Your Lifestyle Is Your Medicine
“Your Life Style Is Your Medicine” is a podcast that focuses on how a person's lifestyle can be the key to health and happiness. Routed in the principles of lifestyle medicine, Ed Paget, osteopath, and exercise scientist, interviews area-specific experts on how lifestyle impacts well-being, focusing on purpose, physical activity, nutrition, sleep, and stress, which could lead to a longer, happier life. Edward now runs immersive lifestyle medicine retreats, with the purpose of helping others take back control of their lives to live longer and healthier.
Your Lifestyle Is Your Medicine
Dr. Susan Rossell on the Psychedelic Revolution in Mental Health - Magic Mushrooms
Merging ancient practices with modern science, Dr. Susan Russell explores the benefits of psilocybin as a therapeutic aid for mental health disorders, focusing on its potential impact on conditions like depression and body dysmorphic disorder. The episode discusses the intricacies of psilocybin therapy, including its history, current research, efficacy, and the importance of psychotherapy in achieving successful treatment outcomes.
• Exploring psilocybin's historical context and cultural significance
• Understanding the neuroscience behind psilocybin and its impacts on brain connectivity
• Personal journey of Dr. Russell into psilocybin research
• Investigating psilocybin's role in body dysmorphic disorder treatment
• Caution regarding efficacy and variability of treatment outcomes
• The necessity of therapy as a component of psilocybin experiences
• Current regulatory challenges in psilocybin therapy implementation
• Future research directions and emerging trends in psychedelic therapy
Dr. Susan Rossell is a clinical neuropsychologist and cognitive neuroscientist, recognized internationally for her pioneering research in mental health and neurocognitive disorders. Originally from the UK she is now based in Australia. She serves as a Professorial Research Fellow at Swinburne University of Technology and was the inaugural Director of its Centre for Mental Health. Her expertise spans schizophrenia, bipolar disorder, body dysmorphic disorder, and anxiety, focusing on both neuroimaging and cognitive mechanisms.
Over her career, she has published more than 250 peer-reviewed articles and her research has helped bridge the gap between neuroscience and mental health treatment.
Welcome to the your Lifestyle is your Medicine podcast, where we do deep dives into topics of mind, body and spirit. Through these conversations you'll hear practical advice and effective strategies to improve your health and ultimately add healthspan to your lifespan. I'm Ed Padgett. I'm an osteopath and exercise physiologist with a special interest in longevity. Today's guest is Dr Susan Russell.
Speaker 1:She is a clinical neuropsychologist and cognitive neuroscientist. She's recognized internationally for her pioneering research in mental health and neurocognitive disorders. Originally from the UK, she is now based in Australia and served as a professor or research fellow at Swinburne University of Technology and was the inaugural director of its Centre for Mental Health. Her expertise spans schizophrenia, bipolar disorder, body dysmorphic disorder and anxiety, focusing on both neuroimaging and cognitive mechanisms. Over her career, she has published more than 250 peer-reviewed articles, and her research has helped bridge the gap between neuroscience and mental health treatment.
Speaker 1:In our conversation today, we dive into the world of psilocybin, that's the active compound found in magic mushrooms. We discuss what it is, why there is an interest in using it in conjunction with therapy to help certain mental conditions, and whether or not the research is there to back up the claims, the potential risks and what can go wrong during a psilocybin-induced experience, but also what the future looks like for people who might be interested in using psilocybin for therapeutic purposes. Dr Susan, welcome to the show. Good to be with you. So I thought we could start with a lay of the land and you can explain to my listeners what psilocybin is and why it's gained attention in mental health research. Can we start there?
Speaker 2:Yeah, absolutely so. Psilocybin is a compound found in mushrooms and I think there's about 20 different varieties of mushrooms. It is one of the psychedelics and obviously it's a naturally produced psychedelic. So some of the psychedelics are synthetic, but this is a natural one.
