bade">RSS feed</a>, or find out <a href="https://theconversation.com/how-to-listen-to-the-conversations-podcasts-154131">how else to listen here</a>.</p><img src="https://counter.theconversation.com/content/191502/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robin Carhart-Harris is scientific advisor to a number of new companies and not-for-profits that are seeking to develop psychedelic therapy and bring it to market. These include Beckley Psytech, Journey Colab, Journey Space, Mindstate, Usona, Synthesis and Mydecine. He has previously received funding from the Medical Research Council. Wayne Hall received AUD 5,000 for writing a briefing paper on psychedelic drugs for the National Drug and Alcohol Research Centre at University of New South Wales, which receives funding form the Australian government.</span></em></p><p class="fine-print"><em><span>Josjan Zijlmans does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Today’s psychedelics researchers still have to deal with the fallout of the decadeslong freeze on research. Listen to ‘The Conversation Weekly’ podcast.Daniel Merino, Assistant Science Editor & Co-Host of The Conversation Weekly Podcast, The ConversationGemma Ware, Editor and Co-Host, The Conversation Weekly Podcast, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1792632022-03-16T19:11:16Z2022-03-16T19:11:16ZAI maps psychedelic ‘trip’ experiences to regions of the brain – opening new route to psychiatric treatments<figure><img src="https://images.theconversation.com/files/452287/original/file-20220315-15-1mh1o5b.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3840%2C2160&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Psychedelics have been the subject of a recent surge of interest in their potential therapeutic effects.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/concept-deep-learning-mindfulness-psychology-royalty-free-image/1256602998">metamorworks/iStock via Getty Images</a></span></figcaption></figure><p>For the past several decades, psychedelics have been widely stigmatized as dangerous illegal drugs. But a recent <a href="https://doi.org/10.1038/s41583-020-0367-2">surge of academic research</a> into their use to treat psychiatric conditions is spurring a recent shift in public opinion.</p>
<p>Psychedelics are <a href="https://www.healthline.com/health/what-is-a-psychotropic-drug">psychotropic drugs</a>: substances that affect your mental state. Other types of psychotropics include antidepressants and anti-anxiety medications. Psychedelics and other types of hallucinogens, however, are unique in their <a href="https://doi.org/10.1124/pr.115.011478">ability to temporarily induce</a> intense hallucinations, emotions and disruptions of self-awareness.</p>
<p>Researchers looking into the therapeutic potential of these effects have found that psychedelics can dramatically reduce symptoms of <a href="https://dx.doi.org/10.1177%2F0269881116675513">depression and anxiety</a>, <a href="https://doi.org/10.1038/s41591-021-01336-3">PTSD</a>, <a href="https://doi.org/10.1126/sciadv.abh2399">substance abuse</a> and <a href="https://doi.org/10.1038/s41583-020-0367-2">other psychiatric conditions</a>. The intense experiences, or “trips,” that psychedelics induce are thought to create a temporary window of <a href="https://doi.org/10.1038/s41398-021-01706-y">cognitive flexibility</a> that allows patients to gain access to elusive parts of their psyches and forge better coping skills and thought patterns. </p>
<p>Precisely how psychedelics create these effects, however, is still unclear. So as researchers in <a href="https://scholar.google.com/citations?user=pzTU_S4AAAAJ&hl=en">psychiatry</a> and <a href="https://scholar.google.com/citations?hl=en&user=fOi-AjQAAAAJ">machine learning</a>, we were interested in figuring out how these drugs affect the brain. With artificial intelligence, we were able to <a href="https://doi.org/10.1126/sciadv.abl6989">map people’s subjective experiences while using psychedelics</a> to specific regions of the brain, down to the molecular level.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Gloved hands using forceps to remove a mushroom from a beaker to examine on a Petri dish" src="https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/452565/original/file-20220316-8368-1jfhj0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Psilocybin, a psychoactive compound found in some mushrooms, has been the focus of many studies for its potential therapeutic qualities.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/psilocybin-and-magic-mushrooms-royalty-free-image/1316793235">24K-Production/iStock via Getty Images</a></span>
