FDA Calls Psychedelic Psilocybin a ‘Breakthrough Therapy’ for Severe Depression

By Yasemin Saplakoglu

The FDA is helping to speed up the process of researching and approving psilocybin, a hallucinogenic substance in magic mushrooms, to treat major depressive disorder (MDD).

For the second time in a year, the U.S. Food and Drug Administration (FDA) has designated psilocybin therapy — currently being tested in clinical trials — as “breakthrough therapy,” an action that is meant to accelerate the typically sluggish process of drug development and review. It is typically requested by a drug company and granted only when preliminary evidence suggests the drug may be an enormous improvement over already available therapy, according to the FDA.

Last year, the FDA granted “breakthrough therapy” status to psilocybin therapy in the still-ongoing clinical trials run by the company Compass Pathways, which are looking into psilocybin’s potential to treat severe treatment-resistant depression, or depression in patients who have not improved after undergoing two different antidepressant treatments, according to New Atlas.

Now, the FDA has granted another “breakthrough therapy” status to the psychedelic treatment, this time for a U.S.-based clinical trial conducted by the nonprofit Usona Institute, according to a statement from the company. This clinical trial, which includes 80 participants at seven different sites across the U.S., focuses on the efficacy of treating patients with MDD with a single dose of psilocybin.

There are more than 17 million people in the U.S. who have major depressive disorder, or severe depression that lasts more than two weeks, according to the statement. Psilocybin, with a single dose, could profoundly impact the brain and have long-lasting impacts after wiping away depressive symptoms, according to the statement.

The phase 2 trial is expected to be completed by early 2021, and with the help of this status, Usona expects it to quickly move into a larger phase 3 trial, according to New Atlas. Around one in three treatments previously given a Breakthrough Therapy status have moved on to get market approval, New Atlas wrote.

“What is truly groundbreaking is FDA’s rightful acknowledgement that MDD, not just the much smaller treatment-resistant depression population, represents an unmet medical need and that the available data suggest that psilocybin may offer a substantial clinical improvement over existing therapies,” Dr. Charles Raison, the director of clinical and translational research at Usona, said in the statement.

This isn’t the first time that a psychedelic has been researched for its potential in treating depression. In March, the FDA approved a nasal spray depression treatment for treatment-resistant patients based on Esketamine, a substance related to ketamine — an anesthetic that’s also been used as an illicit party drug. But much is still unknown even of this approved drug. Though fast-acting, it’s unclear how Esketamine changes the brain and thus what its long-term effects will be, according to a previous Live Science report.

https://www.livescience.com/psilocybin-depression-breakthrough-therapy.html

A Growing Push To Loosen Laws Around Psilocybin, Treat Mushrooms As Medicine


A growing body of research suggests psychedelic mushrooms may have therapeutic benefits for certain conditions. Now a movement seeks to decriminalize them.

Douglas rattles around a collection of glass jars in the storage closet of his Denver apartment. They’re filled with sterilized rye grains, covered in a soft white fungus — a mushroom spawn. Soon, he’ll transplant it in large plastic bins filled with nutrients such as dried manure and coconut fiber.

Over the course of two weeks, a crop of mushrooms that naturally contain psilocybin, a psychoactive ingredient, will sprout. The species he grows include psilocybe cubensis.

“I mean, it’s a relatively quiet thing to do. There’s just lots of waiting,” says Douglas, which is his middle name. He didn’t want to be identified because this is an illegal grow-and-sell operation; psychedelic mushrooms were federally banned in 1970, along with several other hallucinogens.

“Mushrooms are really easygoing, especially psilocybin,” he says. “They kind of just grow themselves.”

Denver is at the forefront of a national movement that seeks to access these mushrooms, largely for medicinal use. On Tuesday, voters are weighing in on a ballot measure to decriminalize them. And while that may sound ambitious, a campaign in Oregon is gathering signatures for a ballot measure in the 2020 election and seeks to legalize mushrooms with a medical prescription for use in approved clinics.

In Iowa, Republican lawmaker Jeff Shipley recently proposed two bills: one removing psilocybin from the state’s list of controlled substances, and the other legalizing it for medical use. And last year, a campaign in California did not get enough signatures to qualify for the ballot. The group that led the campaign hopes to try again in 2020, according to their Facebook page.

