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When psychedelic mental health treatment started getting increased attention a few years ago, Massachusetts General Hospital psychiatrist Jerrold Rosenbaum was skeptical.
"I was among those who had ideas about psychedelics from the 1960s and my response was what you would expect from an old psychiatrist," Rosenbaum said.
He thought of the controversies surrounding the use of psychedelics in that era, stories about bad trips and other stigma associated with the substances.
"So I repeated those stereotyped myths — but I said them with great authority," he chuckled.
But when he started hearing about the potential benefits of psychedelics from colleagues and patients with treatment-resistant depression, he became curious. He began taking a closer look at the research.
"We're pretty convinced that there's a story there that these substances do change the brain or allow the brain to change in a way that can be helpful for those who suffer psychiatric disorders," Rosenbaum said.
Now, Rosenbaum finds himself at the helm of MGH's new Center for the Neuroscience of Psychedelics, which officially launched Tuesday. The center will focus on studying how and why the brain reacts to psychedelics, and its research could shed new light on what their use could mean for mental health treatment.
"There is general recognition that we've got some really unsatisfactory pharmaceutical agents and that we have a lot of mental illness that is not being treated successfully," said author Michael Pollan, who attended the kick off event and is a member of the center's advisory board. "The openness to innovation that I never expected to find is profound and the beginning of this center is an indication of that."
Right now, Pollan said, a lot of the research focuses on patients' descriptions of the often spiritual experiences brought on by psychedelics and a subsequent alleviation of their mental health conditions. The center plans to use neuroimaging and other sophisticated technologies to better understand what is happening in the brain during those experiences.
Rosenbaum says some of the early focus will be on how psychedelics affect what's known as rumination, a repetitive pattern of thought that many patients can't seem to escape. Rumination appears to be a factor in various mental health conditions such as depression, anxiety, addiction and obsessive compulsive disorder. Some research suggests that psychedelics affect what's known as the default mode network of the brain, which is involved with rumination.
"Some psychedelics have been shown to lead to decreased activity in the brain's default mode network," Rosenbaum explained. "And we know that that's a region where there is increased activity during rumination in many patient populations. So one of the questions is: Does that decrease in brain activity lead to an improvement in a patient's symptoms?"
Projects the center has already started working on include research into a synthetic version of psilocybin, a naturally occurring psychedelic in some fungi, and how it affects rumination and other cognitive processes in those with depression. Rosenbaum says the center will also study MDMA, in combination with mindfulness, and its potential benefits for Gulf War veterans with post traumatic stress disorder. Rosenbaum says psychedelics should be considered a tool to facilitate traditional psychotherapy.
Although some psychedelic substances remain illegal under federal drug laws, substances such as psilocybin and MDMA can be approved for use in medical research. Dr. Sharmin Ghaznavi, the center's associate director, says there are big differences between recreational and therapeutic uses of these substances.
"When it comes to recreational use, bad things can happen and people can have bad trips," Ghaznavi said. "But that doesn't happen in well-controlled studies. It's really about preparing the patient for the experience and doing the therapeutic work and giving the space for the patient to do the work."
The MGH center plans to recruit patients for clinical trials but will not offer treatment with psychedelics, at least for now. Among other projects the Center will undertake is researching the plant substances studied and collected by Harvard ethnobotanist Richard Schultes, author of the 1970s book "The Plants of the Gods: Their Sacred Healing and Hallucinogenic Powers."
Schultes researched plant medicine in indigenous communities around the world and documented how more than 100 different plants affect the brain. While much of Shultes work involved personally ingesting substances and documenting those experiences, the center hopes to use technologies such as DNA bar-coding and stem cells to look at the science behind the plants Schultes studied.
"To use new tools and technologies to go back to this work from a half century ago is really exciting," said Stephen Haggarty, director of chemical neurobiology at the MGH Center. "They were just scratching the surface back then. But we have an opportunity to use the Boston ecosystem of students, clinicians and scientific researchers to look at how these plants might address some of the unsolved problems in psychiatry."
While psychedelics appear to be having a renaissance at the moment, with potential benefits touted for other health conditions ranging from depression to addiction to cluster headaches, there are critics who say that not enough is known about them to ensure they are safely used. Currently the center will screen patients for clinical trials. Certain patients, such as those with a history of psychosis, would be excluded from the clinical research.
"I think there's good reason to be skeptical," said Ghaznavi. "The reality is that the research is still early, but the signal is strong. So we need to pay attention to it and investigate it."
Dr. Rosenbaum, the center's director, still has a lot of questions about psychedelics himself, and says he hopes the research will help answer them, perhaps proving — or disproving — some of the theories about what they may be able to provide.
"I'm hopeful," he said. "I never tried them and I'm not going to. I'm just an old cautious guy. But the nature of science is that studies are designed to disprove your hypothesis. So so we come into it with that mindset, but also with the optimism and hope that we'll find new ways to help people who we haven't been able to help."
This segment aired on March 10, 2021.
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