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20 Years of Human Neuroscience Research with Psychedelics

David Nutt

In 2025 it will be 20 years since the Centre for Psychedelic Research began its study of psychedelic drugs in humans, first at Bristol University and then since 2008 at Imperial College London. What started out as an imaging study of the brain mechanisms of psilocybin in collaboration with Robin Carhart-Harris and Amanda Feilding has turned into a life changing body of research that has encompassed many hundreds of colleagues: doctors psychologists and neuroscientists. My talk will take the audience through the early challenges of getting licenses and permits, persuading ethics committees that the research was both safe and important, making the drug formulations and getting funding including through crowd sourcing. I will share our amazement at the early findings with psilocybin and then LSD of the unexpected decrease rather than increase in brain activity predicting the psychological effects. This led to both a restructuring of our ideas about the brain mechanisms of the psychedelic state and also the possibility of using psilocybin to treat depression. I will share the very significant ethical and bureaucratic challenges of getting the first clinical trial conducted and the remarkable outcomes in patients with treatment-resistant depression. These discoveries led to more support from philanthropists who had family members with depression and related disorders that allowed us to conduct the first comparative study of psilocybin and an SSRI in depression. This showed both comparative efficacy and tolerability in favour of psilocybin and also fundamentally different brain mechanisms supporting a theory we had developed that there were alternative ways to lift depression. Subsequently we have developed an efficient approach to studying macrodose psilocybin as a therapy for anorexia nervosa and fibromyalgia, and midi-dose psilocybin as psycholytic therapy for OCD, data that are currently in analysis will be presented at the meeting. I will also share details of new trials of a macrodose of psilocybin we have started in heroin and gambling addiction. I will also explore current research needs and regulatory challenges and suggest ways in which the field could most rapidly progress.

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