Frontiers in Psychiatry
June 12, 2023
Rayyan Zafar, Maxim Siegel, Rebecca Harding et al.
95 citations
Psychedelic therapy is regaining scientific and medical interest, with growing evidence for its safety and efficacy in treating psychiatric disorders, including addiction. This review charts research on these interventions for addiction, starting with the socioeconomic impact of addiction and current treatment options. It examines historical studies from the mid-late 1900s, real-world evidence from naturalistic and survey-based studies, and modern clinical trials from first-in-human to phase II. The review also covers translational neuropsychopharmacology techniques like fMRI and PET that help explain therapeutic mechanisms. A better understanding of these treatment effects can optimize psychedelic therapy development and improve patient outcomes.
Molecular psychiatry
September 1, 2023
Matthew B Wall, Rebecca Harding, Rayyan Zafar et al.
39 citations
Psychedelic therapy shows promise for treating depression, addiction, PTSD, and other psychiatric disorders. Classic serotonergic psychedelics like psilocybin and LSD act primarily at the 5-HT2A receptor, while ketamine, MDMA, and ibogaine also show potential. Modern neuroimaging techniques, especially PET and MRI, now allow precise measurement of brain effects. Key knowledge gaps remain: the link between acute drug effects and long-term clinical outcomes, detailed characterization of 5-HT2A receptor effects, and the role of neuroplasticity. Future studies combining PET with 5-HT2A-selective ligands like [11C]Cimbi-36 and MRI could bridge molecular, functional, and clinical understanding.
Psychological medicine
December 1, 2023
Paul McCrone, Henry Fisher, Clare Knight et al.
34 citations
Psilocybin-assisted psychotherapy (PAP) may be a cost-effective treatment for severe depression, depending on the price of the drug and the level of therapist support. A decision model compared PAP with conventional medication, cognitive behavioural therapy (CBT), and their combination over six months. PAP produced the highest quality-adjusted life years (0.310) but also the highest expected healthcare cost (£6,132 to £7,652). PAP became cost-effective when therapist support costs were reduced by 50% and the psilocybin price dropped to £400–£800 per person. From a societal perspective, PAP's cost-effectiveness improved further. More long-term outcome data are needed.
Molecular Psychiatry
April 26, 2025
Rebecca Harding, Neomi Singer, Talma Hendler et al.
4 citations
Psilocybin therapy reduces anhedonia more than the SSRI escitalopram in major depressive disorder, yet escitalopram dampens emotional responses to musical surprises while psilocybin therapy preserves them. Escitalopram increases brain activity in memory and emotion regions during musical surprises, whereas psilocybin therapy decreases activity in the ventromedial prefrontal cortex and angular gyrus and increases sensory region activation. These contrasting neural and behavioral effects suggest fundamentally different treatment mechanisms: psilocybin may maintain subjective responses by reducing the salience of prediction errors or strengthening hedonic expectations, while escitalopram may weaken hedonic priors.
June 30, 2022
Matthew B. Wall, Rebecca Harding, Rayyan Zafar et al.
3 citations
preprint
Psychedelic therapy shows potential for treating psychiatric disorders like depression, addiction, and PTSD. Classic serotonergic psychedelics such as psilocybin, LSD, DMT, and 5-MeO-DMT are the main focus, along with ketamine, MDMA, and ibogaine. The concurrent use of advanced neuroimaging methods, particularly PET and MRI, has allowed precise assessment of brain effects, benefiting the development of these treatments. The text identifies gaps in knowledge that future multimodal imaging studies could address, providing a stronger foundation for psychedelic therapy.
Open Science Framework
October 20, 2025
Natalia Fernandez-Vinson, Roger Atkins, Marcus Glennon et al.
This registered clinical study investigates whether N,N-dimethyltryptamine (DMT), alone or combined with reactivating alcohol-related memories, can produce lasting changes in the brain, cognition, and drinking behavior in people with mild alcohol use disorder who are hazardous drinkers but not seeking treatment. Up to 120 participants will be assigned to one of four groups: alcohol memory retrieval plus DMT, alcohol memory retrieval plus placebo, control memory retrieval plus DMT, or control memory retrieval plus placebo. Drinking levels will be measured over three lab sessions and a nine-month follow-up using timeline follow-back and blood tests.
The International Journal of Neuropsychopharmacology
February 1, 2025
Rebecca Harding, Natalie Ertl, Rayyan Zafar
Both escitalopram and psilocybin therapy reduced impulsivity and anhedonia in people with major depressive disorder, but they altered brain connectivity in different ways. Psilocybin increased connectivity between the amygdala and the left anterior insula and putamen, and between the limbic striatal network and the bilateral insula, paracingulate, and temporoparietal junction. Escitalopram decreased connectivity between the amygdala and the right cerebellum and occipital cortex, and between the limbic striatum and the insula. The escitalopram-induced reduction in limbic striatal–insula connectivity correlated with reduced anhedonia. These results suggest the two treatments affect reward-related brain circuitry through distinct mechanisms.