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Robin Carhart‐Harris

Imperial College London, Centre for Neuropsychopharmacology Division of Experimental Medicine London United Kingdom

123 papers in the library · 14,072 citations · publishing 2010-2026

Papers

The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories

The International Journal of Neuropsychopharmacology December 17, 2013 Robin Carhart‐Harris, Matthew B. Wall, David Erritzøe et al. 110 citations

MDMA (ecstasy) makes recalling favorite autobiographical memories feel more vivid, emotionally intense, and positive, while making recall of worst memories feel less negative. In a double-blind, placebo-controlled fMRI study with 19 participants who had prior MDMA experience, 100 mg of MDMA altered brain activity during memory recall: it increased activation in the fusiform gyrus and somatosensory cortex for favorite memories and decreased activation in the left anterior temporal cortex for worst memories. These neural changes suggest MDMA creates a positive emotional bias, which may explain why it helps patients revisit traumatic memories during psychotherapy for PTSD.

Canalization and plasticity in psychopathology

Neuropharmacology December 27, 2022 Robin Carhart‐Harris, Shamil Chandaria, David Erritzøe et al. 106 citations

A theoretical model proposes that psychopathology arises from a defensive process called canalization, which narrows an individual's range of thoughts, feelings, and behaviors by increasing precision or reducing variance in neural responses. This contrasts with an early form of plasticity, TEMP (Temperature or Entropy Mediated Plasticity), which increases variance and learning rate. Canalization entrenches pathology as the agent develops expertise in their disorder, while TEMP, combined with gentle psychological support, may counter this entrenchment. The model distinguishes adaptive from maladaptive canalization and suggests concrete experiments to test its hypotheses.

Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation

Frontiers in Psychiatry August 7, 2020 Richard J. Zeifman, Anne Catherine Wagner, Ros Watts et al. 104 citations

In two prospective studies with convenience samples of people planning to use a psychedelic (total N=358), participants completed questionnaires before use and at 2 and 4 weeks afterward. Across both studies, significant decreases occurred in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may reduce experiential avoidance, depression severity, and suicidal ideation, and that reduced experiential avoidance may be a transdiagnostic mechanism in psychedelic therapy. Integrating psychedelics with therapies targeting experiential avoidance, such as acceptance and commitment therapy, may enhance outcomes.

Case analysis of long-term negative psychological responses to psychedelics

Scientific Reports September 25, 2023 Rebecka Bremler, Nancy Katati, Parvinder Shergill et al. 102 citations

Negative psychological responses to psychedelics lasting more than 72 hours are real and can include new psychiatric diagnoses or worsened symptoms. In a sample of 32 individuals who completed an online questionnaire, 37.5% received a new psychiatric diagnosis after their psychedelic experience, and 87% experienced anxiety symptoms. Deeper interviews with 15 of the most severe cases revealed potential causes: unsafe environments, unpleasant acute experiences, prior psychological vulnerabilities, high or unknown drug doses, and young age. The findings cannot estimate how common such harms are due to the small, selective sample and study design focused only on negative outcomes.

Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential?

Frontiers in Psychiatry July 19, 2021 Rita Kočárová, Jiřı́ Horáček, Robin Carhart‐Harris 95 citations

Psychedelic therapy may work across many psychiatric disorders by increasing neuronal and mental plasticity, which enhances the potential for change. Combined with psychotherapy, this plasticity can promote healthy adaptability and resilience, protecting long-term well-being. The authors propose that psychedelics' core action is transdiagnostic, offering prophylactic benefits beyond current treatments. They link candidate neurological and psychological markers to a predictive processing model, suggesting broad public health impact.

Serotonergic psychedelics LSD & psilocybin increase the fractal dimension of cortical brain activity in spatial and temporal domains

NeuroImage June 30, 2020 Thomas F. Varley, Robin Carhart‐Harris, Leor Roseman et al. 91 citations

Psychedelic drugs like psilocybin and LSD increase the fractal dimension of brain activity, suggesting that the brain moves toward a critical state between order and disorder. Using fMRI data from volunteers, the study tested two fractal measures: one for functional connectivity networks and one for BOLD time-series. Both drugs significantly increased the fractal dimension of functional connectivity networks. LSD also significantly increased the fractal dimension of BOLD signals, while psilocybin showed a non-significant trend in the same direction. Changes in the fractal dimension of BOLD signals were localized to brain areas in the dorsal attention network. These results indicate that psychedelic-induced changes in consciousness are associated with evolution toward a critical zone.

