
#337 - The Future of Psychedelic Medicine
Making Sense with Sam Harris - Subscriber ContentTue Oct 03 2023
The Future of Psychedelic Medicine:
- Jeannie Fontana and Robin Carhart-Harris discuss the TREAT Initiative in California and the potential of psychedelics for mental health care.
- Jeanne Fontana is a MD-PhD involved in the TREAT California Initiative, which aims to provide funding for research and access to mental health treatments using psychedelic medicines.
- Robin Carhart-Harris is a leading researcher in the field of psychedelic medicine. He has conducted studies on LSD, psilocybin, MDMA, and DMT.
- The TREAT California Initiative requires 1 million signatures from registered voters in California to qualify for the ballot. It aims to provide $5 billion in funding for research and affordable access to mental health treatments using psychedelic medicines.
- The coalition supporting the initiative includes unions representing firefighters, postal workers, veterans, LGBTQ communities, and university students.
- MDMA therapy is close to receiving FDA approval for treating PTSD. Psilocybin therapy is being studied extensively for treatment-resistant depression. Other compounds like ketamine, LSD, DMT, mescaline, ibogaine are also being researched.
- Safety concerns vary among different compounds. Psilocybin and LSD have low physical toxicity but can lead to psychological risks if not taken under proper supervision or set/setting conditions. MDMA and ketamine have higher toxicity profiles with potential neurotoxicity or bladder toxicity at high doses.
- Classic serotonergic psychedelics stimulate serotonin 2A receptors, leading to a breakdown in brain network integrity and an increase in communication between networks. MDMA stimulates serotonin release while DMT's role as an endogenous neurotransmitter remains unknown.
- Well-run studies can be costly, ranging from hundreds of millions to at least $100 million depending on study design and sample size. The TREAT Institute aims to run large-scale clinical trials funded by the $5 billion initiative.
MDMA and Serotonin:
- MDMA stimulates the release of serotonin.
- Question about specificity due to serotonin spiking up in a dying brain.
- Unclear if there is enough endogenous DMT for functional effects.
Future Compounds:
- Possibility of discovering new compounds beyond current studies.
- In silico modeling used to search libraries for potential molecules.
Improving Existing Drugs:
- Research on reducing off-target effects and improving drugs like psilocybin.
- Questions regarding microdosing and low doses of psilocybin.
The Biopsychosocial Intervention:
- Importance of understanding aspects beyond drug therapy in psychedelic treatment.
Shulgin Library and New Compounds:
- Preservation of Sasha Shulgin's library containing 200 compounds for research.
- Efforts to study and preserve findings from the compounds.
Potential Applications Beyond Mental Health:
- Promising applications in traumatic brain injury, neurodegenerative diseases, and inflammatory conditions.
Understanding Phenomenology Under Psychedelics:
- Breakdown of brain networks correlates with ego dissolution and encounters with sentient beings.
- Convergence of reports attributed to archetypes and collective unconscious rather than something beyond the brain.
Default Mode Network:
- Initial focus on default mode network breakdown during psychedelic experiences.
- Recent studies show other neighboring networks also break down and correlate with ego dissolution.
Microdosing:
- Self-blinded citizen science studies suggest positive effects may be explained by placebo effect.
- Need for more research due to practical challenges in conducting controlled studies.
Religion and Spirituality:
- Criticism of organized religion while recognizing validity of core religious experiences.
- Need for non-denominational framing in exploring these experiences secularly using psychedelics.
The Future of Psychedelic Medicine:
- Jeannie Fontana and Robin Carhart-Harris discuss the TREAT Initiative in California and the potential of psychedelics for mental health care.
- Jeanne Fontana is a MD-PhD involved in the TREAT California Initiative, which aims to provide funding for research and access to mental health treatments using psychedelic medicines.
- Robin Carhart-Harris is a leading researcher in the field of psychedelic medicine. He has conducted studies on LSD, psilocybin, MDMA, and DMT.
- The TREAT California Initiative requires 1 million signatures from registered voters in California to qualify for the ballot. It aims to provide $5 billion in funding for research and affordable access to mental health treatments using psychedelic medicines.
- The coalition supporting the initiative includes unions representing firefighters, postal workers, veterans, LGBTQ communities, and university students.
- MDMA therapy is close to receiving FDA approval for treating PTSD. Psilocybin therapy is being studied extensively for treatment-resistant depression. Other compounds like ketamine, LSD, DMT, mescaline, ibogaine are also being researched.
- Safety concerns vary among different compounds. Psilocybin and LSD have low physical toxicity but can lead to psychological risks if not taken under proper supervision or set/setting conditions. MDMA and ketamine have higher toxicity profiles with potential neurotoxicity or bladder toxicity at high doses.
- Classic serotonergic psychedelics stimulate serotonin 2A receptors, leading to a breakdown in brain network integrity and an increase in communication between networks. MDMA stimulates serotonin release while DMT's role as an endogenous neurotransmitter remains unknown.
- Well-run studies can be costly, ranging from hundreds of millions to at least $100 million depending on study design and sample size. The TREAT Institute aims to run large-scale clinical trials funded by the $5 billion initiative.
MDMA and Serotonin:
- MDMA stimulates the release of serotonin.
- Question about specificity due to serotonin spiking up in a dying brain.
- Unclear if there is enough endogenous DMT for functional effects.
Future Compounds:
- Possibility of discovering new compounds beyond current studies.
- In silico modeling used to search libraries for potential molecules.
Improving Existing Drugs:
- Research on reducing off-target effects and improving drugs like psilocybin.
- Questions regarding microdosing and low doses of psilocybin.
The Biopsychosocial Intervention:
- Importance of understanding aspects beyond drug therapy in psychedelic treatment.
Shulgin Library and New Compounds:
- Preservation of Sasha Shulgin's library containing 200 compounds for research.
- Efforts to study and preserve findings from the compounds.
Potential Applications Beyond Mental Health:
- Promising applications in traumatic brain injury, neurodegenerative diseases, and inflammatory conditions.
Understanding Phenomenology Under Psychedelics:
- Breakdown of brain networks correlates with ego dissolution and encounters with sentient beings.
- Convergence of reports attributed to archetypes and collective unconscious rather than something beyond the brain.
Default Mode Network:
- Initial focus on default mode network breakdown during psychedelic experiences.
- Recent studies show other neighboring networks also break down and correlate with ego dissolution.
Microdosing:
- Self-blinded citizen science studies suggest positive effects may be explained by placebo effect.
- Need for more research due to practical challenges in conducting controlled studies.
Religion and Spirituality:
- Criticism of organized religion while recognizing validity of core religious experiences.
- Need for non-denominational framing in exploring these experiences secularly using psychedelics.