Below, we explore a number of research themes that proved salient in 2022. It’s quite a long webpage, so you might prefer to use the contents table below (and the ‘scroll to top button’ in the bottom right-hand-side of your screen) to dip in-and-out of different topics.
Meta: Psychedelic Research Trends
Three charts that demonstrate how psychedelic research and clinical trials continued to ramp up in 2022:
Evaluating the Role of the Therapeutic Alliance
The partnership between a patient and their therapist has long been thought to be an influential and consequential aspect of traditional psychotherapies. This patient-provider relationship, known as the ‘Therapeutic Alliance’, is often recognised for its complex, dynamic, and intersubjective nature. In spite of these theoretical intricacies, a number of specific features and constructs have been identified as playing a crucial role in mediating the quality of the therapeutic alliance: aspects such as levels of trust between a therapist and patient, a collaborative relationship, and a mutual agreement on the objectives of therapy.
Given the essential role that therapists play in many psychedelic-assisted therapy protocols, many would assume that the quality of therapeutic alliance will be an important factor in determining the success of PATs. Despite this, little formal research has evaluated the precise role that the therapeutic alliance might play in eliciting the apparent benefits of PATs. However, over the course of 2022 a number of studies and publications began to add to what is now a prominent, and somewhat contentious, topic.
In March, researchers at Imperial College London published results of a study that sought to shed more light on this emerging area of research. In this study by Murphy et al. (2022), researchers performed a re-analysis of Imperial’s previous Trial of Psilocybin versus Escitalopram for Depression1 (Carhart-Harris et al., 2021) in an attempt to better understand, “the relationships between the therapeutic alliance and rapport, the quality of the acute psychedelic experience and treatment outcome” (Murphy et al., 2022).
The researchers found evidence to support the conventional belief that the quality of a therapeutic alliance is associated with better therapeutic outcomes for participants who had undergone psilocybin-assisted therapy. Specifically, the strength of the therapeutic alliance and rapport between the therapist and patient was found to predict experiences of emotional breakthrough and mystical type experiences, both of which are frequently regarded as integral to positive treatment outcomes.
Researchers also described how a strong therapeutic alliance and rapport (measured between the first and second dosing sessions) led to increased emotional breakthrough and greater patient depression outcomes, respectively (Murphy et al., 2022).
The results of this study seem to align well with prevailing views of psychedelic-assisted therapy and reflect findings in earlier reviews of the importance of the therapeutic alliance in therapy2.
Although the Imperial study was the first to formally investigate the effect of the therapeutic alliance in a clinical trial of psychedelics, as aforementioned, the importance of the alliance has been implicitly or explicitly recognized in many other psychedelic studies and publications. In fact, in an April 2022 publication, Peter Oehen and Peter Gasser reflect on how MDMA-assisted therapy has been used in preparation for LSD-assisted therapy, in an attempt to enhance the therapeutic alliance in a patient population suffering complex PTSD3.
The importance of a strong therapeutic alliance for psychedelic-assisted therapy was also noted in an August 2022 paper by researchers at the University of Alabama at Birmingham. In this publication Ortiz et al. (2022) discussed a number of “special considerations” that should be taken into account when establishing a therapeutic alliance with individuals from ‘vulnerable populations’, or those who have traditionally been left out of psychedelic research.
The authors explained that the lived experiences of these underrepresented and vulnerable groups may introduce new dynamics into the process of developing a therapeutic relationship that demand more reflexive, empathetic, transparent, and culturally competent care:
“Insofar that hardship, adversity, and maltreatment are daily realities for vulnerable populations in general – and especially in healthcare settings (e.g., Sorkin et al., 2010) – establishing therapeutic alliance may require dedicated time and specialised skills.”
Given this received wisdom regarding the importance of therapeutic alliance in PATs, many were surprised to learn that a post hoc analysis of COMPASS Pathways’ Phase 2b trial4 found that therapeutic alliance did not predict improvement in depressive symptom severity.
As in the Imperial study (Murphy et al., 2022), COMPASS’ post hoc analysis found that emotional breakthrough (as measured by the EBI) predicted therapeutic outcomes5. However, unlike the findings of the Imperial study, the latter found that, “[t]he direct effect of [therapeutic alliance] on depression outcomes was not significant for any path”.
COMPASS was keen to point out that its study represents a “larger, more robust TRD sample” than the Imperial group’s, with the poster’s authors also noting that, “effects in smaller trials are often not confirmed in larger samples.”