Speaker 2:There is a very long history of evidence from way back in cave paintings and cavemen all the way through the indigenous cultures, that they used it as part of ceremonies for wellness and to also connect with the spirits, but a lot of sort of writings with regards to treating people with it treating people with anxiety conditions, mental health conditions, helping them deal with the way that they would refer to it as deal with their demons. It was picked up in the 50s and 60s as a potential interesting medicine to help with mental health problems and then certainly some of the original evidence would suggest very favourably that it does help with mental health problems. And then unfortunately, there was a pause to a lot of that research because a lot of it was done very unethically. That's a very long story, but essentially that's the brief version of it. And then there was an international ban for a number of years until it was picked up again recently.
Speaker 2:And you know, piecing together all of the history, both long-term history and short-term history, it does suggest that it suggests that there is some benefit for using for mental, in mental health. Um, and also, you know, we know more about pharmacology now, uh, than than we did back in the 60s, um 50s and 60s, and, and, and indeed, when people have looked at, uh, the pharmacology of psilocybin, it has relevant compounds that we know are important in mental health. So it interacts with the serotonin system. So there's a lot of bits of the puzzle that have come together to suggest that we should be, as researchers and as clinicians, considering whether it is useful for mental health conditions.
Speaker 1:Interesting. So it's like the indigenous people or our ancestors way back when intuitively knew how to use it. And then now we had a go at it in the 50s and 60s, messed that up a little bit or whatever political reasons, unethical research and so on. I think I remember reading about some of that stuff and then and now we've got the science to figure out a bit more how it works.
Speaker 2:we're going full circle and bring it back into into treatment again yeah, that's exactly right, I've read about this thing called the stoned ape hypothesis as well, saying that potentially we may have followed, um, you know, the bison or or some four-legged animals, and they would have where they would have pooped, the mushrooms would have grown in the poop and we may have eaten it and then maybe expanded our minds that way absolutely, in fact, I just I recently went to a a really fascinating series of lectures by an archaeologist, um, talking about all of these sorts of things and showing how um it influenced some of the cave drawings and showing how there were little pouches that obviously contained the mushrooms that they found in some of the very, very old archaeological digs.
Speaker 1:So we know it's been around for a long time so you're a research scientist with a background in clinical neuropsychology. How did you get interested in? I'm saying psilocybin, but you said psilocybin which one's the-. You can say it either way.
Speaker 2:It doesn't really matter, I think, because I'm like this international scientist, I say it either way. I know people have noticed I say it either way. So it's like and I can't remember which way around the Brits say it one way and the Americans say it another, and the Australians, because I think we flip-flop between them, because I live in Australia.
Speaker 2:Why did I get interested? So I, for the last about 15 years, have really focused a lot most of my research on body dysmorphia. So this is a disorder where people are profoundly distressed with what we refer to as imagined ugliness. They look in the mirror and they see these disfiguration or deformations of their body. They don't like the way that they look, so much that they won't go out there in the community. They get very anxious. They either avoid mirrors or become totally focused with mirrors, trying to check their deficits, so on and so forth. So I've been working with this condition for about 15 years now and I've thrown a lot of different research angles in terms of trying to better understand the condition, but also in terms of trying to improve the treatments for it.
Speaker 2:We still don't really have very specific treatments for body dysmorphia. We have adapted some of the therapeutic models from OCD, which is one of the most similar conditions, and there's okay success. I'm not going to say it's anything great. You know about 40% of people do seem to get a little. You know some amount better, but there's loads of relapse and that's really concerning to me. So we've got to. You know there's this and it's also not a low frequency condition. It's got the same frequency as bipolar disorder and schizophrenia. It's about 1% of the population. Frequency is bipolar disorder and schizophrenia it's about 1% of the population and actually there's an argument that it's actually greater than some of these other you know very prominent mental health disorders.
