Art courtesy of Dewey Saunders
Ego Death, Prosocial Behavior, and Other Cutting-Edge Research on Psychedelics
Ego Death, Prosocial Behavior, and Other Cutting-Edge Research on Psychedelics
Every month, we get into a different health topic and explore the research. For December, we’re highlighting five new studies on psychedelics that we hope inspire some interesting holiday dinner conversations.
And we’ve also collected clinical trials that are recruiting people to study the therapeutic uses of psychedelics. Clinical trials are research studies intended to evaluate a medical intervention. They allow researchers to study a particular treatment that may not have a lot of data on its safety or effectiveness yet. Phase 1 clinical trials are the first time most drugs will be used in humans, so it’s about finding a safe dose. If the drug makes it through the initial trial, it can be used in a larger, phase 2 trial to see whether it works well. Then it may be compared to a known effective treatment in a phase 3 trial. If the drug is approved by the FDA, it will go on to a phase 4 trial. Speak with your doctor about any clinical trial you are considering.
Cell Reports (2018)
Inside your brain, neurons communicate by sending signals to one another through a complex web of connections. Throughout your life, the brain constantly adapts to change by rewiring itself to form new connections. This is called neuroplasticity. It’s been hypothesized that drugs that promote neuroplasticity may help with various mental health conditions, such as depression, anxiety, and post-traumatic stress disorder, because people with these conditions have been shown to have distinct changes in the structure and functionality of different brain regions. Ketamine is one such drug that has been shown to promote neuroplasticity. And while other psychedelics, such as MDMA, psilocybin, DMT, and LSD, have demonstrated therapeutic potential in depression and anxiety, it hasn’t been clear why or how they might have certain effects on the brain.
Researchers at the University of California, Davis, took brain cultures of rats and treated them with DOI (an amphetamine), DMT, and LSD for twenty-four hours. They found that across the board, all of the psychedelic compounds promoted neural growth: new neural connections and brain activity that was previously not there. The hope is that studies like this will dismantle the historical stigma around psychedelics and foster better understanding of their safety and therapeutic potential.
Journal of Psychopharmacology (2018)
A team of researchers from Canada recruited 1,266 college students and asked them to complete an online survey. The survey asked about their history of psychedelic use and alcohol use, and it included two psychological scales that assessed emotional regulation and history of intimate-partner violence.
From the results of the survey, the researchers found that increased intimate-partner violence was associated with the participants’ alcohol use. And for women, alcohol use was related to worse emotional regulation. But the findings related to psychedelic use (which was reported by a staggering 32 percent of respondents) were much more positive. Psychedelic use among men was associated with increased emotional regulation. And—drum roll—men who reported taking a psychedelic even once were half as likely to report ever perpetrating intimate-partner violence. The researchers hypothesize that the increased emotional regulation could explain the reduction in intimate-partner violence among these men. (This correlation between increased emotional regulation and reduced violence was not found for the female psychedelic users—perhaps because female-perpetrated intimate-partner violence may be due to other factors, like physical defense.)
Given that the study was based on information reported by participants online, it has limitations. But it does open the interesting question of whether psychedelic therapies could be used to reduce violent behavior.
Meditation and psychedelics both have the ability to transform a person’s experience of consciousness. Researchers believe this is due to changes in the default mode network. The DMN is a brain network that controls wakefulness, awareness, and memory as well as perception of the self, or ego. When people use psychedelics, many report a partial or complete loss of ego, or sense of self, which may be due to reduced blood flow to the DMN. On the other hand, an overactive DMN may play a role in mental health disorders such as depression and anxiety.
To explore the effects of a combination of meditation and psychedelics, researchers from Switzerland studied thirty-eight people over the course of a five-day silent meditation retreat. The morning of the fourth day, participants were randomized to receive either psilocybin (the active component of psychedelic mushrooms) at a dose of 21.82 milligrams (plus or minus 3.7 milligrams, depending on their body weight) or a placebo. All participants continued to go about their regularly scheduled meditation sessions. Brain scans of the participants were taken before and after the retreat.
The researchers found that post-retreat, participants who took psilocybin had significant changes in connections between areas of the brain associated with the DMN, signifying evidence of ego dissolution, which has been reported in similar studies. And four months later, these changes in brain connectivity among the psilocybin group were associated with positive changes in mood, behavior, spirituality, and attitudes about the self. This study emphasizes the potential beneficial effects of psychedelics and meditation and their therapeutic effects when used together.
Current Biology (2018)
Researchers at Johns Hopkins studied the effects of MDMA on the California two-spot octopus, which is believed to be the most behaviorally advanced invertebrate. They put one octopus at a time into a three-chambered tank that had little doorways allowing movement between the chambers. The left chamber contained an interesting object, the center one was empty, and the right contained either a male or female octopus. After recording the activity of the different octopuses for thirty minutes, the researchers found that the octopuses preferred interacting with the female octopus in the right chamber over interacting with the object in the left chamber. But when there was a male octopus in the right chamber, they preferred to spend more time with the object.
