Psilocybin structure, pharmacodynamics and effects Flashcards

1
Q

What is psilocybin chemical structure

A

Psilocybin is a naturally occurring psychedelic compound found in certain species of mushrooms. It is structurally similar to serotonin.

Tryptamine Backbone: Psilocybin is a member of the tryptamine family. It has a structure based on the tryptamine molecule, which is a derivative of the amino acid tryptophan.

Phosphorylated Group: Psilocybin is unique due to a phosphate group attached to its molecular structure. This phosphorus-containing group is part of what makes psilocybin distinct from other tryptamines.

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2
Q

What is the Functional Groups of psilocybin?

A

4-hydroxy (4-HO) Group: It has a hydroxyl group (-OH) attached to the fourth carbon of the indole ring, similar to the structure of the neurotransmitter serotonin.

N,N-dimethyl Group: Attached to the nitrogen (N) atom of the tryptamine structure, it has two methyl groups (–CH₃)

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3
Q

Metabolism to Psilocin

A

In the body, psilocybin is quickly dephosphorylated to psilocin (4-HO-DMT), which is the compound that actually exerts the psychedelic effects. Psilocin has a very similar structure but without the phosphate group.

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4
Q

How are ‘magic mushrooms consumed’?

A
  • Most typically they are consumed by eating the raw or dried fruiting bodied of the fungi.
  • Dried mushrooms can also be smoked.
  • Synthetic psilocybin is taken orally in capsules
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5
Q

Do mushrooms that produce psilocybin also generate other psychoactive compounds in addition to psilocybin?

A
  1. Psilocin: This is the active metabolite of psilocybin. Once psilocybin is ingested, it is quickly converted into psilocin in the body, which is primarily responsible for the psychedelic effects.
  2. Baeocystin and Norbaeocystin: These are analogs of psilocybin and are present in smaller amounts in many psilocybin-producing mushrooms. Baeocystin is similar to psilocybin but with a methyl group in place of psilocybin’s ethyl group. Norbaeocystin is a demethylated derivative of baeocystin. The psychoactive properties of these compounds are less understood, but they are believed to contribute to the overall psychoactive effects of the mushrooms.
  3. Tryptophan Derivatives: Some psilocybin-producing mushrooms may also contain other compounds derived from tryptophan, the amino acid that serves as the starting point for the synthesis of psilocybin and related compounds.

The combined effect of these compounds, along with psilocybin and psilocin, contributes to the overall psychedelic experience associated with these mushrooms. However, the precise role and psychoactive potency of some of these minor compounds are not as well studied as psilocybin and psilocin.

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6
Q

What is the Entourage Effect in reference to psilocybin?

A

The “entourage effect” is a term that originates from the study of cannabis and refers to the idea that various compounds within a plant work together synergistically to produce a particular effect. In the context of psilocybin mushrooms, the entourage effect would suggest that the combination of various psychoactive and non-psychoactive compounds found in these mushrooms (like psilocybin, psilocin, baeocystin, norbaeocystin, and others) work together to produce the overall psychedelic experience.

Synergistic Interaction: It’s hypothesized that the different compounds in psilocybin mushrooms may interact synergistically, meaning that their combined effect is greater than the sum of their individual effects.

Modulation of Effects: The presence of various compounds could potentially modulate the intensity, duration, and quality of the psychedelic experience. For example, minor compounds like baeocystin might subtly alter the effects of psilocybin and psilocin.

Complexity of Experience: The entourage effect might explain why the effects of psychedelic mushrooms can vary between different species or even different batches of the same species. The specific concentration and ratio of compounds could influence the nuances of the experience.

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7
Q

What happens after oral ingestion of psilocybin?

A

After ingestion, psilocybin is rapidly converted to psilocin by liver enzymes. It is psilocin that reaches the brain and is responsible for producing the neuropsychological effects.

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8
Q

How is dosage calculated for ingestion?

A

Clinical research studies have administered doses based mg/kg (dose based on weight).

Determine the Dose per Kilogram:

First, you need to decide on the appropriate mg/kg dose. In clinical research, common doses of psilocybin range from about 0.1 to 0.4 mg/kg. The specific dose within this range depends on factors like the purpose of the treatment, the setting, and the individual’s health and experience with psychedelics.

Formula - Individual dose = body weight (kg) x Dose (mg)

Convert to Mushroom Weight (if using whole mushrooms instead of pure psilocybin):

Since psilocybin content in mushrooms varies, a rough average is used for conversion. A common estimate is that dried psilocybin mushrooms contain about 1% psilocybin by weight.
Convert the psilocybin dose to mushroom weight by dividing the dose in milligrams by 0.01 (or multiply by 100).

Formula - Mushroom weight (g) = Individuals dose (mg) / 0.01

Example Calculation:
Assume a dose of 0.2 mg/kg and an individual weighing 70 kg.
Individual’s Dose (mg) = 70 kg × 0.2 mg/kg = 14 mg of psilocybin.
To convert this to dried mushroom weight: 14 mg / 0.01 = 1.4 grams of dried mushrooms.