The authors speculate that the therapy model used in COMPASS’ trials (which, as we have mentioned elsewhere, is referred to as ‘psychological support’) may have less variance from therapist to therapist, and as such may have “less potential to differentiate outcomes”.
COMPASS appears to be pitching this lack of relationship between therapeutic alliance and outcomes as a benefit, given that less emphasis on the therapy element (which is even described as “a safety measure”, in the poster6) allows them to make the case that the drug is driving efficacy.
Contrast this pursuit of standardised, low-variance psychological support with the types of therapy seen in MAPS’ trials of MDMA-AT for PTSD, which provides a great deal of latitude7. Beyond differing philosophies among trial sponsors, might it be the case that aspects like the quality of therapeutic alliance and the flexibility with which a therapist can operate are more important for certain drug-assisted therapies than others? Given the effects of an entactogen like MDMA, it may not be surprising if patients undergoing MDMA-assisted therapy might benefit from a more ‘involved’ facilitator or therapist; versus, say, a patient undergoing psilocybin therapy, which might be more introspective and as such the therapist could adopt a less involved approach. It’s also possible that the importance of therapeutic alliance might differ between conditions, as alluded to above.
While 2022 was a productive year for this research topic, there’s still a dearth of data. Given that we only have two post hoc analyses of controlled studies, which produced conflicting results, the causal effect of therapeutic alliance on patient outcomes–if any–remains unclear. Nevertheless, ongoing research and discussions, such as those highlighted above, will undoubtedly shed more light on this topic.
A Closer Look at Drug Interactions
Drug-drug interaction (DDI) studies provide important information on how psychedelics might interact with other commonly prescribed medications, which can impact their safety and/or efficacy. Regulators may require (modern) DDI studies for labelling any approved psychedelics.
Over the course of 2022, a number of studies looked at interactions between psychedelics and commonly prescribed antidepressants.
One systematic review conducted by researchers at the Oregon Health and Science University (OHSU) reviewed the existing body of evidence8 on interactions between various psychiatric medications and MDMA or psilocybin (Sarparast et al., 2022). Most of the studies identified (24) looked at the interaction between MDMA and psychiatric drugs like antipsychotics, anxiolytics, mood stabilisers, NMDA antagonists, and various antidepressant drug classes.
The review identified that the co-administration of MDMA with monoamine oxidase inhibitors (MAOIs) can lead to dangerous adverse effects, and has “contributed to the majority of deaths cited in published case studies.” Beyond safety concerns, the authors also discuss how common antidepressants like SSRIs and SNRIs can dampen the subjective effects of MDMA. In fact, the authors found that citalopram, paroxetine, or fluoxetine “attenuated the subjective effects of MDMA by ~30 – ~80%, while physiological effects were attenuated by ~6 – ~14%”9.
A limited number of studies on the interactions between SSRIs and serotonergic psychedelics like LSD and psilocybin have arrived at mixed findings10. In order to explore these interaction effects, Natalie Gukasyan and colleagues at Johns Hopkins conducted an online survey of 595 individuals to explore “the extent to which serotonergic antidepressants may diminish psilocybin’s effects both concurrently and after discontinuation” (Gukasyan et al., 2022).
The Johns Hopkins study looked at the interaction between psilocybin and common antidepressants. It found that psilocybin’s effects may be diminished by serotonergic antidepressants acutely and even after a medication washout period. In roughly half of survey participants, the dampening effect persisted for as long as three months after discontinuing SSRIs11.
While not a drug interaction, a post-hoc analysis conducted using data from Imperial College London’s Trial of Psilocybin versus Escitalopram for Depression (Carhart-Harris et al., 2021) looked at the impact of recent antidepressant exposure on the effects of psilocybin. The results were presented by David Erritzoe at the Interdisciplinary Conference on Psychedelic Research (ICPR) in September 2022.
Kelan Thomas, PharmD shared with Psychedelic Alpha that:
“The Erritzoe ICPR post-hoc analysis figure very clearly illustrated that participants who had recently discontinued their current antidepressant medication for enrollment in their trial had a less robust psilocybin antidepressant effect, which was equivalent to escitalopram’s antidepressant response.”
Thomas also noted that moving forward, he hopes to see trials investigate whether increasing the dose of psilocybin administered to patients might help overcome the attenuating effects of recent antidepressant exposure seen in these studies.
