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Lauren Lepow

The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

6 papers in the library · 155 citations · publishing 2021-2026

Papers

The Psychedelic Future of Post-Traumatic Stress Disorder Treatment

Current Neuropharmacology January 5, 2024 Tamar Glatman Zaretsky, Kathleen M. Jagodnik, Robert Barsic et al. 73 citations

Post-traumatic stress disorder (PTSD) affects an estimated 12 million U.S. adults, and many remain symptomatic despite standard psychological and pharmacological treatments. Psychedelic compounds—including psilocybin, LSD, DMT, ayahuasca, MDMA, and ketamine—are being studied as potential therapies. This comprehensive review summarizes current PTSD treatments and their shortcomings, then examines clinical studies of psychedelic-assisted therapy for PTSD and related disorders. For each drug, the review covers history, psychological and somatic effects, pharmacology, and safety, along with proposed mechanisms for trauma treatment. It concludes with future directions to maximize therapeutic benefit and minimize risk for individuals and communities affected by trauma.

Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy

Frontiers in Neuroscience September 20, 2021 Lauren Lepow, Hirofumi Morishita, Rachel Yehuda 70 citations

A framework is proposed for investigating how psychedelic-assisted psychotherapy (PAP) produces neurobiological changes that underlie recovery from illnesses like PTSD. The authors suggest that psychedelics may remove brakes on adult neuroplasticity, inducing a state similar to developmental critical periods (CPs) when the brain is exquisitely sensitive to environmental input. They highlight ocular dominance plasticity in the visual system as a model for characterizing CPs in limbic systems relevant to psychiatry. This CP framework may help integrate neuroscientific inquiry with the influence of the environment both in development and in PAP, moving beyond traditional focus on pharmacologic properties alone.

Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy.

Focus (American Psychiatric Publishing) July 1, 2023 Lauren Lepow, Hirofumi Morishita, Rachel Yehuda 9 citations

Psychedelic-assisted psychotherapy may work by reopening a critical period of heightened neuroplasticity, similar to developmental windows when the brain is especially sensitive to environmental input. The paper proposes that psychedelics could remove molecular brakes on adult neuroplasticity, creating a brain state akin to neurodevelopment. Drawing on ocular dominance plasticity in the visual system as a model, the authors suggest this framework could help explain how combining psychedelic compounds with psychotherapy produces enduring clinical improvements in conditions like PTSD. The framework integrates neuroscientific inquiry with the influence of environment both in development and in therapy.

The case for an integrative model: Hypotheses and rationale for integrative MDMA-Assisted Psychotherapy (IMAP)

Psychedelics January 8, 2026 Rachel Yehuda, Amy Lehrner, Miryam Sperka et al. 2 citations

The original manual for MDMA-assisted therapy (MDMA-AT) for PTSD, developed by the Multidisciplinary Association for Psychedelic Studies (MAPS), introduced concepts like “inner healing intelligence” from transpersonal traditions, which lacked clear grounding in trauma science and were difficult to standardize. In response, a new model called Integrative MDMA-Assisted Psychotherapy (IMAP) is proposed. IMAP is a principle-guided, patient-driven approach rooted in humanistic and trauma-focused psychotherapy. It offers flexible, relationally attuned support for nonlinear therapeutic processes, drawing on contemporary PTSD theories and evidence-based trauma interventions while retaining experiential approaches. The model invites empirical study to determine essential therapeutic elements in psychedelic contexts.

Balancing Innovation and Evidence: Reflections on Structured Protocols in MDMA-Assisted Therapy Versus a Principle-Guided, Patient-Directed Approach

Psychedelic Medicine March 10, 2026 Amy Lehrner, Miryam Sperka, Lauren Lepow et al. 1 citation

MDMA-assisted therapy for post-traumatic stress disorder has shown strong clinical effects, high response rates, and low dropout when using a principle-guided, patient-directed model that includes nondrug preparatory and integrative sessions. This perspective argues that embedding MDMA into highly structured, manualized cognitive-behavioral treatment protocols may misapprehend the therapy's synergistic nature, blunt its transformative effects, and potentially cause harm. The field should prioritize research on real-world evidence, treatment optimization, and mechanisms of action of this distinct patient-directed model rather than immediately adapting existing protocols.

Psychodynamic Perspectives on Psychedelic States and Treatment Contexts: A Conceptual and Clinical Introduction.

Psychodynamic psychiatry June 1, 2026 Nadav Liam Modlin, Zsofia Elek, Carolina Maggio et al.

Psychedelic therapy may help people access unconscious mental content—preverbal, dissociated, or developmentally buried material—that emerges through bodily sensations, symbolic images, and intense emotions. A psychodynamic framework, drawing on psychoanalytic theory, can guide clinicians in working with this material across four phases: screening, preparation, the treatment session, and follow-up integration. Although neurobiological mechanisms like 5-HT2A receptor activation are well studied, unconscious processes remain underexplored. The authors argue that psychoanalytic models, though currently underrepresented, can deepen understanding of therapeutic change beyond symptom reduction and should inform future research, training, and individualized care as psychedelic treatments move toward broader clinical use.