Speaker 2:So I have been scratching my head for a long time about how to help people with body dysmorphia and a couple of things happened to me about six years ago where I was, you know one. I was, you know, trying to think outside the box but also I was trying to see what was out there and you know I literally spent a few weeks pulling down every paper I could possibly find on body dysmorphia and going through to see if there was anything out there that might give me some clues as to a potential treatment. And I found a case study where somebody had given them psilocybin and had some really profound changes in the person the way that the person thinks and the way that the person appraised their body and actually got better. So my journey started there, essentially better. So my journey started there essentially. And you know, I did my training in the UK and I knew some of the UK experts that had worked in psilocybin and we had long chats about whether they saw the usefulness of psilocybin with body dysmorphia and people did.
Speaker 2:I guess there was a little bit of an abundance of caution at the time, though you know this was. This was before it was really like well known yeah, it was about six or seven years ago. I mean, it really has accelerated quite quickly in the last few years, and there was a suggestion that to, in order to do the work that I wanted to do in BDD, I might want to set up some small studies in conditions that had already been investigated and were showing some promise. So so that's why my first indications that I actually have clinical trials that I've run were major depression, where there was already some evidence that it worked, and then over the last few years, I've obviously moved and we've got some um studies set up now for body dysmorphia and anorexia. So yeah, that was my, that's my little journey.
Speaker 1:So that was that case study that you found. Did that research, you wrote that case study. Ever follow up with that? Did they do any more research on?
Speaker 2:no, they never did anymore. No, anyway, and it seemed to be. I always be. I was always a little bit skeptical about whether it was done legally, to be quite honest, but you know, it was out there.
Speaker 1:Okay. So then you looked at other research to do with depression, which had some clinical trials behind it, and then you moved into making clinical trials for BDD. Yeah, yeah exactly so with your sort of background in neuroscience, how do you think the psilocybin actually interacts?
Speaker 2:with the brain. I think that this was the really critical thing for me. It wasn't just the case study, it was actually really looking at the underlying neurobiology and the changes in the brain when you take psilocybin. That actually really triggered my complete interest. I think a case study is not always the best to pin your hopes on. So what some of the evidence had started to show with major depressive disorder is that when people take psilocybin it opens the brain up to new experiences.
Speaker 2:There's a type of brain scan that we do, called resting states. So people lie in either an MRI scanner or an MEG scanner and we just look at the kind of activity that's going on in the brain when people rest and when they've taken psilocybin. One of the things that has been shown is that the default mode network, or the basic network, becomes more active and more connected with different regions of the brain. So it isn't kind of stuck in this kind of very rigid pattern or quiet pattern, or maybe it's not asleep because people aren't asleep, but you know very dormant dormant would be a better word dormant pattern. The brain becomes more connected with all areas of of the brain and and it's through that kind of process that we are taking people from being very what we recall called rigid or cognitively inflexible to being cognitively flexible, and we know that that opening up of the brain and opening up of the default network and encouraging the brain to be more connected throughout the brain does help people reprocess their ideas and actually see things differently.
Speaker 2:And for me, that was the real thing that we needed in BDD. People with BDD are very rigid. They have this idea that they're ugly. They look in the mirror and they see these abnormalities and you can't change their opinion in any way whatsoever. But so by opening up the brain and making it more flexible to potential other alternatives, um, then we might have something to work on therapeutically, but also, you know, um in terms of um really getting them to challenge their own ideas, um, in that therapeutic process, which which really was the critical thing for me and what does the current research or evidence say about psilocybin's effectiveness in treating uh sort of um the body dysmorphia or even depression, compared to what else is out there at the moment?
Speaker 2:yeah, so this is, this is really where there's um, uh, it's quite complex, so I'll start. I mean, the disorder that's been the most work is, obviously, is depression and end-of-life anxieties and depressions as well, and look for me, I well, also a lot of this work has been done with people that are treatment-resistant or very severe and have had the conditions for a long time. Um, look, there's promise, that there is real promise. Um, it's, it's. It's certainly not a silver bullet, um, it's certainly not, um, uh, something where you know you just take it and you get better. And you know you, you come out of the session and you know you just take it and you get better. And you know you come out of the session and you know your life's changed. The therapy that surrounds the psilocybin experience is really important and making sure that you've got experienced therapists that unpack their experiences, experiences and really, um, I guess, capitalize on the opening up of the brain and opening up of the of of your thought processes to enable you to work through some of the challenges and some of the places that you might have become stuck um, in your thinking patterns, um, um, so it has shown some promise and, and you know, um, with some of the work that we've been doing over the last few years, what we've started to show is that a third to 40% of people do get a lot better. Whether they stay better, I'm not sure, because you know we don't have massive long-term follow-ups yet, but you know they do get better and over a year period of time they do stay better. I'm not sure, because you know we don't have massive long-term follow-ups yet, but you know they do get better and over a year period of time they do stay better. A third of people have a fluctuating course. Not quite a third, maybe more like 20% don't seem to get better at all.
