Abstract Psychiatric trials typically define success as symptom reduction, yet patients prioritize meaning, vitality, and functioning. This imbalance undervalues experiential benefits, distorting clinical, policy, and FDA decisions. Psychedelic trials illustrate this, where robust well-being gains sometimes accompany modest symptom effects. We argue well-being should be elevated to co-primary...
Demoralization, a syndrome of helplessness, hopelessness, and loss of meaning and chronic pain are common sources of distress in early palliative care. Psilocybin-assisted therapy (PAT) is an emerging intervention with preliminary data suggesting improvements in pain and demoralization. To date, PAT has not been studied among people living with both demoralization and chronic pain nor has it...
medRxivJuly 10, 2026Daniel Copeland, Naoise Mac Giollabhui, Louisa G Sylvia et al.
preprint
Background: Despite growing evidence that lifestyle interventions reduce depressive symptoms, the psychological mechanisms underlying these effects remain poorly understood. This study examined whether mindfulness and rumination mediate the antidepressant effects of heated yoga (HY), a multicomponent intervention combining physical activity, attentional training, and thermoregulatory stress....
This paper explores whether some religious and spiritual experiences (RSEs) associated with depression resemble hypomania/mania. Content analysis and phenomenological analysis were used to characterize first-person RSE reports associated with depression (N = 249). Findings reveal that some RSEs that follow depression are characterized by long-duration states (lasting days to weeks) of positive...
This paper examines first-person experiences of demons, devils, and Satan contained in the Alister Hardy RERC database of religious and spiritual experiences (RSEs). Word frequency analysis, content analysis, and phenomenological analysis are used to characterize the features of demonic experiences and how they relate to psychopathology and religious/cultural affiliations. Results show that...
Despite being induced by a transient pharmacological exposure, psychedelic experiences can catalyze enduring psychological transformation, presenting a central challenge for understanding the mechanism of action of psychedelic medicines. To address this challenge, the Allostatic Reset Model (ARM) of psychedelic action is proposed, which conceptualizes psychedelic therapeutic effects as a...
The serotonergic psychedelic psilocybin induces neural plasticity and profoundly alters consciousness. The benzodiazepine midazolam blunts neural plasticity and induces conscious sedation and amnesia at low doses. In our recent open label pilot study, we administered oral psilocybin (25 mg) along with intravenous midazolam at doses allowing a full psychedelic experience while blunting memory...
Abstract Introduction The wellbeing of university undergraduates is a pressing area of concern, with one in five students reporting serious psychological distress. In previous semesters of a course on mental wellbeing, we asked undergraduates to engage with a standardized wellness program for the general population and provide feedback through weekly surveys and a final reflection paper. Based...
Psychedelics have been increasingly studied for their potential to influence mental health and well-being, yet their relationship with broader health behaviors remains underexplored. This study examined associations between lifetime psychedelic use and health-related behaviors, including substance use, dietary habits, and impulsive tendencies. Using an extensive cross-sectional online survey,...
Psychedelic therapy has the potential to become a revolutionary and transdiagnostic mental health treatment, yielding enduring benefits that are often attributed to the experiences that coincide with peak psychedelic effects. However, there may be an underrecognized temporal structure to this process that helps explain why psychedelic and related altered states of consciousness can have an...
Psilocybin-assisted therapy (PAT) is an experimental treatment with transformative promise. Developing standards for PAT psychotherapy protocols is a priority, but psychotherapeutic protocol components of PAT have been subjected to little rigorous research. This study was designed to assess protocol components in a trial of PAT. The Enhanced Critical Incident Technique (E-CIT) was used to...
ABSTRACT The diverse nature of religious and spiritual experiences (RSEs) eludes easy comparison or conceptualization. Here we explore the phenomenological, situational and conceptual principles that connect eighty-two diverse RSE reports from the Hardy Database (https://alisterhardytrust.uwtsd.ac.uk/). We tentatively suggest that in addition to being unexpectedly significant and imbued with...