For Douglas, it’s a sign that change is on the horizon, one that could have implications for his business, which he says he runs for the supplemental income, but also because he believes mushrooms are beneficial.

“Cultivating psilocybin and offering medicine to people to change their lives, that will be my mission, or my way of serving others,” he says.

With his DIY setup of glass jars, large plastic bins and a pressure cooker for sterilization, Douglas can produce up to $1,000 of mushrooms a month. He learned how to do this thanks to Internet videos. He purchased his first mushroom spores online and received them in the mail; companies legally are allowed to sell spores since they don’t contain psilocybin.

If the Denver ballot measure passes, adults 21 and older who are caught with psilocybin mushrooms, or even growing them for personal use, would become the “lowest law enforcement priority” for local police. Plus, the city and county of Denver would be barred from spending any money to prosecute psilocybin cases.

The notion that state laws around mushrooms could be loosened up, much like they have been for cannabis, is not without controversy. Matthew Johnson, who has spent the past 15 years researching psychedelics at Johns Hopkins University in Baltimore, says decriminalization of illegal drugs is generally a good thing, but he wouldn’t support policy that encourages people to use psilocybin without professional supervision.

“(This therapy) needs to be done by appropriately trained and credentialed medical and psychological professionals,” he says.

Research suggests that psilocybin is not addictive, causes few ER visits compared to other illegal drugs and could be used to treat a number of ailments. Johnson believes the most promising research is on treating anxiety and depression in cancer patients. In a study he conducted with other researchers at Johns Hopkins, he says they found even a single dose can positively affect an individual for several months.

“It’s really unprecedented in medical history to see effects for depression that are caused by a single medication,” he says.

Preliminary research has been conducted for other potential uses, including curbing nicotine addiction and for treatment-resistant depression. And while Johnson believes psilocybin could one day become a groundbreaking treatment, he’s emphatic about the potential risks involved.

“The most common side effect is the so-called ‘bad trip,’ ” he says. “(It) can be well-managed in a medical research setting, but that sometimes leads to dangerous behavior when out in the wild.”

Under the influence of psilocybin, people can panic and put themselves in unsafe situations; there have been fatalities, he says.

Johnson says he thinks that, in as little as five years, research on psilocybin will lead to the first medication approved by the Federal Drug Administration. Once that happens, he thinks the government will have to remove it as a Schedule 1 drug — a substance like heroin that the DEA considers to have “no accepted medical use and a high potential for abuse.”

Until then, Deanne Reuter, the assistant special agent in charge at the DEA’s Denver office, says the agency will continue prosecuting cases of psilocybin possession and trafficking.

“Any controlled substance is a concern,” she says. “It’s obviously on a Schedule 1 for a reason.”

Reuter admits they don’t see many cases of psilocybin trafficking. Typically, they’ll bust a drug dealer carrying several types of narcotics, including mushrooms.

“The trafficking of psilocybin seems to be like a small, niche kind of community,” she says.

Douglas would agree. He has little competition and knows most of the people he sells his product to. Still, he knows the work he does it risky.

“With decriminalization and stuff I can operate a little bit more freely, have to worry less,” he says.

If the Denver ballot measure passes, it wouldn’t protect someone like him, who’s selling mushrooms for profit. Still, he says it’d be a step closer to a future where he can freely provide people with something he believes in.

https://www.npr.org/sections/health-shots/2019/05/07/720828367/a-growing-push-to-loosen-laws-around-psilocybin-treat-mushrooms-as-medicine

Eating mushrooms may reduce the risk of cognitive decline

A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than two standard portions of mushrooms weekly may have 50 per cent reduced odds of having mild cognitive impairment (MCI).

A portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

“This correlation is surprising and encouraging. It seems that a commonly available single ingredient could have a dramatic effect on cognitive decline,” said Assistant Professor Lei Feng, who is from the NUS Department of Psychological Medicine, and the lead author of this work.

The six-year study, which was conducted from 2011 to 2017, collected data from more than 600 Chinese seniors over the age of 60 living in Singapore. The research was carried out with support from the Life Sciences Institute and the Mind Science Centre at NUS, as well as the Singapore Ministry of Health’s National Medical Research Council. The results were published online in the Journal of Alzheimer’s Disease on 12 March 2019.

