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Dr. Robin Carhart-Harris: The Science of Psychedelics for Mental Health | Huberman Lab Podcast

Andrew Huberman・106 minutes read

Research in psychedelics, such as psilocybin, is showing promise in treating major depression, with clinical trials revealing significant relief in over 67% of users. The discussion covers the potential therapeutic benefits of psychedelics, the brain-altering effects of substances like LSD and DMT, and the importance of integrating psychedelic therapy for lasting benefits.

Insights

  • Psilocybin, found in magic mushrooms, has shown promising results in alleviating major depression in over 67% of users in clinical trials.
  • Psychedelics like LSD, DMT, and psilocybin are being researched for their potential mental health benefits and brain-altering effects.
  • Psychedelic therapy sessions involve a combination of psychedelics and therapy in a controlled environment, emphasizing trust, openness, and letting go for positive outcomes.
  • The use of suggestive language like "inner healer" in psychedelic therapy has raised concerns about potentially biasing participants and influencing outcomes.
  • Increased brain connectivity observed during and after psychedelic use is linked to therapeutic benefits, with potential applications for treating conditions like depression.

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Recent questions

  • What are the potential benefits of psychedelic therapy?

    Psychedelic therapy shows promise in treating conditions like major depression, PTSD, and fibromyalgia. Studies indicate that psychedelics like psilocybin can alleviate major depression in over 67% of users, with lasting benefits. The therapy involves a combination of psychedelics and therapy sessions, focusing on trust, openness, and letting go. Patients often experience breakthroughs and improved cognitive flexibility, leading to positive outcomes. Integration after therapy is crucial for maintaining benefits and promoting healing, showcasing the potential of psychedelic therapy in mental health treatment.

  • How do psychedelics impact brain circuitry?

    Psychedelics like psilocybin alter brain circuitry by increasing communication between brain areas that typically do not interact. This enhanced connectivity persists even after the psychedelic journey ends, leading to functional changes in the brain. The activation of serotonin 2A receptors is believed to be responsible for this increased connectivity, which correlates with therapeutic outcomes for conditions like depression. Studies suggest that moving along a continuum from linear to non-linear thinking may have therapeutic value, showcasing the profound impact of psychedelics on brain circuitry.

  • What is the significance of ego dissolution during psychedelic experiences?

    Ego dissolution during psychedelic trips involves a temporary loss of self-boundaries, leading to a sense of interconnectedness with others and the world. This experience allows individuals to realize the illusory nature of the self and embrace the interconnectedness of all things. Classic psychedelics target receptors for ego dissolution, offering a unique perspective on the self and the world. While ego dissolution may not last beyond the psychedelic experience, it can lead to profound insights and potential therapeutic benefits, highlighting the transformative power of psychedelics on one's sense of self.

  • How do microdosing and macrodosing of psychedelics differ?

    Microdosing involves sub-perceptible doses of psychedelics like LSD or psilocybin, aiming to induce subtle changes in behavior and cognition. It is believed to potentially improve well-being and creativity without the hallucinogenic effects of macrodosing. However, studies on microdosing lack compelling evidence due to study design challenges and placebo effects. On the other hand, macrodosing with perceptible doses of psychedelics like psilocybin has shown promising results in treating conditions like major depression. The dosages for macrodosing are carefully controlled to ensure therapeutic benefits without overwhelming the individual, showcasing the differences in approach between microdosing and macrodosing.

  • What are the key principles of psychedelic therapy?

    Psychedelic therapy involves key principles such as trust, letting go, and being open to the experience. Patients are guided through therapy sessions in settled conditions with music playing, creating a unique environment for introspection and healing. Therapeutic rapport, readiness to surrender, and willingness to confront personal issues are crucial components in achieving positive outcomes in psychedelic therapy. The therapy sessions typically involve wearing an eye mask, keeping the eyes closed, and listening to music without lyrics to enhance the experience. By following these principles, patients can navigate the psychedelic journey effectively and potentially achieve transformative results in mental health treatment.