</figcaption>
</figure>
<h2>Mapping ‘trips’ in the brain</h2>
<p>Every psychedelic functions differently in the body, and each of the subjective experiences these drugs create have different therapeutic effects. <a href="https://dx.doi.org/10.1177%2F0269881108094300">Mystical type experiences</a>, or feelings of unity and oneness with the world, for example, are associated with decreases in depression and anxiety. Knowing how each psychedelic creates these specific effects in the body can help clinicians <a href="https://doi.org/10.1126/sciadv.abp8283">optimize their therapeutic use</a>.</p>
<p>To better understand how these subjective effects manifest in the brain, we analyzed over 6,000 written testimonials of hallucinogenic experiences from <a href="https://www.erowid.org">Erowid Center</a>, an organization that collects and provides information about psychoactive substances. We transformed these testimonials into what’s called a <a href="https://www.codecademy.com/learn/dscp-natural-language-processing/modules/dscp-bag-of-words/cheatsheet">bag-of-words model</a>, which breaks down a given text into individual words and counts how many times each word appears. We then paired the most commonly used words linked to each psychedelic with receptors in the brain that are known to bind to each drug. After using <a href="https://stats.oarc.ucla.edu/stata/dae/canonical-correlation-analysis/">an algorithm</a> to extract the most common subjective experiences associated with these word-receptor pairs, we mapped these experiences onto different brain regions by matching them to the types of receptors present in each area. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/fOvTtapxa9c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Natural language processing, which allows computers to interpret human languages, helped in analyzing subjective psychedelic experiences.</span></figcaption>
</figure>
<p>We found both new links and patterns that confirm what’s known in the research literature. For example, changes in sensory perception were associated with a <a href="https://doi.org/10.3389/fphar.2015.00225">serotonin receptor</a> in the visual cortex of the brain, which binds to a <a href="https://www.verywellmind.com/what-is-serotonin-425327">molecule</a> that helps regulate mood and memory. Feelings of transcendence were connected to dopamine and opioid receptors in the <a href="https://doi.org/10.1523/JNEUROSCI.1138-17.2019">salience network</a>, a collection of brain regions involved in managing sensory and emotional input. Auditory hallucinations were linked to a number of receptors spread throughout the <a href="https://doi.org/10.1093/schbul/sbw130">auditory cortex</a>.</p>
<p>Our findings also align with the <a href="https://doi.org/10.1124/pr.118.017160">leading hypothesis</a> that psychedelics temporarily reduce <a href="https://dx.doi.org/10.1146%2Fannurev-psych-113011-143750">top-down executive function</a>, or cognitive processes involved in inhibition, attention and memory, among others, while amplifying brain regions involved in sensory experience.</p>
<h2>Why it matters</h2>
<p>The U.S. is going through a profound <a href="https://www.hhs.gov/about/news/2021/12/07/us-surgeon-general-issues-advisory-on-youth-mental-health-crisis-further-exposed-by-covid-19-pandemic.html">mental health crisis</a> that has been exacerbated by the COVID-19 pandemic. Yet there have been no truly new psychiatric drug treatments since Prozac and other selective serotonin reuptake inhibitors, the most common type of antidepressants, of the <a href="https://www.theguardian.com/society/2016/jan/27/prozac-next-psychiatric-wonder-drug-research-medicine-mental-illness">1980s</a>.</p>
<p>Our study shows that it’s possible to map the diverse and wildly subjective psychedelic experiences to specific regions in the brain. These insights may lead to new ways to combine existing or yet to be discovered compounds to produce desired treatment effects for a range of psychiatric conditions.</p>