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9
Q

Types of dosages?

A

Microdose: Generally ranges from 0.1 to 0.5 grams of dried mushrooms. This dose is intended to be sub-perceptual, meaning it doesn’t induce significant psychedelic effects.

Low Dose: Around 0.5 to 2 grams of dried mushrooms. This dose may lead to mild perceptual changes and emotional effects.

Moderate Dose: Typically between 2 to 3.5 grams of dried mushrooms. This is often considered a standard recreational dose, leading to a more intense psychedelic experience.

High Dose: Above 3.5 grams of dried mushrooms. High doses can lead to very intense experiences, including profound changes in perception, deep introspection, and possible ego dissolution.

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10
Q

What are some examples of psychoactive mushroom species and examples of their effects?

A

Each species can vary in terms of potency, the nature of the psychedelic experience it induces, and other characteristics. Here are a few well-known examples:

  1. Psilocybe Cubensis
    Common Names: Golden Teacher, Mexican Mushroom, Cubes
    Effects: Known for providing a balanced psychedelic experience with visual hallucinations and profound changes in thought and mood. The intensity can range from mild to strong depending on the dose.
    Popularity: One of the most widely known and cultivated species due to its relatively high psilocybin content and ease of growth.
  2. Psilocybe Semilanceata
    Common Names: Liberty Cap
    Effects: Noted for producing strong, vivid visual hallucinations and a powerful spiritual experience. It’s generally considered more potent than P. Cubensis on a per gram basis.
    Habitat: Commonly found in nature, especially in grassy areas, and has a distinctive conical cap.
  3. Psilocybe Azurescens
    Common Names: Flying Saucer Mushroom, Blue Runners, Blue Angels
    Effects: Known to be one of the strongest psilocybin mushrooms, with high levels of psilocybin and psilocin. Users report extremely powerful visual hallucinations and profound insights, along with strong euphoria.
    Habitat: Grows naturally in a small area of the West Coast of the United States and is more challenging to cultivate.
  4. Psilocybe Cyanescens
    Common Names: Wavy Caps
    Effects: Similar to P. Azurescens in potency but may produce a more intense neurological experience, including synesthesia (blending of sensory experiences, like “hearing” colors).
    Habitat: Often found in wood chips and mulched garden beds in the wild.
  5. Psilocybe Mexicana
    Common Names: Teonanácatl, Pajaritos
    Effects: Traditionally used in Native American religious ceremonies, it’s known for inducing a lighter, more euphoric experience, often with less intense visual hallucinations compared to stronger species.
    Cultivation: It’s one of the species used to produce psilocybin truffles or “sclerotia,” which are compact masses of hardened mycelium.
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11
Q

How does micro-dosing work?

A

Microdoses range from 5-10% of a regular dose, and produce sub-perceptual effects, free from visual distortions. Usually a dose of 1-2 mg

A common regimen consists of taking a microdose once every three days for a period of a month. Reposts have shown improved mood, enhanced creativity, and boosted energy and focus.

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12
Q

What is the onset and duration of psychoactive effects after orally administering pure psilocybin?

A

Psychoactive effects appear above 20 - 90 min after oral administration of pure psilocybin. They last for at least 3 - 6 hours

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13
Q

What happens when psilocin reaches the brain, and what are the functions of the serotonergic system it affects?

A

Once psilocin reaches the brain, it binds to several different subtypes of serotonin (5-HT) receptors resulting in a number of different effects.

The serotonergic system is windspread in the brain and gastrointestinal tract, and is involved in regulating many aspects of our human experience such as mood, appetite, sexual behaviour, cognitive and memory function, pain, sleep, body temperature and reward system.

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14
Q

How can the interaction between psilocin (the active metabolite of psilocybin) and specific serotonin receptors in the brain leads to its psychedelic effects?

A
  1. 5-HT2A Receptor and Psilocin
    Mechanism: Psilocin primarily binds to the 5-HT2A receptor, a subtype of serotonin receptors. This binding is crucial for the psychedelic effects of psilocin.
    – Example: When psilocin binds to the 5-HT2A receptors in the brain, it can lead to altered perceptions, visual hallucinations, and changes in thought processes.
  2. Ketanserin as an Antagonist
    Function: Ketanserin is a 5-HT2A receptor antagonist, which means it blocks these receptors.
    Effect of Blocking: By blocking the 5-HT2A receptors, ketanserin prevents psilocin from binding to them. This effectively diminishes or nullifies the psychedelic effects that psilocin would normally induce.
    – Example: If someone takes ketanserin before or during the use of psilocybin, they might experience significantly reduced or no psychedelic effects, as the primary action site of psilocin is blocked.
  3. Other Serotonergic Receptors
    Lower Affinity Binding: Psilocin also binds to other serotonin receptor subtypes like 5-HT2C, 5-HT1A, and 5-HT1B, but with lower affinity compared to 5-HT2A.
    Less Impact on Consciousness: These receptors are less involved in the consciousness-altering effects of psilocybin. This means that while they may contribute to the overall experience, they are not as central to the psychedelic effects as the 5-HT2A receptor.
    – Example: Binding of psilocin to these other receptors might influence mood, anxiety, and various cognitive processes, but these effects are more subtle and less pronounced compared to the vivid perceptual and cognitive alterations mediated by the 5-HT2A receptor.
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15
Q

What is the role of ketanserin in relation to the effects of psilocybin?