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Summary

00:00

Psychedelics, Depression, and Science: A Podcast Exploration

  • Andrew Huberman hosts the Huberman Lab podcast, focusing on science and science-based tools for daily life.
  • Dr. Robin Carhart-Harris, a neurology and psychiatry professor at UCSF, is a leading researcher in psychedelics' impact on neural circuitry.
  • Carhart-Harris' lab studies how psilocybin alters brain circuitry, leading to new ideas and learning.
  • Clinical trials show psilocybin can alleviate major depression in over 67% of users.
  • The discussion covers the use of psychedelics in treating depression and other mental health challenges.
  • Psychedelics like LSD, DMT, and psilocybin are explored for their brain-altering effects and potential mental health benefits.
  • Carhart-Harris explains the history of psychedelics research and evolving legislation for their therapeutic use.
  • The podcast is separate from Huberman's Stanford roles, aiming to provide science information to the public.
  • Sponsors like Eight Sleep, Levels, and HVMN Ketone-IQ are mentioned for their products related to sleep, glucose monitoring, and ketone supplements.
  • Live events hosted by Huberman in Toronto and Chicago in September 2023 are announced, focusing on mental and physical health tools and science.

12:51

Unconscious Processing and Psychedelics: A Summary

  • Blindsight phenomenon: individuals with blindsight can accurately guess despite being blind, suggesting subconscious processing.
  • Pharmacologic-induced states reveal subconscious aspects not typically accessible.
  • Blindsight relates to non-conscious processing below conscious awareness thresholds.
  • Unconscious aspects in psychology involve personal and collective unconscious, including repressed memories and trauma.
  • Classic psychedelics like LSD and psilocybin reveal repressed material with therapeutic value.
  • Microdosing involves sub-perceptible doses of psychedelics like LSD or psilocybin.
  • Microdosing aims to induce subtle changes in behavior and cognition, potentially improving well-being and creativity.
  • Studies on microdosing lack compelling evidence due to study design challenges and placebo effects.
  • A study on microdosing LSD showed that positive expectancy drove the placebo response more than actual dosing.
  • Clinical trials comparing psilocybin dosages for depression treatment show promising results, with 25 milligrams being a perceptible dose, likely more than 2 grams of mushrooms.

27:15

"Psilocybin Therapy: Key Principles and Outcomes"

  • Psilocybin content in magic mushrooms is around 1% to a little higher, with psilocin as a metabolite.
  • 1 gram of magic mushrooms contains about 10 milligrams of psilocybin.
  • Psilocybin trials have shown positive results in treating major depression with doses ranging from 10 to 25 milligrams.
  • Experiences during psilocybin therapy sessions predict therapeutic outcomes reliably.
  • Patients in psilocybin therapy sessions typically use an eye mask and keep their eyes closed.
  • Psychedelic therapy involves settled conditions with music playing, creating a unique environment.
  • Music without lyrics is typically used in psychedelic therapy sessions, starting spacious and becoming atmospheric.
  • Psychedelic therapy is a combination treatment involving both psychedelics and therapy.
  • Trust, letting go, and being open are key principles in guiding patients through psychedelic therapy sessions.
  • Therapeutic rapport, readiness to surrender, and willingness to confront are crucial components in achieving positive outcomes in psychedelic therapy.

42:19

"Psychedelic Experience: From Anxiety to Breakthroughs"

  • A student is working on characterizing different phases of the psychedelic experience, with the early phase dominated by negative emotions and anxiety.
  • The latter half of the psychedelic journey involves a shift towards positivity and breakthroughs.
  • Initial struggles during the psychedelic experience are attributed to the drug's effects on breaking down normal waking consciousness.
  • Common fears during the experience include feeling like one is losing their mind or could be dying.
  • Under the influence of psychedelics, there is increased communication between brain areas that typically do not interact.
  • Studies have shown that this enhanced communication persists even after the psychedelic journey ends.
  • The activation of serotonin 2A receptors is believed to be responsible for the increased connectivity between brain areas.
  • There is a debate on whether the increased connectivity directly leads to subjective experiences or if they occur in parallel.
  • Efforts are being made to develop psychedelics for therapeutic use without hallucinogenic properties to treat conditions like depression.
  • The idea of separating the therapeutic effects of psychedelics from their hallucinogenic properties is met with skepticism due to the complexity of the relationship between mind and brain.

