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.
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.
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.
Philosophy, psychiatry & psychology
January 1, 2021
Tehseen Noorani
68 citations
Psychedelic-assisted psychotherapy is returning to psychiatry, and the concept of 'set and setting' is central to its use. An ethnography of psychedelic therapeutics on the US east coast from 2015-2019 reveals political and economic pressures to contain psychedelic experiences, which often overflow such attempts. Two key qualities emerge: a labor of protecting spaces, revealing an attentiveness to disconnection that tensions with psychedelic discourses of connection; and how psychedelic experiences, as 'mind-manifesting', reflect the self, re-presenting epistemic disagreements about the self's nature. These qualities offer an analytics for reading the cultural politics of psychedelic use.
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.
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.
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.
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.
Nature medicine
June 3, 2025
Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman et al.
26 citations
A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.
Psychiatr Res Clin Pract
February 11, 2025
Jules Evans, Marc Aixalà, Brian T. Anderson et al.
18 citations
Thirty psychedelic researchers identified critical gaps in knowledge about harms from psychedelic use, including how to define those harms, predict them, and treat them effectively. They recommend better online information, peer support groups, affordable therapy, and psychiatric consultation for people experiencing post-psychedelic difficulties. The researchers also call for improved funding for a psychedelic safety net, suggesting that psychedelic philanthropists, investors, and companies commit 1% of their investment to support safety measures such as research and support services. The article outlines practical steps to make the field of psychedelic medicine safer.
Therapeutic Advances in Psychopharmacology
September 1, 2025
Suresh Muthukumaraswamy, Matthew J. Baggott, Eduardo Ekman Schenberg et al.
8 citations
Psychedelic-assisted therapy (PAT) is a complex intervention combining pharmacological, psychotherapeutic, and contextual elements that interact dynamically with patient experiences and healthcare settings. Conventional randomized controlled trials may fail to capture these complexities. This position paper advocates applying the UK Medical Research Council's framework for complex interventions to PAT development and evaluation, emphasizing the need to articulate the theory of therapeutic change, structure intervention development into phases, account for contextual interactions, and incorporate stakeholder perspectives.
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.
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.
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.
Front Psychol
August 21, 2024
Tehseen Noorani, Oliver Davis, Alex Dymock et al.
5 citations
The article argues that the humanities and social sciences are essential for understanding psychedelic experiences, because these experiences are shaped by context, culture, and personal history—factors often overlooked by biomedical research. It introduces the concept of "anthropotechnics" to analyze how cultural practices and settings influence the outcomes of psychedelic use. The authors contend that integrating humanistic perspectives can provide a more complete picture of how set and setting affect psychedelic experiences, moving beyond purely neurobiological explanations.
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.
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.
PsyArXiv
February 23, 2025
Suresh Muthukumaraswamy, Matthew Baggott, Eduardo Ekman Schenberg et al.
3 citations
preprint
Psychedelic-assisted therapy (PAT) is a complex, multi-component intervention, yet most clinical trials evaluate it as a simple pharmaceutical treatment, limiting real-world validity. This position piece advocates applying the UK Medical Research Council's complex intervention framework to PAT, emphasizing theory of change, structured development, context, and stakeholder input. Pragmatic randomized controlled trials, informed by the PRECIS-2 tool, are proposed to align trial designs with real-world healthcare settings. The authors contrast drug-centric and psychotherapy-augmented views of PAT's efficacy, and recommend integrating qualitative data, adaptive designs, and comparative effectiveness research. A pluralistic evidentiary model is suggested to advance psychedelic medicine while avoiding past developmental pitfalls.
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.
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.
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.
Psychedelics
May 16, 2026
Tam Martin Fowles, Tehseen Noorani
The authors argue that research into psychedelics and psychosis/madness must be not only expanded but also conducted wisely. They note increasing publications on psychedelic use by people who have experienced psychosis and present a narrative account of the lead author, who had a breakdown diagnosed as psychosis in 1989 and used psychedelics for healing in 2024. The paper connects current psychedelic-assisted therapy research with insights from critical, historical, user-led, participatory, and theoretical literatures on psychosis. It offers research questions and frameworks, highlighting the concept of 'integration' versus 'sealing over' from earlier psychosis research. The authors call for interdisciplinary, methodologically diverse research that avoids speaking 'for' subjects.
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.
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.
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.