PLoS ONE
March 14, 2024
Adam W Levin, Rafaelle Lancelotta, Nathan D Sepeda et al.
65 citations
In a small randomized trial of psilocybin-assisted therapy for adults with major depressive disorder, the therapeutic alliance between participants and facilitators strengthened from the final preparation session to one week after the intervention. A stronger alliance before the psilocybin sessions predicted lower depression scores at 4 weeks, 6 months, and 12 months afterward. Stronger alliance also correlated with more intense mystical experiences and psychological insight during the drug sessions, which in turn predicted better depression outcomes. The findings suggest the therapeutic relationship is important for treatment success.
BMJ Open
May 1, 2023
Alan K Davis, Adam W Levin, Paul B Nagib et al.
19 citations
Psilocybin-assisted therapy may help treat post-traumatic stress disorder (PTSD), which current treatments often fail to relieve, especially in U.S. military veterans. This open-label pilot study will test two psilocybin doses (15 mg and 25 mg) combined with psychotherapy in 15 veterans with severe, treatment-resistant PTSD. The primary safety outcome tracks adverse events and suicidal ideation; the primary PTSD outcome uses the Clinician Administered PTSD Scale-5. Follow-up continues for 6 months after the second session. Results will be published in a peer-reviewed journal.
Psychedelic medicine (New Rochelle, N.Y.)
September 1, 2023
Zachary Herrmann, Adam W Levin, Steven P Cole et al.
9 citations
Among 228 healthcare providers who treat psychiatric disorders with medications and reported at least one lifetime psychedelic use, retrospective measures showed improvements in depression, anxiety, and well-being after psychedelic exposure. Suicidality decreased and resilience increased. A factor analysis indicated that a cluster of mystical, interpersonal, and personal experiences predicted these improvements. The preferred psychedelic agent did not affect outcomes, and frequency of use was not associated with outcomes, though effect sizes varied. Harm was reported by 13.2% (n = 30), consistent with general population rates. Pre-exposure alcohol use, aggressive impulses, and desire to die by suicide improved most often, while marijuana use most often worsened or did not change.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Adam W Levin
4 citations
A new model called HEALS (Hemispheric Annealing and Lateralization Under Psychedelics) proposes that psychedelics reverse the typical hierarchical relationship between the brain's hemispheres. Normally, the left hemisphere predominates while the right is inhibited. Under psychedelics and other altered states of consciousness, this hierarchy flips, releasing the right hemisphere from left-hemisphere inhibition. The article reviews neuroimaging evidence for lateralization under psychedelics and contrasts cognitive and emotional changes—such as attention, social and emotional intelligence, creativity and insight, and language—with those functions in each hemisphere. It also examines laterality in meditative and trance states, suggesting that many phenomena in psychedelic and other altered states may stem from atypical annealing between hemispheres toward right-hemisphere predominance.
Expert review of clinical pharmacology
June 11, 2025
Victor Pablo Acero, Taylor A Flatt, Peter M Gooch et al.
Psychedelic compounds can produce rapid and lasting depression symptom reduction after one or two administrations paired with psychotherapy, unlike traditional antidepressants. Current evidence on their antidepressant mechanisms is fragmented across biological, psychological, social, and spiritual domains. This review identifies key mechanisms in each domain, comparing them with those of conventional antidepressants to highlight overlaps and differences. The authors caution that focusing too narrowly on discrete pathways may limit progress, as psychedelics likely work through complex, interwoven processes. Future research should examine how suprapharmacological factors—set, setting, therapy modality, and integration—shape outcomes, moving beyond frameworks used for standard antidepressants.