56:20

Psychedelics and SSRIs: Therapeutic Brain Effects

  • Microdosing may not have psychedelic effects but could drive therapeutic responses through serotonin receptor agonism.
  • Selective serotonin reuptake inhibitors (SSRIs) like Lexapro can also drive therapeutic responses.
  • There are no licensed non-psychedelic drugs that selectively agonize the serotonin 2A receptor for psychiatric use.
  • Increases in communication components of neurons, dendritic growth, and synaptic spine growth are seen with psychedelics.
  • Increased connectivity between brain areas observed during psychedelic use can persist after the effects wear off.
  • Functional changes in the brain post-psychedelic use correlate with therapeutic outcomes for depression.
  • Increased global connectivity in the brain post-psychedelic use is associated with improved symptom severity.
  • Moving along a continuum from linear to non-linear thinking may have therapeutic value.
  • Extreme modularity of brain function may be depressive, while increased crosstalk between brain modules correlates with positive outcomes.
  • Microdosing with 1 milligram of psilocybin did not show any changes in brainwaves, suggesting macro doses in controlled settings may be more effective.

01:09:21

"LMNT: Electrolyte drink for cell function"

  • LMNT is an electrolyte drink with sodium, magnesium, and potassium but no sugar.
  • Electrolytes like sodium, magnesium, and potassium are crucial for cell function, especially nerve cells.
  • LMNT contains 1,000 milligrams of sodium, 200 milligrams of potassium, and 60 milligrams of magnesium.
  • It is recommended to drink LMNT in the morning, during physical training, after sweating, and in the sauna.
  • To try LMNT, visit drinklmnt.com/huberman for a free sample pack with purchase.
  • Psychedelic therapy dosing sessions typically occur one to three weeks apart.
  • Psychedelic therapy for anorexia involves three dosing sessions, showing promising results.
  • Integration after psychedelic therapy is crucial for lasting benefits and may involve daily conversations or journaling.
  • Psychedelic therapy has shown impressive results in treating depression, with up to 70% experiencing relief.
  • Ongoing integration and practice are essential after psychedelic therapy to maintain benefits and promote healing.

01:22:54

Psilocybin Study Shows Brain Changes and Benefits

  • Study conducted using a repeated measures design with a placebo dose of 1 milligram of psilocybin given initially.
  • EEG headsets used to record brain activity during the experience, while MRI scanning done before and after to analyze brain connectivity and anatomy changes.
  • Significant improvements in psychological well-being observed with a 25 milligram dose of psilocybin.
  • Increase in informational complexity of brain activity seen with psilocybin, correlating with subjective effects.
  • MRI scanning revealed changes in major white matter tracts between prefrontal cortex, thalamus, and striatum.
  • Decrease in axial diffusivity observed post-psilocybin, indicating increased tract integrity.
  • Neuroplasticity evident after one session with 25 milligrams of psilocybin, showing anatomical changes.
  • Cognitive flexibility improved after 25 milligrams of psilocybin, not significantly after placebo dose.
  • Psilocybin therapy being studied for fibromyalgia patients with generalized chronic pain.
  • Study participants wear EEG caps during sessions, focusing on mechanistic analysis of psilocybin's effects on fibromyalgia.

01:37:30

Psychedelic Therapy: Inner Healer and Challenges

  • In psychedelic therapy, interpersonal interactions are emphasized over intrapersonal experiences, with the concept of the inner healer being a key focus.
  • The use of suggestive language like "inner healer" in MDMA therapy has been critiqued for potentially biasing or priming participants.
  • Pre-trial expectancy significantly influences responses to escitalopram but not to psilocybin therapy, challenging the idea of classic psychedelic therapy as merely a placebo response.
  • The duration of LSD trips, lasting 8 to 15 hours, poses practical challenges for research compared to psilocybin's 4 to 6-hour duration.
  • The cost and staffing requirements of longer therapy sessions, especially with psilocybin, are major factors in the expense of psychedelic therapy.
  • There is interest in shortening therapy sessions to reduce costs while maintaining therapeutic outcomes.
  • Combining psilocybin and MDMA in therapy, known as a "hippy flip," is sometimes done by underground therapists to balance out the affective components of each substance.
  • The use of MDMA alongside psilocybin is believed to counteract the potentially murky or introspective aspects of psilocybin with its more uplifting and stimulating effects.
  • While not recommended for recreational use, the combination of psilocybin and MDMA in therapy settings is being explored for its therapeutic potential by some underground therapists.
  • Underground therapists may be using trial and error methods to explore the therapeutic benefits of combining different psychedelic compounds.

