Augmentation of psychotherapy with DMT, ayahuasca, psilocybin and ketamine

WPA World Congress of Psychiatry, Berlin 2017.
10.10.2017 | 08:15 – 09:45 | Hall A3

Beyond classical antidepressants: experimental psychopharmacological interventions to treat social and affective disorders

Only a few innovative psychopharmacological compounds have been developed by big pharmaceutical companies for patients with affective disorders in the recent decade. At the same time, a variety of promising compounds which do not act via monoaminergic neurotransmission are currently being investigated in academic settings. Thus, the aim of the present symposium is the discussion of chances, opportunities and challenges of such compounds. To do so, Franz Vollenweider will give an introduction about currently available psychoactive compounds and will illustrate their clinical, behavioural and neuronal effects using Psilocybin as an example. Afterwards, Simone Grimm will extend the topic by reporting about effects of Ketamine on emotional working memory as well as on functional and structural brain changes in patients with depression and healthy controls. Milan Scheidender will then demonstrate first experiences in the augmentation of psychotherapy with psychoactive compounds such as DMT, Ayahuasca, Psilocybin or Ketamine. Finally, Markus Heinrichs will give insights into his recent findings about differential effects of oxytocin in disorders with disturbed social interactions.

Augmentation of psychotherapy with DMT, ayahuasca, psilocybin and ketamine

In the context of the renaissance of psychedelic research we are currently facing a paradigm shift in the understanding of consciousness and psychotherapeutic transformation. While the burden in mental health care is soaring to worldwide epidemic levels, there is an unmet clinical need to investigate novel approaches to combine pharmacology and psychotherapy, and shift the paradigm from pharmacological substitution to transformation-based therapy.

Recently, increased scientific interest in a class of rapid-acting psychoactive compounds (e.g. ketamine, psilocybin, ayahuasca, and dimethyltryptamine - DMT) targeting serotonergic and glutamatergic neurotransmission underscores their potential to facilitate rapid neurobehavioral change within this emerging new treatment paradigm. Rapid-acting serotonergic drugs exert their therapeutic potential by increasing synaptic plasticity and by acutely destabilizing local brain network hubs and global network connectivity, thus providing the occasion for resetting of neurocircuitries that underlie maladaptive behaviors.

In my talk, I will give an overview about how the subjective and clinical effects of psychedelics such as ketamine, psilocybin and ayahuasca can be explained from the perspective of contemporary neuroscience. In particular, advanced neuroimaging technologies provide exciting novel insights into the brain dynamics underlying pharmacologically induced altered states of consciousness. Through enhancing adaptive neuroplasticity, cognitive flexibility and psychological well-being, rapid acting psychoactive drugs may be a missing pharmacological key element towards integrative transformational healthcare.