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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

What it is like to be a bit: an integrated information decomposition account of emergent mental phenomena

Neuroscience of Consciousness November 1, 2021 Andrea I. Luppi, Pedro A. M. Mediano, Fernando E. Rosas et al. 42 citations

Consciousness can be better understood by decomposing it into distinct information-theoretic elements rather than measuring it as a single quantity of integrated information. The authors propose Integrated Information Decomposition (ΦID), which provides a formal argument that whether consciousness is an emergent phenomenon depends on its information-theoretic composition. Two organisms may have the same amount of integrated information yet differ in composition. A new measure, ΦR, and the ΦR-ing ratio quantify how efficiently information is used for conscious processing. This approach enables identification of qualitatively different 'modes of consciousness' and mapping them to phenomenology, starting with selfhood. ΦID offers new ways to explore the relationship between information, consciousness, and neural dynamics.

Different hierarchical reconfigurations in the brain by psilocybin and escitalopram for depression

Nature Mental Health August 5, 2024 Gustavo Deco, Yonatan Sanz Perl, Samuel Johnson et al. 39 citations

Two serotonergic interventions—psilocybin therapy and the antidepressant escitalopram—rebalance brain dynamics in major depressive disorder through opposite hierarchical reconfigurations. In a double-blind phase II trial, 22 patients received two 25 mg doses of psilocybin plus daily placebo, while 20 patients received two 1 mg doses of psilocybin plus daily escitalopram. Resting-state fMRI scans before and after treatment, analyzed with generative effective connectivity models, showed that the two treatments produced significantly different and opposite changes in whole-brain hierarchy. Machine learning predicted treatment response with 85% accuracy. The findings suggest that depression may involve disrupted function of brain regions that orchestrate dynamics from the top of the hierarchy.

Effects of external stimulation on psychedelic state neurodynamics

bioRxiv (Cold Spring Harbor Laboratory) November 2, 2020 Pedro A. M. Mediano, Fernando E. Rosas, Christopher Timmermann et al. 39 citations preprint

Psychedelics reliably increase brain entropy (neural signal diversity), an effect linked to psychological changes and opposite to the decrease seen during loss of consciousness. This study investigated how context—specifically stimulus manipulation—modulates that entropy increase. Participants under LSD or placebo experienced eyes-closed versus eyes-open conditions, or no stimulus, music, or video. Brain entropy rose with LSD across all conditions but was largest with eyes closed. Entropy changes consistently matched subjective ratings of the psychedelic experience, except during video viewing, suggesting competition between external stimuli and internal LSD-induced imagery. The findings provide quantitative evidence that context shapes neural dynamics during psychedelic experiences, supporting the practice of eyes-closed psychedelic psychotherapy, and challenge simplistic views of brain entropy as a direct measure of conscious level.

Changes in music-evoked emotion and ventral striatal functional connectivity after psilocybin therapy for depression

Journal of Psychopharmacology November 26, 2022 Melissa Shukuroglou, Leor Roseman, David Nutt et al. 38 citations

Listening to music after psilocybin therapy for treatment-resistant depression increases the pleasure people feel from music, and this increase correlates with a reduction in anhedonia (loss of pleasure). Nineteen patients received a low dose (10 mg) and then a high dose (25 mg) of psilocybin one week apart. Functional MRI scans before and after treatment showed that during music listening, functional connectivity between the nucleus accumbens (a brain reward region) and areas resembling the default mode network decreased after treatment. The findings suggest psilocybin therapy enhances music-evoked pleasure and point to a possible brain mechanism involving reduced connectivity in the default mode network.

Trends in the Top-Cited Articles on Classic Psychedelics

Journal of Psychoactive Drugs February 3, 2021 Bhanu Sharma, David W. Lawrence, Roland R. Griffiths et al. 37 citations

An analysis of the top-cited classic psychedelic publications found that recent highly cited work (published after 2010) focuses more on clinical trials and therapeutic applications, especially for affective and substance use disorders, while older highly cited work was dominated by basic science and preclinical studies. Psilocybin was the primary substance in recent top-cited articles, whereas LSD was more common in older ones. The recent cohort also had a much higher annual citation rate. The field is moving from foundational pharmacological understanding toward identifying clinical uses.

