PsychopharmaStahlogy Show: Psychedelic Assisted Psychotherapy The PsychopharmaStahlogy Show is a special podcast series released on the NEI Podcast. In the first three part series, Dr. Andrew Cutler asks Dr. Stephen Stahl important questions relating to psychedelic assisted psychotherapy as a novel approach to the treatment of psychiatric disorders. Episodes released under this theme include:

Part I - Episode 98 Now You See It, Now You Don’t: The Power of Psychedelic-Assisted Psychotherapy What types of psychotherapies are typically used in conjunction with these dissociative agents? How does psilocybin differ from ketamine for the treatment of mental health conditions? What are the risks, if any associated with this type of therapeutic approach?

Part II - Episode 100 Forgetting to Be Addicted: Altering Compulsivity in the Addiction Process What has research shown about the effectiveness of psychedelic or dissociative agents in the treatment of addiction? What is pharmacological extinction? What types of addictions have been researched, using this method as a treatment approach?

Part III - Episode 102 Forgetting Your PTSD: Using Reconsolidation to Forget Traumatic Memories What exactly is reconsolidation? How does disrupting this process work to neutralize fear conditioning? How has hallucinogen-assisted psychotherapy been implemented as an attempt to block reconsolidation of activated memories during psychotherapy sessions?

Transcript from Part I - Episode 98

DR STAHL: When we understand these drugs, the rate at which they occupy the receptors, the degree to which they occupy the receptors, how fast they come off the receptors, are all changing the drug into different things. So what we want to do is tweak the kind of experience that you're having so that your memory can be modified, but you're not freaking out or having a bad experience or abusing it. As it's possible to do that by dosing, that not only the absolute dose, but the way it's dosed, so that how fast it's on, how long it's on, how fast it’s off the receptor.

DR CUTLER: So you've mentioned a bad experience or bad trip or freaking out, and we’ve mentioned obviously some of the potential cardiovascular effects and things like this. What other risks are there with these types of treatments?

DR STAHL: That they don't work, I suppose is one of the other ones. That you're just wasting time and you raising hope. But I think that you’re playing with fire here. Is it possible that you will change memories you want to keep? Is it possible that you will change the underlying synaptogenesis in a bad direction because we don't really know what the heck we’re doing? So I think this is basically something that needs to be carefully thought through and not just say, well, let's approve psilocybin and any psychotherapy goes. Or like my acquaintance in Santa Barbara is doing, give an IM (intramuscular) shot ketamine and then just do it what make sense to you. That could actually cause more harm than good.

DR CUTLER: Ketamine as we know can cause significant elevations of blood pressure, and you mentioned the same with MDMA. The kinds of things that can do. There's probably a lot of risks that we don't know, and unless these things are studied in really careful, rigorous clinical trials, it's really hard to get an accurate risk benefit assessment.

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     Additional Resources:

2021 NEI Synapse: Virtual Half-Days The Cutting-Edge of Major Depressive Disorder CME credits: 2.0 | Date: September 25, 2021

Encore Presentation Out of the Pipeline: What Next? Optimizing Outcomes for Treatment-Resistant Depression CME credits: 1.25 | Expires: November 8, 2023

2021 NEI Congress Pre-Conference Workshop Recreational Drug Use November 4, 2021 | Colorado Springs, CO and Virtual

Video Snippets Psychedelics: What Is Their Therapeutic Potential? CME credits: 0.5 | Expires: September 25, 2021

Encore Presentation Treatment-Resistant Depression: Current Best Practices and a Look to the Future CME Credit: 1.0 | Expires: November 10, 2022

Article Ketamine for Treatment-Resistant Depression: A Review of the Data CME credit: 1.0 | Expires: February 23, 2024

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