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Robin L Carhart-Harris

International Computer Science Institute, University of California, San Francisco

54 papers in the library · 5,976 citations · publishing 2015-2026

Papers

Increased low-frequency brain responses to music after psilocybin therapy for depression.

Journal of affective disorders July 15, 2023 Matthew B Wall, Cynthia Lam, Natalie Ertl et al. 36 citations

Psilocybin-assisted therapy for depression alters the brain's response to music, suggesting an elevated responsiveness to music after treatment that is related to subjective drug effects during dosing. Nineteen patients with treatment-resistant depression underwent two psilocybin dosing sessions. Brain scans before and after treatment showed increased activity in the superior temporal cortex when listening to music, and decreased activity in the medial frontal lobes during rest. These changes in music-related brain activity correlated with the intensity of subjective effects felt during the psilocybin sessions. The findings imply that psychedelic therapy may enhance emotional responsiveness to music, which could be relevant for treating depression.

Brain dynamics predictive of response to psilocybin for treatment-resistant depression.

Brain communications January 1, 2024 Jakub Vohryzek, Joana Cabral, Louis-David Lord et al. 33 citations

Psilocybin therapy for depression shows promise, but its causal mechanisms are unknown. By comparing brain dynamics in treatment responders (those with >50% symptom reduction) and non-responders before treatment, researchers used large-scale brain modeling to identify brain regions whose perturbation could shift a depressive brain state to a healthy one. The identified regions correlated with density maps of serotonin receptors 5-HT2a and 5-HT1a, where psilocin (psilocybin's active metabolite) acts as an agonist. These findings provide causal mechanistic evidence linking specific brain regions and serotonergic transmission to recovery from depression via psilocybin.

LSD-induced changes in the functional connectivity of distinct thalamic nuclei.

NeuroImage December 1, 2023 Stefano Delli Pizzi, Piero Chiacchiaretta, Carlo Sestieri et al. 27 citations

LSD selectively alters the functional connectivity between specific thalamic nuclei and sensory and associative cortical areas. Using structural and resting-state functional MRI in healthy volunteers under acute LSD administration, researchers found increased coupling of the ventral complex, pulvinar, and non-specific thalamic nuclei with somatosensory and auditory cortices, as well as with associative cortex regions rich in serotonin 2A receptors. At subcortical levels, LSD increased connectivity among these thalamic nuclei but decreased striatal-thalamic connectivity. These nucleus-specific changes help explain LSD's modulation of subcortical-cortical circuits and associated behavioral effects.

From relaxed beliefs under psychedelics (REBUS) to revised beliefs after psychedelics (REBAS).

Scientific reports January 29, 2025 Richard J Zeifman, Meg J Spriggs, Hannes Kettner et al. 26 citations

A preliminary test of the REBUS model found that a high dose of psilocybin (25 mg) reduced confidence in negative self-beliefs in 11 healthy individuals, both during the acute experience and four weeks later. Greater brain signal entropy and stronger subjective effects under psilocybin correlated with larger decreases in negative self-belief confidence. Decreases in negative self-belief confidence were linked to increases in well-being. The findings provide initial evidence that relaxing and revising negative self-beliefs may underlie psilocybin's positive psychological effects, with increased neuronal entropy as a possible mechanism. Replication in larger clinical samples is needed.

A role for the serotonin 2A receptor in the expansion and functioning of human transmodal cortex.

Brain January 1, 2024 Andrea I Luppi, Manesh Girn, Fernando E Rosas et al. 25 citations

Serotonin 2A receptor (5-HT2AR) signaling drives both the evolutionary expansion and ongoing modulation of the human cerebral cortex's most complex cognitive centers. The cortex is organized along a gradient from simple sensory processing to high-level integration, with the transmodal cortex at the apex—a region disproportionately enlarged in humans and rich in 5-HT2AR expression. During early brain development, 5-HT2AR signaling on neural progenitor cells stimulates their proliferation, contributing to cortical expansion. In the adult brain, 5-HT2AR agonism promotes neuroplasticity, learning, and cognitive flexibility with therapeutic potential. The receptor thus plays a dual role in enabling cortical growth and sophisticated functioning.

A critical evaluation of QIDS-SR-16 using data from a trial of psilocybin therapy versus escitalopram treatment for depression

Journal of Psychopharmacology April 25, 2023 Brandon Weiss, David Erritzøe, Bruna Giribaldi et al. 24 citations

A reanalysis of data from a trial comparing psilocybin therapy (PT) to escitalopram (ET) for major depressive disorder found that 14 of 16 outcome measures favored PT, but the QIDS-SR-16 did not. The QIDS-SR-16 showed higher variance, imprecision from compound items and sum-scoring, vague response options, and lack of focus on a core depression factor. When the trial data were examined at item, facet, and factor levels, results suggested PT was superior in reducing depressed mood, anhedonia, a core depression factor, and specific symptoms like sexual dysfunction. This raises concerns about relying on individual scales that miss depression's multidimensional structure.

