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Suresh Muthukumaraswamy

School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

41 papers in the library · 2,212 citations · publishing 2013-2026

Papers

LSD flattens the hierarchy of directed information flow in fast whole-brain dynamics

bioRxiv (Cold Spring Harbor Laboratory) April 28, 2024 Kenneth Shinozuka, Prejaas Tewarie, Andrea I. Luppi et al. 5 citations preprint

LSD weakens the brain's directed connectivity hierarchy by increasing the balance between senders and receivers of neural signals. This finding supports the REBUS theory, which proposes that psychedelics flatten the hierarchy of information flow in the brain. Analyzing magnetoencephalography data from 16 healthy participants given 75 micrograms of intravenous LSD, the study found that LSD diminishes the asymmetry of directed connectivity averaged over time. Machine learning classifiers distinguished LSD from placebo more accurately when trained on hierarchy metrics than on traditional functional connectivity measures.

Qualitative content analysis of expectations in participants with depression about to begin LSD microdosing treatment: Identifying the need for psychedelic expectancy measures.

Neuropharmacology December 1, 2025 Carina Joy Donegan, Dimitri Daldegan-Bueno, Tehseen Noorani et al. 4 citations

Before starting a low-dose LSD regimen, people with major depression held varied expectations shaped largely by media and personal experience. Over half had tried other treatments that failed. Many expected subtle effects or had no specific expectations, while some anticipated changes in consciousness or neural rewiring. Hope served both as a motivator and a buffer against disappointment. The findings underscore how media influences expectations and suggest that current expectancy measures miss important factors specific to psychedelic therapy.

LSD microdosing in major depressive disorder: results from an open-label trial

Neuropharmacology November 5, 2025 Dimitri Daldegan‐bueno, C Donegan, Rachael L. Sumner et al. 4 citations

In an open-label phase 2A trial, 19 participants with major depressive disorder, most of whom were taking antidepressants, took microdoses of LSD twice weekly for eight weeks. No serious adverse events occurred, and one participant withdrew due to anxiety. Depression scores on the Montgomery-Åsberg Depression Rating Scale dropped by 59.5% at the end of the intervention, with improvements sustained for up to six months. Anxiety, rumination, stress, and quality of life also improved. The results provide preliminary evidence that microdosed LSD is safe and feasible for treating moderate depression, but randomized controlled trials are needed.

The Role of the Dorsolateral Prefrontal Cortex in Ego Dissolution and Emotional Arousal During the Psychedelic State.

Human brain mapping April 1, 2025 Clayton R Coleman, Kenneth Shinozuka, Robert Tromm et al. 4 citations

LSD alters consciousness by changing connectivity between the dorsolateral prefrontal cortex (DLPFC), thalamus, and visual areas. In healthy participants, stronger functional connectivity between the left and right DLPFC, thalamus, and fusiform face area correlated with greater ego dissolution. Emotional arousal was linked to increased connectivity between the right DLPFC, intraparietal sulcus, and salience network. A confirmatory reverse analysis supported these findings. Magnetoencephalography data showed that LSD increased theta-band information flow from the thalamus to the DLPFC, supporting the idea that disrupted thalamic gating underlies ego dissolution. The results clarify the DLPFC's role in LSD-induced altered states.

General Anesthesia and Discrete Components of Ketamine Neurophysiology.

JAMA psychiatry June 1, 2026 Ben Deverett, Duan Li, Theresa R Lii et al. 1 citation

Ketamine produces distinct brain-wave patterns that may be linked to its therapeutic effects. General anesthesia selectively blocks one of these patterns—theta oscillations—while leaving another pattern, beta-gamma oscillations, intact. In 52 participants, ketamine given during anesthesia preserved beta-gamma power increases but eliminated the characteristic theta augmentation seen during awake administration. This suggests that different neurophysiologic effects of ketamine can be separated, offering a way to investigate which brain-wave changes underlie its antidepressant, analgesic, or dissociative properties.

LSD microdosing for major depressive disorder: Mood and pharmacokinetic outcomes from a Phase 2a trial

Progress in Neuro-Psychopharmacology and Biological Psychiatry February 18, 2026 Dimitri Henriques Daldegan-Bueno, C Donegan, Rachael L. Sumner et al. 1 citation

Taking very low doses of LSD (8 micrograms) repeatedly over a short period may temporarily improve mood in people with depression, though the effect needs confirmation in controlled experiments. The drug's behavior in the body was measured in this group, and no evidence of tolerance or increased sensitivity appeared, even when the dose was gradually increased.