Speaker 2:So from my you know point of view as a scientist and also also as a human, this is an experimental technique at the moment. Um, it's got massive promise, um, but what we I think we need to be working out is is those people that do seem to um get some positive effects, why that is, and who they are and and who the people that haven't changed are too. Because, well, what do we do? Is there something that we could perhaps do differently with them to get them to a position where they might receive some benefits? So, at the moment I think it's got massive problems.
Speaker 2:And look, and I've also had a look at some of the really large data sets that are out there now, where you know there are some clinical trials have done, you know, up to 200 people, and actually that does seem to be the pattern within those large data sets as well. But what happens is the data is published as a group, as we all know, and the people that do get better do get profoundly better. So it kind of skews the evidence to say, oh well, this technique is great and look, it has promise and it has a potential to be great, but at the moment it's not great for everybody. So there is a little bit of caution there. And then to come to your question about BDD look, there's just not the evidence yet. And there's myself and I know there's another group in Canada still looking at whether it would be a useful intervention for body dysmorphia. But you know, based on everything that we've seen in depression and based on, you know, our first few cases, look, it's got some promise but we're still working on it okay.
Speaker 1:So it seems to me from what you're saying is, if you can get better understanding who would benefit, then you can screen out the people who perhaps wouldn't benefit and then we can show that it's more, uh, more effective. Um, yeah, now these people aren't just taking like a mushroom or psilocybin and then just being left their own devices. We call it psilocybin assisted therapy. What have you? Is there a study where you've gone with cognitive behavioral therapy or the or whatever, uh, psychological techniques that are best used for depression and then compare that to psilocybin assisted therapy?
Speaker 2:um, so yeah, at the moment I'm not aware of any study that's compared for depression and then compare that to psilocybin-assisted therapy. So yeah, at the moment I'm not aware of any study that's compared psilocybin-assisted psychotherapy with the standard treatment as usual in terms of the psychotherapy, so CBT. But there is one study from Imperial College in London who have compared psilocybin-assisted psychotherapy with a standard pharmacology which is an SSRI, and actually I think that the team were a little surprised by those findings where the SSRIs actually did pretty well and there wasn't the massive effect sizes that we've seen with some of the other studies where, look, psilocybin did a little bit better but it wasn't profound. And I know that those results came out about 18 months ago and I know they've been doing lots of analysis of you know reasons for this and we'll start to see some of those papers, I think, come out over the next few months.
Speaker 2:But, um, so this is what I mean it's, it's not, it's, it isn't, it isn't a silver bullet. I think that there is a lot we need to know and, and of course, that what? What that gives me a lot of caution about is psilocybin. Assisted psychisted psychotherapy is very expensive and the reason why it's expensive is because there's so much psychotherapy. You know that goes beforehand, during the dosing day session and then afterwards, whereas you know some of the very common medications the SSRIs are a lot cheaper, and so you know there has to be an element of caution in terms of the cost benefit of some of these interventions, and I know you know health economists think about this all the time what is actually the best bang for buck and what is actually going to keep people as well as we possibly can do given limited resources?
Speaker 1:Exactly, and talking about best bang for the buck, you mentioned about how there's this rigidity in theocybin-assisted therapy, or even SSRIs. Compare to those almost free therapies.
