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IAm Dr. Robin Carhart-Harris from Imperial College London I study the use of MDMA & Psilocybin mushrooms in the treatment of depression." AMA

Mar 2nd 2013 by londonreal • 53 Questions • 2184 Points

Hey Folks, London Real here to present another fantastic IAmA with one of our guests, Dr Robin Carhart-Harris.

On our show he talked about the effects of Psilocybin & MDMA and how they could be used to help with depression and addiction, his controversial colleague Professor David Nutt who claimed Cannabis & Ecstasy were safer & less addictive than Alcohol & Tobacco, and why he refrains from sampling psychedelics in order to remain objective about his research.

EPISODE: http://www.londonreal.tv/episodes/dr-robin-carhart-harris-psychedelics-as-medicine/

PUBBLISHED WORK: http://www1.imperial.ac.uk/medicine/people/r.carhartharris/

I leave you with Dr Robin Carhart Harris...

UPDATE: We are Done. Thanks everyone this has been AWESOME please check out our episode with Robin and his research

Q:

Hello:

I am 43 years old and a chronic sufferer of "cluster" headaches. At one point, I was on 13 different pharmaceuticals (nothing narcotic, because those don't touch these headaches). I have "cultivated" a network of support that has allowed me to medicate with nothing more than magic mushrooms for the past 2 years. This is the only medication that has worked for me. I'm working full-time again and I no longer think about suicide on a daily basis. It has literally saved my life. My question is not medical, because I know this substance works. But I also know that my helpers are risking prison time by helping. Do you see any hope for legalization in the future?

A:

In terms of medicinal use, I really hope so. Glad you've been helped.

I think it's important to campaign and make people aware of cases like your own.


Q:

Hi, Dr. Carhart-Harris,

What do you use, if anything, to follow an MDMA treatment? I have heard of people taking 5-HTP to combat the serotonin depletion. Does this work?

A:

We didn't give anything. 5-HTP is a good idea though and in the future we'd test this i.e. see if one group given 5-HTP have less severe hangovers... It was a bit of an oversight not to have done this in the first place..


Q:

Dr. Harris, how do you find your research subjects?

A:

They're lovely mostly.


Q:

Dr. Harris, how do you find your research subjects?

A:

It's not hard to recruit, that's for sure!


Q:

How would you explain the entities in a DMT experience on a neurobiological level? Just dream-like projections of the self?

A:

I think they're probably archetypal, humans are primed to see entities (our mothers eg) from a very early age. I just think it's the mind's internal models of what might be out there that become manifest and then confuse us into thinking they're actually 'out there'


Q:

When you were younger, was it your intent to work with psychedelics, or is it something that interested you after you began researching other fields?

A:

It was my reading that inspired me. I didn't plan it but when I read stan grof's realms of the human consciousness, it was then that I knew what I wanted (and had) to do.


A:

I had a strange experience when I was quite young which opened my eyes but then essentially forgot about it until I became very interested in psychology and specifically psychoanalysis and I learned that people believed in the 50s and 60s that LSD could allow access to difficult to access psychological material. That absolutely fascinated me.


Q:

Do you think if credible scientists started coming out as having taken psychedelics, it would start a more open dialogue on the discussion of drugs in society? I mean Dr. Griffiths paper on guidelines for safety even said a researcher should know the experience before doing any sort of clinical research.

A:

Maybe some knowledge yes. I do think it's good not to get too involved in these drugs as recreation though. The famous big users weren't very good scientists. They dreamt up a lot of stuff with very little evidence to support it. It's best to stay grounded in this realm.


Q:

I think it's great that researchers are exploring psilocybin mushrooms to help people struggling with addiction and/or depression. My question is, given the amazing results of the Marsh Chapel Experiment and the followup at Johns Hopkins University, how do you feel about psilocybin use among otherwise healthy individuals to achieve greater life satisfaction and wellbeing?

A:

I think it has a place.

Huxley had a kind of elitist view about this which I used to dislike but now sort of understand. He said you need to have the intellectual capacity to put the experience into a context. I sort of see what he meant. I think you at least need to be able to ground yourself after the experience.

All the benefits come from returning to normal waking consciousness and its that state we should celebrate. The psyche state is an incredibly useful holiday but we need to be mature in returning to normality because otherwise nothing would get done and society would be chaotic. Huxley wrote beautifully about this in DoP


Q:

What are your thought's on the recreational use of psilocybin and MDMA?