The Role of the Dorsolateral Prefrontal Cortex in Ego Dissolution and Emotional Arousal During the Psychedelic State

bioRxiv Preprint Server December 9, 2024 Clayton R. Coleman, Kenneth Shinozuka, Robert Tromm et al. 1 citation preprint

Lysergic acid diethylamide (LSD) alters consciousness by affecting brain connectivity, particularly in the dorsolateral prefrontal cortex (DLPFC). Using fMRI and MEG data from healthy participants, the study found that ego dissolution—a hallmark of the psychedelic experience—was positively correlated with increased functional connectivity between the left and right DLPFC, thalamus, and fusiform face area. Emotional arousal was linked to stronger connectivity between the right DLPFC, intraparietal sulcus, and salience network. A confirmatory analysis supported these findings. MEG data showed that LSD increased directed information flow from the thalamus to the DLPFC in the theta band, suggesting disrupted thalamic gating contributes to ego dissolution. These results indicate a key role for the DLPFC in LSD-induced states of consciousness.

Local activity alterations in autism spectrum disorder correlate with neurotransmitter properties and ketamine induced brain changes.

medRxiv : the preprint server for health sciences October 21, 2024 Pascal Grumbach, Jan Kasper, Joerg F Hipp et al. 1 citation preprint

Autism spectrum disorder involves altered resting-state brain function, and an imbalance between excitation and inhibition is a proposed mechanism. In two large independent cohorts, individuals with autism consistently showed reduced local brain activity in default mode network nodes and increased activity in temporal regions, cerebellum, and brainstem. These activity changes spatially overlapped with multiple neurotransmitter systems, including dopamine, glutamate, GABA, and acetylcholine. The NMDA-antagonist ketamine, but not the GABA-potentiator midazolam, induced activity changes resembling those seen in autism, suggesting that pharmacologically shifting the excitation-inhibition balance can mimic autism-related brain alterations.

LSD Relaxes Structural Constraints on Brain Dynamics and Default Mode Decoupling Tracks Ego Dissolution

bioRxiv (Cold Spring Harbor Laboratory) March 5, 2026 Venkatesh Subramani, Annalisa Pascarella, Jérémy Brunel et al.

Lysergic acid diethylamide (LSD) loosens the brain's usual alignment between anatomical structure and neural activity in a frequency-dependent way. Low-frequency brain waves (theta, alpha, beta) become less constrained by the structural connectome, indicating a global relaxation of large-scale dynamics. High-frequency gamma activity shows selective reorganization rather than uniform disruption. Greater gamma-band decoupling within core default-mode network regions predicts the intensity of ego dissolution across individuals. LSD does not cause indiscriminate disintegration but drives system-specific rebalancing: visual and attentional systems decouple while auditory networks strengthen coupling. These findings suggest psychedelic states emerge from frequency-dependent relaxation of structural constraints, with default-mode reorganization as a neural correlate of ego dissolution.

A Novel Stability Indicating High Performance Liquid Chromatography Method for Lysergic Acid Diethylamide Quantification: From Microdosing Applications to Broader Analytical Use.

Journal of chromatographic science November 15, 2025 Mahima Bansal, Estelle Miller, Rachael Sumner et al.

A new high-performance liquid chromatography method accurately measures LSD and separates it from its degradation product iso-LSD. Validated according to international guidelines, the method works even when LSD is exposed to stress conditions that cause breakdown. Applied to illicit microdosing samples from a New Zealand drug checking service, the analysis found a significant discrepancy between users' estimated doses and actual LSD levels. This highlights risks for people using non-pharmaceutical microdosing preparations and underscores the need for reliable quality control to ensure safety.

Participant Experiences of Microdosed Lysergic Acid Diethylamide in a 6-Week Randomised Controlled Trial

Journal of Humanistic Psychology November 10, 2025 Robin J. Murphy, Mia Wardlaw, Thomas A. Smith et al.