Speaker 2:Yeah, so, look, I've actually just recently come back from South America and really been thinking about, you know, some of these alternate ways. And yeah, I mean we, we know the meditation and mindfulness actually does have some really amazing benefits across all mental health conditions. Um, we also know, uh, changing our diet has amazing effects across all mental health conditions. We pollute our body with all kinds of rubbish nowadays, um, so I I think the more we understand, um, you know, some of these things, the more we are going to actually not be prescribing these actual major big interventions like psilocybin, assisted psychotherapy. So the ethos where you know in the beginning, when we when we firstotherapy.
Speaker 2:So the ethos where you know in the beginning, when we first started this re-emergence, you know, about 10 years ago, where we were treating people with very treatment-resistant conditions. That's where I see these medicines probably going to be attached to long-term, because there is a lot that we can do to help our bodies. That isn't, you know, this profound, very expensive intervention. So, yeah, working on our breath, working on mindfulness practices, working on changing our diet, working on exercising, even, you know, even if it's just going out for a walk, there is a lot of things that we can do that. Don't involve um a lot of expense. Uh, um takes, gives the person the control back in terms of looking after their mental health, um, and and makes your, I guess, journey very personalized yeah, that makes sense.
Speaker 1:It's in that regards. It's probably like a lot of uh things to do with with the body you got. 80 of the disorders will get better with, you know, some minimal intervention. That's the 20 that we need to focus on, because they're the ones that don't get better no matter. No matter what you do, but that's where you have to get.
Speaker 1:It's the same with my areas as an osteopath. It's lower back pain 80 of lower back pain, pretty straightforward to treat and not even that interesting sometimes. But it's the 20% where it just doesn't change or the person has a whole laundry list of problems. That's where you know, for a clinician like myself, that's where it really gets interesting and you want to push the envelope and try and find out what you can do.
Speaker 2:Absolutely yeah.
Speaker 1:So psilocybin has been described as as a psychedelic therapy can you explain to us what this psychedelic experience is and what's going on in the brain when that happens?
Speaker 2:yeah, absolutely so. Um, uh. We usually encourage uh people to close their eyes because the psychedelic effect is usually more intense. We would mostly play people music to get people out of their mind and out of their thinking patterns and so to distract them from the everyday chatter. As we often think about it.
Speaker 2:So psilocybin has a strong influence on the passage of time. It has the ability to change our perceptions and bring us into our bodies in a way that we just wouldn't normally experience. Some people say it's like time standing still and then, when they're in that, they can often have these really profound visions. Visions of things that are replays of their lives, where they want to perhaps work on a different ending, visions of things which they can't explain and they've never seen before. Often there is an intense feeling of happiness, euphoria, calmness, an ability to perhaps interact with the visions and things that are happening to them in a way where they feel more in control than they felt previously. You know, there's a lot of kind of positivity and discovery I think people talk about when they have these psychedelic experiences.
Speaker 2:Of course, I would be remiss if I didn't point out that there are some also quite unpleasant experiences People can feel quite anxious or worried about what's going on, revisiting things that have happened to them that are not so pleasant, and these are often referred to as a bad trip.
Speaker 2:You know, the more I have had experience working in this field. There are bad trips, you know, and we have to accept them and we have to prepare people for them. We have to really, um, you know, help people through all of that. But, um, these are things that I think people need to work through and that that's the way that they've been, um, you know, um really kind of talked about in the psychotherapy and psychology literature over the last few years. These are things that are coming up for individuals that have perhaps prevented them from moving forward and are part of this stuckness or cognitive inflexibility or rigidity that we're seeing in terms of their mental illness. So this is the challenge that they have. They need to work through these things, and that is anxiety provoking and it can be quite scary, but what we're finding is, with people that do work through these unpleasant events, they are having some quite profound changes to their lives.
Speaker 1:Okay, that's good to hear. So if a person has an unpleasant trip, it's not just the whole thing, it's not just a waste of time, and they have this unpleasant experience and then that's that they can actually get a sort of a silver lining at the end.
Speaker 2:Yeah, yeah, yeah, especially if they can make like, look, and this doesn't always happen.
