The inaugural lecture in our CME– and CE-accredited training series, The Science of Psychedelics, revolves around pharmacology and the mechanism of action of the classic psychedelics, such as psilocybin and LSD. Being the nerdy clinical biologist with an affinity for the neuropharmacology of psychoactive drugs that I am, I chose to dive right in and spend part of my afternoon with the lovely Dr. Zelfand. Here’s a short recap so you can get a sneak peek inside this online, accredited training course focusing on the science of psychedelic medicine.
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Meet the Drugs: A Friendly Yet Informative Introduction to Psychedelic Compounds
The first module of The Science of Psychedelics begins with Dr. Zelfand categorizing the different classes of psychedelic compounds. From ergolines and tryptamines to the phenethylamine class, which includes stimulant-like drugs like MDMA, she does a great job categorizing each class and describes their unique properties. Dr. Zelfand’s passion for the subject matter is immediately apparent as well, immediately engaging the student as they embark on their psychedelic journey.
Examining the Neuropharmacology of the Classic Psychedelics: Psilocybin & LSD
I love exploring the various mechanisms of action of diverse psychoactive compounds and the classic psychedelic drugs certainly act in some interesting ways when they get to our brain. One fact Dr. Zelfand highlighted is the striking structural similarity between the serotonin we endogenously produce in our human bodies and the classic serotonergic psychedelics, such as LSD and psilocybin. In fact, one peer-reviewed journal article exploring hallucinogens and serotonin 5-HT2A receptor-mediated signaling pathways described how “the discovery of the hallucinogenic effects of LSD and the observations that LSD and the endogenous ligand serotonin share chemical and pharmacological profiles led to the suggestion that biogenic amines like serotonin were involved in the psychosis of mental disorders such as schizophrenia.” Indeed, learning that the pathological origins of schizophrenia are rooted in our discovery that acid makes one hallucinate is certainly fascinating. But not nearly as interesting as the neuropharmacological reason why that trip lasts quite so long!
Microcrystallography Data Reveals a Quirky Mechanism for LSD’s Action in the Brain
Personally, my favorite part of this module was Dr. Zelfand’s explanation of why LSD lasts so incredibly long compared to other psychedelic drugs. As per her explanation, the LSD molecule wedges into the serotonin receptor’s binding pocket at an unexpected angle, causing the receptor to fold over the LSD molecule (like a lid), essentially trapping the LSD molecule in the receptor. Indeed, it is because of this fascinating reaction that the LSD trip can last for over 12 hours!
Understanding Psychedelic Action on the Default Mode Network (DNM)
The revival of psychedelic science and research has had profound implications on our understanding of brain functioning. Perhaps one of the most interesting and relevant brain structures with respect to psychedelics is the Default Mode Network (DNM). Also known as a “resting-state brain network”, the DNM has been found to be altered in several psychopathological conditions such as depression and anxiety. Dr. Zelfand eloquently explains how DNM activity is lowered under the influence of psychedelic drugs and that these positive changes tend to last well after the psychedelic experience has ended. Zelfand artfully draws upon the research of Carhart-Harris and colleagues as well, to discuss their latest findings on the DNM and how psychedelic drugs affect it. Also discussed is the concept of “neural crosstalk” along with a fantastic explanation of Carhart-Harris’ famous “this is your brain on psilocybin” diagram demonstrating this phenomenon.
Measuring the Mystical Experience With Science & Technology
Experiences on psychedelics have been described as some of the most meaningful experiences people have had in their entire lives. Dr. Zelfand dives deep into the significance of the mystical experience and how the early psychedelic studies in terminal patients helped shape the industry at large and the movement as a whole. As the world is witnessing how drugs like psilocybin could radically help cancer patients accept their own death, the public perception around these compounds is starting to shift rapidly. Dr. Zelfand explains how the latest advances in brain imaging and other technologies have helped inspire progress in the psychedelic movement today and what exciting frontiers researchers are pursuing next.
The Perfect Blend of Nerdy Science and Important Information for Clinicians and Enthusiasts Alike
The Science of Psychedelics kicks off with the perfect blend of nerdy science and the important information clinicians need to build a sound foundation for understanding psychedelic therapy. Dr. Zelfand’s first module was a pleasure to take part in and I eagerly await to catch the next segment in this dynamic and accredited program.