Newsletter - Psychedelic Medicine Association

November Newsletter | Psychedelic Medicine Association

Welcome to the next edition of the Psychedelic Medicine Association monthly psychedelic science roundup!

We also wanted to remind you about our November webinar: Psychedelics' Potential in Addressing Eating Disorders! Head here to learn more and register!

Now for the science!

In this newsletter, we’ll cover:

Psychedelic Medicine | Integrative Approach
Ayahuasca | Therapeutic Potential
Psychedelics | Mechanism of Action
LSD | Reward-Related Brain Activity
Psychedelics & Therapy | Supportive Psychotherapeutic Model

And don't forget to join us in our members-only Facebook group where you can discuss these articles and much more!

So glad to have you along in this journey,

Lynn Marie Morski, MD, JD
President, Psychedelic Medicine Association

1. Psychedelic Medicine | Integrative Approach

Psychedelic medicine at a crossroads: Advancing an integrative approach to research and practice

Gabriella Gobbi, Antonio Inserra, Kyle T. Greenway, Michael Lifshitz, Laurence J. Kirmayer

Abstract:

Psychedelics have been already used by human societies for more than 3000 years, mostly in religious and healing context. The renewed interest in the potential application of psychedelic compounds as novel therapeutics has led to promising preliminary evidence of clinical benefit in some psychiatric disorders. Despite these promising results, the potential for large-scale clinical application of these profoundly consciousness-altering substances, in isolation from the sociocultural contexts in which they were traditionally used, raises important concerns. These concerns stem from the recognition that the mechanisms of therapeutic action of psychedelics are not entirely dependent on neurobiology, but also on the psychological, social and spiritual processes for their efficacy. For these reasons, physicians or psychotherapists involved in psychedelic-assisted psychotherapy need training in ways to accompany patients through this experience to promote positive outcomes and address potential side effects. Psychedelic therapies may foster the emergence of a novel paradigm in psychiatry that integrates psychopharmacological, psychotherapeutic, and cultural interventions for patients with mental health issues.

2. Ayahuasca | Therapeutic Potential

Ayahuasca's therapeutic potential: What we know – and what not

Lucas Oliveira Maia, Dimitri Daldegan-Bueno, Isabel Wießner, Draulio B. Araujo, Luís Fernando Tófoli

Abstract:

The therapeutic potential of the psychedelic brew ayahuasca has been investigated in preclinical and clinical studies. Currently, the most consistent evidence refers to depression. However, various studies suggest that ayahuasca may comprise therapeutic benefits in other health conditions. This narrative review provides a comprehensive, up-to-date overview of ayahuasca's therapeutic effects in diverse clinical conditions in human (clinical, cross-sectional, observational, and qualitative) and preclinical (animal and in vitro) studies. In addition to summarizing and discussing the most commonly studied conditions, such as depression, anxiety, and substance use disorders (SUD), we also examine less frequently studied psychiatric, neurological, and physical conditions. Moreover, we discuss evidence from epidemiological studies on the impact of regular, long-term ayahuasca use on health and psychosocial outcomes. Overall, evidence for depression and SUD is more consistent, with numerous and diverse studies. However, a growing body of evidence suggests that other conditions equally relevant to public health might be promising targets for ayahuasca's therapeutic effects. This includes preliminary studies indicating potential for grief, eating disorders, posttraumatic stress disorder, personality disorders, Parkinson's and Alzheimer's disease, and severe physical illnesses (e.g., cancer, chronic conditions). Moreover, preliminary evidence in long-term ayahuasca users does not suggest detrimental effects but possible benefits for individual and collective health. In light of the emerging evidence of psychedelic drugs as therapeutic agents, it is essential to further investigate in rigorous designs the therapeutic potential of ayahuasca in conditions other than depression.

