Monthly Archives: February 2023

A report on the new study was published on Feb. 15, 2022 in the Journal of Psychopharmacology.

Our findings add to evidence that, under carefully controlled conditions, this is a promising therapeutic approach that can lead to significant and durable improvements in depression, says Natalie Gukasyan, M.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. She cautions, however, that the results we see are in a research setting and require quite a lot of preparation and structured support from trained clinicians and therapists, and people should not attempt to try it on their own.

Over the last 20 years, there has been a growing of research with classic psychedelics the pharmacological class of compounds that include psilocybin, an ingredient found in so-called magic mushrooms. According to the National Institute on Drug Abuse, psilocybin can produce perceptual changes, altering a persons awareness of their surroundings and of their thoughts and feelings. Treatment with psilocybin has shown promise in research settings for treating a range of mental health disorders and addictions.

For this study, the researchers recruited 27 participants with a long-term history of depression, most of whom had been experiencing depressive symptoms for approximately two years before recruitment. The average age of participants was 40, 19 were women, and 25 identified as white, one as African American and one as Asian. Eighty-eight percent of the participants had previously been treated with standard antidepressant medications, and 58% reported using antidepressants in their current depressive episodes.

After screening, participants were randomized into one of two groups in which they received the intervention either immediately, or after an eight-week waiting period. At the time of treatment, all participants were provided with six to eight hours of preparatory meetings with two treatment facilitators. Following preparation, participants received two doses of psilocybin, given approximately two weeks apart between August 2017 and April 2019 at the Behavioral Biology Research Center at Johns Hopkins Bayview Medical Center. Participants returned for follow-up one day and one week after each session, and then at one, three, six and 12 months following the second session; 24 participants completed both psilocybin sessions and all follow-up assessment visits.

The researchers reported that psilocybin treatment in both groups produced large decreases in depression, and that depression severity remained low one, three, six and 12 months after treatment. Depressive symptoms were measured before and after treatment using the GRID-Hamilton Depression Rating Scale, a standard depression assessment tool, in which a score of 24 or more indicates severe depression, 1723 moderate depression, 816 mild depression and 7 or less no depression. For most participants, scores for the overall treatment decreased from 22.8 at pretreatment to 8.7 at one week, 8.9 at four weeks, 9.3 at three months, 7 at six months and 7.7 at 12 months after treatment. Participants had stable rates of response to the treatment and remission of symptoms throughout the follow-up period, with 75% response and 58% remission at 12 months.Psilocybin not only produces significant and immediate effects, it also has a long duration, which suggests that it may be a uniquely useful new treatment for depression, says Roland Griffiths, Ph.D., the Oliver Lee McCabe III, Ph.D., Professor in the Neuropsychopharmacology of Consciousness at the Johns Hopkins University School of Medicine, and founding director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Compared to standard antidepressants, which must be taken for long stretches of time, psilocybin has the potential to enduringly relieve the symptoms of depression with one or two treatments.

The researchers emphasize that further research is needed to explore the possibility that the efficacy of psilocybin treatment may be substantially longer than 12 months. Johns Hopkins is one of the sites of a national multisite randomized, placebo-controlled trial of psilocybin for major depressive disorder.

Other researchers who contributed to the study are Alan Davis, Frederick Barrett, Mary Cosimano, Nathan Sepeda and Matthew Johnson from the Johns Hopkins University School of Medicine.

The study was funded in part by a crowd-sourced campaign organized by Tim Ferriss and by grants from the Riverstyx Foundation and Dave Morin. Support for Alan Davis and Natalie Gukasyan was provided by a grant from the National Institutes of Health (T32DA07209, National Institute on Drug Abuse). Support for authors was also provided by the Center for Psychedelic and Consciousness Research, which is funded by the Steven and Alexandra Cohen Foundation, Tim Ferriss, Matt Mullenweg, Craig Nerenberg and Blake Mycoskie. The funders had no role in study design, data collection and analysis, or in decision to publish or manuscript preparation.

COI: Alan Davis is a board member of Source Research Foundation. Matthew Johnson has received grant support from the Heffter Research Institute that is unrelated to this study, and he is an advisor to the following companies: AJNA Labs, AWAKN Life Sciences, Beckley Psytech, Entheon Biomedical, Field Trip Psychedelics, Mind Medicine, Otsuka Pharmaceutical Development & Commercialization and Silo Pharma. Roland Griffiths is a board member of the Heffter Research Institute and has received grant support from the institute unrelated to this study. Griffiths is site principal investigator, and Johnson and Gukasyan are co-investigators for a multisite trial of psilocybin-assisted therapy for major depressive disorder sponsored by Usona Institute.

Read more:

Psilocybin Treatment for Major Depression Effective for Up to a Year ...