After a six-week double-blind placebo-controlled trial of 10 µg of lysergic acid diethylamide taken every third day, healthy male participants reported changes in emotions, mood, social life, mindfulness, cognition, work, creativity, and physiological effects. Openness to experience and bidirectionality of effects were overarching themes. Some reported changes have potential clinical relevance for mood disorders, and reports of changes in anxiety suggest careful patient and dose selection. Participants' experiences with set and setting, uncertainty from placebo control, and perceived bidirectionality of effects inform psychedelic clinical trial design.

General anesthesia dissociates discrete components of ketamine neurophysiology

medRxiv August 7, 2025 Ben Deverett, Duan Li, Theresa R. Lii et al. preprint

Ketamine produces dissociative, analgesic, and antidepressant effects, but it is unclear whether its underlying neurophysiological signatures can be separated. In this observational cohort study, 52 participants (healthy volunteers, elective surgery patients, and patients with depression) received a subanesthetic infusion of ketamine or placebo, with or without general anesthesia. When ketamine was given under general anesthesia, its characteristic low-frequency brain wave augmentation was absent, while high-frequency power modulation was preserved. This selective modulation suggests a method for investigating the distinct roles of high- and low-frequency neural activity in ketamine's behavioral effects.

155. EXPLORING LSD MICRODOSING IN AN OPEN-LABEL PILOT FOR MAJOR DEPRESSIVE DISORDER: THE INTERPLAY OF BEHAVIORAL ACTIVATION, MOOD IMPROVEMENT, AND CONNECTEDNESS

The International Journal of Neuropsychopharmacology August 1, 2025 C Donegan, D Daldagen-Bueno, Robin J. Murphy et al.

In an open label trial, 17 people with major depressive disorder took 15 doses of LSD at home and one in a clinic over 8 weeks. Afterward, participants reported increased connectedness to self, others, and nature; greater motivation for activities; improved mood; and better coping with negative situations. Some experienced side effects or no change in symptoms. The findings suggest that microdosing LSD may create a positive feedback loop where improved mood, behavioral activation, and connectedness reinforce each other, and that adding a titration protocol and encouraging psychologically beneficial activities could enhance benefits and reduce side effects.

Exploring Microdosing Psychedelics as a Self-Managed Treatment for Premenstrual Dysphoric Disorder: A Qualitative Study

July 25, 2025 Rachael L. Sumner, Yuxin Ni, Suresh Muthukumaraswamy preprint

People with premenstrual dysphoric disorder (PMDD) microdose psilocybin to manage their symptoms, and all 14 interview participants reported benefit, though their regimens and treatment goals varied widely. PMDD is a severe mood disorder with limited treatment options. Participants described how PMDD harmed their quality of life and why they turned to microdosing. The findings suggest clinical trials into microdosing psychedelics for PMDD are warranted, as current information to support people engaging in this practice is lacking.

Tū Wairua: Development of an Indigenous Rongoā Māori Approach to Healing with Psilocybin Containing Mushrooms

February 27, 2025 Anna-Leigh Hodge, Anna Forsyth, Tehseen Noorani et al. preprint

A Māori-led research project, Tū Wairua, will integrate traditional Māori healing practices (rongoā Māori) with psilocybin-assisted therapy to address problematic methamphetamine use in Māori communities. Based at Rangiwaho Marae in Te Tairāwhiti, the project is driven by kaupapa Māori methodology and biomedical psychedelic science. It aims to develop a culturally-appropriate treatment, build a skilled Māori workforce, and challenge legislation restricting Indigenous psychedelics. The work represents a shift toward health interventions that respect Indigenous wisdom and address the unique needs of Māori communities.

Overcoming blinding confounds in psychedelic randomized controlled trials using biomarker driven causal mediation analysis

June 13, 2023 Suresh Muthukumaraswamy preprint

Effect sizes in randomized controlled trials of psychedelic-assisted therapies are likely inflated because participants and study personnel can often tell who received the active drug, breaking the blind. Causal mediation analysis using objectively measured biomarkers could identify genuine causal pathways between treatment and outcome even when blinding fails. Psychedelic therapies should not be approved as regular medicines until such causal pathways are clearly established. Premature approval risks expanding indications based on low-quality evidence, setting a precedent for other therapies, and allowing efficacy to become unstable after approval.