A:

Be careful, read up and don't get yourself a criminal record.

Also, don't ever let recreational use become your life. It's the same with all drugs.


Q:

In light of the discoveries you have made in the effect on repetitive thinking and the deregulation of the control centres by these chemicals, do you think they might also ameliorate symptoms of people on the Autistic Spectrum

A:

People are looking into that with MDMA.

I think the psychotherapy structure around it would have to be extensive.


Q:

Do you think that research like this could actually lead to the introduction of these drugs as therapies if proven beneficial, or do you think mainstream societal fear of "drugs" as legitimate pharmaceuticals (and the pharmaceutical lobby) will deter its use?

A:

I think they will be developed as therapies.


Q:

Are you spiritual or religious at all? If not, do you think this type of research will give insights into where the idea of God or spirituality originated?

A:

I was brought up cathloic and attending church every sunday, sent to a catholic school, was an alter server.

I love the art of religion and I'm fond of it.

I'm a scientist and an atheist now though and I feel a bit sad every now about the lost magic that comes with atheism.

I feel wonder about the beauty of nature though. I can feel an overwhelming euphoria about the vast beauty of nature.

Plus, I'm fond of Buddhist ideas and used to meditate.

Sorry, last bit: yes, I feel like we're on the verge of major insights about the biological underpinnings of spiritual type experiences and how religious structure evolved from the spiritual experiences of pre-historic and ancient man


Q:

Hello Dr Carhart-Harris, what, if any, other substances apart from Psilocybin and MDMA do you believe can offer help treating depression/addiction or other mental health issues. Also what do you think these types of substancs can offer in unlocking any further secrets of the mind, and what obstacles do you see in expanding types and number of substances people like yourself can use for research, thanks

A:

Hmm, a safer MDMA would be good. ie. one that doesn't cause serotonin depletion.

DMT could be useful as could LSD.

LSD in alcohol addiction I'm especially interested in...

I also think LSD will be most useful for unlocking secrets of the mind. It's the most potent and interesting psychedelic imo.


Q:

I'd be interested in hearing about what kind of regulatory barriers you've dealt with in this line of research.

A:

Home Office, Ethics, R&D, site specific, internal opposition, MP opposition, ignorance, conservative press...


Q:

After having tried them back in college all i can think is what if you have someone that has a "bad trip"? I personally never experienced that but was always in good spirits heading into it I can't imagine it would always go so well with someone who suffers from Depression.

A:

It will be very difficult for some patients, you're absolutely right. We have to be prepared for bad trips and we will prep the patients for difficult experiences. We'll ask them to reveal feelings of anxiety as soon as they feel them. We'll reassure them it's normal and even potentially useful to feel some anxiety and we'll reassure them that we're with them all the way and that they should explore sources of anxiety rather than try to flee them as it will be in the confrontation that the potential benefits will be greatest.


Q:

Do you think the UK government will change their drug classing system anytime soon? If not what do you predict will happen in the next couple years? With new research chemicals filling in the legal market with so little known about their long term effects.

A:

I think the next government, which will likely be labour will make some reforms yes.

Reform is inevitable but the Tories won't do it. The thing is, it's pretty likely the Tories will get a kicking at the next GE


Q:

Do you believe that using Psychedelics and MDMA (or MDMA analogues) recreationally, is something that responsible adults should be able to legally do? or do you see them as purely medicinal tools?

2) and also what is your opinion on the comparative Neurotoxcity in MDMA, BK-MDMA, and Alcohol?

A:

I think that there should be psychedelic centres where anyone, properly screened can sample the experience in the right kind of setting. These centres would be staffed my medical health professionals and people shouldn't be allowed to abuse the opportunity to have the experience. I think it would be problematic if psychedelics could be taken out of the clinic (like medicinal cannabis in the US eg) because without question you will get some disasters and it would mean a return to the 60s and the tarnishing of these drugs' name again.


Q:

I have heard anecdotal evidence for psilocybin as a possible reliever of migraines. Do you know of any research in this area? Thanks very much.

A:

Yes, Andrew Sewell is a name worth googling. It's a credible idea. A lot of migraine drugs are ergot derivatives a bit like LSD, plus classic psychedelics probably do have a potent effect of blood vessels.


Q:

What are your thoughts on microdosing? Say 5-10 micrograms of LSD every day for an extended period.

A:

Therapeutically?

I'm not sure, I'd worry about become a bit detached from reality.

Although, this is sub-psychedelic, so it's an interesting idea.