Determining MCI in seniors

MCI is typically viewed as the stage between the cognitive decline of normal ageing and the more serious decline of dementia. Seniors afflicted with MCI often display some form of memory loss or forgetfulness and may also show deficit on other cognitive function such as language, attention and visuospatial abilities. However, the changes can be subtle, as they do not experience disabling cognitive deficits that affect everyday life activities, which is characteristic of Alzheimer’s and other forms of dementia.

“People with MCI are still able to carry out their normal daily activities. So, what we had to determine in this study is whether these seniors had poorer performance on standard neuropsychologist tests than other people of the same age and education background,” explained Asst Prof Feng. “Neuropsychological tests are specifically designed tasks that can measure various aspects of a person’s cognitive abilities. In fact, some of the tests we used in this study are adopted from commonly used IQ test battery, the Wechsler Adult Intelligence Scale (WAIS).”

As such, the researchers conducted extensive interviews and tests with the senior citizens to determine an accurate diagnosis. “The interview takes into account demographic information, medical history, psychological factors, and dietary habits. A nurse will measure blood pressure, weight, height, handgrip, and walking speed. They will also do a simple screen test on cognition, depression, anxiety,” said Asst Prof Feng.

After this, a two-hour standard neuropsychological assessment was performed, along with a dementia rating. The overall results of these tests were discussed in depth with expert psychiatrists involved in the study to get a diagnostic consensus.

Mushrooms and cognitive impairment

Six commonly consumed mushrooms in Singapore were referenced in the study. They were golden, oyster, shiitake and white button mushrooms, as well as dried and canned mushrooms. However, it is likely that other mushrooms not referenced would also have beneficial effects.

The researchers believe the reason for the reduced prevalence of MCI in mushroom eaters may be down to a specific compound found in almost all varieties. “We’re very interested in a compound called ergothioneine (ET),” said Dr. Irwin Cheah, Senior Research Fellow at the NUS Department of Biochemistry. “ET is a unique antioxidant and anti-inflammatory which humans are unable to synthesise on their own. But it can be obtained from dietary sources, one of the main ones being mushrooms.”

An earlier study by the team on elderly Singaporeans revealed that plasma levels of ET in participants with MCI were significantly lower than age-matched healthy individuals. The work, which was published in the journal Biochemical and Biophysical Research Communications in 2016, led to the belief that a deficiency in ET may be a risk factor for neurodegeneration, and increasing ET intake through mushroom consumption might possibly promote cognitive health.

Other compounds contained within mushrooms may also be advantageous for decreasing the risk of cognitive decline. Certain hericenones, erinacines, scabronines and dictyophorines may promote the synthesis of nerve growth factors. Bioactive compounds in mushrooms may also protect the brain from neurodegeneration by inhibiting production of beta amyloid and phosphorylated tau, and acetylcholinesterase.

Next steps

The potential next stage of research for the team is to perform a randomised controlled trial with the pure compound of ET and other plant-based ingredients, such as L-theanine and catechins from tea leaves, to determine the efficacy of such phytonutrients in delaying cognitive decline. Such interventional studies will lead to more robust conclusion on causal relationship. In addition, Asst Prof Feng and his team also hope to identify other dietary factors that could be associated with healthy brain ageing and reduced risk of age-related conditions in the future.

https://medicalxpress.com/news/2019-03-mushrooms-cognitive-decline.html

Psilocybin-containing “Magic Mushrooms” reset brain connectivity in depression

by Amanda Oldt

Recent findings suggest that treatment with psilocybin may “reset” brain connectivity in patients with treatment-resistant depression.

“Several of our patients described feeling ‘reset’ after the treatment and often used computer analogies. For example, one said he felt like his brain had been ‘defragged’ like a computer hard drive, and another said he felt ‘rebooted,’” Robin L. Carhart-Harris, PhD, of Imperial College London, said in a press release. “Psilocybin may be giving these individuals the temporary ‘kick start’ they need to break out of their depressive states and these imaging results do tentatively support a ‘reset’ analogy. Similar brain effects to these have been seen with electroconvulsive therapy.”

To assess psilocybin for treatment-resistant depression, researchers used functional MRI to measure cerebral blood flow (CBF) and blood oxygen-level dependent resting-state functional connectivity before and after psilocybin treatment among 16 patients with treatment-resistant depression.

