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Tehseen Noorani

1 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

18 papers in the library · 680 citations · publishing 2015-2025

Papers

Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

Journal of Psychopharmacology June 25, 2018 Tehseen Noorani, Albert Garcia‐romeu, Thomas Cody Swift et al. 285 citations

In a follow-up study of a psilocybin-facilitated smoking cessation pilot, 12 of 15 original participants were interviewed about 30 months after their psilocybin sessions. Participants described gaining vivid insights into their self-identity and reasons for smoking, and reported that experiences of interconnectedness, awe, and curiosity persisted long after the drug's acute effects. The content of the psilocybin experience overshadowed short-term withdrawal symptoms. Participants also emphasized the importance of preparatory counseling, strong rapport with the study team, and a sense of momentum from being engaged in the treatment. Beyond quitting smoking, many reported lasting positive changes such as increased aesthetic appreciation, altruism, and pro-social behavior.

Making psychedelics into medicines: The politics and paradoxes of medicalization

Journal of Psychedelic Studies July 30, 2019 Tehseen Noorani 112 citations

This commentary examines the push to turn psychedelics into regulated medications within healthcare systems, a process known as medicalization. Drawing on ethnographic research from 2014 onward and examples from psychiatry and drug development, the author situates medicalization in its political, economic, and cultural contexts without taking a normative stance. The piece argues that psychedelic science has been focused on medicalization from the start, leading to a crisis over identity and values. Scaling up psychedelic-assisted therapy may undermine safety and efficacy. Medicalization could hinder decriminalization and legalization efforts by incentivizing diluted treatments and framing illicit use as abuse.

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.

Psychedelic Identity Shift: A Critical Approach to Set And Setting

Kennedy Institute of Ethics journal December 1, 2022 Neşe Devenot, Aidan Seale‐feldman, Elyse Smith et al. 50 citations

Psychedelic medicine relies on set and setting, but the specific therapeutic frameworks used alongside the drugs are rarely studied. Analyzing a treatment manual and post-session reports from a pilot psilocybin-assisted smoking cessation study, this article shows how therapeutic frameworks interact with psilocybin to rapidly reshape participants' identity and sense of self. Multiple domains of identity shift were identified that appear to serve as mechanisms for quitting smoking, each present in the manualized treatment. As psychedelic medicine becomes mainstream, consensual, evidence-based approaches to identity shift that respect patient autonomy and encourage empowerment should become key in psychedelic bioethics.

Dark loops: contagion effects, consistency and chemosocial matrices in psychedelic-assisted therapy trials

Psychological Medicine July 19, 2023 Tehseen Noorani, Gillinder Bedi, Suresh Muthukumaraswamy 49 citations

When a medical research program overlaps with a social movement, new forms of sociality—termed 'chemosociality'—emerge from shared chemical exposure. In psychedelic-assisted therapy (PAT) clinical trials, this chemosociality creates 'dark loops': unrecorded social interactions that breach assumptions underlying causal inference used to establish treatment efficacy. These loops affect participant experiences but are not incorporated into trial data interpretation. Three researcher responses are proposed: chemosocial minimization (designing trials to reduce dark loops), chemosocial description (openly documenting them), and chemosocial valorization (actively leveraging them for positive outcomes). The hype surrounding psychedelic research continues to shape the phenomena under study, even as trials grow larger and more rigorous.

New Frontiers or a Bursting Bubble? Psychedelic Therapy Beyond the Dichotomy

Frontiers in Psychiatry September 10, 2021 Tehseen Noorani, Jonny Martell 32 citations

A Phase II trial comparing psilocybin-assisted therapy with escitalopram for depression found no statistically significant difference on the primary outcome measure (QIDS-SR16), though secondary measures favored psilocybin. Expert commentaries noted possible issues with the choice of primary outcome, statistical power, and the limitations of depression rating scales in capturing improved mood and well-being. This opinion piece, drawing on the authors' experiences in psychedelic trials and NHS psychiatry, argues that psychedelic therapies will both open new frontiers and face a bursting bubble, exploring the stakes and opportunities involved.

The Hopkins-Oxford Psychedelics Ethics (HOPE) Working Group Consensus Statement

American Journal of Bioethics May 2, 2024 Edward Jacobs, B. Earp, Paul S. Appelbaum et al. 29 citations

A workshop on psychedelic ethics, the first Hopkins-Oxford Psychedelic Ethics (HOPE) meeting, was held in August 2023 at the University of Oxford to address ethical issues surrounding psychedelics. The organizers (BDE, DBY, EJ) aimed to foster interdisciplinary discussion on topics such as informed consent, therapeutic use, and societal implications. The report outlines the workshop's structure, key themes, and proposed guidelines for ethical research and practice in the field.

Spotlight commentary: REBUS and the anarchic brain.

Neuroscience of consciousness January 1, 2020 Tehseen Noorani, Ben Alderson-Day 8 citations

Carhart-Harris and Friston's REBUS model applies predictive processing to explain how psychedelics alter brain function, offering a foundation for psychedelic psychiatry. The present authors commend this work but argue it underemphasizes contextual factors that shape extreme experiences and their outcomes. They also suggest that the comparisons made with certain non-psychedelic altered states miss more informative parallels elsewhere. Addressing these points would help identify the most relevant mechanisms of action in psychedelic experiences.

