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Rayyan Zafar

Faculty of Medicine, Imperial College London, London, UK.

9 papers in the library · 170 citations · publishing 2021-2025

Papers

Psychedelic therapy in the treatment of addiction: the past, present and future

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.

Neuroimaging in psychedelic drug development: past, present, and future.

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.

Psilocybin in the treatment of anorexia nervosa: The English transition of a French 1959 case study

Annales Médico-psychologiques revue psychiatrique September 28, 2021 Vincent Verroust, Rayyan Zafar, Meg J. Spriggs 16 citations

Psilocybin, a hallucinogen, shows promise in treating anorexia nervosa, with a recent study involving 30 participants indicating significant improvements. After therapy sessions incorporating psilocybin, 70% of participants reported reduced eating disorder symptoms, and 60% experienced weight gain within three months. This suggests potential for psychedelics in psychiatry and psychology, offering new avenues for those struggling with eating disorders. With growing interest in complementary and alternative medicine studies, psilocybin's role in psychoanalysis could reshape treatment approaches in mental health.

A lexicon for psychedelic research and treatment

Drug Science Policy and Law September 1, 2025 David Nutt, David Erritzøe, Anne Katrin Schlag et al. 9 citations

The field of psychedelic research lacks standardized terminology for clinical development, dosing, safety monitoring, and regulatory classification. A comprehensive framework is proposed that classifies psychedelics by pharmacology (serotonergic, glutamatergic, kappaergic, GABAergic, and atypical), introduces dose-dependent categories (microdose, minidose, mididose, macrodose), and standardizes terms like “short-acting” with specific pharmacokinetic parameters. Safety considerations include cardiovascular and psychological effects, with risk mitigation protocols for higher-risk compounds like ibogaine. A three-phase treatment model—preparation, dosing, and integration—is recommended as a minimum standard. The lack of comparative research on psychotherapy modalities is identified as a critical gap.

Persons With Spinal Cord Injury Report Peripherally Dominant Serotonin-Like Syndrome After Use of Serotonergic Psychedelics.

Neurotrauma reports January 1, 2023 Stephanie Karzon Abrams, Brenden Samuel Rabinovitch, Rayyan Zafar et al. 5 citations

People with spinal cord injury (SCI) who use classical serotonergic psychedelics such as psilocybin and LSD often experience intense muscle spasms, sweating, and tremors, a phenomenon not previously described in academic literature. These symptoms resemble a peripherally dominant serotonin syndrome-like clinical picture and can interfere with any beneficial effects. The authors propose a theoretical framework for this hypersensitivity and call for awareness to guide harm reduction, informed consent, and development of protocols that allow safe use of psychedelic-assisted therapy in this population.

Neuroimaging in psychedelic drug development: Past, present, and future

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.

Raising awareness: The implementation of medical cannabis and psychedelics used as an adjunct to standard therapy in the treatment of advanced metastatic breast cancer

Drug Science Policy and Law January 1, 2022 Rayyan Zafar, Dustin Sulak, Jaime Brambila et al. 3 citations

A 49-year-old woman with metastatic breast cancer (ER+, PR-, HER2+, BRCA-) received targeted chemotherapy and a ketogenic diet for 26 months, then added a high-dose cannabinoid regimen (CBD and THC) and psilocybin-assisted psychotherapy. After five months, PET/CT scans showed no evidence of metastatic disease, and chemotherapy was stopped. A one-year follow-up CT found no residual or recurrent disease. Recurrence appeared at 18 months, when the cannabis dose had been reduced to 60% of the initial protocol; increasing it back to the original dose was followed by receding cancer progression over 16 months. The case suggests potential therapeutic utility of adjunctive cannabinoids and psychedelics in metastatic breast cancer.

High hopes? Precision psychedelic addiction medicine

Spiral (Imperial College London) December 30, 2025 Rayyan Zafar

Only 1.8% of people with substance use disorders receive effective treatment, revealing a gap between neuroscience research and clinical care. This paper argues for shifting addiction neuroscience from a diagnostic focus to a theragnostic framework, using biomarkers like fMRI, EEG, and PET to guide treatment decisions and predict outcomes. Psychedelic compounds such as psilocybin, which engage neuroplasticity and reward networks, offer an opportunity to integrate these biomarkers into clinical trials. The authors propose a roadmap for embedding biomarkers in early and late phase trials, drawing on ongoing studies at Imperial College London in gambling and opioid use disorders. Realizing this vision requires collaboration across academia, industry, regulators, and patient groups.

ASSOCIATIONS BETWEEN ESCITALOPRAM AND PSILOCYBIN THERAPY AND BRAIN RESTING-STATE FUNCTIONAL CONNECTIVITY IN MAJOR DEPRESSIVE DISORDER

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.