One week after treatment, all patients exhibited decreased depressive symptoms.

At 5 weeks, 47% of the cohort met criteria for treatment response.

Whole-brain analyses indicated decreases in CBF in the temporal cortex, including the amygdala, following treatment with psilocybin.

Decreased CBF in the amygdala was associated with decreased depressive symptoms.

Posttreatment, resting-state functional connectivity was increased in the default-mode network.

Treatment response at 5 weeks was predicted by increased resting-state functional connectivity in the ventromedial prefrontal cortex-bilateral inferior lateral parietal cortex and decreased resting-state functional connectivity in the parahippocampal prefrontal cortex.

“Through collecting these imaging data we have been able to provide a window into the after effects of psilocybin treatment in the brains of patients with chronic depression,” Carhart-Harris said in the release. “Based on what we know from various brain imaging studies with psychedelics, as well as taking heed of what people say about their experiences, it may be that psychedelics do indeed ‘reset’ the brain networks associated with depression, effectively enabling them to be lifted from the depressed state.”

Carhart-Harris RL, et al. Sci Rep. 2017;doi:10.1038/s41598-017-13282-7.

https://www.healio.com/psychiatry/depression/news/online/%7B3089a96c-7e81-494d-abd8-248d77aefbab%7D/magic-mushrooms-may-reset-brain-connectivity-in-depression?utm_source=selligent&utm_medium=email&utm_campaign=psychiatry%20news&m_bt=1162769038120

Psychedelic Therapy and Bad Trips


Synthetic psilocybin, a compound found in magic mushrooms, has been administered to cancer patients in a study at New York University. Researcher Anthony Bossis says many subjects report decreased depression and fear of death after their session. Although some patients do not report persistent positive feelings, none report persistent adverse effects. Photo: Bossis, NYU.

By John Horgan

Bossis, a psychologist at New York University, belongs to an intrepid cadre of scientists reviving research into psychedelics’ therapeutic potential. I say “reviving” because research on psychedelics thrived in the 1950s and 1960s before being crushed by a wave of anti-psychedelic hostility and legislation.

Psychedelics such as LSD, psilocybin and mescaline are still illegal in the U.S. But over the past two decades, researchers have gradually gained permission from federal and other authorities to carry out experiments with the drugs. Together with physicians Stephen Ross and Jeffrey Guss, Bossis has tested the potential of psilocybin—the primary active ingredient of “magic mushrooms”–to alleviate anxiety and depression in cancer patients.

Journalist Michael Pollan described the work of Bossis and others in The New Yorker last year. Pollan said researchers at NYU and Johns Hopkins had overseen 500 psilocybin sessions and observed “no serious adverse effects.” Many subjects underwent mystical experiences, which consist of “feelings of unity, sacredness, ineffability, peace and joy,” as well as the conviction that you have discovered “an objective truth about reality.”

Pollan’s report was so upbeat that I felt obliged to push back a bit, pointing out that not all psychedelic experiences—or mystical ones–are consoling. In The Varieties of Religious Experience, William James emphasized that some mystics have “melancholic” or “diabolical” visions, in which ultimate reality appears terrifyingly alien and uncaring.

Taking psychedelics in a supervised research setting doesn’t entirely eliminate the risk of a bad trip. That lesson emerged from a study in the early 1990s by psychiatrist Rick Strassman, who injected dimethyltryptamine, DMT, into human volunteers.

From 1990 to 1995, Strassman supervised more than 400 DMT sessions involving 60 subjects. Many reported dissolving blissfully into a radiant light or sensing the presence of a loving god. But 25 subjects had “adverse effects,” including terrifying hallucinations of “aliens” that took the shape of robots, insects or reptiles. (For more on Strassman’s study, see this link: https://www.rickstrassman.com/index.php?option=com_content&view=article&id=61&Itemid=60

Swiss chemist Albert Hofmann, who discovered LSD’s powers in 1943 and later synthesized psilocybin, sometimes expressed misgivings about psychedelics. When I interviewed him in 1999, he said psychedelics have enormous scientific, therapeutic and spiritual potential. He hoped someday people would take psychedelics in “meditation centers” to awaken their religious awe.