Recently listening to Henryk Goreckis Symphony No. 3 brought Rob Jacobs back to a life-changing experience that happened a decade ago. After ingesting a psychedelic drug as part of a formal study at Johns Hopkins, he was lying on a couch at the research center, wearing eyeshades and feeling a deep emotional connection to the music playing through his headphones.

It was unbelievably beautiful. It literally moved me to tears, Jacobs, now 52, wrote in his post-session report in 2010. It seemed to capture the human condition, the beauty and sadness of existence. Melancholy but majestic. It was like I could see right into the heart of the matter with crystal clarity.

Jacobs remembers all these feelings, which came on as he began experiencing the effects of psilocybin the active ingredient in so-called magic mushrooms.

Goreckis 27-minute composition, also known as Symphony of Sorrowful Songs, is one of a collection of mostly classical pieces that help unlock elevated states of consciousness for study participants at the Johns Hopkins Center for Psychedelic and Consciousness Research. The seven-hour and 40-minute playlist, developed by researchers at Johns Hopkins, seeks to express the sweeping arc of the typical medium- or high-dose psilocybin session. (There is extra time built into the playlist, as session length can vary.)

This playlist supported the psychedelic experiences of those who participated in a new study published Nov. 4 in JAMA Psychiatry that found that psilocybin may show promise as a treatment for adults with major depression. A version of the playlist is available on Spotify.

The research center, which launched in September 2019, is believed to be the first such center in the country and the largest of its kind in the world. Its research focuses on how psychedelics can impact brain function and mood in healthy individuals and in patient populations, including conditions such as tobacco addiction and anorexia nervosa as well as anxiety and depression in people with life-threatening cancer.

The 2010 study Jacobs participated in examined the impact of psilocybin on spiritual practices in Jacobs case, meditation.

Psychologist Bill Richards, whose involvement in psychedelic research dates back to 1963, masterminded the playlist. As a researcher at the center, he emphasizes that the music is chosen for its ability to guide and support the participants experience.

Were exploring the human psyche, which might take you through some painful things in childhood. It may take you into some archetypal or visionary realms that you never knew were possible. It might take you beyond usual consciousness into a realm that feels eternal, says Richards.

Psilocybin researchers at NYU Langone Health and the Usona Institute in Madison, Wisconsin, have since adapted the playlist for their own research.

Richards reasoning for choosing classical music, as well as the structure of the Johns Hopkins playlist, inspired Usonas playlist, which uses seven pieces from the Hopkins list. Usona added Spanish guitar, non-Western classical music and modern works with some classical structure.

We were striving to create a blend of resonance with the music and emotional/psychological challenge that are thought to be beneficial, says Malynn Utzinger, co-founder and director of integrative medicine at Usona. We paid attention to the structure and tone of each section of the Hopkins list, and while we did not use quite as much strictly classical music, we wanted to create a list with a relatively high amount of structured music versus ambient.

The Birth of a Playlist

The playlist, which Johns Hopkins has used since it began its psychedelic research 20 years ago, dates back to 1967. At the time, Richards was involved in similar research at the Spring Grove Hospital Center in Catonsville, which is now part of the Maryland Psychiatric Research Center. There, he and other researchers investigated LSD, psilocybin and other psychedelics for treating substance use disorder, depression and the psychological distress associated with terminal cancer. The drugs were also studied for their effects on the professional lives of religious and mental health professionals.

We were working with 33 RPMs and turntables, and always trying to decide what record to play next, Richards recalls. We developed a certain intuitive list of favorites that just seemed to work well with a lot of people. Peoples experiences were going deeper and deeper, becoming very profound.

The late music therapist Helen Bonny, who also worked at the center, devised a number of cassette tape playlists with names such as peak experience for her doctoral thesis. When Richards joined center Director Roland Griffiths to initiate psilocybin research at Johns Hopkins in 1999, he created a formal playlist that drew partly from Bonnys tapes as well as from music he had used. His son Brian, who worked at the Johns Hopkins center as a postdoctoral research fellow, contributed in particular to what Richards calls the welcome back to Earth music.

The playlist is divided into segments: background music that plays as the participant arrives for his or her session; music that plays when the drug is starting to take effect, at which point he or she is lying down and wearing eyeshades and headphones; the ascent; the peak; the post-peak; and the welcome back music. There are usually two researchers in the room, referred to as guides, who simultaneously listen to the playlist through speakers.

The music in each section is deliberately chosen to accompany a particular part of the psychedelic journey. For example, Richards finds that Samuel Barbers iconic Adagio for Strings works well as participants approach the peak, when the effects of the psilocybin are steadily intensifying.

The music chromatically develops, and it goes up and reaches this exquisite climax and then comes back down, he says.