However, these results stand in stark contrast to some released by COMPASS this year. In the Supplementary Appendix of their Phase 2b publication (Goodwin et al, 2022), a post-hoc subgroup analysis12 noted “no apparent difference in the efficacy response of participants withdrawn from antidepressant medication prior to baseline [n=53] compared with those who entered the trial drug-free [n=26].”
Additionally, COMPASS conducted a small (n=19) open-label study that evaluated the safety and efficacy of a single 25 mg psilocybin dose in participants with treatment-resistant depression already taking a single SSRI. Results from this trial were featured in a poster presented at the American Society of Clinical Psychopharmacology Annual Meeting, stating the combination was well tolerated, produced an average -14.9 point improvement in MADRS total score at Week 3 compared with baseline (comparable to the 12 point change in the Phase 2b trial), and produced similar subjective psychedelic effects. Further research is undoubtedly required to make sense of these conflicting results.
2022 also provided evidence of the 5-HT2A antagonist ketanserin’s ability to reduce the duration of the subjective effects of LSD. Earlier studies have shown that ketanserin, when given before a psychedelic, can prevent subjective effects from developing.
In 2022, however, Anna Becker and colleagues found that ketanserin, when administered one hour after LSD, reduced the total trip duration from 8.5 to 3.5 hours (Becker et al., 2022). The trip was terminated 2.5 hours after the administration of ketanserin. While this might not quite be the quick ‘trip neutraliser’ that the folks at MindMed might have been after, it’s worth noting that ketanserin may have a more favourable side effect profile when compared to other commonly used ‘trip stoppers’ such as benzodiazepines or antipsychotics.
While the evidence generated in 2022 contributed to our understanding of how psychedelics interact with other drugs, there’s plenty of work to be done. Not only are drug developers and researchers exploring a broader variety of psychedelics, but also a broader array of indications. This increases the drug-drug interaction possibilities, especially given that some conditions have very different first-line treatments than others.
Furthermore, it will be interesting to see if studies that aim to explore synergistic effects between psychedelics and other types of drug13, but also the effects of the co-administration of psychedelics like the recently-completed MDMA-LSD14 study conducted at University Hospital Basel (NCT04516902)15.
We should expect that 2023 will bring more drug interaction studies, such as Small Pharma’s recently initiated SSRI and DMT interaction study or Cybin’s attempt to examine the effect of SSRIs on the response to psilocybin therapy.
Neuroplasticity: Psychedelics’ Primary Mechanism of Action?
As we introduced in last year’s Review, research efforts have become increasingly concentrated on developing a greater understanding of how psychedelics elicit their apparent therapeutic effects; i.e., their mechanism of action. One of the popular working hypotheses is that psychedelic-induced neuroplasticity is the driver of therapeutic effects.
Neuroplasticity refers to the brain’s ability to reorganise and change neural pathways and connections to achieve both structural and functional changes. A gamut of drugs, including traditional antidepressants and ketamine, have been shown to induce different forms of neuroplasticity in humans (Grieco et al., 2022). Recent research suggests that psychedelics induce neuroplasticity, leading to changes in (functional) brain activity and (structural) connectivity.
As seen in 2021, much of the research on psychedelics and neuroplasticity conducted in 2022 emerged predominantly from preclinical models. These early in-vitro and in-vivo investigations shed more light on how different psychedelics can elicit changes in gene and protein expression that are indicative of neuroplastic effects (Inserra et al., 2022); stimulate (potentially) long-lasting structural plasticity through synaptogenesis or dendritogenesis (Jefferson et al., 2022); and, induce a “window of heightened neuroplasticity” that may prove propitious from a therapeutic perspective (Dwiel et al., 2022).
Though there was no significant clinical research on neuroplasticity was published in 2022, several reviews synthesised our current understanding of the concept and the potential implications of emerging preclinical research (Calder and Hassler, 2022; Grieco et al., 2022; Olson, 2022; van Elk and Yaden, 2022; Vollenweider and Smallridge, 2022).
Now, researchers might focus on measuring the functional and structural neuroplastic effects of psychedelics in the human brain. Here, neuroimaging techniques might prove to be some of the more useful tools that researchers have at their disposal. For example, hippocampal volume measured using structural magnetic resonance imaging (MRI) may shed light on the structural neuroplastic effects of psychedelics. Longitudinal functional MRI (fMRI) studies, meanwhile, could elucidate the functional neuroplastic effects that are thought to be induced by psychedelics16.