Yet in his 1980 memoir LSD: My Problem Child, Hofmann confessed that he occasionally regretted his role in popularizing psychedelics, which he feared represent “a forbidden transgression of limits.” He compared his discoveries to nuclear fission; just as fission threatens our fundamental physical integrity, so do psychedelics “attack the spiritual center of the personality, the self.”

I had these concerns in mind when I attended a recent talk by Bossis near New York University. A large, bearded man who exudes warmth and enthusiasm, Bossis couldn’t reveal details of the cancer-patient study, a paper on which is under review, but he made it clear that the results were positive.

Many subjects reported decreased depression and fear of death and “improved well-being” after their session. Some called the experience among the best of their lives, with spiritual implications. An atheist woman described feeling “bathed in God’s love.”

Bossis said psychedelic therapy could transform the way people die, making the experience much more meaningful. He quoted philosopher Victor Frankl, who said, “Man is not destroyed by suffering. He is destroyed by suffering without meaning.”

During the Q&A, I asked Bossis about bad trips. Wouldn’t it be awful, I suggested, if a dying patient’s last significant experience was negative? Bossis said he and his co-researchers were acutely aware of that risk. They minimized adverse reactions by managing the set (i.e., mindset, or expectations, of the subject) and setting (context of the session).

First, they screen patients for mental illness, eliminating those with, say, a family history of schizophrenia. Second, the researchers prepare patients for sessions, telling them to expect and explore rather than suppressing negative emotions, such as fear or grief. Third, the sessions take place in a safe, comfortable room, which patients can decorate with personal items, such as photographs or works of art. A researcher is present during sessions but avoids verbal interactions that might distract the patient from her inner journey. Patients and researchers generally talk about sessions the following day.

These methods seem to work. Some patients, to be sure, became frightened or melancholy. One dwelled on the horrors of the Holocaust, which had killed many members of his family, but he found the experience meaningful. Some patients did not emerge from their sessions with persistent positive feelings, Bossis said, but none reported persistent adverse effects.

Bossis has begun a new study that involves giving psilocybin to religious leaders, such as priests and rabbis. His hope is that these subjects will gain a deeper understanding of the mystical roots of their faiths.

http://blogs.scientificamerican.com/cross-check/psychedelic-therapy-and-bad-trips/

New study shows that use of psychedelic drugs does not increase risk of mental illness

An analysis of data provided by 135,000 randomly selected participants – including 19,000 people who had used drugs such as LSD and magic mushrooms – finds that use of psychedelics does not increase risk of developing mental health problems. The results are published in the Journal of Psychopharmacology.

Previously, the researchers behind the study – from the Norwegian University of Science and Technology in Trondheim – had conducted a population study investigating associations between mental health and psychedelic use. However, that study, which looked at data from 2001-04, was unable to find a link between use of these drugs and mental health problems.

“Over 30 million US adults have tried psychedelics and there just is not much evidence of health problems,” says author and clinical psychologist Pål-Ørjan Johansen.

“Drug experts consistently rank LSD and psilocybin mushrooms as much less harmful to the individual user and to society compared to alcohol and other controlled substances,” concurs co-author and neuroscientist Teri Krebs.

For their study, they analyzed a data set from the US National Health Survey (2008-2011) consisting of 135,095 randomly selected adults from the US, including 19,299 users of psychedelic drugs.

Krebs and Johansen report that they found no evidence for a link between use of psychedelic drugs and psychological distress, depression, anxiety or suicidal thoughts, plans and attempts.

In fact, on a number of factors, the study found a correlation between use of psychedelic drugs and decreased risk for mental health problems.

“Many people report deeply meaningful experiences and lasting beneficial effects from using psychedelics,” says Krebs.

However, Johansen acknowledges that – given the design of the study – the researchers cannot “exclude the possibility that use of psychedelics might have a negative effect on mental health for some individuals or groups, perhaps counterbalanced at a population level by a positive effect on mental health in others.”

Despite this, Johansen believes that the findings of the study are robust enough to draw the conclusion that prohibition of psychedelic drugs cannot be justified as a public health measure.

Krebs says:

“Concerns have been raised that the ban on use of psychedelics is a violation of the human rights to belief and spiritual practice, full development of the personality, and free-time and play.”