Association Between Lifetime Classic Psychedelic Use and Hypertension in the Past Year

Hypertension March 8, 2021 Otto Simonsson, Peter S. Hendricks, Robin Carhart‐Harris et al. 36 citations

Adults who had used a classic psychedelic at least once in their lifetime had 14% lower odds of hypertension in the past year, after adjusting for confounders. The association was strongest for tryptamine psychedelics (DMT, ayahuasca, psilocybin), which were linked to 20% lower odds of hypertension. No significant association was found for LSD or mescaline. The authors note these findings are correlational and call for randomized controlled trials to test causal effects.

Neuroplasticity and psychedelics: A comprehensive examination of classic and non-classic compounds in pre and clinical models

Neuroscience & Biobehavioral Reviews April 4, 2025 Claudio Agnorelli, Kate Godfrey, Gabriela Sawicka et al. 32 citations

Classic psychedelics (LSD, psilocybin, N,N-DMT) and non-classic psychedelics (ketamine, MDMA) enhance neuroplasticity—the nervous system's ability to adapt—through molecular, structural, and functional changes. Animal studies indicate these drugs induce meta-plasticity (heightened sensitivity to environmental stimuli) and hyper-plasticity (re-opening developmental windows for long-term structural changes), with implications for mood and behavior. Translating these findings to humans faces challenges due to limitations in current imaging techniques, but promising new directions include novel PET radioligands, non-invasive brain stimulation, and multimodal approaches. This review informs the development of targeted interventions for neuropsychiatric disorders.

Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences

Scientific Reports August 22, 2023 Hannes Kettner, Stephen Ross, Richard J. Zeifman et al. 31 citations

Co-using a low dose of MDMA with psilocybin or LSD is associated with less intense challenging experiences—such as grief and fear—and increased feelings of self-compassion, love, and gratitude, compared to using psilocybin or LSD alone. In a survey of 698 people planning to use these substances, the 27 who also took a low dose of MDMA reported these benefits without a reduction in mystical-type experiences or compassion. Medium-to-high MDMA doses did not show the same effects. The findings suggest MDMA may buffer against some difficult aspects of psychedelic experiences, but the study's small, non-experimental convenience sample limits certainty.

Effects of classic psychedelic drugs on turbulent signatures in brain dynamics

Network Neuroscience January 1, 2022 Josephine Cruzat, Yonatan Sanz Perl, Anira Escrichs et al. 28 citations

Psychedelic drugs like LSD and psilocybin may treat neuropsychiatric disorders by dose-dependently altering the brain's functional hierarchy—the organization of neural activity across regions. Using a turbulence framework that measures local synchronization (vorticity) in both space and time, researchers found that both drugs produce consistent and distinct effects, particularly compressing the default mode network, a higher-level network. These findings support the hypothesis that psychedelics modulate the functional hierarchy and provide a quantitative comparison of how LSD and psilocybin change brain dynamics, with implications for therapeutic use.

Serotonergic psychedelic drugs LSD and psilocybin reduce the hierarchical differentiation of unimodal and transmodal cortex

bioRxiv (Cold Spring Harbor Laboratory) May 3, 2020 Manesh Girn, Leor Roseman, Boris C. Bernhardt et al. 27 citations preprint

LSD and psilocybin flatten the brain's hierarchical organization, reducing the functional separation between sensory and higher-order cognitive networks. Using a non-linear dimensionality reduction technique on resting-state fMRI data, the authors found that both drugs compressed the principal gradient of cortical connectivity, which normally spans from unimodal (sensory) to transmodal (association) cortex. This flattening was driven by decreased differentiation at both ends of the hierarchy—default and frontoparietal networks at the upper end and somatomotor networks at the lower end—and was accompanied by increased crosstalk between unimodal and transmodal regions. Changes in the principal gradient under LSD tracked self-reported ego-dissolution. The findings support a mechanistic model of the psychedelic state and demonstrate that macroscale connectivity gradients are sensitive to serotonergic modulation.

Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression

Journal of Psychopharmacology March 22, 2024 Tommaso Barba, David Erritzøe, Meg J. Spriggs et al. 26 citations

In a clinical trial comparing psilocybin plus psychological support to escitalopram plus psychological support for major depressive disorder, patients who discontinued their SSRI or SNRI medication before receiving psilocybin showed a reduced treatment effect on all depression severity and well-being measures compared with those who were unmedicated at trial entry. Discontinuation did not affect the intensity of the acute psychedelic experience. The findings are exploratory and hypothesis-generating, not confirmatory, and the study did not test SSRI/SNRI continuation. A controlled trial comparing discontinuation versus continuation before psilocybin is needed.

Distributed harmonic patterns of structure-function dependence orchestrate human consciousness

bioRxiv (Cold Spring Harbor Laboratory) August 10, 2020 Andrea I. Luppi, Jakub Vohryzek, Morten L. Kringelbach et al. 26 citations preprint

Consciousness arises from how the brain's structural wiring shapes its dynamic activity. By decomposing resting-state fMRI data into harmonic modes of the human structural connectome, a generalizable signature of lost consciousness emerges—whether from anesthesia or brain injury—while a reversed signature characterizes psychedelic states induced by LSD or ketamine, reflecting decoupling of function from structure. This connectome harmonic approach discriminates between behaviorally indistinguishable brain-injured patients and tracks covert consciousness, linking neurobiology to conscious experience.

DMT alters cortical travelling waves

bioRxiv (Cold Spring Harbor Laboratory) May 8, 2020 Andrea Alamia, Christopher Timmermann, Rufin Vanrullen et al. 25 citations preprint

The psychedelic drug DMT rapidly induces an immersive conscious state with vivid visual imagery. EEG recordings showed that DMT alters cortical traveling waves: the typical alpha-band backward wave of eyes-closed rest decreased, while a forward wave similar to that seen during visual stimulation increased. This supports a model where psychedelics reduce the precision-weighting of prior expectations, shifting the balance from top-down to bottom-up information flow. The findings suggest that backward traveling waves are correlates of precision weighting and that reduced backward and increased forward waves are a mechanistic principle of psychedelic-induced altered states.

Connectome-harmonic decomposition of human brain activity reveals dynamical repertoire re-organization under LSD

bioRxiv (Cold Spring Harbor Laboratory) July 14, 2017 Selen Atasoy, Leor Roseman, Mendel Kaelen et al. 25 citations preprint

Lysergic acid diethylamide (LSD) alters the energy and power of individual harmonic brain states in a frequency-selective manner, expanding the repertoire of active brain states. This non-random increase in co-activation across frequencies suggests a general re-organization of brain dynamics. The frequency distribution of active brain states under LSD follows power-laws, indicating dynamics at the edge of criticality. These methods offer insights into complex brain dynamics in health and disease.

Psychedelics and sexual functioning: a mixed-methods study

Scientific Reports February 7, 2024 Tommaso Barba, Hannes Kettner, Caterina Radu et al. 24 citations

Psychedelics may improve sexual functioning and satisfaction days or weeks after use, according to two studies. In a large naturalistic study, people who used psychedelics reported greater pleasure, communication during sex, and satisfaction with their partner and appearance. A controlled clinical trial comparing psilocybin therapy with the SSRI escitalopram for depression found that those given psilocybin reported positive changes in sexual functioning after treatment, while those given escitalopram did not. This is the first quantitative investigation of psychedelics' post-acute effects on sexual functioning, suggesting a potential benefit and a need for further research.