A

Ketanserin (antagonist) = Blocks effect of psilocybin.

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16
Q

How does psilocybin affect the dopamine system?

A

Interaction with Dopamine System

Indirect Influence: Psilocybin and its active metabolite, psilocin, indirectly affect the dopamine system. While they don’t bind strongly to dopamine receptors like they do with serotonin receptors, their activity in the brain can lead to changes in dopamine release and transmission.
Dopamine Release: Psilocybin can increase the release of dopamine in certain areas of the brain. This is thought to contribute to the mood-altering effects of psilocybin.
Examples of Dopamine-Related Effects
Mood Changes: Dopamine is closely associated with mood and reward. The elevated mood or feelings of euphoria that some users experience under the influence of psilocybin could be partly due to increased dopamine activity.

Altered Thought Patterns: Dopamine plays a role in cognitive processes. Changes in thought patterns, such as non-linear thinking or enhanced creativity reported during psilocybin use, might be influenced by altered dopamine transmission.

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17
Q

What is temporal synesthesia?

A

Simply - A phenomenon where one sensation is experienced by a second sensory pathway. One may see colours while listening to music, or hear sounds when while smelling a fragrance.

Temporal synesthesia, also known as time-space synesthesia, is a neurological phenomenon where individuals perceive time as a spatial construct. In this form of synesthesia, people experience time units like hours, days, weeks, or years as occupying specific spatial positions or shapes around their body or in an external space.

Characteristics of Temporal Synesthesia:

– Spatial Representation of Time: Individuals with temporal synesthesia may visualize units of time in spatial arrangements. For example, a year might be seen as a circle surrounding the individual, with months or days at fixed points around the circle.
– Automatic and Involuntary: Like other forms of synesthesia, these experiences are automatic and not a result of conscious effort or imagination.

Impact on Perception and Cognition:
– Temporal synesthesia can influence how individuals perceive the passage of time and can sometimes aid in memory and organization, as the spatial representation of time can serve as a mental calendar.
– It can also lead to unique perspectives on planning and time management, as individuals with this form of synesthesia might “see” their schedules and deadlines in a spatial layout.

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18
Q

What is meant by depersonalisation in the context of psilocybin use?

A

Depersonalisation -detached observer.

This refers to a disconnection or detachment from one’s sense of self or identity. For example, during a psilocybin experience, an individual might feel as though they are observing themselves from an outside perspective, losing the usual sense of personal identity.

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19
Q

What is meant by derealisation in the context of psilocybin use?

A

This is often described as the feeling that the external world is unreal.

Some go as far as to say that the ego has dissolved to merge with a larger consciousness that is beyond bodies, thoughts or identities. This can be pleasurable, aweing and can cause deep positive emotions. It can also be frightening and agitating.

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20
Q

What are serotonin 2A (5-HT2A) receptors?

A

They are G-protein coupled receptors located postsynaptically to serotonergic neurons.

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21
Q

Where are 5-HT2A receptors highly expressed in the brain?

A

They are highly expressed in the cortex and in regions associated with the default mode network (DMN).

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22
Q

How is ketanserin used in research involving 5-HT2A receptors?

A

Ketanserin, an antagonist of 5-HT2A receptors, can be labeled with radioactive ions to visualize these receptors in the brain during imaging studies.

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23
Q

What is the research significance of ketanserin in relation to 5-HT2A receptors?

A

It is used to block the effects of drugs like psilocybin by binding to 5-HT2A receptors, thereby diminishing their subjective effects.

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24
Q

What conditions are associated with increased densities and functioning of 5-HT2A receptors?

A

Anxiety and stress in humans have been linked to increased densities and functioning of 5-HT2A receptors.

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25
Q

What have postmortem studies revealed about 5-HT2A receptors in depressed and suicidal individuals?

A

Postmortem studies have shown greater expression of 5-HT2A receptors in the brains of depressed and suicidal individuals.

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26
Q

How have animal studies contributed to understanding 5-HT2A receptors?

A

Knockout or downregulation of 5-HT2A receptors in mice has been shown to result in decreased anxiety levels.

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27
Q

What is the relationship between SSRIs and 5-HT2A receptors?

A

Antidepressant medications like SSRIs are associated with reduced levels of 5-HT2A receptors.

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28
Q

How do psilocybin and SSRIs modulate serotonergic activity?

A

Psilocybin activates 5-HT2A receptors, while SSRIs primarily affect serotonin reuptake.