Commenting on the research in a piece for the journal Nature, Charles Grob, a paediatric psychiatrist at the University of California-Los Angeles, says the study “assures us that there were not widespread ‘acid casualties’ in the 1960s.” However, he urges caution when interpreting the results, as individual cases of adverse effects can and do occur as a consequence of psychedelic use.

For instance, Grob describes hallucinogen persisting perception disorder, sometimes referred to as “a never-ending trip.” Patients with this disorder experience “incessant distortions” in their vision, such as shimmering lights and colored dots. “I’ve seen a number of people with these symptoms following a psychedelic experience, and it can be a very serious condition,” says Grob.

http://www.medicalnewstoday.com/articles/290461.php

Psychedelic mushrooms put your brain in a “waking dream,” study finds

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Psychedelic mushrooms can do more than make you see the world in kaleidoscope. Research suggests they may have permanent, positive effects on the human brain.

In fact, a mind-altering compound found in some 200 species of mushroom is already being explored as a potential treatment for depression and anxiety. People who consume these mushrooms, after “trips” that can be a bit scary and unpleasant, report feeling more optimistic, less self-centered, and even happier for months after the fact.

But why do these trips change the way people see the world? According to a study published today in Human Brain Mapping, the mushroom compounds could be unlocking brain states usually only experienced when we dream, changes in activity that could help unlock permanent shifts in perspective.

The study examined brain activity in those who’d received injections of psilocybin, which gives “shrooms” their psychedelic punch. Despite a long history of mushroom use in spiritual practice, scientists have only recently begun to examine the brain activity of those using the compound, and this is the first study to attempt to relate the behavioral effects to biological changes.

After injections, the 15 participants were found to have increased brain function in areas associated with emotion and memory. The effect was strikingly similar to a brain in dream sleep, according to Dr. Robin Carhart-Harris, a post-doctoral researcher in neuropsychopharmacology at Imperial College London and co-author of the study.

“You’re seeing these areas getting louder, and more active,” he said. “It’s like someone’s turned up the volume there, in these regions that are considered part of an emotional system in the brain. When you look at a brain during dream sleep, you see the same hyperactive emotion centers.”

In fact, administration of the drug just before or during sleep seemed to promote higher activity levels during Rapid Eye Movement sleep, when dreams occur. An intriguing finding, Carhart-Harris says, given that people tend to describe their experience on psychedelic drugs as being like “a waking dream.” It seems that the brain may literally be slipping into unconscious patterns while the user is awake.

Conversely, the subjects of the study had decreased activity in other parts of the brain—areas associated with high level cognition. “These are the most recent parts of our brain, in an evolutionary sense,” Carhart-Harris said. “And we see them getting quieter and less organized.”

This dampening of one area and amplification of another could explain the “mind-broadening” sensation of psychedelic drugs, he said. Unlike most recreational drugs, psychotropic mushrooms and LSD don’t provide a pleasant, hedonistic reward when they’re consumed. Instead, users take them very occasionally, chasing the strange neurological effects instead of any sort of high.

“Except for some naïve users who go looking for a good time…which, by the way, is not how it plays out,” Carhart-Harris said, “you see people taking them to experience some kind of mental exploration, and to try to understand themselves.”

Our firm sense of self—the habits and experiences that we find integral to our personality—is quieted by these trips. Carhart-Harris believes that the drugs may unlock emotion while “basically killing the ego,” allowing users to be less narrow-minded and let go of negative outlooks.

It’s still not clear why such effects can have more profound long-term effects on the brain than our nightly dreams. But Carhart-Harris hopes to see more of these compounds in modern medicine. “The way we treat psychological illnesses now is to dampen things,” he said. “We dampen anxiety, dampen ones emotional range in the hope of curing depression, taking the sting out of what one feels.”

But some patients seem to benefit from having their emotions “unlocked” instead. “It would really suit the style of psychotherapy where we engage in a patient’s history and hang-ups,” Carhart-Harris said. “Instead of putting a bandage over the exposed wound, we’d be essentially loosening their minds—promoting a permanent change in outlook.”

Thanks to Steven Weihing for bringing this to the attention of the It’s Interesting community.

http://www.washingtonpost.com/news/to-your-health/wp/2014/07/03/psychedelic-drugs-put-your-brain-in-a-waking-dream-study-finds/