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Psychedelic Research Bulletin: January 2023

This January, outcomes of psychedelic use were closely examined. Studies looked at how experiences are integrated, how challenging experiences lead to growth, and the relationship between psychedelic use and nature-relatedness.

January also saw the first (case) study of changing menstrual patterns following psychedelic use and a study that looked at the safety of psychedelics for individuals who are immunocompromised. In this review, we cover 20 of January’s most interesting papers.

The consequences of psychedelic use

representative survey found that six out of ten recreational psychedelic users have never had a bad trip. Of the 600 who had used psychedelics, 9% indicated having had a bad trip lasting beyond the day of dosing. One in 40 had sought help after a distressing experience.

An analysis of NSDUH survey data (6300 psychedelic users) found correlations between psychedelic use and substance abuse disorders. Those who used LSD and psilocybin were likelier, while those who used mescaline were less likely to abuse other substances.

The previous study contrasts with a third survey (3800 participants) which found that those who took psilocybin were higher on a score of nature-relatedness. The researchers see a relationship between nature-relatedness and other positive traits. It should be noted that all these effects are correlative. As such, other factors (e.g. socio-economic) might also help explain the identified relationships.

Looking specifically at psychedelic retreat-goers, an interview study found that one in three individuals experienced challenges in integration. The participants, who went to a Synthesis retreat, reported challenges that included a lack of support or spiritual bypassing. However, having a challenging experience correlated with positive after-effects, including long-term remission of significant health conditions.

Investigating psilocybin-assisted therapy (PAT), researchers identified characteristics of patient ‘readiness’. The theory-building article discussed intrapersonal (e.g. openness to experience & motivation) and interpersonal (e.g. therapeutic alliance) factors that would help identify who will be most helped by PAT.

New areas under investigation

Women’s health is a topic that is seldom the focus of psychedelic research. However, an interview study (three participants) published in January, broke this pattern and identified diverse reactions to psychedelics relevant to women’s health. One participant had a resumption of menstruation, another found it came earlier, whilst the third interviewee reported improved regularity.

Microdosing has been regularly covered in psychedelic research. In January, a naturalistic study was published with a novel focus on emodiversity (the diversity of emotions) whilst microdosing. The study found a decrease in positive and overall emodiversity. While, participants reported greater levels of awe, there were fewer happy, glad, and joyful emotions.

The cost-effectiveness of ketamine, but how sure are we?

An economic modelling study argued that esketamine is a cost-effective option for treatment-resistant depression. The study compared the costs to several models of societal outcomes in Italy. Though promising, the evidence for esketamine treatment, especially on long-term outcomes, is still quite limited.

That was also argued in another recent review that looked at 22 ketamine studies, four of which were RCTs (the gold standard). The review covered data from over 2300 patients, and identified antidepressant effects but also cautioned that there is a high chance of bias in the included RCTs.

Still, that hasn’t stopped smaller studies from further investigating the (short-term) effectiveness of ketamine in different populations. One such study found comparable effects between those with bipolar and unipolar treatment-resistant depression. Anxiety-reducing effects were also reported to be greater for the bipolar group.

Similarly, a case series (four patients) found ketamine to be an effective add-on treatment for those with psychotic treatment-resistant depression. The ability to use ketamine alongside other drugs (e.g. antidepressants) is, next to the wide availability, what sets it apart from classical psychedelics.

The other studies that came out in January

Two studies proposed theories of 1) how ayahuasca works and 2) the underlying structure of brain signals that produce (or at least correlate with) consciousness. The first study synthesised the psychotherapeutic and neurobiological processes that go on and is a very comprehensive, and up-to-date overview of the effects of ayahuasca. The second study showed that patterns of brain activity (structure-function coupling) are a generalisable indicator of consciousness. An increase in coupling indicates lower/no consciousness (e.g. anaesthesia) and psychedelics are associated with decoupling.

Further analysis of the creativity studies by Wießner and colleagues found lower complexity of language whilst under the influence of a low dose of LSD. Though we generally believe psychedelics to increase certain processes (lighting up the brain in scans), this study and the previously discussed microdosing study also showed lowered complexity (of language and emotions respectively).

What isn’t lowered is the immune response of cells (T cells and monocyte immune response) when exposed to several classical psychedelics. Though the study was in cells, the researchers argued that it provided evidence for the safety of psychedelics for those with terminal illnesses (for whom they can provide psychological relief).

Finally, two studies looked further at MDMA-assisted therapy for PTSD. The first investigated fMRI data from veterans and first responders. It found a correlation between reductions in PTSD and amygdala-hippocampal connectivity, and 2) reduced amygdala-precuneus connectivity during memory recall. The second study is a pre-print which found that participants had significant improvements in self-experience (e.g. the ability to identify and describe emotions one experiences). Bessel van der Kolk (The Body Keeps The Score) is the first author of the study.

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