01:50:49

Exploring Psychedelic Medicine for Mental Health

  • Psychedelic plant medicine includes fungi, with a history of trial and error leading to potential benefits for certain patients.
  • Precision and personalized medicine are buzz terms, suggesting advantages in combining substances like psilocybin and MDMA in specific cases.
  • Psilocybin can delve into deep psychological issues aggressively, potentially overwhelming patients with conditions like PTSD.
  • MDMA, on the other hand, offers a more positive and reliable experience, making it suitable for therapy, especially for PTSD.
  • The fear of "bad trips" is discussed, emphasizing the necessity of confronting trauma directly for therapeutic progress.
  • DMT is a potent psychedelic acting on the serotonin 2A receptor, offering intense but brief experiences compared to classic psychedelics like psilocybin.
  • DMT and 5-MeO DMT are described as "rocket ships" into intense experiences, with 5-MeO potentially inducing more reliable ego dissolution.
  • Ego dissolution is explained as a temporary loss of self-boundaries, leading to a sense of interconnectedness with others and the world.
  • The power of ego dissolution lies in realizing the illusory nature of the self and embracing the interconnectedness of all things.
  • The discussion delves into the interconnected nature of the brain and the concept of drawing boundaries between different modules within it.

02:04:32

Psychedelics and Ego: Mind and Body

  • The nervous system extends through both mind and body.
  • Family relationships are not just based on being human but also genealogical convergence.
  • Drawing boundaries in relationships is a construct and a game.
  • Classic psychedelics target receptors for ego dissolution.
  • MDMA may induce empathy for others and oneself.
  • Cocaine inflates egos, while psychedelics dissolve egos.
  • Serotonin 2A receptors are targeted by classic psychedelics for ego dissolution.
  • Ego dissolution during psychedelic trips may not last, leading to potential relapses.
  • Legalities around psychedelics vary, with some areas decriminalizing substances like psilocybin.
  • Different silos exist in the psychedelic landscape, including labs, therapists, recreational use, and pharmaceutical companies.

02:17:17

Psychedelic Licensing: Trials, Therapies, and Concerns

  • Licenses are not currently available for psychedelics, but there are discussions about potential shutdowns.
  • A church in Oakland is selling psychedelics under the guise of religious rights, similar to Native Americans using peyote.
  • The FDA is a crucial point for licensing psychedelics as medicines for legal prescription.
  • Phase III trials are essential for licensing, with successful trials leading to FDA approval.
  • MDMA therapy for PTSD has shown promising results, with remission rates of around 67%.
  • MAPS is leading the MDMA therapy work and may potentially become the provider.
  • Psilocybin therapy for treatment-resistant depression is in phase III trials by Compass, with results expected around 2026.
  • Various psychedelic research centers globally are exploring treatments for a range of psychiatric disorders.
  • There are concerns about the training and certification of providers for psychedelic therapy.
  • The evolution of attitudes towards psychedelics from taboo to therapeutic is evident, with increasing philanthropic support for research.

02:32:00

"Psychedelic Therapy: Paradigm Shift in Health"

  • Psychedelic therapy is a major paradigm challenge, offering a different approach that is currently appealing.
  • Andrew Huberman expresses gratitude for the potential of psychedelics in treatments, emphasizing the importance of combining them with other treatments for mental and physical health improvements.
  • Robin Carhart-Harris is commended for his work in the field of psychedelics, particularly for his generosity in attributions and caution regarding preliminary results.
  • Viewers are encouraged to explore Dr. Carhart-Harris's research, support it, and engage with his social media accounts for further insights into psychedelic science.
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