Speaker 2:But you know we're seeing people that make sense of it and really work with the psychotherapist to interpret why that happened to them or what it, what, what, what was happening to them.
Speaker 2:You know there are some people that never make sense of it but also, um, do say it seems some benefits, and they're also people that don't make any sense of it and actually it just wasn't awesome. So, you know it, we can't, we can't be, um, you know, uh, completely convinced that there is, uh, that there, there is an explanation, um, so you might have a bad trip and you might have a bad trip and that's not great, but, um, we can't and we don't, we still don't know why, and so, like this comes down to again really thinking about who we are going to recommend these interventions for we we have, we have had, we have had one um, you know we've talked about it a lot in the community there was one of our participants in one of our trials had an extraordinarily bad trip, never really made sense of it, never really kind of connected it into their life in any way, and it just sat with her and it was not great what is your scientific brain think of it?
Speaker 1:is it like a chemical reaction or is it an emotional reaction?
Speaker 2:I I I mean in terms of the participant. They had a significant history of depression and it was a very complex journey that they'd gone through. I don't think they were quite ready to unpack what would happen to them over their lives.
Speaker 2:And I also. I think there were potentially some personality issues, but there was also a lot of potential clinical information that we didn't record at the time that we now do to really try and think about this who is best for this intervention? And actually that's what my science brain said. Well, we need to look at this and we need to look at this and we need to look at this. I mean, in terms of the existing models of how people were screened into the therapy, we did exactly what was the universal standard at the time, but I think there were some potential things that we could collect that might give us evidence for why this person might not be suitable to this intervention long term. But yeah, it was a learning exercise.
Speaker 1:Okay, so what's happening with regards to getting this type of therapy rolled out into the mainstream now? What are the barriers and whereabouts is it with the regulation and legality and that kind of stuff?
Speaker 2:so I know australia um hit the uh all the the worldwide media a couple of years ago because, uh, we had a very strange uh announcement from my tga, which was our regulatory body, downscheduling it, allowing authorised prescribers to prescribe psilocybin in a regulated setting, and an authorised prescriber was basically a psychiatrist who had experience working in clinical trials in the field. So I think we've got 10 to 12 authorised prescribers over the last. So what would it be 18 months since that regulation? So it's still not very many. So I have written about this and I do still stand by what I have said.
Speaker 2:I thought I think um, uh, silas albin, assisted psychotherapy has an amazing promise. I think we need to do a great deal more research to really understand what that promise is. I think down regulating it was way um before it should be incredibly premature. I think there's so much more that we need to know. However, we've got that situation now and so you know that is the way that it is in Australia, but it's been a really interesting journey to watch because it's not been. You know the huge number of clinics and the huge number of authorized prescribers. I think a lot of people thought it was going to be and the reason I think I've already alluded to is it's really expensive and people have to do it privately. So we've got this sort of mixed system in Australia, where we've got both public and private health systems and psilocybin assisted psychotherapy isn't on the public health system at the moment, so there's no access to any funding on the public health system in terms of being able to pay for this, so it costs about $25,000.
Speaker 1:Wow, how many sessions would a person have?
Speaker 2:So I mean a very typical, both. Typical in terms of a research, clinical trial, and then how it's been sort of rolled out would be three therapy sessions before a dosing session and then another three therapy sessions. Another dosing session, another three. So it's about nine to 10 therapy sessions and then the two dosing session, another three. So it's about nine to ten uh therapy um sessions and then the two dosing days.
Speaker 2:But remember, um, it's not, it's not just um, a single um authorized prescriber. That um is in the room. There's a dyad partner who is also in, a very experienced therapist. So you're paying two very experienced therapists. Um, uh, there has to be uh screening doctors around, there has to be people that can um monitor ecgs and and so on. So it's not the. It's very labor intensive um, as well as the, the psilocybin at the moment, if you want GMP.