Psychedelics and schizophrenia: Distinct alterations to Bayesian inference.

NeuroImage November 1, 2022 Hardik Rajpal, Pedro A M Mediano, Fernando E Rosas et al. 23 citations

Schizophrenia and drug-induced states from LSD and ketamine both increase neural signal diversity, but they differ in brain connectivity: schizophrenia shows increased information flow from front to back of the brain, while the drugs reduce it. These differences can be modeled by altering Bayesian inference in a predictive processing framework: drug effects correspond to reduced precision of prior beliefs, whereas schizophrenia involves increased precision of sensory information. The findings clarify similarities and differences between these altered states, with implications for understanding consciousness and developing mental health treatments.

Exploring 5-MeO-DMT as a pharmacological model for deconstructed consciousness.

Neuroscience of consciousness January 1, 2025 Christopher Timmermann, James W Sanders, David Reydellet et al. 19 citations

The psychedelic 5-MeO-DMT can, in its most extreme cases, produce a complete absence of self-experience and other perceptual content while preserving a quality of aroused, waking awareness. In an exploratory observational study in naturalistic ceremonial settings, micro-phenomenological interviews, questionnaires, and EEG recordings revealed a dynamic progression of effects, including variable disruptions of bodily and narrative self, reduced phenomenal distinctions, and visual imagery. EEG showed global alpha and posterior beta power reductions, suggesting inhibition of top-down brain models. The findings indicate 5-MeO-DMT's potential as a pharmacological model for deconstructed consciousness, though retrospective questionnaires have limitations.

Spatial Correspondence of LSD-Induced Variations on Brain Functioning at Rest With Serotonin Receptor Expression.

Biological psychiatry. Cognitive neuroscience and neuroimaging July 1, 2023 Stefano Delli Pizzi, Piero Chiacchiaretta, Carlo Sestieri et al. 18 citations

LSD alters brain functional connectivity and local signal amplitude in opposite directions depending on the type of serotonin receptor involved. In healthy volunteers, LSD increased activity and connectivity in cortical regions of the default mode and attention networks, which have high densities of 5-HT2A receptors; these changes correlated with visual hallucinations. Conversely, LSD decreased activity and connectivity in limbic areas rich in 5-HT1A receptors. The spatial patterns of these functional changes overlapped with the distribution of the two serotonin receptor subtypes, suggesting distinct receptor-mediated mechanisms underlie LSD's reorganization of brain networks.

Reduced Brain Responsiveness to Emotional Stimuli With Escitalopram But Not Psilocybin Therapy for Depression

American Journal of Psychiatry May 7, 2025 Matthew B Wall, Lysia Demetriou, Bruna Giribaldi et al. 16 citations

Psilocybin therapy greatly improved depressive symptoms but had only a small effect on how the brain responds to emotional stimuli. This contrasts with SSRIs, which often reduce emotional responsiveness alongside their antidepressant action. The findings suggest that psychedelic therapy may work through different neural mechanisms than conventional antidepressants.

Autonomic nervous system activity correlates with peak experiences induced by DMT and predicts increases in well-being.

Journal of psychopharmacology (Oxford, England) October 1, 2024 Valerie Bonnelle, Amanda Feilding, Fernando E Rosas et al. 16 citations

The joint influence of the sympathetic and parasympathetic nervous systems over cardiac activity, known as sympathovagal coactivation, is positively related to ratings of spiritual experience and insightfulness during the DMT-induced peak experience, and also to improved well-being two weeks later. The balance between the two autonomic branches before DMT injection predicted insightfulness scores and subsequent coactivation. These findings demonstrate the autonomic nervous system's involvement in psychedelic-induced peak experiences.

Body mass index (BMI) does not predict responses to psilocybin

Journal of Psychopharmacology November 14, 2022 Meg J Spriggs, Bruna Giribaldi, Taylor Lyons et al. 15 citations

A fixed 25 mg dose of psilocybin produces similar acute psychedelic effects and improvements in well-being regardless of body mass index (BMI). Pooling data from three therapeutic studies, results support the null hypothesis that BMI does not predict overall intensity of the altered state, mystical experiences, perceptual changes, or emotional breakthroughs. There was weak evidence that lower BMI participants reported greater 'dread of ego dissolution,' but BMI did not meaningfully add to predictions beyond age, sex, and study. Mystical-type experiences and emotional breakthroughs strongly predicted well-being improvements, but BMI did not. These findings suggest body weight-adjusted dosing may be unnecessary, supporting fixed dosing to reduce practical and financial burdens on psychedelic therapy scalability.