A project that is currently underway at University College London’s Department of Psychology and Language Science appears to be taking steps towards better understanding the neuroplastic effects of psychedelics using brain imaging. The researchers explain the focus of the Understanding Neuroplasticity by Tryptamines Project, or UNITy for short, on their website, sharing:
“This will be the largest controlled study to use fMRI to ‘image’ the brain during a DMT17 trip and assess lasting changes in brain networks that underlie changes in cognition, behaviour and wellbeing. We think our results will lead to the first mechanistic understanding of the macroscopic effects of psychedelic drugs on the human brain.
While the induction of neuroplasticity has been discussed largely in reference to potential beneficial therapeutic implications, as Calder and Hassler (2022) postulate in their review:
“Neuroplasticity may not only play a role in positive long-term effects of psychedelics but also undesirable ones. Drug induced neuroplastic changes in sensory regions could conceivably be a factor in psychedelic-induced flashbacks, as well as the rarer and more severe hallucinogen persisting perceptual disorder (HPPD), in which some drug effects, including hallucinations and psychological distress, persist after the drug has been metabolised.”
It will be important to investigate the degree to which neuroplasticity is responsible not only for the beneficial effects of psychedelics, but also whether the putative mechanism contributes to the adverse effects experienced by some individuals. There are several studies (NCT03554174, NCT04630964, NCT05601648) underway using a variety of neuroimaging methods to determine whether psilocybin changes neuroplasticity in patients with depression and whether they are associated with any antidepressant effects18. Some results can be expected in 2023.
Skipping the Trip: Non-Hallucinogenic Psychedelics (Psychoplastogens)
In light of the growing body of evidence supporting the hypothesis that drug-induced neuroplasticity drives–at least in part–the therapeutic effects of psychedelics, some have begun to describe these compounds as “psychoplastogens”.
“The term ‘psychoplastogen’ was coined to distinguish compounds that produce rapid and sustained effects from those that induce plasticity following chronic administration (e.g., traditional antidepressants). By definition, psychoplastogens are therapeutics that rapidly induce neuroplasticity following a single dose leading to long-lasting changes in behavior.”
Grieco et al., 2022
Some are so confident in neuroplasticity as the mechanism of action (or, of interest) that they believe the subjective effects of psychedelics may not be necessary to their apparent therapeutic effects. To this end, research on so-called ‘non-hallucinogenic psychedelics’, or psychoplastogens, has emerged and accelerated over the past few years. Put simply, psychoplastogens are being developed with the aim of eliminating the acute subjective effects of ‘first generation’ psychedelics like psilocybin, LSD, and DMT while not compromising on therapeutic efficacy.
Proponents of this class of drugs have suggested that, by eliminating the subjective effects, non-hallucinogenic treatment options may prove to be more accessible, safe, and affordable than their classical psychedelic counterparts19.
Among the proponents of this endeavour is UC Davis researcher David Olson, whose company Delix Therapeutics has raised over $100m ($40 million in 2022 alone). However, competition in this space has rapidly accelerated, with a number of other companies, such as Gilgamesh Pharmaceutical and Onsero Therapeutics20, working to develop their own non-hallucinogenic candidates.
Research into non-hallucinogenic psychedelics isn’t only the remit of North American drug developers, however. In January, a Shanghai-based research group described the design of new, non-hallucinogenic psychedelic analogues that displayed antidepressant-like activity in mice (Cao et al., 2022).
It’s important to remember that these novel psychoplastogens remain in the discovery and preclinical stages of development, with in-human trials yet to indicate their safety or efficacy (or, whether they are non-hallucinogenic in humans).
However, as Cunningham et al. (2022) pointed out, the development of non-hallucinogenic psychedelic analogs is perhaps not without precedent. A compound by the name of Ariadne had previously been studied in-humans at Bristol-Myers Company, where it demonstrated some “remarkable therapeutic effects.” In spite of its promise, Ariadne’s development was eventually abandoned by Bristol-Myers21.
The compound, which is a non-hallucinogenic analog of the synthetic hallucinogen DOM (2,5-dimethoxy-4-methyl-amphetamine), reportedly produced some therapeutic benefits for patients with schizophrenia, catatonia, and Parkinson’s (ibid.).