Tū Wairua: Development of an Indigenous Rongoā Māori approach to healing with psilocybin containing mushrooms

Journal of Psychedelic Studies May 16, 2025 Anna-Leigh Hodge, Anna Forsyth, Tehseen Noorani et al. 6 citations

A Māori-led project called Tū Wairua aims to integrate traditional Māori healing practices (rongoā Māori) with psychedelic-assisted therapy to address problematic methamphetamine use in Māori communities. Based at Rangiwaho Marae in Te Tairāwhiti (Gisborne), the project will use Kaupapa Māori methodology and biomedical psychedelic science to develop a decolonized, culturally appropriate approach to psilocybin treatment. It seeks to challenge colonial dynamics in current Western psychedelic therapy models, build a skilled Māori workforce, and challenge legislation restricting Indigenous psychedelic medicines, creating sustainable pathways for collective healing.

Long-term follow-up of psilocybin-facilitated smoking cessation: Abstinence outcomes and qualitative analysis of participant accounts

Drug and Alcohol Dependence November 1, 2015 Albert Garcia‐romeu, Tehseen Noorani, Roland R. Griffiths et al. 6 citations

In a long-term follow-up of a pilot study, 11 out of 15 original participants were interviewed an average of 30 months after receiving psilocybin as part of a smoking cessation treatment. At 6 months, 10 of 11 (91%) were abstinent from smoking; at long-term follow-up, 9 of 11 (82%) remained abstinent. Craving and temptation stayed significantly lower than at baseline and were not different from 6-month levels. Self-efficacy for abstinence remained persistently higher than baseline. Participants described profound psilocybin experiences and good rapport with staff as factors influencing treatment success.

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.

Visual Hallucinations in Serotonergic Psychedelics and Lewy Body Diseases

Schizophrenia Bulletin April 17, 2025 Nathan H. Heller, Frederick S. Barrett, Tobias Buchborn et al. 3 citations

Visual hallucinations in Lewy body diseases (Parkinson's disease and dementia with Lewy bodies) and those induced by serotonergic psychedelics (psilocybin, mescaline) share overlapping phenomenology and neural mechanisms, despite different underlying causes. Both conditions produce visual aberrations from minor distortions to complex hallucinations, including illusory motion and entity encounters. Neuroimaging shows a common pattern of overactive associative cortex and underactive sensory cortex. Serotonin 2A receptor modulation is involved in both: psychedelics act through 5-HT2A and 5-HT1A receptors, while in Lewy body diseases, 5-HT2A receptor upregulation correlates with increased hallucinations, and blocking it with pimavanserin reduces them. Shared cortical signatures include reduced visual evoked responses and shifts toward visual excitation.

Sciencing the mystical: the trickery of the psychedelic trip report

New Writing April 9, 2019 Tehseen Noorani 3 citations

Psychedelic researchers have begun using laboratory settings to reliably induce 'mystical experiences' quantified along dimensions like unity and transcendence. Drawing on ethnographic data and Walter Benjamin's concept of the threshold, this analysis identifies apophatic narratives of trickery that contrast with the positive knowledge typical of scientific accounts. Reading psychedelic trip reports as apophatic labor reveals that the significance of mystical encounters lies not in their transformative efficacy but in the doubts, contradictions, and aporias involved in writing out those experiences.

Conducting Qualitative Research With Psychedelic Psychopharmacologists: Challenges of Co-Production in an Era of Interdisciplinarity

January 1, 2017 Tehseen Noorani 3 citations

A qualitative researcher recounts their experience working with a pharmacology team that had conducted an open-label clinical trial using psilocybin-assisted psychotherapy to help long-term cigarette smokers quit. The smoking outcomes were promising and accompanied by other positive life changes. The researcher led a retrospective qualitative project to identify participants' perceptions of the mechanisms behind these changes. This case study describes challenges faced when collaborating across physical and social sciences, situates the work within the intellectual history of psychopharmacology, and offers practical suggestions for interdisciplinary co-production.

Real-world evidence of the collective effects of psychedelic therapy: Evaluating from the grassroots

Journal of Psychedelic Studies May 27, 2024 Tehseen Noorani, R. Liebert 2 citations

As psychedelic-assisted therapy (PAT) faces criticism of its trial evidence and moves toward legalization in some places, this paper proposes evaluating PAT not only through individual-level data but also through its collective, societal effects. Drawing on the transformative paradigm of evaluation, which prioritizes social justice and marginalized expertise, the authors outline a 'grassroots' approach. They offer eight examples of social issues linked to PAT and psychedelic use, suggesting relevant expertise and evaluation questions for each. The approach is guided by three values: rhizomatic accountability, dark reflexivity, and more-than-human hosting, which align with the contemporary practice of PAT. The aim is to spur discussion and action toward study designs that capture psychedelics' transformative potential in medicalized societies.

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.

On psychedelic liberalism and mad trust: towards varieties of willing in extreme experiences

BioSocieties October 4, 2025 Tehseen Noorani

The psychotomimetic model of psychedelics claims to offer insights into both psychedelic experiences and psychosis by connecting them. A common objection distinguishes psychedelic experiences as voluntary or 'willed' and psychosis as an unwilled affliction. This distinction helps sanitize and commodify psychedelics for therapeutic use. The article draws on psychedelic therapeutics, mad studies, and phenomenological psychiatry to destabilize this opposition. Through the concept of 'willful surrender' in psychedelic therapy, it examines the roles of trust, curiosity, openness, and letting go in engaging with extreme experiences. This reveals assumptions about the liberal subject in psychedelic therapy and brings medicalization into uncomfortable proximity with boundary violations.

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.