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29
Q

What is the role of the 5-HT1 receptor subtype in serotonin regulation?

A

The 5-HT1 receptor subtype acts as an autoreceptor that inhibits serotonin release when stimulated, providing negative feedback to control serotonin levels in the synapse.

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30
Q

How do antidepressants affect 5-HT1 receptors with chronic use?

A

Chronic use of antidepressants desensitizes 5-HT1 receptors, which restores serotonin release and reduces limbic responsiveness, leading to emotional blunting.

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31
Q

What is the effect of psilocybin on emotional processing and consciousness?

A

Psilocybin activates 5-HT2A receptors, facilitating emotional processing, disrupting normal consciousness, and increasing sensitivity to the environment.

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32
Q

How do serotonin receptors influence other neurotransmitters when activated?

A

Serotonin receptors, when activated, modulate the release of neurotransmitters such as dopamine, GABA, acetylcholine, norepinephrine, and glutamate, impacting various neurological processes.

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33
Q

What role does glutamate play in the central nervous system?

A

Glutamate is the primary excitatory neurotransmitter in the brain, crucial for rapid transmission of information.

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34
Q

How does psilocybin affect glutamate levels and what implications does this have?

A

Psilocybin, as a 5-HT2A agonist, increases glutamate activity in the prefrontal cortex (PFC), influencing prefrontal network activity and contributing to its psychedelic effects.

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35
Q

What changes in cerebral blood flow and glutamate levels are observed with psilocybin use?

A

Psilocybin increases cerebral blood flow and glutamate concentrations in the medial prefrontal cortex (mPFC), while decreasing them in the hippocampus. This correlates with experiences of ego dissolution.

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36
Q

How does psilocybin affect GABA levels in the brain?

A

Psilocybin also increases GABA, an inhibitory neurotransmitter, in the medial prefrontal cortex (mPFC).

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37
Q

What are the theories explaining the reduction in glutamate and cerebral blood flow in the hippocampus during psilocybin administration?

A

One theory suggests that psilocybin’s agonism of 5-HT2A receptors on GABAergic interneurons inhibits glutamate release. Another theory proposes that psilocin (psilocybin’s active form) activates 5-HT1A receptors in the hippocampus, which also modulates serotonin function.

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38
Q

Why is understanding psilocybin’s effects important for psychiatric research?

A

Understanding how psilocybin interacts with complex brain systems and neurotransmitter networks can provide insights into psychiatric disorders and potentially improve treatment protocols.

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39
Q

What methods were used in the study by Dr. Robin Carhart-Harris to measure brain changes during psilocybin use?

A

Arterial spin labeling (ASL) perfusion and blood-oxygen level-dependent (BOLD) fMRI were used to monitor physiological changes in the brain.

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40
Q

How quickly did participants experience subjective effects after psilocin infusion, and why was this significant?

A

Participants experienced subjective effects within five seconds of psilocin infusion, allowing researchers to correlate these effects with measured brain activity in real-time.

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41
Q

What were the unexpected results of the study regarding brain activity under psilocybin influence?

A

Contrary to expectations, the study found decreased blood flow and BOLD signal in subcortical and cortical regions rather than increased activity.

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42
Q

Which brain regions showed the most significant decreases in blood flow during psilocybin use?

A

The thalamus and anterior and posterior cingulate cortex (ACC/PCC) exhibited the most notable decreases in blood flow.

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43
Q

What was observed regarding connectivity between the medial prefrontal cortex (mPFC) and the PCC during the study?

A

There was decreased connectivity between the medial prefrontal cortex (mPFC) and the posterior cingulate cortex (PCC) during psilocybin use.

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44
Q

How did changes in cerebral blood flow (CBF) correlate with subjective effects reported by participants?

A

Greater decreases in CBF in the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) correlated with more intense subjective effects reported by participants.

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45
Q

How did the BOLD fMRI scans of 15 participants differ from the ASL perfusion study in terms of brain activity under psilocybin influence?

A

The BOLD fMRI scans showed similar decreases in cerebral blood flow (CBF) as ASL, with additional decreases in regions like higher order visual areas not observed in ASL.

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46
Q

What unexpected findings emerged from the neuroimaging studies of psilocybin?

A

Contrary to previous assumptions, psilocybin decreased neural activity instead of increasing it. Regions showing the most consistent decreases were the posterior cingulate cortex (PCC) and medial prefrontal cortex (mPFC), areas typically active under normal conditions.

47
Q

How did psilocybin affect the activity of the posterior cingulate cortex (PCC), a region associated with the default mode network (DMN)?

A

Psilocybin led to a reduction in blood flow in the PCC, despite its high metabolic activity in normal conditions, potentially influencing consciousness, self-awareness, and ego.

47
Q

What is the default mode network (DMN) and its role in the brain?

A

The DMN is a network of brain regions with extensive cortico-cortical connections, involved in introspection, self-referential thoughts, and integrating information across the brain efficiently.