For the onset of the drug, on the other hand, he thinks the best music is unfolding and has a dependable structure.

Its going somewhere, its picking you up and carrying you. Its got some force, some substance, he says. It doesnt have very unpredictable changes of rhythm or something thats going to startle or frighten you. So, its a net of reassurance, almost, and of leadership.

The music helps keep participants from prematurely returning to normal conscious awareness, Richards says.

I think of it as a nonverbal support system, sort of like the net for a trapeze artist, he says. If all is going well, youre not even aware that the net is there you dont even hear the music but if you start getting anxious, or if you need it, its immediately there to provide structure.

The majority of the music is either instrumental or choral with non-English text, and purposefully so. In order to keep participants inside the experience, only the last section of the playlist uses selections with recognizable words.

Its the structure, the harmonic design, the richness, the unfolding, the harmonies, the dissonance, that really matters, he says. If youre truly trying to shift consciousness beyond the level of the everyday self, you have to get beyond language.

Jacobs, an adjunct instructor in English and literature at the Community College of Baltimore County and the Osher Lifelong Learning Institute at Johns Hopkins University, wasnt familiar with most of the music he heard during his sessions. Because of that, he felt that it didnt preload any experience and was more supportive than directive.

At the end of his session, however, he was glad to hear the familiar tune of the Beatles Here Comes the Sun, which Richards considers part of the welcome back to Earth music. (The song was included on previous versions of the current playlist, which can vary slightly between studies. For the JAMA study, the second to last song is Louis Armstrongs What a Wonderful World.)

A decade later, former study participant Jacobs says his experience with psilocybin showed him that life is a fundamentally spiritual experience. It made him less frightened of death, more centered and more committed to a spiritual path.

That kind of revelation is something Richards has seen from the beginning. In the early days of his research, he recalls most participants with substance use disorder being unfamiliar with Brahms symphonies. After the sessions, they bought the music for themselves.

It spoke [to them]. It took on meaning in the struggle, the unfolding, the dissonance being resolved. They could understand that that type of classical music is a language about life and human experience. And when youre in the music, its so different from listening to the music.

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Excerpt from:

Inside the Johns Hopkins Psilocybin Playlist - Hopkins Medicine

Perhaps no region of the brain is more fittingly named than the claustrum, taken from the Latin word for hidden or shut away. The claustrum is an extremely thin sheet of neurons deep within the cortex, yet it reaches out to every other region of the brain. Its true purpose remains hidden away as well, with researchers speculating about many functions. For example, Francis Crick of DNA-discovery fame believed that the claustrum is the seat of consciousness, responsible for awareness and sense of self.

What is known is that this region contains a large number of receptors targeted by psychedelic drugs such as LSD or psilocybin the hallucinogenic chemical found in certain mushrooms. To see what happens in the claustrum when people are on psychedelics, Johns Hopkins Medicine researchers compared the brain scans of people after they took psilocybin with their scans after taking a placebo.

Their findings were published online on May 23, 2020, in the journal NeuroImage.

The scans after psilocybin use showed that the claustrum was less active, meaning the area of the brain believed responsible for setting attention and switching tasks is turned down when on the drug. The researchers say that this ties in with what people report as typical effects of psychedelic drugs, including feelings of being connected to everything and reduced senses of self or ego.

Our findings move us one step closer to understanding mechanisms underlying how psilocybin works in the brain, says Frederick Barrett, Ph.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and a member of the schools Center for Psychedelic and Consciousness Research. This will hopefully enable us to better understand why its an effective therapy for certain psychiatric disorders, which might help us tailor therapies to help people more.

Because of its deep-rooted location in the brain, the claustrum has been difficult to access and study. Last year, Barrett and his colleagues at the University of Maryland, Baltimore, developed a method to detect brain activity in the claustrum using functional magnetic resonance imaging (fMRI).

For this new study, the researchers used fMRI with 15 people and observed the claustrum brain region after the participants took either psilocybin or a placebo. They found that psilocybin reduced neural activity in the claustrum by 15% to 30%. This lowered activity also appeared to be associated with stronger subjective effects of the drug, such as emotional and mystical experiences. The researchers also found that psilocybin changed the way that the claustrum communicated with brain regions involved in hearing, attention, decision-making and remembering.

With the highly detailed imaging of the claustrum provided by fMRI, the researchers next hope to look at the mysterious brain region in people with certain psychiatric disorders such as depression and substance use disorder. The goal of these experiments will be to see what roles, if any, the claustrum plays in these conditions. The researchers also plan to observe the claustrums activity when under the influence of other psychedelics, such as salvinorin A, a hallucinogen derived from a Mexican plant.

Excerpt from:

Research Story Tip: Psychedelic Drug Psilocybin Tamps Down Brains Ego ...