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David Nutt

Imperial College London, NIHR Imperial Biomedical Research Centre

208 papers in the library · 21,656 citations · publishing 2007-2026

Papers

Long-term effects of psilocybin on dynamic and effectivity connectivity of fronto-striatal-thalamic circuits

bioRxiv (Cold Spring Harbor Laboratory) November 7, 2024 Lorenzo Pasquini, Jakub Vohryzek, Anira Escrichs et al. 4 citations preprint

Psilocybin induces fast and sustained improvements in mental well-being, yet its long-term mechanisms are not fully understood. Four weeks after a full dose, fronto-striatal-thalamic (FST) circuitry—involved in goal-directed behavior and motivation—shows increased dynamic activity and flexibility in healthy volunteers. Computational modeling indicates that reduced structural constraints on functional dynamics cause this increased flexibility. Long-term changes include increased bottom-up and reduced top-down information flow, mediated by serotonergic (5-HT2A) and dopaminergic (D2) receptor systems. This functional re-organization of FST circuits may represent a common mechanism underlying clinical improvements across neuropsychiatric disorders such as substance abuse, major depression, and anorexia.

Psychedelics as Psychiatric Medications

March 1, 2023 David Nutt, David Castle 4 citations

Psychedelic agents such as psilocybin, MDMA, ayahuasca, and LSD are being reinvestigated for their therapeutic potential in psychiatry. Psilocybin, found in 'magic mushrooms,' has been used to reduce distress in people with depression and anxiety related to life-ending cancers. MDMA has shown lasting efficacy for severe posttraumatic stress disorder. These compounds integrate psychotherapy with biological treatments, challenging established psychiatric practice and offering new insights into brain function and healing. The book covers the history, clinical aspects, risks, side effects, and precautions of these drugs.

Individual and combined effects of Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) on striato-cortical connectivity in the human brain

bioRxiv (Cold Spring Harbor Laboratory) November 21, 2020 Matthew B. Wall, Tom P. Freeman, Chandni Hindocha et al. 4 citations preprint

Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are two major cannabis constituents with contrasting actions: THC is psychoactive and addiction-promoting, while CBD may have opposite effects. In two placebo-controlled, double-blind studies, inhaled THC (8 mg) strongly disrupted functional connectivity in associative and sensorimotor striatal networks, and this disruption was selectively alleviated in the limbic striatum when co-administered with CBD (10 mg). Oral CBD (600 mg) alone increased connectivity in the associative network but caused minor decreases in limbic and sensorimotor networks. The insula emerged as a key region affected by cannabinoid-induced connectivity changes, with implications for cannabis-related disorders and cannabinoid therapeutics.

Neural correlates of the DMT experience as assessed via multivariate EEG

bioRxiv July 18, 2019 Christopher Timmermann, Leor Roseman, Michael Schartner et al. 4 citations preprint

Intravenous DMT, a fast-acting psychedelic, markedly alters human brain activity. Compared with a placebo, DMT reduced oscillatory power in alpha and beta brainwaves and increased spontaneous signal diversity. Time-referenced analyses linked changes in subjective experience to changes in brain activity. Emergence of delta and theta frequency oscillations correlated with the peak of the experience, particularly its eyes-closed visual component. These findings advance understanding of the neurobiological underpinnings of immersive states of consciousness.

LSD alters eyes-closed functional connectivity within the early visual cortex in a retinotopic fashion

Journal of Vision September 1, 2016 Leor Roseman, Martin I. Sereno, Robert Leech et al. 4 citations

Under LSD, the visual cortex's resting-state functional connectivity (RSFC) becomes more dependent on its intrinsic retinotopic organization, as if the brain were processing actual visual input despite closed eyes. In 10 healthy subjects, RSFC between non-adjacent patches of V1 and V3 that represent congruent parts of the visual field (both horizontal or both vertical meridians) was significantly stronger than connectivity between incongruent patches (horizontal-vertical), compared to placebo. The difference between congruent and incongruent connectivity was greater under LSD (Cohen's d=1.6), suggesting that psychedelic imagery involves transient local retinotopic activation similar to that from visual stimulation.

Perturbing whole‐brain models of brain hierarchy: An application for depression following pharmacological treatment

Annals of the New York Academy of Sciences July 21, 2025 Marcel Socoró-garrigosa, Yonatan Sanz Perl, Morten L. Kringelbach et al. 3 citations

The scale at which the brain represents information remains a key question in neuroscience. Evidence shows that information is encoded not just in localized areas but across distributed, hierarchical networks. The hierarchy of causal influences shaping brain activity patterns is a signature of different brain states, relevant to neuropsychiatric disorders. Using whole-brain models guided by the thermodynamics of mind framework, researchers estimated brain hierarchy and studied in-silico transitions in static functional connectivity. Applying this to major depressive disorder, they built resting-state whole-brain models of depressed patients before and after treatment with psilocybin or escitalopram.