“To date, Ariadne provides the strongest support for the therapeutic potential of non-hallucinogenic 5-HT2A receptor agonists on the basis of the total available data”
Cunningham et al. (2022)
Some are concerned by this growing focus on non-hallucinogenic psychedelics, however. In November, Yaden et al. (2022) argued that beyond scientific or clinical uncertainties, the growing focus on developing molecules that lack the characteristic subjective effects of psychedelics might introduce some important ethical issues that should be considered as this field of research matures.
The authors argue that there are likely other benefits of the subjective psychedelic and interpersonal therapeutic experience that non-hallucinogenic compounds and treatments would be unable to reproduce. The prospect of “withholding such typically positive, meaningful, and therapeutic experiences from most patients [in favour of a psychoplastogen],” the trio contend, raises a number of ethical concerns.
“Thus, even if it is possible that nonsubjective psychedelics could bring about equivalent treatment effects in terms of measurable decrements in clinical symptoms, it is highly unlikely that they would also replicate the less-tangible, but perhaps no less important, effects on well-being derived from the human-to-human therapeutic encounter and associated sense-making of the narrative content of drug-induced subjective experiences or altered states of consciousness.”
Yaden et al. 2022
Accordingly, Yaden et al. (November 2022) argue that, in light of the valuable extra-clinical benefits of subjective psychedelic experiences, for “reasons rooted in autonomy and respect”, classical psychedelics should be offered as “the default treatment option and standard of care for those who do not have specific contraindication”. However, the authors add that patients should be permitted to choose to be treated using non-hallucinogenic alternatives should it be preferable.
Until the efficacy of classical psychedelics and non-hallucinogenic psychoplastogens are compared via clinical trials, the therapeutic utility (and, extra-clinical benefits) of the acute subjective psychedelic experience will continue to be the subject of considerable debate.
Some researchers are employing novel trial designs in an attempt to arrive at the answer of whether subjective effects are necessary faster than the time it would take novel psychoplastogens to progress to (and through) mid-stage clinical trials. Notable examples include a trial led by Boris Heifets at Stanford that was completed in 2022. The trial22 administered ketamine to half of the participating patients undergoing anaesthesia for non-cardiac surgery, and compared their depressive symptoms to those who received placebo. The unpublished results are intriguing, and discussed in further detail in our methods panel. Another inventive trial design23 sees psilocybin co-administered with midazolam, a drug that prevents patients from remembering what happened.
As we enter a new year, we might expect to see the first psychoplastogens entering in-human studies, as well as innovative trial designs such as those mentioned above providing preliminary insights into the importance (or lack thereof) of the trip24.
As psychedelic research has revealed more about the mechanisms that appear to underlie their effects, researchers have begun to hypothesise ways in which these molecules might be harnessed to treat a growing list of indications. As seen throughout 2022, psychedelic research appears to be moving beyond the confines of psychiatry and into the domains of neurology, pain, immunology, inflammation, and more.
Examples of Indications Explored in Psychedelic Research Publications and (2022)
- Bipolar Disorders: Bosch et al., 2022; DellaCrosse et al., 2022; Morton et al., 2022; NCT04433845; Elsayed et al., 2022; Fernandes-Nascimento et al., 2022.
- Personality Disorders: Traynor et al., 2022; Nasrallah, 2022.
- Eating Disorders: Otterman, 2022; Ledwos et al., 2022; Gukasyan et al., 2022; Fadahunsi et al., 2022; Reichelt, 2022; Williams et al., 2022; Borgland and Neyens, 2022; Peck et al., 2022.
- Behavioural Disorders: Kelmendi et al., 2022; Moreton et al., 2022; Singh et al., 2022; NCT04656301; Johnson and Letheby, 2022; Rodrigues et al., 2022; Wizla et al., 2022.
- Schizophrenia: Wolf et al., 2022; Rajpal et al., 2022; Sapienza et al., 2022; Arnovitz et al., 2022; Mahmood et al., 2022.
- Autism Spectrum Disorder: Markopoulos et al., 2022.
- Alzheimer’s: Carvalho et al., 2022; McManus et al., 2022; Forester et al., 2022; Borbély et al., 2022.
- Cognitive Deficits: Buzzelli et al. 2022.
- Aneurysms: Ismail et al., 2022.
- Other: Webb et al., 2022; Butler et al., 2022.
- Headache Disorders: Schindler et al., 2022; Madsen et al., 2022; Rusanen et al., 2022; Schindler, 2022.