Personally I'm not convinced though but remain open-minded.


Q:

What made you want to study them?

A:

The idea that they could access hidden parts of the mind. What is more fascinating than that!


Q:

Can you give us a TLDR (too long didn't read/abstract) on WHAT Psilocybin and MDMA does to use that would help with these things? (Like, does it raise our serotonin or dopamine levels, or is it due to the reaction our body has with the drug that is what produces the results).

If it IS a serotonin/dopamine increase, have you tried the two in conjunction with Ginko Bilboa or other nootropics to increase or prolong the effects?

A:

psilocybin stimulates serotonin receptors and the psychedelic effects appear to occur through the serotonin 2A receptor.

MDMA increases levels of serotonin, noradrenaline and dopamine and doesn't really stimulate any receptors directly.


Q:

How do these drugs interact with other anti-depressant drugs? Mainly SSRI's such as prozac?

A:

SSRIs attenuate the effects because they upregulate 5-HT2A receptors because of increased synaptic 5-HT


Q:

Studies involving MDMA and psilocin are becoming more common -- not just at ICL but elsewhere -- but LSD seems to have been conspicuously absent from the latest line of research. Do you think this is because of societal stigma regarding LSD, its cost of production and acquisition, a lesser expectation of therapeutic potential, or something else?

A:

The stigma mostly.

Plus, psilo is a nice little drug, more manageable than LSD because of shorter duration of effects. LSD also has a very non-selective pharmacology - but then that makes it interesting too.


Q:

As far as questions go, I don't really have any that haven't already been asked. That being said, I just wanted to say you're wicked fuckin awesome and keep the research going.

A:

Very sweet, thanks dude


Q:

Can you tell us more about the troubles and walls you've had to deal with and get past to research illegal supplements like these?

and to follow up, What laws/ political B.S. is the most detrimental to your work and advancing care and knowledge for your studies?

A:

Some MPs have taken a dislike and tried some personal attacks on my seniors. Ignorance is the main problem but the next generation of politicians will be less ignorant. People like David Nutt are so important for breaking taboos and tackling misinformation.


Q:

I was recently watching a documentary on nat geo on hallucinogenics. A man (~52yrs) has been suffering cluster headaches for years and discovered that consuming psilocybin mushrooms every two months eliminates the headaches. My question is; how does psilocybin do this?

A:

Maybe via constricting blood vessels - the research needs to be done


Q:

In higher doses people often report spiritual experiences, seeing other forms of themselves, interacting with other beings, and entering other "dimensions". Do you think there's something to that? Or in your opinion are these all just manifestations of the brain ?

A:

I think there is something in that but I think it can be explained psychologically eg with reference to Jungian theory and writings on the phenomenology of the mystical/spiritual experience. I don't think it's metaphysical however.

Yes, they are manifestations of the brain. There's no question imo. But I still think that is an absolutely amazing thing.


Q:

Will you be joining us at the next ICPR in Amsterdam? Your talk this year was great.

A:

Thanks :-)

Sure, if I can.


Q:

Dr. Carhart-Harris, if you could have any historical person work on the trials with you, who would you pick and why? Also, who do you pick to work with you, if you can already and why?

A:

I think Sidney Cohen was under-rated. He's my main hero from the 60s era.

I also like Huxley's poetic descriptions in DoP

But, if I had to choose one, it would probably be Freud. an incredible mind.


Q:

Q1.What biological function or advantage does the production of psilocybin bestow upon plants/fungi that produce it?

Q2. Are there any receptor (serotonin 2a receptors?) that only bind with psychedelic compounds, and if so, for what biological or evolutionary reason do they exist?

A:

Maybe to stop sheep eating them. Liberty caps also look a bit like droppings and that's another deterrent. The best explanation is that it's to stop things hosting on them though. Doesn't stop humans though!


Q:

Hi :) thank you for taking the time to talk with us. * 1. what are your thought's on Terence McKenna's stoned ape theory? (http://www.youtube.com/watch?v=hOtLJwK7kdk) * 2. do use synthasized psilocybin or do you use fresh mushrooms for your study's? * 3. Have you personally used mushrooms?

A:
  1. I'm not really familiar with the stoned ape theory, can you summarise?