MDMA-assisted psychotherapy for AUD: Bayesian analysis of WHO drinking risk level and exploratory analysis of drinking behavior and psychosocial functioning at 3 months follow-up.

Alcohol and alcoholism (Oxford, Oxfordshire) May 14, 2025 Hannah Thurgur, Ben Sessa, Laurie Higbed et al. 3 citations

In an open-label feasibility study, 14 adults with alcohol use disorder who had recently completed detoxification underwent an eight-week course of ten psychotherapy sessions, including two sessions with MDMA. Bayesian analysis estimated a 55%–63% probability of a two-level reduction in World Health Organization drinking risk three months after treatment. Preliminary findings also indicated reductions in alcohol craving and improvements in sleep and aspects of psychosocial functioning at the three-month follow-up compared to baseline. The results provide initial insights into MDMA-assisted psychotherapy's potential to improve quality of life and well-being beyond reducing drinking.

LSD reconfigures the frequency-specific network landscape of the human brain

bioRxiv March 24, 2025 Kenneth Shinozuka, Mattia Rosso, Clayton R. Coleman et al. 3 citations preprint

LSD profoundly alters consciousness by reorganizing brain networks in specific frequency bands. Analyzing MEG data from 14 healthy participants, the substance enhances high alpha (12.1, 13.3 Hz) activity across all conditions and high beta (25.3 Hz) in three conditions, while suppressing low beta (18.1, 19.3 Hz) and low alpha (8.5 Hz). LSD also shifts network spatial distributions: low alpha moves anteriorly toward the motor cortex, high alpha becomes more localized to the visual cortex, and low beta expands over temporal and occipital cortices. These frequency- and region-specific changes add nuance to theories of network disintegration under psychedelics.

Neuroimaging and the Investigation of Drug-Drug Interactions Involving Psychedelics.

Neurosci Insights October 8, 2024 Matthew B. Wall, Rebecca Harding, Natalie Ertl et al. 3 citations

Psychedelic therapies are new psychiatric treatments that may need to be combined with existing medications, but little is known about their interactions with common psychiatric drugs. This commentary reviews key findings on such drug-drug interactions and proposes that multimodal neuroimaging, combining PET and fMRI with other measures, offers the most thorough way to study these interactions across molecular, functional, and clinical levels.

A virtual clinical trial of psychedelics to treat patients with disorders of consciousness

bioRxiv (Cold Spring Harbor Laboratory) August 19, 2024 Naji Alnagger, Paolo Cardone, Charlotte Martial et al. 3 citations preprint

Disorders of consciousness, such as unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), have few treatments. Using whole-brain computational models built from individual patients' fMRI and diffusion-weighted imaging data, this virtual clinical trial simulated the effects of LSD and psilocybin. The psychedelics shifted the brains of patients with disorders of consciousness closer to a critical dynamical state, with a larger effect in MCS patients. In UWS patients, the treatment response depended on structural connectivity, whereas in MCS patients it aligned with baseline functional connectivity. These results provide a computational foundation for considering psychedelics in treating disorders of consciousness and highlight the role of computational modeling in drug discovery and personalized medicine.

Psychedelics: reconnecting the brain to heal the mind

The Biochemist March 25, 2024 David Nutt 3 citations

Natural psychedelics like magic mushrooms have been used for at least 7000 years, with a resurgence in the 1950s and 1960s after LSD was synthesized and used therapeutically. Non-medical use led to a global ban in the early 1970s. Over the past 20 years, research has revived, showing that psychedelics act as agonists of the serotonin 5-HT2A receptor, altering neuro-circuitry to produce more integrated and flexible brain activity. These changes, observed in healthy volunteers, predicted benefits for mental illnesses like depression and addiction, confirmed by subsequent trials. A single psychedelic experience can yield very long-lasting improvements across several mental illnesses. Given these consistent positive outcomes, psychedelic therapy will likely soon be widely approved in Western medicine, as it already is in Australia for treatment-resistant depression.

Neuroimaging in psychedelic drug development: Past, present, and future

June 30, 2022 Matthew B. Wall, Rebecca Harding, Rayyan Zafar et al. 3 citations preprint

Psychedelic therapy shows potential for treating psychiatric disorders like depression, addiction, and PTSD. Classic serotonergic psychedelics such as psilocybin, LSD, DMT, and 5-MeO-DMT are the main focus, along with ketamine, MDMA, and ibogaine. The concurrent use of advanced neuroimaging methods, particularly PET and MRI, has allowed precise assessment of brain effects, benefiting the development of these treatments. The text identifies gaps in knowledge that future multimodal imaging studies could address, providing a stronger foundation for psychedelic therapy.