<p>Pychiatrist <a href="https://maps.org/product/lsd-psychotherapy/">Stanislav Grof</a> famously proposed, “psychedelics, used responsibly and with proper caution, would be for psychiatry what the microscope is to the study of biology and medicine or the telescope for astronomy.” As psychedelics and other hallucinogens become more commonly used clinically and culturally, we believe more research will <a href="https://doi.org/10.1126/sciadv.abp8283">further illuminate the biological basis</a> of the experiences they invoke and help realize their potential.</p><img src="https://counter.theconversation.com/content/179263/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sam Friedman receives funding from IBM and Bayer. </span></em></p><p class="fine-print"><em><span>Galen Ballentine does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Pinpointing the molecular targets behind the subjective effects of psychedelic drugs could help clinicians and researchers better treat psychiatric conditions.Galen Ballentine, Resident in Psychiatry, SUNY Downstate Health Sciences UniversitySam Friedman, Machine Learning Scientist at the Broad Institute of MIT &, Harvard UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1051242018-11-25T17:23:29Z2018-11-25T17:23:29ZWhat if psychedelics could revolutionize the way you die?<figure><img src="https://images.theconversation.com/files/246758/original/file-20181121-161612-1h5xkxn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A team of Canadian therapists have filed an application with Health Canada seeking permission to provide psilocybin-assisted psychotherapy to patients with terminal cancer. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>My story begins eight years ago, when I was approached by my first client requesting that I supervise her in a therapeutic session with a psychedelic medicine.</p>
<p>She had debilitating depression and anxiety brought on by a breast cancer diagnosis. Although she had survived her cancer, she couldn’t shake her terrible emotional distress. She had tried therapists, pills and a residential program. Nothing had worked.</p>
<p>Then she came across stories in the media about research at UCLA using psilocybin (the active ingredient in magic mushrooms) with cancer patients suffering from what was called “end-of-life distress” and how this new treatment was <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210962?FIRSTINDEX=0&RESULTFORMAT=&fulltext=Charle%20S.%20Grob&hits=10&maxtoshow=&resourcetype=HWCIT&searchid=1">showing really promising results</a>.</p>
<p>She was desperate to try it for herself.</p>
<p>Well, as a licensed therapist and academic, could I help this woman? Reading the research literature, I learned that psychedelic research was becoming well-developed as a treatment for the psycho-spiritual depression and “existential anxiety” that often accompany the diagnosis of a life-threatening illness.</p>
<p>I also found myself in a bind: The science was telling me that psilocybin is the treatment most likely to benefit patients with existential anxiety when other treatments have failed; my ethical code from the B.C. Association of Clinical Counsellors tells me to act to my client’s benefit; federal law forbids me to use this treatment.</p>
<p>This is why, together with colleagues in the <a href="https://thera-psil.ca/ourteam/">Therapeutic Psilocybin for Canadians</a> project, I filed an application with Health Canada in January 2017, seeking a so-called “Section 56 exemption” — to permit us to provide psilocybin-assisted psychotherapy to patients with terminal cancer. </p>
<h2>Immediate decrease in death anxiety</h2>
<p>Recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/">research at Johns Hopkins Medical Centre</a> and <a href="https://doi.org/10.1177/0269881116675512">New York University</a> indicates that treatment of this end-of-life distress with psilocybin-assisted psychotherapy is safe and effective.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=794&fit=crop&dpr=1 600w, https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=794&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=794&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=997&fit=crop&dpr=1 754w, https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=997&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/246757/original/file-20181121-161630-17yngt7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=997&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Dinah Bazer found relief from cancer anxiety by being treated with a dose of psilocybin administered by a New York University study.</span>
<span class="attribution"><span class="source">(AP Photo/Bebeto Matthews)</span></span>
</figcaption>
</figure>
<p>The research indicated it led to immediate, substantial and sustained decreases in depression, death anxiety, cancer-related demoralization and hopelessness.</p>
<p>It resulted in increased quality of life, life meaning and optimism. And these changes had persisted at a six-month follow-up.</p>
<p>Patients attributed improved attitudes about life and death, self, relationships and spirituality to the psilocybin experience, along with better well-being, life satisfaction and mood.</p>