  2. The psilo is synthesised. It goes in IV so can't be from plant material because of microbes. 3. I hate that question, sorry, please understand that it's not wise to answer, put it this way, I'm very different to Terrance McKenna :-)


Q:

*1. >In his book Food of the Gods, McKenna proposed that the transformation from humans' early ancestors Homo erectus to the species Homo sapiens mainly had to do with the addition of the mushroom Psilocybe cubensis in its diet - an event which according to his theory took place in about 100,000 BC (this is when he believed that the species diverged from the Homo genus). He based his theory on the main effects, or alleged effects, produced by the mushroom.< *2. I understand completely.

A:

Yes, I've heard that theory and i'm here to be honest, so I will. I think it's dreamt-up nonsense like most of McKenna's stuff. Sorry.


Q:

What is the most common similarity in experiences reported by people who take psilocybin?

A:

geometric hallucinations and odd bodily sensations (tingling) as they come up.

at least at our doses.


Q:

20 Years ago hallucinogenics were my drug of choice. With proper preparation: a place, a partner, a plan of play and no work the next day, I and my mates always had a lovely time. I credit my experience especially with Mushrooms with opening my mind to the interconnectedness of humanity. It made me a more compassionate person I think. I credit my LSD use with allowing me to re-qualify past events so that they took on a more objective and less emotional base in my mind. I was able to psychologically distance myself from some negative influences from my child hood. I resent the resistance to using these tools to help the soft science of psychology make in roads with PTSD and depression. Like anything that changes a person, controls must be put in place. What do you see as the most important control factor in your studies?

A:

I think it's really important that an academic working with these drugs respects their power. That sounds a bit grand but as soon as you start being complacent about the drugs, that's when negative events become more likely. I have to remind myself before each administration that the volunteer is about to embark on something remarkable and should be properly prepared for that.


Q:

Do you know anything about the research chemical 2C-i-NBOMe aka 25i-NBOMe? If so do you believe that these may also have therapeutic benefits? It's been said that it has similar effects to that of LSD but I personally cannot vouch for that through personal use or research.

A:

I don't know sorry


Q:

I’m not sure if this is the correct AMA to ask this question on, but I figured it’d be the best time to ask. Do psilocybin and/or MDMA pose any negative health risks when used?

A:

Yes. The risks around psilocybin are psychological mainly. If taken in the wrong environment or if you're in the wrong frame of mind without people around you who could look after you if you start getting anxious and/or paranoid, then there's the potential for a very difficult experience. It's extremely important that attention is paid to set and setting, or how you feel at the time and what kind of environment you're in. Physiologically, psilocybin is very safe. With this said, psilocybin may pose some significant mental health benefits however if taken in the right way with the right people around you. With MDMA, it's a little different. The experience is less psychologically challenging but more physiologically taxing. The serotonin low that follows an MDMA experience is a bit of a problem and if the drug's really over-used then there's a potential risk of causing some damage to the serotonin system - which could affect mood for example. The moderation message with MDMA is very important.


Q:

Were you involved in that study that came out about 6 months ago (may have been more) that found users of psilocybin to have a permanent improvement in empathy over those who had never?

A:

Nope, wasn't me sorry. Maybe Roland Griffiths?


Q:

how would you compare the effectiveness of psilocybin & mdma on depression and addiction compared to hoffman's lysergic acid diethylamide?

A:

Difficult to say.

psilocybin for depression imo

MDMA for PTSD

And maybe psilocybin and LSD for addiction

LSD is incredibly potent and addiction (esp to alcohol) is maybe the most stubborn psychiatric disorder of all, so LSD for addiction is worth a shot.


Q:

How much is known about the damage caused by MDMA to serotonin receptors, and the potential for self-repair of those cells?

A:

There's no damage to serotonin receptors with MDMA but some potential damage to axonal fibers. Repair does happen it seems. Full repair seems to happen in most areas but there's some suggestion that some cortical regions may not show complete recovery. See Erritzoe et al. in Archives of Gen Psychiatry for this paper.


Q:

And one final one: have you heard many connections between high end psilocybin intake while meditating in the dark and having an experience which is best described as a waking lucid dream for several hours?

Though not very common some modern people and indigenous people tend to describe this sort of experience, often times venturing into space and travelling to other worlds as realistically as normal waking life.

A:

Yeah, it's interesting


Q:

How does a general day at the lab go? What do you spend most of your time doing? What are the people around you like?

A:

Regulatory stuff! :-(

Plus a bit of writing, which I love


Q:

What are your thoughts on the latest ketamine studies and it's effect on cell repair?