The difference between 'placebo group' and 'placebo control': a case study in psychedelic microdosing

PsyArXiv May 24, 2022 Balázs Szigeti, David Nutt, Robin Carhart-Harris et al. 3 citations preprint

Blinding in medical trials is meant to distribute expectancy effects evenly across treatment arms, but it often fails. Using computational modeling, this work shows that weak blinding combined with positive treatment expectancy can create an 'activated expectancy bias' (AEB), which inflates treatment effect estimates and can produce false positive findings. To address this, the authors introduce the Correct Guess Rate Curve (CGRC), a statistical tool that estimates what a perfectly blinded trial would have found from imperfectly blinded data. Re-analyzing a self-blinding psychedelic microdose trial, they find that observed placebo-microdose differences are susceptible to AEB and may be false positives, suggesting microdosing acts as an active placebo. The results underscore the difference between trials with a placebo control group and genuinely placebo-controlled trials.

Raising awareness: The implementation of medical cannabis and psychedelics used as an adjunct to standard therapy in the treatment of advanced metastatic breast cancer

Drug Science Policy and Law January 1, 2022 Rayyan Zafar, Dustin Sulak, Jaime Brambila et al. 3 citations

A 49-year-old woman with metastatic breast cancer (ER+, PR-, HER2+, BRCA-) received targeted chemotherapy and a ketogenic diet for 26 months, then added a high-dose cannabinoid regimen (CBD and THC) and psilocybin-assisted psychotherapy. After five months, PET/CT scans showed no evidence of metastatic disease, and chemotherapy was stopped. A one-year follow-up CT found no residual or recurrent disease. Recurrence appeared at 18 months, when the cannabis dose had been reduced to 60% of the initial protocol; increasing it back to the original dose was followed by receding cancer progression over 16 months. The case suggests potential therapeutic utility of adjunctive cannabinoids and psychedelics in metastatic breast cancer.

A Virtual Clinical Trial of Psychedelics to Treat Patients With Disorders of Consciousness

Advanced Science November 20, 2025 Paolo Cardone, Charlotte Martial, Yonatan Sanz Perl et al. 2 citations

Simulated administration of LSD and psilocybin in computational models of patients with disorders of consciousness (DoC), including unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), shifted brain activity closer to criticality—the phase transition between order and chaos. The effect was greater in MCS patients. In UWS patients, the treatment response correlated with structural connectivity, while in MCS patients it aligned with baseline functional connectivity. These results provide a computational foundation for using psychedelics in DoC treatment and highlight the potential role of computational modeling in drug discovery and personalized medicine.

A long, strange trip: Ketamine treatment in psychiatry.

J Psychopharmacol October 27, 2025 David Nutt, Celia J. A. Morgan, David Erritzøe et al. 2 citations

Ketamine, originally developed as an anesthetic, has emerged as a promising treatment for severe depression and other psychiatric conditions, particularly in patients who have not responded to traditional therapies. The compound can provide rapid relief from depressive symptoms, often within hours, which contrasts with conventional antidepressants that may take weeks to work. This surprising discovery has opened a new frontier in mental health treatment, offering hope for those with challenging mood disorders. However, the use of ketamine in psychiatry also raises concerns about its potential for abuse and long-term side effects, necessitating careful clinical oversight.

The effects of psilocybin therapy versus escitalopram on cognitive bias: A secondary analysis of a randomized controlled trial

medRxiv March 21, 2025 Jessica S. Henry, Bruna Giribaldi, David Nutt et al. 2 citations preprint

In a randomized controlled trial of 59 patients with major depressive disorder, two high-dose psilocybin therapy sessions produced large increases in optimism and improvements in dysfunctional attitudes related to achievement, dependency, and self-control after six weeks. By contrast, a six-week daily course of escitalopram produced no change in optimism and only improved dysfunctional attitudes in the achievement domain. Psilocybin therapy was superior to escitalopram in remediating negative cognitive biases in depression.

Study Protocol for ‘PsilOCD: A Pharmacological Challenge Study Evaluating the Effects of the 5-HT2A Agonist Psilocybin on the Neurocognitive and Clinical Correlates of Compulsivity’

Cureus January 29, 2025 Sorcha O'Connor, Kate Godfrey, Sara Reed et al. 2 citations

The study aims to uncover the neural mechanisms by which psilocybin-assisted therapy affects obsessive-compulsive disorder (OCD) and whether those brain changes align with improvements in cognitive symptoms. A secondary goal is to test whether a low, tolerable dose is both practical and effective as a clinical treatment. The results will provide essential data for designing a future randomized controlled trial.