Psychedelics and the science of self-experience

The British Journal of Psychiatry March 1, 2017 Matthew M. Nour, Robin Carhart‐Harris 90 citations

Altered self-experiences, which occur in some psychiatric conditions and can be induced by psychoactive drugs or spiritual practices, are now being studied through a neuroscience framework that combines functional neuroimaging with altered states from psychedelic drugs. This emerging understanding may significantly benefit psychiatry.

Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison

Schizophrenia Bulletin August 5, 2020 Pantelis Leptourgos, Martin Fortier-Davy, Robin Carhart‐Harris et al. 88 citations

A multidisciplinary working group reviewed evidence on the similarities and differences between hallucinations induced by psychedelics and those occurring in schizophrenia-spectrum disorders, examining data from pharmacology, brain imaging, phenomenology, and anthropology. The authors highlight both shared features and distinct characteristics across these scales, and attempt to integrate findings using computational approaches. They conclude with recommendations for future research, emphasizing the need for further study to clarify the relationship between these types of hallucinations.

Psychedelics and health behaviour change

Journal of Psychopharmacology May 29, 2021 Pedro J. Teixeira, Matthew W. Johnson, Christopher Timmermann et al. 87 citations

Healthy behaviors like diet, exercise, and not smoking greatly reduce risks for cancer, diabetes, and cardiovascular disease, but lifestyle diseases remain a major burden. Psychedelic substances, particularly psilocybin, are being explored as tools to promote positive lifestyle change. Psilocybin has low toxicity, is non-addictive, and has shown favorable changes in patients with depression, anxiety, and substance misuse. The article describes proposed mechanisms of action and research linking psychedelics to health behavior change, suggesting that combining psychedelic experiences with methods like Cognitive Behaviour Therapy and Motivational Interviewing may help improve diet, exercise, nature exposure, and mindfulness.

Study Protocol for “Psilocybin as a Treatment for Anorexia Nervosa: A Pilot Study”

Frontiers in Psychiatry October 20, 2021 Meg J. Spriggs, Hannah Douglass, Rebecca J. Park et al. 78 citations

Anorexia nervosa is a severe psychiatric condition with few approved treatments. This paper describes how individuals with lived experience of anorexia nervosa helped shape a pilot study of psilocybin-assisted therapy through two online focus groups involving eleven people, and presents the protocol for that study at Imperial College London. Twenty female participants aged 21–65 with a body mass index of 15 kg/m² or above will receive three oral doses of psilocybin (up to 25 mg) over six weeks, supported by psychological preparation and integration, with a 12-month remote follow-up.

More Realistic Forecasting of Future Life Events After Psilocybin for Treatment-Resistant Depression

Frontiers in Psychology October 12, 2018 Taylor Lyons, Robin Carhart‐Harris 78 citations

Patients with treatment-resistant depression showed a significant pessimism bias when predicting future life events, which was linked to the severity of their depressive symptoms. One week after receiving two doses of psilocybin (10 and 25 mg) with psychological support, this pessimism bias decreased significantly, depressive symptoms greatly improved, and patients became more accurate at predicting future events. No such change occurred in non-depressed controls. The findings suggest that psilocybin with psychological support might correct pessimism biases in treatment-resistant depression, enabling a more positive and accurate outlook.

Psychedelics as a treatment for disorders of consciousness

Neuroscience of Consciousness January 1, 2019 Gregory Scott, Robin Carhart‐Harris 72 citations

The classic psychedelic psilocybin may increase conscious awareness in patients with disorders of consciousness, based on its ability to increase brain complexity—a reliable index of conscious level. The authors propose testing this hypothesis but also confront the considerable ethical and practical challenges that must be addressed for direct assessment.

In vivo mapping of pharmacologically induced functional reorganization onto the human brain’s neurotransmitter landscape

Science Advances June 14, 2023 Leor Roseman, Christopher Timmermann, Daniel Golkowski et al. 65 citations

The effects of mind-altering drugs on brain function arise from complex interactions with multiple neurotransmitter systems, not just one. By linking the distribution of 19 neurotransmitter receptors and transporters (measured with PET) to changes in functional connectivity (measured with fMRI) caused by 10 drugs—anesthetics (propofol, sevoflurane, ketamine), psychedelics (LSD, psilocybin, DMT, ayahuasca), and others (MDMA, modafinil, methylphenidate)—the work shows a many-to-many mapping between drug effects and neurotransmitter systems. The drugs' impacts follow hierarchical gradients of brain structure and function, and regional susceptibility to drug-induced changes mirrors susceptibility to structural alterations from brain disorders.