The flattening of spacetime hierarchy of the N,N-dimethyltryptamine brain state is characterized by harmonic decomposition of spacetime (HADES) framework.

National science review May 1, 2024 Jakub Vohryzek, Joana Cabral, Christopher Timmermann et al. 13 citations

The human brain's activity constantly reorganizes across space and time, and decomposing whole-brain recordings into harmonic modes reveals gradient-like patterns linked to different functions. Using the HADES framework, researchers analyzed brain activity in healthy participants after taking the serotonergic psychedelic DMT. They found significant decreases in contributions across most low-frequency harmonic modes during the DMT state. Specifically, the second functional harmonic, which represents the uni- to transmodal functional hierarchy, decreased, supporting the hypothesis that psychedelics alter this hierarchy. Dynamic measures of fractional occupancy, lifetime, and latent space precisely described the changes in the brain's spacetime hierarchical organization during the psychedelic state.

The science of psychedelic medicine.

Nature medicine February 6, 2026 Joshua S Siegel, Conor Liston, Ginger E Nicol et al. 10 citations

Classic psychedelics, acting at the serotonin 5-HT2A receptor, alter brain function and consciousness. Research converges on two complementary processes: acute neural desynchronization, which destabilizes entrenched network patterns, and subacute neuroplasticity, which opens a window for psychological and behavioral change. Evidence of therapeutic response across neuropsychiatric indications is reviewed, integrating mechanistic findings. Challenges include discrepancies between preclinical evidence that non-hallucinogenic psychedelic analogs engage putative therapeutic mechanisms and clinical evidence linking subjective experience to therapeutic response, risks of enhanced neuroplasticity, and questions about trial design, scalability, and regulatory approval. The growth of psychedelic science may compel a rethinking of the relationship between subjective experience and biological change in psychiatry.

Prediction of hallucinogen persisting perception disorder and thought disturbance symptoms following psychedelic use.

PNAS nexus April 1, 2025 Katie Zhou, David de Wied, Robin L Carhart-Harris et al. 9 citations

Delusional ideation decreased one month after a planned psychedelic experience, while magical thinking showed no change. Over 30% of participants reported hallucinogen persisting perception disorder (HPPD)-type effects at four weeks, though fewer than 1% found them distressing. Younger age, female gender, a history of psychiatric diagnosis, and baseline trait absorption predicted HPPD-like effects. Lifetime psychedelic use at baseline correlated positively with both magical thinking and delusional ideation, suggesting these traits may correlate with psychedelic use rather than being caused by it.

Long-term benefits to psychological health and well-being after ceremonial use of Ayahuasca in Middle Eastern and North African immigrants and refugees.

Frontiers in psychiatry January 1, 2024 Matthew X Lowe, Hannes Kettner, Del R P Jolly et al. 9 citations

Ceremonial ayahuasca use is associated with significant improvements in mental health, well-being, and psychological functioning among Middle Eastern and North African (MENA) immigrants and refugees. In a longitudinal online survey of 15 primarily female participants, reductions in depression, anxiety, and shame were reported, along with increases in cognitive reappraisal and self-compassion. Most participants reported no lasting adverse effects and experienced positive behavioral changes persisting months after ingestion. The findings suggest naturalistic ayahuasca use might hold therapeutic potential for MENA populations exposed to trauma prior to and during migration, though data are preliminary.

Network control energy reductions under DMT relate to serotonin receptors, signal diversity, and subjective experience.

Communications biology April 18, 2025 S Parker Singleton, Christopher Timmermann, Andrea I Luppi et al. 7 citations

After DMT injection, the brain requires less control energy to transition between states compared to placebo, indicating a more flexible and less constrained brain dynamic. These energy changes track with EEG signal diversity and subjective intensity of the drug experience. The regional pattern of DMT's effects aligns with serotonin 2a receptor density, and a model using receptor distribution and pharmacokinetics can predict the drug's impact on brain energy trajectories.

Harmonic decomposition of spacetime (HADES) framework characterises the spacetime hierarchy of the DMT brain state

bioRxiv August 21, 2023 Jakub Vohryzek, Joana Cabral, Christopher Timmermann et al. 7 citations preprint

The brain's activity constantly reorganizes across space and time. A new framework called Harmonic Decomposition of Spacetime (HADES) was developed to track how spatial activity patterns (harmonic modes) change over time. As a proof-of-principle, HADES was applied to brain recordings from healthy participants under the psychedelic DMT and in a normal state. DMT significantly decreased contributions from most low-frequency harmonic modes. After normalizing by condition, a specific decrease appeared in the second functional harmonic, which represents the brain's hierarchy from unimodal to transmodal regions, supporting the hypothesis that psychedelics alter this functional hierarchy. Dynamic measures of fractional occupancy, lifetime, and latent space precisely described changes in the spacetime hierarchical organization of brain activity during the psychedelic state.