Neuroplasticity and Psychedelics: a comprehensive examination of classic and non-classic compounds in pre and clinical models

arXiv (Cornell University) November 29, 2024 Claudio Agnorelli, Meg J. Spriggs, Kate Godfrey et al. 2 citations

Classic psychedelics (LSD, psilocybin, N,N-DMT) and non-classic psychedelics (ketamine, MDMA) enhance neuroplasticity, the nervous system's ability to adapt. Animal studies indicate these drugs induce meta-plasticity, heightening sensitivity to environmental stimuli, and hyper-plasticity, reopening developmental windows for long-term structural changes that affect mood and behavior. Translating these findings to humans is challenged by limitations in current imaging techniques, but emerging approaches like novel PET radioligands, non-invasive brain stimulation, and multimodal methods offer promising directions. This review informs development of targeted interventions for neuropsychiatric disorders and advances understanding of psychedelics' therapeutic potential.

Evidence for tolerance in psychedelic microdosing from the self-blinding microdose trial

October 19, 2022 Stefan Baumann, Robin Carhart-Harris, David Nutt et al. 2 citations preprint

In a placebo-controlled citizen science trial with 240 participants, microdosing tolerance was assessed by tracking whether correct guesses of receiving a microdose decreased with more doses taken. Correct guess probability declined overall, indicating tolerance developed. This tolerance was specific to LSD and LSD-analogue microdoses, not psilocybin microdoses. The findings suggest that microdosers may need to periodically suspend their routine to avoid tolerance and that psilocybin may be better suited for long-term protocols.

The role and basis of the drug laws

Prometheus September 1, 2010 David Nutt 2 citations

In October 2009, the UK home secretary requested David Nutt's resignation as chair of the government's advisory council on the misuse of drugs after the publication of his paper arguing that ecstasy and LSD are less dangerous than alcohol. Nutt had previously clashed with the Home Office over an editorial comparing the harms of ecstasy unfavorably to those of horse riding. The incident highlighted tensions between academic publication and scientific advice to government. Nutt now chairs the Independent Scientific Committee on Drugs.

Distinct brain responses to psilocybin and escitalopram in depression captured by the Fluctuation-Dissipation Theorem

bioRxiv (Cold Spring Harbor Laboratory) June 16, 2026 Paulina Clara Dagnino, Irene Acero-Pousa, Gorka Zamora-López et al. 1 citation

Psilocybin and the conventional antidepressant escitalopram produce opposite changes in the brain's hierarchical non-equilibrium dynamics when treating major depressive disorder. Using resting-state fMRI before and after treatment, researchers built whole-brain models and measured how much each patient's brain activity deviated from the fluctuation-dissipation theorem. Baseline measures distinguished treatment responders from non-responders within each group. The deviation from the fluctuation-dissipation theorem may serve as a marker to differentiate the brain effects of psilocybin and escitalopram, contributing to understanding how these treatments work for depression.

The effects of psilocybin therapy versus escitalopram on cognitive bias: A secondary analysis of a randomized controlled trial.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology June 23, 2025 Jessica S. Henry, Bruna Giribaldi, David Nutt et al. 1 citation

In patients with major depressive disorder, two high-dose psilocybin therapy sessions produced large increases in optimism and improvements in all three domains of dysfunctional attitudes (achievement, dependency, self-control) at six weeks, while a six-week daily course of escitalopram improved only the achievement domain and did not change optimism. Psilocybin also made patients more optimistic about desirable life events, whereas escitalopram reduced pessimism about negative life events. The findings suggest psilocybin therapy is superior to escitalopram for remediating negative cognitive biases in depression.

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.

The Role of the Dorsolateral Prefrontal Cortex in Ego Dissolution and Emotional Arousal During the Psychedelic State

bioRxiv Preprint Server December 9, 2024 Clayton R. Coleman, Kenneth Shinozuka, Robert Tromm et al. 1 citation preprint

Lysergic acid diethylamide (LSD) alters consciousness by affecting brain connectivity, particularly in the dorsolateral prefrontal cortex (DLPFC). Using fMRI and MEG data from healthy participants, the study found that ego dissolution—a hallmark of the psychedelic experience—was positively correlated with increased functional connectivity between the left and right DLPFC, thalamus, and fusiform face area. Emotional arousal was linked to stronger connectivity between the right DLPFC, intraparietal sulcus, and salience network. A confirmatory analysis supported these findings. MEG data showed that LSD increased directed information flow from the thalamus to the DLPFC in the theta band, suggesting disrupted thalamic gating contributes to ego dissolution. These results indicate a key role for the DLPFC in LSD-induced states of consciousness.