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Johns Hopkins Center for Psychedelic and Consciousness Research

The fact that these new and positive clinical findings had to be postponed for several decades dramatically illustrates the destructive capacity of politics to hinder potentially significant medical advances. Romano et al. examined the effect of serotonin depletion on eyeblink conditioning by bilateral intracerebroventricular administration of 5,7-dihydroxytryptamine. They achieved up to 85% and 90% depletion of serotonin in the cortex and hippocampus, respectively. Serotonin depletion failed to change the expression of 5-HT2A receptors, however, and had no significant effect on acquisition of trace classic conditioning. Serotonin depletion likewise had no effect on the enhancement of learning produced by LSD or on the retardation of learning produced by MDL11939. Overall, at least in rodent models, Psychedelics seem to exacerbate neophobia, increase responsiveness to sensory stimulation, and interfere with response habituation across multiple sensory modalities and behavioral responses .

Indirect evidence for a role of 5-HT2A receptors in mediating psychedelic-induced hallucinations comes from a study by Huot et al. . In that study, ketanserin binding was used to compare 5-HT2A receptor density in postmortem brains of patients with Parkinson’s disease who experienced visual hallucinations with the brains of PD patients who did not experience hallucinations. Six brains from patients with idiopathic PD who experienced visual hallucinations were compared with six PD patients without visual hallucinations and five healthy, age-matched controls. In PD patients with visual hallucinations, ketanserin binding was increased 45.6% in inferolateral temporal cortex compared with PD patients who did not have visual hallucinations. The authors suggest that increased 5-HT2A density in the inferolateral temporal cortex may be the basis for visual hallucinations in PD patients and that 5HT2A antagonists may alleviate this symptom. Arguably one of the biggest factors in making psychedelic research more accepted in the United States and elsewhere is the knowledge that psychedelics produce no neurotoxic effects at the doses administered in clinical trials.

But psychedelics research is in its early stages and the threshold for results being judged impressive is high. Griffiths R,, Richards W,, Johnson M,, McCann U,, Jesse R. Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. The drug session itself is given in a room with soft ambient lighting and a comforting soundtrack . 35There are generally two therapists present in the room who are there to provide reassurance, medical cover, and care. It is important to note that there is no expectation of conversation during the “trip” and no direction by either therapist of the patient’s speech or thought.

Acute adverse reactions were characterized by strong dysphoria and/or anxiety/panic, but occurred only at the two highest doses of psilocybin in a relatively small number of subjects. All acute adverse drug reactions were successfully managed through interpersonal support and did not require psychopharmacological intervention. Follow-up questionnaires indicated no subsequent drug abuse, persisting perception disorders, prolonged psychosis, or other long-term impairment of functioning in any of the subjects.

Being in a good state of mind, with trusted friends and a safe environment before taking psychedelics reduces the risk of having a bad trip. Drugs that affect a person’s mental state can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’). U.S. states such as Oregon and Colorado have also instituted decriminalization and legalization measures of psychedelics and states like New Hampshire and others are attempting to do the same.

I have already mentioned the LSD trial by Gasser in Switzerland, and this has led to this drug being made available for compassionate use in named patients by a few psychiatrists in that country. The other addiction study with psilocybin was conducted by Michael Bogenschutz and colleagues at the University of New Mexico. They gave two psilocybin sessions to 10 alcohol-dependent patients in addition to standard therapy.

Quantitative autoradiography revealed large increases in -labeled AA incorporation, particularly in the neocortex. The largest increases were seen in brain regions having high densities of 5-HT2A receptors, compared with 5-HT2C sites. In contrast with most other G protein–coupled receptors , the 5-HT2A receptor undergoes downregulation in response either to agonist or antagonist treatment . Two nonconserved residues in the 5-HT2A receptor, S421 in the C terminus, and S188 in intracellular loop 2, have been reported to be essential for agonist-induced desensitization in cloned receptors expressed in human embryonic kidney 293 (HEK-293) cells (Gray et al., 2003).

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