3. Psychedelics | Mechanism of Action

The neural basis of psychedelic action

Alex C. Kwan, David E. Olson, Katrin H. Preller & Bryan L. Roth

Abstract:

Psychedelics are serotonin 2A receptor agonists that can lead to profound changes in perception, cognition and mood. In this review, we focus on the basic neurobiology underlying the action of psychedelic drugs. We first discuss chemistry, highlighting the diversity of psychoactive molecules and the principles that govern their potency and pharmacokinetics. We describe the roles of serotonin receptors and their downstream molecular signaling pathways, emphasizing key elements for drug discovery. We consider the impact of psychedelics on neuronal spiking dynamics in several cortical and subcortical regions, along with transcriptional changes and sustained effects on structural plasticity. Finally, we summarize neuroimaging results that pinpoint effects on association cortices and thalamocortical functional connectivity, which inform current theories of psychedelic action. By synthesizing knowledge across the chemical, molecular, neuronal, and network levels, we hope to provide an integrative perspective on the neural mechanisms responsible for the acute and enduring effects of psychedelics on behavior.

4. LSD | Reward-Related Brain Activity

Low doses of lysergic acid diethylamide (LSD) increase reward-related brain activity

James Glazer, Conor H. Murray, Robin Nusslock, Royce Lee & Harriet de Wit

Abstract:

Renewed interest in classic psychedelics as treatments for psychiatric disorders warrants a deeper understanding of their neural mechanisms. Single, high doses of psychedelic drugs have shown promise in treating depressive disorders, perhaps by reversing deficits in reward processing in the brain. In addition, there are anecdotal reports that repeated ingestion of low doses of LSD, or "microdosing", improve mood, cognition, and feelings of wellbeing. However, the effects of low doses of classic psychedelics on reward processing have not been studied. The current study examined the effects of two single, low doses of LSD compared to placebo on measures of reward processing. Eighteen healthy adults completed three sessions in which they received placebo (LSD-0), 13 μg LSD (LSD-13) and 26 μg LSD (LSD-26) in a within-subject, double-blind design. Neural activity was recorded while participants completed the electrophysiological monetary incentive delay task. Event-related potentials were measured during feedback processing (Reward-Positivity: RewP, Feedback-P3: FB-P3, and Late-Positive Potential: LPP). Compared to placebo, LSD-13 increased RewP and LPP amplitudes for reward (vs. neutral) feedback, and LSD-13 and LSD-26 increased FB-P3 amplitudes for positive (vs. negative) feedback. These effects were unassociated with most subjective measures of drug effects. Thus, single, low doses of LSD (vs. placebo) increased three reward-related ERP components reflecting increased hedonic (RewP), motivational (FB-P3), and affective processing of feedback (LPP). These results constitute the first evidence that low doses of LSD increase reward-related brain activity in humans. These findings may have important implications for the treatment of depressive disorders.

5. Psychedelics & Therapy | Supportive Psychotherapeutic Model

Psychedelic-supportive psychotherapy: A psychotherapeutic model for, before and beyond the medicine experience

Elizabeth Wolfson

Abstract:

A renaissance is underway as research studies are substantiating psychotherapeutic and physiological benefits of psychedelic medicines, along with advancements towards legalization, expansion of professional training programs and a renewed cultural recognition of the healing qualities of the medicines. Pending legislation, a cadre of trained psychotherapists are poised to apply their expertise for those who might benefit however, they are currently largely blocked from doing so. There are also ranks of competent psychedelically informed psychotherapists who might provide support to clients engaging with the medicines but are lacking guidelines to do so.

‘Psychedelic-Supportive Psychotherapy’ is a proposed model which might be immediately implemented by qualified practitioners for working with clients adjacent to but not during a medicine experience without compromising ethical or legal risk. This model aimed at psychotherapists who are increasingly challenged to help clients already engaging with or considering psychedelics, draws from the current field of knowledge to respond to a moral imperative for practitioners to act in the service of client's best interests and expand access for diverse communities. It balances psychedelic harm reduction perspectives with support for the emotional, psychological, and spiritual gains to be had when clients use psychedelics outside of therapy and can process the experience within their therapy. The model of psychedelic-supportive psychotherapy,’ is transtheoretical, its core premise being centrality of the therapeutic relationship as a change agent even as the therapist is not physically present in the client's medicine journey. Here a foundational structure is presented along with criteria, parameters, and recommendations for practitioners in its application.

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