Psychedelics have shown early evidence for a range of benefits and low harm profiles in extant research. However, adverse effects (AEs) research in psychedelics has been limited, leading to underspecified AE profiles, inconsistent measurement, and potential undercounting of AEs. The development of safe, effective psychedelic therapies and treatments for AEs when they occur requires a thorough...
To address the challenge of predicting psychological response to a psychosocial intervention we tested the possibility that baseline gene expression profiles might provide information above and beyond baseline psychometric measures. The genomics strategy utilized individual level inferences of transcription factor activity to predict changes in loneliness and affect in response to two...
This study aims to estimate the lower, middle, and upper bounds of potential demand for psilocybin-assisted therapy (PSIL-AT) for major depressive disorder (MDD) and treatment-resistant depression (TRD) in the United States. We calculated potential PSIL-AT demand for MDD and TRD by estimating the number of U.S. patients with MDD, identifying those in treatment, and determining who qualifies as...
Aspects of the acute experience induced by the serotonergic psychedelic psilocybin predict symptomatic relief in multiple psychiatric disorders and improved well-being in healthy participants, but whether these therapeutic effects are immediate or are based on memories of the experience is unclear. To examine this, we co-administered psilocybin (25 mg) with the amnestic benzodiazepine midazolam...
A single dose of psilocybin, a psychedelic that acutely causes distortions of space-time perception and ego dissolution, produces rapid and persistent therapeutic effects in human clinical trials1-4. In animal models, psilocybin induces neuroplasticity in cortex and hippocampus5-8. It remains unclear how human brain network changes relate to subjective and lasting effects of psychedelics. Here...
It is a paradox that psychotomimetic drugs can relieve symptoms that increase risk of and cooccur with psychosis, such as attention and motivational deficits (e.g., amphetamines), pain (e.g., cannabis) and symptoms of depression (e.g., psychedelics, dissociatives). We introduce the ideas of psychotomimetic compensation and psychotomimetic sensitization to explain this paradox. Psychotomimetic...
Objective: Despite considerable research examining the efficacy of psychedelic-assisted therapies (PATs) for treating psychiatric disorders, assessment of adverse events (AEs) in PAT research has lagged. Current AE reporting standards in PAT trials are poorly calibrated to features of PAT that distinguish it from other treatments, leaving many potential AEs unassessed. Methods: A...
Fruitful comparison of psychedelic, spiritual, and psychotic experiences requires a degree of phenomenological nuance. Some shared features of these phenomena, such as encounters and communications with supernatural entities, are obfuscated by scientific and clinical terminology. Other supposed distinctions are based on an atemporal view of dynamic experiences. In Section 2 of this...
Charles Raison, MD, is a Professor of Human Ecology and Psychiatry in the Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison. Dr. Raison also serves as Director of Clinical and Translational Research for Usona Institute, as Director of the Vail Health Behavioral Health Innovation Center, Director of Research on Spiritual Health for Emory Healthcare,...
Abstract Psychedelic therapy has the potential to become a revolutionary and transdiagnostic mental health treatment, yielding enduring benefits that are often attributed to the experiences that coincide with peak psychedelic effects. However, there may be an underrecognized temporal structure to this process that helps explain why psychedelic and related altered states of consciousness can...
Background Psychedelic-assisted therapies hold early promise for treating multiple psychiatric conditions. However, absent standards for the care, teams providing psychedelic-assisted therapy pose a major roadblock to safe administration. Psychedelics often produce spiritually and existentially meaningful experiences, and spiritual health practitioners have been involved in administering...
Mental health problems including depression, anxiety, suicide, and burnout are common among health care providers. Resilience and well-being are factors thought to protect against these incidents. Clinical trials and naturalistic studies of psychedelic compounds have shown decreases in depression, anxiety, and suicidality while suggesting improvements in well-being. This secondary analysis of a...