48
Q

How do these findings relate to philosophical and theoretical frameworks like Huxley’s “reducing valve” metaphor and Karl Friston’s free-energy principle?

A

They support the idea that psilocybin alters brain function by reducing the constraints on consciousness and sensory processing, potentially allowing for broader and less filtered experiences.

49
Q

What visual perceptual disturbances are induced by psilocybin?

A

Psilocybin causes visual disturbances such as perceiving coherent structures in random images, seeing objects that aren’t present, and experiencing motion in stationary objects.

50
Q

What is the role of the 5-HT2A receptor in psilocybin-induced visual effects?

A

The 5-HT2A receptor, highly expressed in the visual cortex, is activated by psilocybin, leading to altered excitability in visual networks and potentially causing visual hallucinations and distortions.

51
Q

How do researchers explain the mechanism behind psilocybin-induced visual disturbances?

A

Psilocybin reduces alpha oscillations and increases excitability in the visual cortex, disrupting spontaneous network activity and influencing visual processing.

52
Q

How do atypical antipsychotics relate to the 5-HT2A receptor and visual hallucinations in schizophrenia?

A

Individuals with schizophrenia experiencing visual hallucinations often have increased 5-HT2A receptor densities. Atypical antipsychotics, acting as 5-HT2A receptor antagonists, may exert therapeutic effects by blocking these receptors.

53
Q

What therapeutic effects has psilocybin shown in clinical trials?

A

Psilocybin, combined with non-directive therapy and supportive care, has significantly reduced depression and anxiety for extended periods in various patient populations.

54
Q

What do neuroimaging studies reveal about brain activity during the acute psilocybin state?

A

Neuroimaging studies show decreased activity in certain brain regions, such as the default mode network (DMN), alongside increased connectivity between brain regions involved in emotional processing.

55
Q

What are some possible neural mechanisms behind the therapeutic effects of psilocybin?

A

Hypotheses suggest that psilocybin’s modulation of serotonin receptors, particularly 5-HT2A, may disrupt rigid patterns of thinking and behavior, promoting neuroplasticity and emotional processing.

56
Q

Why are studies in healthy individuals relevant to understanding psilocybin’s therapeutic effects?

A

Studies in healthy individuals provide insights into the acute effects of psilocybin on brain function, helping to inform its potential therapeutic applications in clinical settings.

57
Q

How do hypotheses explain sustained therapeutic responses observed in clinical trial populations?

A

It is hypothesized that the acute alterations in brain activity induced by psilocybin may lead to long-term changes in neural circuits associated with mood regulation and emotional processing.

58
Q

How were early medications designed to treat depression by increasing serotonin levels in the brain?

A

Early medications like monoamine oxidase inhibitors (MAOIs) slowed the breakdown of serotonin and other monoamines, while tricyclic antidepressants blocked their reuptake, increasing synaptic levels of serotonin, dopamine, and norepinephrine.

59
Q

What are SSRIs and how do they differ from older antidepressants?

A

Selective serotonin reuptake inhibitors (SSRIs), developed in the late 1980s, inhibit the reuptake of serotonin specifically, improving depression symptoms with better tolerability and fewer side effects compared to older medications.

60
Q

How might psilocybin offer a novel approach to treating depression?

A

Psilocybin acts through distinct mechanisms, potentially addressing depression in individuals who haven’t responded to conventional treatments, possibly by modulating dysregulated 5-HT2A receptors involved in neuronal excitability and adaptability.

61
Q

What role do 5-HT2A receptors play in depression and how does psilocybin affect them?

A

Dysregulated 5-HT2A receptor activity, particularly in the medial prefrontal cortex, is associated with depressive states. Psilocybin’s stimulation of these receptors may disrupt rigid thinking and offer alternative perceptions. People might not be able to see those options due to rumination and looping of negative thoughts.

62
Q

How does psilocybin affect brain activity in regions like the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC)?

A

Psilocybin acutely reduces activity in the mPFC and ACC, regions crucial for mood and cognition regulation. The degree of deactivation correlates with subjective effects and normalization of overactivity in depression.

63
Q

What neuroimaging findings suggest potential therapeutic mechanisms of psilocybin in depression treatment?

A

Following psilocybin treatment, increased connectivity between the ventromedial prefrontal cortex (vmPFC) and bilateral inferior-lateral parietal cortex (ilPC) predicts reduced depression symptoms. Decreased connectivity between the parahippocampal cortex and prefrontal cortex is also observed post-treatment.

64
Q

How does psilocybin’s acute and post-acute effects on brain networks compare to electroconvulsive therapy (ECT)?

A

Psilocybin disrupts normal brain networks acutely but promotes their reintegration post-treatment, similar to ECT’s impact on the default mode network (DMN), potentially explaining improvements in mood and cognition. Master re set of the brain.

65
Q

What role does the amygdala play in the brain?

A

The amygdala is a brain region involved in emotional processing, particularly in response to perceived threats and emotional stimuli.

66
Q

How does the amygdala typically function in depressed patients and how do SSRIs affect it?

