From TEDMED 2020: Researching psychedelics for psychiatric disorders with Dr. Frederick Barrett

Wednesday, May 13, 2020

Frederick S. Barrett, PhD, is affiliated with the Center for Psychedelic & Consciousness Research (@JHPsychedelics) at Johns Hopkins University, Baltimore (@Hopkins Medicine).

Dr. Barrett spoke with Nick Andrews (@Nick_Andrews_) at @TEDMED 2020 about the research that has been conducted by the Center for Psychedelic & Consciousness Research on the impact of psychedelics, or hallucinogens, on psychiatric disorders. He has no disclosures.

Take-home points

  • Dr. Barrett transitioned into neuroscience research through his interest in the effect of music on human emotions and the brain.
  • Until 1970, psychedelics such as psilocybin were widely used in clinical research, with more than 1,000 academic papers published about their use. For example, psychedelics were used as a model for schizophrenia and helped identify the role of serotonin in psychosis. They were also studied to treat addiction and as a treatment for existential anxiety in cancer. In 1970, psychedelics were deemed illegal by the Controlled Substances Act which brought the United States in compliance with the 1971 Convention on Psychotropic Substances.
    • Roland R. Griffiths, PhD, and a group at Johns Hopkins have led the way in reestablishing clinical research using psychedelics.
    • Enthusiasm at the lab is borne out by the potential that this research might help many people.
  • Institutional concerns also are at work because of the “rich and sordid history” of these compounds.
  • In the next 10 years, Dr. Barrett would like to have a clear understanding of the effect size of psychedelics on mood and substance use disorders.
  • Psychedelic agents have a novel therapeutic quality: Studies support that a few or even one exposure to a psychedelic compound has a short-term biological effect and can lead to a long-lasting therapeutic effect, such as remission of mood disorder or change in personality characteristics. The clinical outcomes are mediated by the intensity of the psychedelic experience.

Summary

  • The Center for Psychedelic & Consciousness Research is working to discern which medical indications have the most promise for being treated with psychedelics. Its goal is a balanced and rational approach to psychedelic research and subsequent treatment considering the societal and political contexts around these drugs.
  • Dr. Barrett trained in music education and psychology and has been a musician all this life. He moved into neuroscience during graduate school and used music as a tool to study emotions and the brain.
  • Music, meditation, and psychedelics have the similar flow component that inspires converging research questions and a desire to analyze the brain and understand this experience that is central to consciousness.
  • Music is fundamental to the human experience, and it is exciting to try to describe the neural circuitry of how music affects the brain and emotions.
  • Music is useful in therapy because it can regulate emotions. There has long been an overlap of the use of psychedelics and music in therapy. A prime example of this is guided imagery and music (GIM), which is a specialized form of therapy that arose out of work done by Helen Bonny, PhD, a nurse, music therapist, and concert violinist. Bonny developed a protocol for using music to regulate emotions during psychedelic experiences.
  • In the next 10 years, Dr. Barrett would like to have a clear understanding of the effect size of psychedelics on mood and substance use disorders.
  • It will be interesting to see whether and how psychedelics are efficacious in treating an array of substance use disorders. If effective, they would be a single-use treatment for addiction to substances that interact with diverse neural circuits.

References

Barrett FS et al. Sci Rep. 2020 Feb 10. doi: 10.1038/S41598-020-59282-y.

Barrett FS, Griffiths RR. Curr Top Behav Neurosci. 2018;36:393-430.

Barrett FS et al. Int Rev Psychiatry. 2018;30(4):350‐62.

Griffiths RR et al. J Psychopharmacol. 2018 Jan;32(1):49-69.

Barrett FS, Janata P. Neuropsychologia. 2016 Oct;91;234-46.

Johnson MW et al. Am J Drug Alcohol Abuse. 2017 Jan;43(1):55-60.

Show notes by Jacqueline Posada, MD, who is associate producer of the Psychcast and consultation-liaison psychiatry fellow with the Inova Fairfax Hospital/George Washington University program in Falls Church, Va. Dr. Posada has no conflicts of interest.

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Podcast Participants

Lorenzo Norris, MD
Lorenzo Norris, MD, is host of the MDedge Psychcast, editor in chief of MDedge Psychiatry, and assistant professor of psychiatry and behavioral sciences at George Washington University, Washington. He also serves as assistant dean of student affairs at the university, and medical director of psychiatric and behavioral sciences at GWU Hospital. Dr. Lorenzo Norris has no conflicts of interest.
Renee Kohanski, MD
Renee Kohanski, MD, is a board-certified psychiatrist with additional training in forensic psychiatry. She has been a board examiner for the American Board of Psychiatry and Neurology, and she has practiced within community mental health and departments of corrections. Currently, she is the sole proprietor of RK Psychiatry Associates. She can be seen and heard as a national commentator on general issues as they may relate to psychiatry. Dr. Renee Kohanski has no conflicts of interest.