“To the extent that MGH is part of Harvard, the return of psychedelics to Harvard is a big historical event,” the writer Michael Pollan said, with a smile, at an online launch earlier this month. Pollan, whose 2018 book “How to Change Your Mind” has contributed to a recent surge in interest in psychedelic research, serves on the center’s advisory board.
“We see our role as doing science and trying to understand how these things work,” said Dr. Jerrold F. Rosenbaum, the center’s director and Mass. General’s former psychiatrist-in-chief. “We’re just trying to understand what’s happening in the brain.”
Since the center was announced in February, Rosenbaum said he receives “handfuls to dozens” of calls each day from people seeking treatment with psychedelics. “It’s going to be some time before these agents are available for treatment. It certainly has triggered a lot of interest and hope in people who have been struggling,” he said.
Mass. General President Peter Slavin likened the psychedelic research to the hospital’s first use of ether as an anesthetic in 1846, a discovery that revolutionized surgery. “We like to look at out-of-the-box ideas related to medicine,” he said.
Mass. General, however, is hardly the first out of the gate on psychedelic research.
The therapeutic potential of psychedelics — drugs that induce states of altered perception and thought, often involving mystical or spiritual feelings — had been neglected for three decades. The drugs, perceived as derelict and dangerous, were outlawed by the federal government in 1970. Not until 2000 could research resume, when a group at Johns Hopkins won federal approval to study them in people.
In recent years, interest has burgeoned, and so has the money, leading to what some call a “psychedelic gold rush” among philanthropists and venture capitalists. A group of private donors gave $17 million to the psychedelic research group at Johns Hopkins Medicine in 2019. Last month, NYU Langone Health announced $10 million in philanthropic support for such studies.
In the absence of any government funding for psychedelic research, the Mass. General center is likewise relying entirely on donors, and has so far raised $3 million.
Major donors include Shoshana and Wayne Blank and Keren Soussan of California, grandparents and mother of Arielle Soussan, who suffered from intractable depression and died of suicide at age 24. Mass. General has also partnered with Atai Life Sciences, a German company, to study a psychedelic drug in animals.
The main drugs researchers are studying are psilocybin, an ingredient in hallucinogenic mushrooms, which shows promise in treating depression, anxiety, and addiction; and MDMA — known in street parlance as “ecstasy” or “molly” — which appears effective in treating post-traumatic stress disorder.
Studies of psilocybin have suggested great potential for treating depression, but not in the usual way. Instead of a daily pill, psilocybin provides a one-time experience that can be life-changing.
Patients undergo weeks of therapy to prepare for their psilocybin “journey.” Then they swallow the pill, don a blindfold, and lie down to experience the drug’s effects for six to eight hours, with two therapists guiding and monitoring throughout. Patients continue with therapy afterward to help them understand and integrate the experience.
“Psychedelics create openness to change,” Rosenbaum said. “Very few people are just giving these as drugs. They’re giving them as substrate during which you do some form of therapy.”
Psilocybin appears to free the brain to reorganize in ways not normally possible in adulthood, said Dr. Michael P. Bogenschutz, the psychiatrist who directs the NYU Langone Center for Psychedelic Medicine. The magnitude of the change depends on the patient’s intention, how strongly the patient wants to change their emotions and behavior. In NYU’s studies, he said, the patients “receive some preparatory therapy to strengthen that motivation.”
“The drug itself has some effects on the brain and on consciousness,” Bogenschutz said. “The evidence is pretty strong [that] it increases formation of new synapses and can change patterns of brain activity for weeks or months afterwards.”
Mass. General’s niche in this research is to examine what exactly happens to the brain’s networks. The center’s team includes Dr. Bruce Rosen, a world leader in functional neuroimaging.
A study expected to start in the spring at Mass. General will enroll 20 patients with treatment-resistant depression. After the patients undergo their psilocybin treatment, researchers will scan patients’ brains in a functional MRI machine to look for changes in neural networks, and repeat the scan months later.
Psychedelic drugs appear very safe, but only “under controlled conditions with properly screened individuals,” said Frederick Streeter Barrett, a cognitive neuroscientist at Johns Hopkins.
“That’s not to say they aren’t powerful drugs,” he said. “Taken in the wrong circumstances by the wrong individuals, they could be possibly very dangerous.” It’s also not known whether the drugs are unsafe in certain people, such as those who have experienced psychosis, he added.
NYU’s Bogenschutz welcomed Mass. General’s entry into the field.
“There is a tremendous amount of work to do, and Mass. General is one of the leading hospitals and one of the leading departments of psychiatry in the world,” he said. “There’s room for lots of people to do this work… There are studies begging to be done, questions begging to be answered.”