Sustained, Multifaceted Improvements in Mental Well-Being Following Psychedelic Experiences in a Prospective Opportunity Sample

Frontiers in Psychiatry June 29, 2021 Keri Mans, Hannes Kettner, David Erritzøe et al. 65 citations

Psychedelic substances like LSD and psilocybin have regained legitimacy in clinical research. In this naturalistic observational study of volunteers intending to take a psychedelic, well-being was assessed using fourteen measures at four time points: 1 week before and 2 weeks, 4 weeks, and 2 years after the experience (sample sizes 654, 315, 212, and 64, respectively). Changes clustered into three factors: 'Being well,' 'Staying well,' and 'Spirituality.' Repeated measures analysis showed improvements in Being Well and Staying Well in the weeks following the experience, and mixed model analyses indicated these improvements remained statistically significant up to 2 years, despite high attrition. Spirituality did not show significant change.

Pattern breaking: a complex systems approach to psychedelic medicine

Neuroscience of Consciousness January 1, 2023 Inês Hipólito, Jonas Mago, Fernando E. Rosas et al. 60 citations

Psychedelic therapy shows promise for mental health, but the psychological mechanisms behind its benefits are unclear. This paper proposes that psychedelics act as destabilizers, both psychologically and neurophysiologically, drawing on the 'entropic brain' hypothesis and the 'RElaxed Beliefs Under pSychedelics' model. Using complex systems theory, it suggests that psychedelics disrupt fixed points or attractors, breaking reinforced patterns of thinking and behavior. The approach explains how increased brain entropy destabilizes neurophysiological set points, leading to new understandings of psychedelic psychotherapy. These insights have implications for reducing risks and optimizing treatment during both the peak experience and the subacute recovery period.

RETRACTED ARTICLE: A mechanistic model of the neural entropy increase elicited by psychedelic drugs

Scientific Reports October 20, 2020 Rubén Herzog, Pedro A. M. Mediano, Fernando E. Rosas et al. 60 citations

Psychedelic drugs such as lysergic acid diethylamide, which activate the serotonin 2A receptor, produce profound changes in consciousness and increase entropy in spontaneous neural activity. This study provides the first model-based explanation for that entropy increase by extending a whole-brain model of serotonergic neuromodulation. The model reproduced the overall entropy rise seen in previous experiments. Entropy changes were not uniform: some brain regions showed increased entropy while others showed decreases, indicating a topographical reconfiguration driven by receptor activation. At the whole-brain level, this reconfiguration was not well explained by receptor density but was closely related to the brain's anatomical connectivity topology.

Effects of psilocybin versus escitalopram on rumination and thought suppression in depression

BJPsych Open September 1, 2022 Tommaso Barba, Sarah Buehler, Hannes Kettner et al. 57 citations

Psilocybin, but not the antidepressant escitalopram, reduced rumination and thought suppression in people with major depressive disorder six weeks after treatment. In a randomized trial of 59 participants, only those given psilocybin showed significant decreases in both maladaptive coping strategies. Among treatment responders, thought suppression decreased exclusively in psilocybin responders, while rumination decreased in both psilocybin and escitalopram responders. Reductions in rumination and thought suppression correlated with ego dissolution and psychological insight during psilocybin sessions, suggesting distinct therapeutic mechanisms for the two treatments.

Associations between lifetime classic psychedelic use and cardiometabolic diseases

Scientific Reports July 13, 2021 Otto Simonsson, Walter Osika, Robin Carhart‐Harris et al. 54 citations

Lifetime use of classic psychedelics is associated with lower odds of heart disease and diabetes. Analyzing data from the National Survey on Drug Use and Health (2005–2014), people who had ever tried a classic psychedelic had 23% lower odds of past-year heart disease and 12% lower odds of past-year diabetes. The associations persisted after adjusting for other factors. The authors suggest classic psychedelic use might benefit cardiometabolic health but call for more research on causal pathways.