Next, the researchers submerged each octopus in a bath containing MDMA for ten minutes, then washed it down and placed it back in the tank. The researchers put a male octopus in the right tank to determine whether the animal’s behavior would change toward the male after the MDMA bath. And that’s exactly what they found: The octopuses spent significantly more time with the male octopus while under the influence of MDMA than they did under normal conditions, indicating the prosocial effects of MDMA. The octopuses also touched the other animal much more while on MDMA. Rather than just cautiously extending one tentacle toward the other octopus from the side of the tank, the animal would move its entire body toward the other octopus in an exploratory way.
These prosocial behaviors and increased warmth toward other animals are a few of the many reasons why MDMA-assisted therapy is being studied for people with post-traumatic stress disorder. It could help them open up and process their trauma—more on that in the next study.
Journal of Psychopharmacology (2018)
The primary project of the Multidisciplinary Association for Psychedelic Studies, a nonprofit research organization that advocates for the benefits of safe psychedelic use, is to move MDMA through the FDA drug development process so that it can be used to treat post-traumatic stress disorder. In 2018, MAPS published the results of its phase 2 clinical trial of MDMA-assisted psychotherapy. Twenty-eight people with chronic PTSD were recruited and randomized to receive either 40, 100, or 125 milligrams of MDMA during two separate eight-hour psychotherapy sessions. They had the option to receive a booster dose of either 20, 50, or 62.5 milligrams of MDMA ninety minutes after the first dose. Both participants and investigators were blinded to which dose of MDMA the participants received. Participants were not guided; instead, the therapists remained open and curious, allowing the participants to guide themselves—with options to lie down, wear an eye mask, or listen to instrumental music. The morning after each MDMA-assisted psychotherapy session, integration sessions were held in which the therapist checked in with the patients and allowed them to digest their experience from the previous day. The researchers found that one month after the sessions ended, participants who had received the highest dose of MDMA had the most significant reductions in PTSD severity.
After the blinded therapy sessions were over, participants then underwent an unblind psychotherapy session with a dose of 100 to 125 milligrams of MDMA. The participants who had initially received only 40 milligrams during the first two sessions underwent three sessions with the higher dose so that they could reap the benefits of higher-dose treatment as well. One month after the unblinded high-dose sessions were complete, participants across the board showed significant reductions in PTSD symptoms compared to their initial symptoms after their first round of low-dose therapy.
One year later, the researchers reassessed all the participants and found a significant overall reduction in PTSD severity compared to when they initially started the study. Seventy-six percent of the study participants no longer met diagnostic criteria for PTSD.
MAPS is currently recruiting for the first phase 3 clinical trial of MDMA-assisted psychotherapy—we’ve included relevant information below.
THE CLINICAL TRIALS
Michael Mithoefer, MD, a psychiatrist who leads clinical studies for MAPS, is recruiting subjects from multiple locations across the US who have been diagnosed with PTSD for the first phase 3 clinical study of MDMA-assisted psychotherapy to see if three sessions can help improve the severity of their PTSD symptoms.
Matthew W. Johnson, PhD, an associate professor of psychiatry and behavioral science at Johns Hopkins, is recruiting smokers to determine if thirteen weeks of cognitive behavioral therapy in combination with a high dose of psilocybin can help smokers quit more effectively than a nicotine patch. Numerous psychedelics have been hypothesized to help with addiction issues—see our Q&A with Thomas Kingsley Brown, PhD, about how ibogaine is being used to treat opioid addiction.
David Nutt, DM, FRCP, the director of the neuropsychopharmacology unit at Imperial College London, is recruiting people in the UK with major depressive disorder for a phase 2 clinical study to determine if psilocybin is an effective treatment compared to the commonly prescribed SSRI antidepressant escitalopram. There are more than twenty clinical studies currently recruiting subjects to study the therapeutic effects of psilocybin.
Psychiatrist Peter Gasser, MD, is a legend in the world of LSD research: He is the only person who is legally allowed to study the psychedelic, having received permission from the Swiss Ministry of Health to conduct studies on its therapeutic potential. In 2014, he published a study showing that LSD-assisted psychotherapy reduced anxiety in people with life-threatening diseases. Now Gasser is recruiting subjects in Switzerland with anxiety disorders for a phase 2 clinical study to determine if a single dose of LSD is effective at reducing clinical anxiety symptoms.
In early 2019, ketamine was approved by the FDA as a medication for treatment-resistant depression after numerous clinical studies demonstrated its rapid antidepressant effects. Francesca Beaudoin, MD, PhD, an emergency medicine physician at Rhode Island Hospital, is recruiting subjects for a phase 1 clinical trial to determine if ketamine is effective for people who need more-immediate help—like those admitted to psychiatric care in the emergency room for suicidal ideation. She’s hoping that an IV of low-dose ketamine for forty minutes is effective at improving mood and suicidal thoughts.
To learn more about ketamine, see our Q&A on ketamine-assisted psychotherapy with psychiatrist Will Siu, MD, and listen to The goop Podcast episode with psychiatrist Steven Levine, MD, on depression and mental health.
This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of goop.