<p>It is heartening to see research moving into Phase 3 clinical trials that will involve many more research participants. However, the foreseeable future for Canadians who need this game-changing therapy is not especially rosy. </p>
<p>At our current rate of progress, it may well still be years before psilocybin successfully completes Phase 3 trials and becomes available as an orthodox medicine.</p>
<h2>Therapists risk criminal penalties</h2>
<p>In the meantime, many Canadians with terminal cancer are also suffering from end-of-life distress, and are in dire need of relief — now. </p>
<p>They face serious and life-threatening illness. Their condition is terminal, so concerns about long-term effects of psilocybin are not relevant. They suffer from serious end-of-life psychological distress (anxiety and depression) to the point that it interferes with their other medical treatments. And this distress has not successfully responded to other treatments.</p>
<p>Psilocybin is currently a restricted drug, meaning that therapists risk criminal penalties if they aid or abet its possession. That means that we cannot recommend or encourage its use.</p>
<p>My professional <a href="https://bc-counsellors.org/code-of-ethical-conduct-and-standards-of-clinical-practice/">Code of Ethics</a>, however, states that our ethical duty is to act in a way that serves our clients’ “best interests.” The service we provide has to be “for the client’s benefit.” We must “take care to maximize benefits and minimize potential harm.”</p>
<h2>A compassionate, humanitarian death</h2>
<p>I agree with the Canadian medical establishment that, in ordinary circumstances, new medicines should be made available to Canadians only when they have successfully completed Phase 3 clinical trials.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=884&fit=crop&dpr=1 600w, https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=884&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=884&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1111&fit=crop&dpr=1 754w, https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1111&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/246762/original/file-20181121-161644-1aohe88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1111&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In the New York University study a pill, containing either a placebo or psilocybin, was presented to the subjects in a chalice.</span>
<span class="attribution"><span class="source">(AP Photo/Seth Wenig)</span></span>
</figcaption>
</figure>
<p>But I contend that the patients described here are not in ordinary circumstances. They have terminal cancer. All other treatments have failed them; they have nothing left to lose. They have the right to die; surely they have the right to try!</p>
<p>These patients deserve access to a still-experimental but promising medicine on compassionate and humanitarian grounds. Because of their extraordinary medical straits, psilocybin now for them represents a reasonable medical choice; it is necessary to them for a medical purpose.</p>
<p>Our application to Health Canada seeking a “Section 56 exemption” will be ruled on very shortly.</p>
<p>We fully expect that it will be denied — for political, not scientific reasons. Justin Trudeau’s Liberal government is likely in no mood to loosen up on psychedelics before the dust from the <a href="https://theconversation.com/ca/search?utf8=%E2%9C%93&q=cannabis">legalization of cannabis</a> has fully settled. I think the government would like it if someone else made that decision.</p>
<h2>Violation of our rights and freedoms</h2>
<p>If our application is denied, we intend to file for a judicial review, and if necessary, a lawsuit in Federal Court challenging that denial. </p>
<p>We believe that prohibition of access to psilocybin for a legitimate medical purpose violates a citizen’s <a href="https://laws-lois.justice.gc.ca/eng/const/page-15.html">Canadian Charter of Rights and Freedoms</a> Section 7 right to “life, liberty and security of person.” </p>
<p>This clause has already been interpreted by the Supreme Court to imply that a citizen has the right to autonomy in making health-care decisions. Charter-based arguments have already led to <a href="https://www.canlii.org/en/nl/nlpc/doc/2013/2013canlii64243/2013canlii64243.pdf">success</a> in <a href="https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/15403/index.do">three recent</a> landmark <a href="https://www.canlii.org/en/ca/fct/doc/2016/2016fc236/2016fc236.html">medical cannabis cases</a>.</p>
<p>We argue that what applies to cannabis also applies to psilocybin:</p>