- Pain: Christie et al., 2022; Watson, 2022; Lyes et al., 2022; Hedau and Anjankar, 2022; Bonnelle et al., 2022; Dworkin et al., 2022; Ednioff et al., 2022; Meade et al., 2022; Glynos et al., 2022; Olofsen et al., 2022.
Inflammation, Immunology, etc.
- Inflammation: Burmester et al., 2022; Richardson et al., 2022; Flanagan and Nichols, 2022; Shen et al., 2022; da Silva et al., 2022; Flanagan et al., 2022; Flanagan and Nichols, 2022; Santos et al., 2022; Smedfors et al., 2022;Borbély et al., 2022; Kermanian et al., 2022.
- Immunology: Szabo et al., 2022; Katchborian-Neto et al., 2022.
- Anti-Microbial: Carrero et al., 2022.
It should be noted that many of these recently postulated extra-psychiatric use cases for psychedelics are yet to be formally investigated or validated.
Some of the more intriguing applications that were discussed or investigated in 2022 include chronic spinal pain (Kelly et al., 2022), various forms of neuralgia, aneurysmal subarachnoid haemorrhages (Kelly et al., 2022), traumatic brain injuries (Kelly et al., 2022), connectomics (Kelly et al., 2022), anti-amoebic potential (Carrero et al., 2022; Katchborian-Neto et al., 2022), and immunological effects (Asher, 2022; Szabo et al. 2022; Katchborian-Neto et al., 2022).
Beyond hypothetical applications, clinical evidence pertaining to a number of other target indications was generated over the course of 2022.
In 2022, two small studies that included 10 and 14 participants, respectively, were published that evaluated psychedelics as a potential treatment for cluster headaches. The first, led by Martin Madsen and colleagues (July 2022), found a significant reduction in headache attack frequency after three moderate doses of psilocybin. A second study, authored by Emmanuelle Schindler and colleagues (2022), failed to find a statistically significant reduction in attack frequency compared with placebo. However, as the authors note, these findings may be a result of the small number of participants studied in the trial.
A systematic review of retrospective surveys by Rusanen et al. (2022), meanwhile, found a “frequent and consistent high self-reported efficacy of psilocybin mushroom and LSD in prophylactic treatment of [cluster headaches].”
With six clinical trials underway, we anticipate learning much more about the therapeutic potential of psychedelic in treating headache disorders as we move into 2023 and beyond (NCT0547759; NCT04218539; NCT03806984; NCT03781128; NCT03341689; NCT02981173)
Another notable trend in research that emerged in 2022 related to the impact that psychedelics have on inflammation. Much of the current body of evidence–as discussed in articles published by Flanagan and Nichols (2022), Smedfors et al. (2022), and Nichols (2022)–points to psychedelics as a potential new class of drug, “that act on serotonergic receptors with anti-inflammatory capacity” (Smedfors et al., 2022).
Through a range of preclinical in vitro and in vivo models, researchers have found psychedelics may produce anti-inflammatory effects “at doses not only below those necessary to elicit a behavioral response, but also greatly under those associated with cardiovascular problems” (Flanagan and Nichols, 2022).
Preclinical research conducted last year by da Silva et al. (2022) focused on the possible anti-neuroinflammatory effects of psychedelics, and the relationship these effects might have with anxiolytic and antidepressant effects. Additionally, Smedfors et al. (2022) evaluated the effects of psilocybin on the release of inflammatory proteins in microglial cell lines in their study published last year.
As mentioned, much of the research conducted to-date has employed preclinical models. However, in 2022 researchers began exploring the impact psychedelics exert on markers of inflammation in healthy volunteers. One early in-human study showed a reduction in inflammation after using psilocybin, with effects lasting up to 7 days (Mason et al., 2022). However, another study, published by Burmester et al. (2022), reported no statistically significant changes when using different markers of inflammation.
While early results in healthy volunteers thus appear to be inconclusive, Burmester et al. (ibid.) suggest that, in the future, “it would be informative to directly assess the immunomodulatory effects of psilocybin in a clinical cohort characterised by heightened inflammation.”
Moving forward, Nichols (2022) points to a range of novel therapeutic applications that psychedelics, if proven to exert potent anti-inflammatory effects in humans, might have:
“If successfully translated to human disease therapeutics, psychedelics at sub-behavioural levels represent a new class of orally available anti-inflammatory with steroid-sparing properties potentially effective in several inflammatory related disease including but not limited to asthma, atherosclerosis, cardiovascular disease, and inflammatory bowel disease.”