Semantic activation in LSD: evidence from picture naming

Language Cognition and Neuroscience August 11, 2016 Neiloufar Family, David Vinson, Gabriella Vigliocco et al. 53 citations

LSD alters cognition by expanding the breadth of semantic activation. In a picture-naming task with ten participants, LSD reduced accuracy and altered error correction patterns compared to placebo, consistent with an increased spread of semantic activation. These effects align with a generalized entropic effect on the mind. The authors recommend future studies include direct neuroimaging and more naturalistic measures of semantic processing.

The administration of psilocybin to healthy, hallucinogen-experienced volunteers in a mock-functional magnetic resonance imaging environment: a preliminary investigation of tolerability

Journal of Psychopharmacology April 15, 2010 Ben Sessa, Amanda Feilding, Robin Carhart‐Harris et al. 53 citations

Up to 2 mg of psilocybin administered as a slow intravenous injection to healthy, hallucinogen-experienced volunteers in a mock-MRI environment produces short-lived but typical drug effects that are psychologically and physiologically well tolerated. The pilot work supports the viability of using functional magnetic resonance imaging to investigate psilocybin's effects on cerebral blood flow and activity.

Prefrontal contributions to the stability and variability of thought and conscious experience

Neuropsychopharmacology September 20, 2021 Andre Zamani, Kalina Christoff, Robin Carhart‐Harris 50 citations

The prefrontal cortex contains multiple subregions linked to different large-scale brain networks, supporting a wide range of mental phenomena from goal-directed thought and executive functions to mind-wandering and psychedelic experiences. A key dimension distinguishing conscious experiences is the stability or variability of mental states over time, which is central to the dynamic framework of thought (DFT) and the relaxed beliefs under psychedelics (REBUS) model. This review synthesizes these frameworks to explain how prefrontal subregions may differentially contribute to the stability and variability of thought and conscious experience, and suggests future research directions.

Serotonin, psychedelics and psychiatry

World Psychiatry September 7, 2018 Robin Carhart‐Harris 49 citations

Serotonin is a complex neuromodulator involved in brain development, perception, cognition, and mood, but no unified theory of its function exists, partly due to its 14+ receptors. While SSRIs are the dominant depression treatment, their widespread use has not reduced depression prevalence, and questions about safety and efficacy persist. Evidence suggests serotonergic processes mediate sensitivity to context, with genetic and pharmacological factors interacting with environment to affect mental health.

A Qualitative Report on the Subjective Experience of Intravenous Psilocybin Administered in an fMRI Environment

Current Drug Abuse Reviews January 9, 2015 Samuel Turton, D.j. Nutt, Robin Carhart‐Harris 48 citations

An analysis of the subjective experiences of psilocybin administered intravenously in an MRI scanner found effects consistent with prior reports on psilocybin's subjective effects. The article documents these phenomena and suggests further research is needed to explore the identified experiences.

Examining Psychedelic-Induced Changes in Social Functioning and Connectedness in a Naturalistic Online Sample Using the Five-Factor Model of Personality

Frontiers in Psychology November 25, 2021 Brandon Weiss, Victoria Amalie Nygart, Lis Marie Pommerencke et al. 47 citations

In an online volunteer sample, naturalistic use of psychedelic compounds was associated with reductions in Neuroticism and increases in Agreeableness and perceived social connectedness over four weeks. These changes covaried, suggesting shared emotion-regulation processes. Preliminary evidence pointed to a specific decrease in critical and quarrelsome interpersonal style, a component of Agreeableness. Baseline levels of Neuroticism, perspective taking, and social connectedness tentatively amplified adaptive changes in those respective traits. Demographic characteristics, social setting, and acute subjective factors showed limited moderating effects. The findings suggest psychedelics might help address interpersonal aspects of personality pathology and loneliness.

Self-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future Research

Frontiers in Psychiatry November 12, 2021 Julia Bornemann, James B. Close, Meg J. Spriggs et al. 43 citations

Eleven individuals with chronic pain who self-medicate with psychedelic drugs described their experiences in a group discussion. Pain scores improved substantially during and after psychedelic experiences across a range of substances and doses. Two processes—Positive Reframing and Somatic Presence—were reliably identified as contributing to improvements in mental wellbeing, relationship with pain, and physical (dis)comfort. Additional strategies such as mindfulness, breathwork, and movement were also widely reported. The authors note that due to the subjective nature of the data, no claims on causality or generalisability can be made. These results will inform the design of a forthcoming controlled trial testing psychedelic therapy for chronic pain.