<blockquote>
<p>The prohibition of … cannabis “limits the liberty of medical users by foreclosing reasonable medical choices through the threat of criminal prosecution. Similarly, by forcing a person to choose between a legal but inadequate treatment and an illegal but more effective one, the law also infringes on security of person.” Supreme Court of Canada, R. v. Smith, 2015</p>
</blockquote>
<p>One thing that unites all of us human beings is that we will die. Imagine if, when our time comes, we could all have the option to die peacefully, with acceptance, without anxiety.</p><img src="https://counter.theconversation.com/content/105124/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bruce Tobin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows therapeutic psilocybin to be a safe and effective antidote to end-of-life anxiety and depression. Does prohibition therefore violate our right to “life, liberty and security?”Bruce Tobin, Adjunct Professor in the School of Child & Youth Care, University of VictoriaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1013032018-09-30T15:14:39Z2018-09-30T15:14:39ZOpening up the future of psychedelic science<figure><img src="https://images.theconversation.com/files/237197/original/file-20180919-158228-1p66ki0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There is a growing research literature suggesting psychedelics hold incredible promise for treating mental health ailments ranging from depression and anxiety to PTSD.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Attempts to replicate classical scientific studies have been failing. These alarming failures have hit psychology, the life sciences and other fields, calling major findings into question. <a href="https://doi.org/10.1038/533452a">Scientists agree</a>: questionable research practices are <a href="https://doi.org/10.1371/journal.pmed.0020124">rife in many disciplines</a>. </p>
<p>We are two psychology PhD students with experience researching mindfulness. We echo the <a href="https://www.scientificamerican.com/article/wheres-the-proof-that-mindfulness-meditation-works1/">scathing criticisms levelled against poorly designed studies within the field of mindfulness research</a>. </p>
<p>As science is only trustworthy when consistent, we need to make sure future work can be replicated. As such, we have decided to spread the word about proper open scientific practice. This is especially important in the nascent interdisciplinary field of psychedelic science, in which we are now conducting research into the practise of “microdosing” substances like LSD (lysergic acid diethylamide) and “magic” mushrooms (psilocybin).</p>
<p>There is a growing research literature suggesting psychedelics hold <a href="https://theconversation.com/the-real-promise-of-lsd-mdma-and-mushrooms-for-medical-science-100579">incredible promise</a> for treating mental health ailments ranging from <a href="https://www.businessinsider.com/psychedelics-trip-therapy-2018-1">depression and anxiety</a> to <a href="https://www.cnn.com/2018/05/01/health/mdma-psychotherapy-ptsd-study/index.html">PTSD</a>. But how do we know for sure?</p>
<p>The way forward for psychedelics is through “open science.” Researchers should pre-register their plans and share their data, <a href="https://osf.io/g5cwy/">as we have in our own research</a>. </p>
<h2>Science must be consistent</h2>
<p>Science needs to have a strong foundation, but right now a lot of the research isn’t replicating. In 2015, the <a href="http://science.sciencemag.org/content/349/6251/aac4716">Reproducibility Project</a> tried to replicate 100 high quality psychology findings. Only <a href="https://www.nature.com/news/over-half-of-psychology-studies-fail-reproducibility-test-1.18248">39 of these findings were replicated</a> — that’s less than half! </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/237196/original/file-20180919-158237-i55cwn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Mindfulness research lacks active control groups and has inconsistent definitions of mindfulness itself.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>This phenomenon isn’t limited to psychology: findings from disciplines such as biology, medicine and chemistry can be hard to believe. For example, <a href="https://retractionwatch.com/2017/07/31/nearly-500-researchers-guilty-misconduct-says-chinese-govt-investigation/">almost 500 authors</a> were found guilty of misconduct by the Chinese government last year, <a href="https://retractionwatch.com/2018/09/04/cancer-journals-retract-10-papers-flag-8-more-and-apologize-for-the-delay/#more-70872">several cancer research papers</a> have been retracted recently and a recent report indicated that as much as <a href="https://pubs.acs.org/doi/pdf/10.1021/acs.jchemed.7b00907">80 per cent of chemists</a> have trouble replicating findings from the literature.</p>
