“Egoic Style of Thinking” Allows Psychedelic Effects in the Human Brain

The “pivotal mental state,” made possible by the hyperplasticity of the brain, is where one pivots from “wellness” or to “illness” when undergoing adaptive pressure or in a psychedelic state, Robin Carhart-Harris, PhD, head of Psychedelic Research, Center for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, England, told virtual attendees at today’s SANA Symposium.

There is converging evidence for the importance of cortical neuroplasticity being associated with serotonin 2A receptor agonism, said Dr Carhart-Harris, who is also a Sana Symposium steering committee member. He defined plasticity as “the ability of a system or phenomenon to be shaped or molded want to be changed.” Recent findings suggest that evolutionarily, the 2a receptor allows for adaptability, and stimulation of the receptor through adversity or exploration is involved in brain growth.

The “pivotal mental state” is when a patient is sensitive to environmental context and the potential for psychological transformation through hyperplasticity.

“The so-called plasticity paradox that perhaps plasticity in and of itself isn't a healing phenomenon and it very much depends on the right kind of supportive enriched favorable context with that plasticity that can move someone in a positive direction.”

“We start to get a picture of what psychedelics are doing in the whole brain targeting, what I think, are now probably the more reliable correlates of what makes human consciousness and the human brain different from other animals; that egoic style of thinking that has within it the ability to be self-conscious, self-reflective,” Dr Carhart-Harris told virtual attendees.

In his session, Dr Carhart-Harris briefly discussed the relaxed beliefs under psychedelics (REBUS) model, which suggests that psychedelic therapy weakens higher-order beliefs, stimulate creative thought, and allow the brain to communicate more freely by breaking down barriers between connections.

Finally, he explained his most recent findings of a trial comparing psilocybin therapy and escitalopram, a selective serotonin reuptake inhibitor (SSRI).

The 6-week, double-blind, randomized, controlled trial involved patients with major depressive disorder who received psychological support throughout the study.

The trial did not show a significant difference in antidepressant effects between psilocybin and escitalopram, but secondary outcomes generally favored psilocybin.

After revaluation of the data, Dr Carhart-Harris suggests that those who did not come off psilocybin medication did “much better” in the psilocybin condition compared with the escitalopram group.

“One implication that is obvious is a longer washout period if you're going to get psilocybin, therapy but another one is discontinuation,” Dr Carhart-Harris said. “The brain and body going back onto a psych medication seems to be what the brain and body and mind want.”

Reference

Carhart-Harris, R. A primer on psychedelics: understanding how they impact the brain. Presented at: SANA Symposium; September 17-19, 2021; Virtual.