A

In depressed patients, the amygdala can be overactive, especially in response to fearful faces. SSRIs reduce this heightened amygdala response.

67
Q

What did a fMRI study involving psilocybin and healthy volunteers reveal about amygdala reactivity?

A

In the study, healthy volunteers given psilocybin showed significantly reduced activation in the right amygdala when viewing negative and neutral pictures compared to placebo. The left amygdala also had reduced activation to negative images. Positive mood increases correlated with less amygdala activation.

68
Q

How did psilocybin affect connectivity between the amygdala and other brain regions in response to threat stimuli?

A

Psilocybin reduced the modulation of top-down connectivity from the amygdala to the primary visual cortex in response to threat stimuli, as shown in another analysis.

69
Q

What did the psilocybin depression trial at the Imperial College of London involve?

A

The trial included a fMRI component where participants underwent brain scans one week before and the morning after psilocybin sessions. They performed an emotional face task during scanning.

Post-psilocybin, the amygdala showed increased activity specifically in response to fearful faces. This heightened response correlated with better outcomes in depression severity and remission rates one week later.

70
Q

What changes were observed in connectivity between the vmPFC and the amygdala after psilocybin treatment?

A

There was a decrease in functional connectivity between the ventromedial prefrontal cortex (vmPFC) and the right amygdala when participants viewed fearful or neutral faces after psilocybin. This change was associated with reduced rumination rather than anxiety.

71
Q

How does this connectivity change compare with findings in emotional dysregulation disorders?

A

In emotional dysregulation disorders, decreased connectivity between the prefrontal cortex and amygdala is linked to heightened anxiety. However, participants in the psilocybin trial did not show increased anxiety post-treatment, suggesting a different mechanism at play.

72
Q

What is the hypothesized significance of increased amygdala activity and altered connectivity post-psilocybin treatment?

A

Unlike SSRIs, which reduce amygdala activation and blunt negative emotions, psilocybin appears to increase amygdala activity while reducing top-down cognitive control. This may facilitate a deeper engagement with emotions, potentially aiding in processing difficult emotions.

73
Q

What did the study involving healthy participants and autobiographical memories under psilocybin reveal?

A

Participants viewed positive autobiographical memory cues and imagined re-experiencing these events while undergoing brain scans. Under psilocybin, they reported higher vividness and visual imagery of memories, correlating with improved wellbeing post-treatment.

74
Q

How did brain activity differ during the memory task under psilocybin compared to placebo?

A

Both psilocybin and placebo activated limbic, striatal regions, and the medial prefrontal cortex during memory tasks. However, under psilocybin, additional visual and sensory cortical areas were activated, suggesting enhanced sensory and perceptual experiences.

75
Q

What potential therapeutic implications were suggested by the authors regarding psilocybin-assisted psychotherapy?

A

The authors speculated that psilocybin might enhance memory recall and modify negative cognitive biases during psychotherapy sessions, potentially aiding in therapeutic outcomes.

76
Q

What types of autobiographical experiences can arise under the influence of psychedelics?

A

Under psychedelics, individuals may undergo psychodynamic autobiographical experiences where emotional past events re-emerge. These experiences can involve a range of emotions like sorrow, guilt, grief, or forgiveness, providing insights into personal situations or relationships.

77
Q

How do medium to high doses of psychedelics affect the recall and verbalization of autobiographical memories?

A

At medium to high doses, autobiographical memories may be less readily verbalized and appear less cohesive, with abstract details or emotions. These experiences often require further exploration and resolution during integration sessions post-treatment.

78
Q

What is notable about mystical and spiritual experiences induced by psilocybin?

A

Psilocybin frequently induces profound mystical and spiritual experiences, which research suggests can predict clinical outcomes.

79
Q

How does psilocybin affect neuronal oscillations related to consciousness?

A

Psilocybin reduces the power of oscillations below 100 Hz during rest, particularly affecting brain regions like the posterior and anterior cingulate cortex (PCC, ACC), retrosplenial cortex (RSC), and parahippocampal regions associated with the default mode network.

80
Q

What specific neuronal activity patterns are associated with insightfulness induced by psilocybin?

A

Psilocybin-induced insightfulness correlates with lagged phase synchronization of delta oscillations within parahippocampal regions and between the RSC and the lateral orbitofrontal cortex. This synchronization is linked to increased retrieval and reattribution of autobiographical memories.

81
Q

How are spiritual experiences linked to neuronal activity patterns induced by psilocybin?

A

Higher intensity of spiritual experiences under psilocybin is associated with increased lagged phase synchronizations of delta oscillations between parahippocampal regions and the RSC. This suggests that spiritual experiences may involve the organization of the self within a broader spatial context through neural synchronization.

82
Q

What is the entropic brain hypothesis concerning psychedelics?

A

The entropic brain hypothesis proposes that psychedelics increase the entropy (or disorder) of spontaneous brain activity. This heightened entropy leads to more vivid and diverse subjective experiences.