<p><a href="https://theconversation.com/ca/topics/replicability-8238">Several great pieces</a> on <em>The Conversation</em> have tackled this issue so there is lots to review if replicability is new to you. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-students-are-the-answer-to-psychologys-replication-crisis-90286">Why students are the answer to psychology's replication crisis</a>
</strong>
</em>
</p>
<hr>
<p>Psychedelic research is an interdisciplinary field combining psychology, biology and medicine and so is an especially important field in which to implement “open science.” </p>
<h2>Open science <strong>= rigorous science</strong></h2>
<p>For <a href="https://www.sagepub.com/sites/default/files/upm-binaries/40007_Chapter8.pdf">statistics in science to work properly</a>, scientists need to guarantee that what they have studied is no more and no less than what they intended to study. </p>
<p>Instead of hiding inconvenient results or adding unplanned research conditions, scientists can use open science to demonstrate their integrity. Open science involves pre-registering hypotheses before doing research, and publishing the entire data set once the research is done. </p>
<p><a href="https://osf.io">Pre-registration happens online</a>. The content of the registration is locked and time stamped, then kept confidential until a set date, when it is released for the public to see. This is done so that the researcher can show they did exactly what they planned to do, which is how we all learned we are supposed to do science. Pre-registration is not even difficult, but researchers need to <a href="https://www.youtube.com/watch?v=kzUtpDBo8wk&index=1&list=PLMOU-iLiJIc0amNVabGXJ0liKwIwxqkO8">learn how to do it</a> and adjust.</p>
<p>Once the study has been published, the data set can be made public. This way, the entire scientific community can examine the data, serving at least two purposes. First, the scientific community can verify that the data supports the conclusions made in the study, ensuring no mistakes were made. Second, other scientists can explore for new patterns in the data to create new hypotheses for new studies, moving science forward faster. </p>
<p>Making the data public makes scientists publicly accountable, and is good for the scientific community at large.</p>
<h2>Co-operation over competition</h2>
<p>So far, most psychedelic research has not been pre-registered, which means it should be considered exploratory and, unfortunately, inconclusive. Some findings may have been by chance rather than clearly caused by the substances used, and these findings need to be replicated by independent labs to ensure they hold up. </p>
<p>A recent call for “<a href="http://chacruna.net/cooperation-over-competition-statement-on-open-science-for-psychedelic-medicines-and-practices/">Cooperation Over Competition</a>” has been made, but its impact remains to be seen. For now, we take the results on psychedelics that scientists have found on faith.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/237226/original/file-20180919-143281-1qtxrlg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The way forward is for scientists to share their plans and data.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Pre-registration is the only way to ensure psychedelic science is conducted with a high level of integrity. Psychedelic science is in its infancy, much as mindfulness research was some few decades ago. We must learn from past mistakes if we do not wish to see the same harsh criticisms levelled upon this field in the future.</p>
<p>This will improve and maintain public trust in the scientific endeavour, especially important for these storied substances. As public consumers of science, we should all be critical of new research and remember the <a href="https://www.wired.com/story/sagan-old-interview/">Sagan Standard</a>: “Extraordinary claims require extraordinary evidence.”</p><img src="https://counter.theconversation.com/content/101303/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>To know the real promise of psychedelic substances like LSD, mushrooms and MDMA, researchers must embrace the principles and practise of ‘open science.’Thomas Anderson, PhD student, University of TorontoRotem Petranker, PhD student in Clinical Psychology, York University, CanadaLicensed as Creative Commons – attribution, no derivatives.