A qualitative analysis of the psychedelic mushroom come-up and come-down.

Npj mental health research February 7, 2025 Ari Brouwer, Joshua K Brown, Earth Erowid et al. 5 citations

Psychedelic therapy may work partly because of an overlooked temporal pattern: the initial 'come-up' phase often feels like an acute stress reaction, while the later 'come-down' phase brings positive feelings similar to recovery from illness or stress. A qualitative analysis of psilocybin experience reports from Erowid.org, using phenomenological, thematic content, and word frequency analysis, shows that negatively valenced states dominate the onset, and positively valenced states dominate the falling phase. This pattern helps explain how initially distressing altered states can ultimately resolve distress, with implications for therapeutic and theoretical understanding of psychedelic treatment.

Exploring serotonergic psychedelics as a treatment for personality disorders.

Neuropharmacology July 1, 2025 Brennan M Carrithers, Daniel E Roberts, Brandon M Weiss et al. 4 citations

Psychedelic therapy may hold potential for treating personality disorders by promoting adaptive changes in personality, though rigorous research is lacking. This review first examines research on psychedelics in individuals with personality disorders using the DSM-5-TR categorical model, then applies the dimensional DSM-AMPD framework to explore how psychedelics might affect self-functioning, interpersonal functioning, and pathological personality traits. The authors discuss clinical relevance, safety considerations, gaps, and recommendations for treating these complex populations.

Dynamic medial parietal and hippocampal deactivations under DMT relate to sympathetic output and altered sense of time, space, and the self.

bioRxiv : the preprint server for biology August 12, 2024 Lorenzo Pasquini, Alexander J Simon, Courtney L Gallen et al. 4 citations preprint

The psychedelic DMT rapidly alters consciousness, producing physical transcendence, vivid auditory distortions, and visual imagery. Using simultaneous fMRI and EKG data from 14 healthy volunteers before, during, and after intravenous DMT (versus placebo), a brain substate emerged immediately after injection characterized by deactivations in the hippocampus and medial parietal cortex alongside increased superior temporal lobe activity. Hippocampal and medial parietal deactivations correlated with disruptions in the sense of time, space, and self-referential processes, reflecting a deconstruction of ordinary consciousness. Superior temporal lobe activations correlated with audio/visual hallucinations and the experience of "entities.

The entropic brain today

Brain December 12, 2025 Robin L Carhart-Harris 2 citations

The entropic brain hypothesis, introduced in 2014 and revised in 2018, proposes that along a dimension of the size of phenomenal consciousness, expansive states—such as expert meditation, psychedelic drug states, and near-death-like experiences—reliably exhibit increased brain entropy, whereas states of reduced or no consciousness—including deep sleep, anesthesia, and disorders of consciousness—show low brain entropy. The hypothesis demonstrates convergent, correlative, predictive, discriminative, and external validity. For example, increased brain entropy under psilocybin predicts improved wellbeing one month later. Changes in brain entropy selectively index the breadth of subjective experience rather than arousal. An entropy-related function is also applied in generative artificial intelligence. The entropic brain is a useful model of conscious states.

Dissociable effects of LSD and MDMA on striato-cortical connectivity in healthy subjects

bioRxiv February 8, 2025 Natalie Ertl, Imran Ashraf, Lisa Azizi et al. 1 citation preprint

LSD and MDMA, two psychoactive drugs being explored for psychiatric use, alter how the striatum—a brain region central to reward and motivation—communicates with other areas. In a resting-state fMRI study, neither drug changed connectivity within the striatum's own networks. However, MDMA reduced connectivity between the limbic striatum and the amygdala, while LSD increased connectivity between the associative striatum and frontal, sensorimotor, and visual cortices. These changes occurred mostly outside standard striatal networks, suggesting the drugs reduce the brain's usual network segregation, which may help explain their therapeutic potential for conditions like addiction, mood disorders, and PTSD.

A synergistic workspace for human consciousness revealed by Integrated Information Decomposition.

eLife July 18, 2024 Andrea I Luppi, Pedro A M Mediano, Fernando E Rosas et al. 1 citation

Loss of consciousness significantly disrupts the brain's ability to integrate information. In a study involving functional MRI analysis, it was revealed that gateway regions in a 'synergistic global workspace' correspond to the default mode network, while broadcaster regions align with the executive control network. This integration breakdown occurs during general anaesthesia or disorders of consciousness, with recovery restoring functionality. The findings enhance understanding of consciousness by bridging Global Neuronal Workspace and Integrated Information Theory, highlighting the critical role of brain networks in maintaining conscious experience.