83
Q

How does psychedelics affect communication between brain regions according to the entropic brain hypothesis?

A

Under psychedelics, the usual communication between interconnected brain regions breaks down, and there is increased integration across various regions of the brain. This phenomenon is known as increased global brain connectivity.

84
Q

How does the entropic brain hypothesis categorize different states of consciousness?

A

The hypothesis suggests that the brain operates on a spectrum of organization, from more chaotic (high entropy) to more ordered (low entropy) states. Normal waking consciousness is typically in the middle of this spectrum.

85
Q

What implications does the entropic brain hypothesis suggest for psychiatric disorders like OCD and depression?

A

States of low entropy (more ordered) are associated with rigid thinking, such as seen in OCD and depression. Conversely, psychedelics induce higher entropy (more disorder), which may explain why they are contraindicated for disorders like schizophrenia and bipolar disorder, which already exhibit disordered brain states.

86
Q

Examples of Low Entropy (More Ordered)

A

Normal Waking Consciousness: During routine tasks or familiar environments, the brain exhibits relatively stable patterns of neural activity. This state is characterized by clear, predictable thinking and focused attention.

Focused Meditation: When engaged in focused meditation practices like mindfulness, the brain tends to reduce spontaneous thought and maintains a more organized pattern of neural firing. This state promotes clarity and a sense of calm.

Routine Activities: Activities that are habitual or well-rehearsed, such as driving along a familiar route or performing repetitive tasks, often involve low entropy brain states. These activities require minimal cognitive effort and rely on established neural pathways.

87
Q

Examples of High Entropy (More Disordered)

A

Psychedelic States: Under the influence of psychedelics like psilocybin or LSD, the brain experiences increased entropy. This leads to heightened sensory perceptions, altered thinking patterns, and a dissolution of boundaries between self and environment.

Dreaming: During REM (rapid eye movement) sleep, the brain enters a state of high entropy characterized by vivid and often bizarre dreams. Neural activity during dreaming is unpredictable and can involve complex scenarios that defy waking logic.

States of Confusion or Delirium: Conditions such as delirium, where there is impaired cognitive function and disorientation, represent high entropy states. The brain’s normal organization breaks down, leading to fragmented thinking, hallucinations, and altered perceptions of reality.

88
Q

What is the Default Mode Network (DMN)?

A

The DMN is a network of brain regions including the prefrontal cortex, posterior cingulate cortex, and inferior parietal lobe. It’s active during introspective and self-referential tasks like daydreaming, self-reflection, and theory-of-mind.

89
Q

What functions does the Default Mode Network (DMN) serve?

A

It supports functions such as judgment, reality testing, sense of self, and mental time travel. It’s also involved in activities where active thinking is minimal, like passive reading or watching television.

90
Q

What happens to the Default Mode Network (DMN) under psychedelics?

A

Psychedelics cause a disintegration of the DMN, leading to decreased oscillatory power and disrupted communication between its regions. This disintegration correlates with experiences of ego dissolution, characterized by a temporary loss of subjective self-identity.

91
Q

What are the consequences of DMN disintegration under psychedelics?

A

It results in increased access to unconscious information, enhanced free association, heightened visual and mental imagery, greater situational awareness, and reduced self-censorship. This process helps alleviate rigid thinking patterns and facilitates creativity by breaking down barriers to novel ideas.

92
Q

How is the disintegration of the Default Mode Network (DMN) relevant to therapeutic responses?

A

By disrupting rigid thinking and self-referential thought patterns, DMN disintegration is implicated in the therapeutic effects of psychedelics. It enables individuals to explore deeper aspects of consciousness and potentially address psychological issues by accessing unconscious material.

93
Q

What is the Relaxed Beliefs Under Psychedelics (REBUS) model?

A

The REBUS model, proposed by Carhart-Harris and Friston in 2019, explains how psychedelics alter brain function to potentially rewrite pathological thinking and habits.

94
Q

What does the hierarchical predictive coding theory propose?

A

Hierarchical predictive coding suggests that the brain uses prior knowledge to interpret incomplete sensory information. Higher brain levels suppress ambiguous or incongruent sensory input, shaping perception, emotion, and cognition. This can lead to biases and limited perspectives.

95
Q

How does psychedelics affect the hierarchical predictive coding model?

A

Psychedelics relax the influence of prior beliefs, allowing for increased flow of information from lower-level brain systems, like the limbic system, which are normally suppressed. This can potentially revise ingrained biases and pathological habits, especially when coupled with therapy.

96
Q

What is meant by the “anarchic brain” in the REBUS model?

A

The “anarchic brain” refers to the state induced by psychedelics where high-level brain systems that typically suppress bottom-up information flow are relaxed. This leads to a temporary breakdown of normal cognitive constraints and a broadening of conscious experience.

97
Q

How do 5-HT2A receptors relate to the REBUS model?

A

5-HT2A receptors, highly expressed in cortical neurons including the visual cortex, mediate the reduction of cortical oscillatory activity under psychedelics. This reduction, particularly in alpha rhythms, is hypothesized to weaken the influence of prior beliefs, facilitating novel cognitive insights and experiences.