Turn on, Tune in, and Drop out: Predictors of Attrition in a Prospective Observational Cohort Study on Psychedelic Use

Journal of Medical Internet Research May 4, 2021 Sebastian Hübner, Eline Haijen, Mendel Kaelen et al. 23 citations

In web-based studies that track people before and after they use psychedelics, many participants stop responding, which can bias the results. Analyzing data from 654 initial participants, younger age, lower education, higher extraversion, and lower conscientiousness predicted dropping out before the four-week endpoint. Neither positive attitudes toward psychedelics nor intense challenging experiences during the drug session predicted dropout. These attrition patterns match those seen in other long-term studies, suggesting they are not unique to psychedelic research. The absence of dropout linked to psychedelic advocacy or negative drug experiences reduces concerns about certain biases in this type of data.

Population pharmacokinetic/pharmacodynamic modeling of the psychedelic experience induced by N,N‐dimethyltryptamine – Implications for dose considerations

Clinical and Translational Science September 11, 2022 Emma Eckernäs, Christopher Timmermann, Daniel Röshammar et al. 22 citations

The psychedelic compound DMT is cleared from the body at a very high rate—26 L/min—indicating its elimination is independent of blood flow. Plasma concentrations follow a two-compartment model, with DMT metabolized to indole 3-acetic acid. The intensity of the psychedelic experience is linked to DMT concentration at an effect site, with half-maximal effect at 95 nM. Simulated median intensity ratings after doses of 1, 4, 7, 14, and 20 mg were zero, 2, 4, 8, and 9 on a 0–10 scale. The model can help predict suitable doses for clinical studies based on desired subjective experience intensity.

Psilocybin therapy for treatment resistant depression: prediction of clinical outcome by natural language processing

Psychopharmacology August 22, 2023 Robert F. Dougherty, Patrick Clarke, Merve Atli et al. 21 citations

A machine learning model that analyzes language from therapy sessions can predict which patients with treatment-resistant depression will respond to psilocybin therapy. Researchers used a zero-shot classifier based on the BART large language model to measure sentiment (valence and arousal) in transcripts of therapist-patient conversations one day after COMP360 psilocybin administration. These sentiment scores, combined with the Emotional Breakthrough Index and treatment arm, were fed into multinomial logistic regression models. The models predicted responder status at week 3 and through week 12 with 85% and 88% accuracy, respectively, and AUC values of 88% and 85%. This approach could enable early identification of patients needing alternative treatments.

Co-design of Guidance for Patient and Public Involvement in Psychedelic Research

Frontiers in Psychiatry September 30, 2021 James B. Close, Julia Bornemann, Maria Piggin et al. 21 citations

A co-designed guide for patient and public involvement (PPI) in psychedelic research addresses the lack of field-specific frameworks. Core values—trust, learning, purpose, and inclusivity—emerged from a workshop with public collaborators. The guidance aims to help researchers plan, evaluate, and improve PPI so that research is done with and by the public rather than on them, strengthening accountability and relevance as the field grows.

Effects of LSD on music-evoked brain activity

bioRxiv (Cold Spring Harbor Laboratory) June 25, 2017 Mendel Kaelen, Romy Lorenz, Frederick S. Barrett et al. 20 citations preprint

Lysergic acid diethylamide (LSD) alters how the brain processes music, particularly by enhancing activity and connectivity in networks linked to music perception and emotion. Sixteen healthy volunteers listened to a 7-minute music piece during fMRI after taking either 75 mcg of LSD or a placebo. The acoustic feature of timbral complexity—the richness of the music's spectral distribution—drove the most pronounced changes in brain activity and connectivity under LSD. These changes correlated with increased feelings of wonder evoked by the music. The results suggest a neurobiological basis for why music is useful in psychedelic therapy.