Edit: here is an article about the study for those who are interested http://www.theatlantic.com/health/archive/2012/10/the-biggest-breakthrough-in-depression-research-in-50-years-is-ketamine/263400/

A:

Interesting but I think classic psychs have more potential


Q:

What is it exactly about psychedelics that make them so non-toxic despite having profound effects on brain chemistry? Why can you take such large quanitites of LSD or psilocybin and suffer comparatively little harm than other psychoactive compounds like cocaine?

A:

Probably because they a lot like serotonin

It's a bit of a myth that you can take large quantities of LSD though. If you take too much it will poison you. LSD is very potent though so you only take tiny doses and yet have a profound experience.


Q:

What do we currently know [and what research have you performed] about the interactions between Psilocybin and antidepressants? We could go through the gambit of the various forms but my curiosity is focused on Norepinephrine-dopamine reuptake inhibitors and Psilocybin.

A:

Good question. There's only anecdotal evidence but it suggests certain ADs attenuate the effects of psychs.

Na/DARIs won't affect psilocybin so much would be my guess. SSRIs more so.


Q:

Any realistic data on human LD50 for MDMA? I've seen different sources range from 1,500 mg to 7,000 mg. I recall reading one story about an individual who was eating over 2,000 mg a day. He collapsed eventually.

A:

2 grams a day! I'm not surprised. It's difficult to do the camprisons but high doses of MDMA are generally a very bad idea is any context.


Q:

Where would you like to see this line of research go over the next 20 years, and how would you like to see it applied?

Also, what do you think about Dr Rick Strassman's famous DMT study?

A:

Strassman's study was very pioneering. I'm not sure what happened to Strassman as a scientist though, he seemed to disappear from the scene. There's probably something I don't know.

Next 20s: careful research, accumulating the evidence, changing the face of psychiatry for the better. Developing the insights on offer from psychedelics in a evidence-based framework.

There will be opposition to this from some elements of the mystical-camp but so be it..

Science is an inherently mystifying force... and it's aim is to better characterise reality by testing it and learning from the evidence...


Q:

Even with the research to back this up and the newer generations openness to the subject, how do we shake the negative 'drug user' stereotype held by older, stubborn and unwilling generations? I am well aware of how these substances can effect you and I think with education, regulation and legalization we can have a safer, more mind opening way to approach 'recreational' use.

A:

By engaging with media. David Nutt has taught me that.


Q:

From what I gather your work has been with unipolar depression. Any thoughts/knowledge to share about bipolar depression and substances like this?

A:

Very difficult. I worry about inducing mania.


Q:

Hello Dr Carhart-Harris, thank you for doing this AMA. I've experimented with MDMA a small number of times and greatly enjoyed it. More specifically I enjoyed the prolonged feeling of positivity that followed me for a few weeks, only to have it give way to my incessant pessimism. With your experience Doctor, what sort of advice would you offer to help the "lessons learned" stick?

A:

MDMA might not be the right compound to treat depression. The serotonin low post-use may be problematic.

Psilocybin has more potential for depression imo but the experience is much more difficult and not always pleasant like MDMA.


Q:

I am not sure if I can phrase this right but here is a shot,

Do psychedelics have a "inert" composition so as no "trip" is produced yet depression is reduced when administered to a patient? Or is the psychedelic aspect necessary for the effectiveness.

I'm asking this as I have read about Cannabinoids that provide no "high" to the user yet can effectively treat conditions. I find this of particular interest as I am somewhat opposed to the recreational use of most narcotics yet feel strongly that their classification as Illegal Substances only leads to hinder scientific research and public awareness/understanding of these substances.

P.s. I have not read a lot into Psilicybin & MDMA, could you recommend some papers/Cochrane reviews to intrigue a young mind?

A:

I do think the psychedelic effects are a necessary part of how these drugs can be beneficial.

Sidney Cohen's 'the beyond within' is a great book about LSD.

David Nutt's book: 'Drugs without the hot air' is also worth a read.

Les Iversen's book on amphetamines and MDMA is nice.

As for papers: Griffiths papers on psilocybin are excellent.


Q:

What seems to be the most profound effect of psilocybin/Psilocin and other Psychadelics?

A:

Ego-dissolution.

Everything profound follows from knocking this 'reducing-valve' out of the way.


Q:

Thanks for the AMA.

I know the law isn't your expertise but would you support decriminalization of MDMA to be able to provide safer and more accurate doses (not cut etc)?

A:

Maybe, I'm not sure. You're right, policy is more David Nutt's domain.

A safer MDMA would be nice and club testing is a good idea.