98
Q

What role do alpha oscillations play in the REBUS model?

A

Alpha oscillations are linked to perceptual processes, including the processing of time and space. Reduced alpha power in regions like the posterior cingulate cortex during psychedelic experiences correlates with ego dissolution, indicating a loosening of self-referential processing.

99
Q

How does neuroplasticity relate to learning and mental health disorders?

A

Neuroplasticity plays a crucial role in learning new skills, acquiring knowledge, and adapting to new situations. Disruptions in neuroplasticity are commonly observed in individuals with mental health disorders, such as major depressive disorder, where reduced brain plasticity is associated with symptoms.

100
Q

What is the role of Brain-derived Neurotrophic Factor (BDNF) in neuroplasticity?

A

BDNF is a critical signaling molecule that promotes neuroplasticity by supporting the growth, survival, and differentiation of neurons. Low levels of BDNF have been implicated in various mental health disorders, indicating its importance in maintaining healthy brain function.

101
Q

How do psychedelic compounds affect neuroplasticity?

A

Psychedelic compounds, including psilocybin, have been shown to increase the expression of BDNF and other genes that support neuroplasticity. Studies suggest that psychedelics promote neuritogenesis (growth of neurites), spinogenesis (formation of dendritic spines), and synaptogenesis (formation of synapses) in cortical neurons.

102
Q

What are the mechanisms behind psychedelics’ effects on neuroplasticity?

A

The effects on neuroplasticity are mediated through the activation of the 5-HT2A receptor and downstream signaling pathways, such as mTOR and TrkB. These pathways are involved in cellular processes that enhance structural plasticity in the brain.

103
Q

How might increased neuroplasticity contribute to therapeutic responses to psychedelics?

A

Enhanced neuroplasticity induced by psychedelics could facilitate the restructuring of neural circuits involved in cognitive and emotional processes. This restructuring may enable individuals to adopt new behaviors, break negative thinking patterns, and potentially alleviate symptoms of mental health disorders.

104
Q

What is inflammation and how is it linked to psychological disorders?

A

Inflammation is a natural immune response that involves the activation of pro-inflammatory cytokines. Elevated levels of these cytokines have been observed in patients with psychological disorders such as depression, suggesting a potential link between inflammation and mental health.

105
Q

What role does serotonin play in inflammation?

A

Serotonin is not only involved in mood regulation but also plays a crucial role in modulating the inflammatory response. It can influence the release of pro-inflammatory cytokines and other immune mediators.

106
Q

How have psychedelic compounds been studied in relation to inflammation?

A

Studies in animal models, particularly with 5-HT2A psychedelic agonists like DOI and LSD, have demonstrated potent anti-inflammatory effects. These compounds have shown promise in reducing the inflammatory response, although research specifically on psilocybin’s effects on inflammation is still underway.

107
Q

What are the implications of psychedelic-induced anti-inflammatory effects?

A

There is growing interest in exploring whether psychedelic substances or other non-psychoactive compounds that target inflammatory pathways could be developed as treatments for various inflammatory disorders. Conditions such as asthma, atherosclerosis, irritable bowel syndrome, and arthritis could potentially benefit from these therapies.

108
Q

How might targeting inflammatory pathways with psychedelics be beneficial for treating psychological disorders?

A

If psychedelics can effectively modulate inflammation, this could offer a novel approach to treating psychological disorders that are linked to inflammatory processes. By reducing inflammation, these compounds might alleviate symptoms and improve overall mental health outcomes.

109
Q

What is the hypothalamo-pituitary-adrenal (HPA) axis?

A

The HPA axis is a key neuroendocrine system that regulates hormone release, influencing metabolism, inflammation, and stress responses.

110
Q

How does psilocybin affect the HPA axis?

A

Psilocybin, through its activation of the serotonin system, including 5-HT2A agonism, can stimulate the HPA axis. Studies have shown increased levels of thyroid-stimulating hormone, adrenocorticotropic hormone (ACTH), cortisol, and prolactin during peak effects of high-dose psilocybin sessions (Hasler 2004).

111
Q

What implications does psilocybin-induced activation of the HPA axis have?

A

Although the specific therapeutic implications are still being investigated, these neuroendocrine effects suggest that psilocybin’s impact extends beyond the brain, potentially influencing metabolic regulation, inflammation, and stress responses.

112
Q

How is current research exploring the role of psilocybin on the neuroendocrine system?

A

Research is in its early stages regarding how psilocybin’s effects on the HPA axis contribute to therapeutic outcomes. Understanding these mechanisms could provide insights into its broader physiological effects and therapeutic potential.

113
Q

What are the broader implications of psilocybin’s actions on various body systems?

A

Psilocybin’s widespread effects on multiple physiological systems underscore its complex pharmacological profile. Further research is needed to elucidate these effects comprehensively and their relevance to therapeutic applications.