Among psychedelic-experienced users, only past use of psilocybin reliably predicts nature relatedness

Journal of Psychopharmacology January 1, 2023 Matthias Forstmann, Christina Sagioglou, Alexander Irvine et al. 18 citations

Among people who have used psychedelics, only past use of psilocybin—not LSD, mescaline, Salvia divinorum, ketamine, ibogaine, or DMT—reliably predicted a stronger sense of connection to nature (nature relatedness). The finding held even when people who had never used psychedelics were included in the analysis. For those who had used only psilocybin, more frequent use was linked to higher nature relatedness. This suggests that psilocybin may have a unique association with nature relatedness, possibly due to its pharmacology or the contexts in which it is used.

Time-resolved network control analysis links reduced control energy under DMT with the serotonin 2a receptor, signal diversity, and subjective experience

bioRxiv (Cold Spring Harbor Laboratory) May 12, 2023 Christopher Timmermann, Emma Eckernäs, Leor Roseman et al. 17 citations preprint

The serotonergic psychedelic DMT rapidly induces a profoundly immersive altered state lasting less than 20 minutes, allowing the entire drug experience to be captured during a single fMRI scan. Using network control theory, which quantifies the input needed to drive transitions between brain states, brain structure and function were integrated to map energy trajectories of 14 individuals undergoing fMRI during DMT and placebo. Global control energy was reduced following DMT compared to placebo. Longitudinal trajectories of global control energy correlated with EEG signal diversity and subjective drug intensity ratings. Regional effects correlated with serotonin 2a receptor density. Receptor distribution and pharmacokinetic information successfully recapitulated DMT's effects on global control energy trajectories.

Neural and subjective effects of inhaled DMT in natural settings

bioRxiv (Cold Spring Harbor Laboratory) August 20, 2020 Carla Pallavicini, Federico Cavanna, Federico Zamberlán et al. 17 citations preprint

Inhaled DMT, a short-acting psychedelic found in plants and animals, was studied in 35 experienced participants in natural settings using wireless EEG and questionnaires. DMT reduced alpha brain waves (8-12 Hz) across the scalp while increasing delta (1-4 Hz) and gamma (30-40 Hz) waves. Increases in gamma power correlated with reports of mystical-type experiences. DMT also altered global synchrony and metastability in gamma and alpha bands and increased signal complexity. These findings align with prior psychedelic research and suggest EEG markers for mystical experiences in natural contexts, underscoring the value of studying these compounds in real-world settings.

A Bayesian Reanalysis of a Trial of Psilocybin Versus Escitalopram for Depression

Psychedelic Medicine October 28, 2022 Bruna Giribaldi, Sandeep M. Nayak, Bilal A. Bari et al. 15 citations

A Bayesian reanalysis of a trial comparing psilocybin (25 mg) to escitalopram (20 mg) over 6 weeks in 59 patients with major depressive disorder found that psilocybin outperformed escitalopram on three of four depression scales, though evidence was not uniformly clinically meaningful. Using skeptical priors that bias results toward zero, the analysis showed strong to extremely strong evidence favoring psilocybin on the BDI-1A, MADRS, and HAMD-17, while evidence on the primary outcome (QIDS SR-16) was indeterminate. For clinically meaningful superiority, evidence was moderate against it for the QIDS SR-16 but moderate to strong for the MADRS and HAMD-17. Psilocybin showed extremely strong evidence of noninferiority to escitalopram across all scales. The findings support further research on psilocybin's relative efficacy.

The entropic heart: Tracking the psychedelic state via heart rate dynamics

bioRxiv (Cold Spring Harbor Laboratory) November 9, 2023 Fernando E. Rosas, Pedro A. M. Mediano, Christopher Timmermann et al. 14 citations preprint

Autonomic signals can reveal aspects of subjective and neural states. A Bayesian framework estimated heart rate entropy under psychedelics. Across four drugs—LSD, DMT, psilocybin, and ketamine—mean heart rate, high-frequency heart rate variability, and heart rate entropy consistently increased during the psychedelic experience. These changes predicted various dimensions of the experience. Heart rate entropy increases correlated with brain entropy increases, while other autonomic markers did not. Cost-efficient autonomic measures can reveal detail about subjective and brain states, opening new research avenues in neuroscience.