Speaker 2:So this is the stuff that we can actually prescribe is expensive, even though you could probably go down the street and pick a number of mushrooms, especially in Australia. But you think, and it's not going to be, go onto any kind of public kind of medical system. So our PBS system, which is our pharmaceutical benefit scheme, which could pay for this long-term. It's just not going to go there for a very long time because I mean and I've talked to people at the pbs there isn't the evidence out there that it is cost effective. Um, there isn't even really a huge amount of evidence that you know it, that it that it is um, uh, universally um uh effective. As I've talked about all the way through, it seems to be effective for some people and not for others. So, in terms of moving forward, we need very large clinical trials and those clinical trials need to be in Australia because they need to be done with Australian standards. Well, anyway, in Australia they need to be done to Australian standards and they need to have health economic data to show that there is cost utility in doing it.
Speaker 2:So at the moment, I think you know the people the 10 or so authorized prescribers will probably stay pretty static. I don't think it's going to get that much bigger. I think there are a handful of clinics that offer this and there are a handful of people that might take it up. But in terms of more universal rollout, it's not going to happen until those large clinical trials have been done.
Speaker 2:And I think there's also now considerably more caution because the FDA have not enjoyed, uh like, uh enjoyed or uh approved, uh some of the evidence that's been um presented to it from the from the uh the um point of view of mdma for um ptsd. So there is actually a little bit more of abundance of caution, I think, in this field than that than there was 18 months ago when the TGA made their announcement. So it's going to for me it's watch the space. I think that as a researcher, I've got loads to do, as some of my friends and clinicians that might want to work in this field. They know that it's going to be a long journey forward.
Speaker 1:You are in an interesting situation. On the one hand, you saw that case study, your interest was piqued, you've seen some potential behind it. Yet you're very sort of reserved about recommending or saying you know this is going to work because you simply don't have the evidence to back it up. And in a way I really admire that, because most people seem to be in one camp or the other. It's like oh, I tried mushrooms with this and I think they're fantastic, and they don't listen to anything that's negative. And there's other people who won't even try mushrooms because they think that you know, their brain is going to be fried and they'll never be the same again. And you're somewhere in the middle of saying well, you know, there's a little bit of evidence saying they could work. We just need to tease that out and see whether or not it's reproducible on a bigger scale yep, I think you've summarized me very accurately.
Speaker 2:I I would really like to say that, you know, I I that I had very good training to be a good scientist, and a good scientist always asks questions, and a good scientist always may remains open to ideas and and new techniques, um, so, um, that that's what techniques. So that's the scientific process, and I think when you get people in one camp or the other, they aren't necessarily trained as scientists, and so I think that that's really why I am in the camp that I'm in. You know, I'm extraordinarily sympathetic to people with long-term mental health issues that really are very desperate, and that's why I do what I do, because I actually want to find the answers to things, but I'm not going to recommend things where we haven't got the answers.
Speaker 1:Okay, so maybe stepping slightly into the pro-silocybin camp. What's coming down the pipeline that could be interesting for people to know about in the future is anything that exciting coming down the pipeline, big studies or promising sort of pilot studies that have been done I think, uh, I think, um, the breadth, I think, is really intrigued me.
Speaker 2:So you know, when this first started about 10 years ago, you know there was a very definite focus on depression and anxiety, and then this end of life depression and anxiety, and now what we're seeing is people really thinking about how broadly psychedelics could be used and there was a long history of also alcohol use disorder as well. In fact, an alcohol use disorder was one of the primary conditions that we saw benefit for in the 50s and 60s as well, and that was actually the last kind of thing that got shut down, before they shut it down, because there was a fabulous facility that really did help people get better with alcohol use disorder. So, anyway, but you know the really broad spectrum of conditions. So this thing, you know all of the various different anxiety disorders and body image disorders. So I've got I've got body dysmorphia trial, I've got an anorexia trial and there are other people around the world. There's some work on OCD and obviously PTSD.
Speaker 2:I think the other big thing to look out for and I'm involved with some of it and I know a couple of other big groups are involved in some of it is really thinking about the delivery of the psychedelics.
Speaker 2:So at the moment, what we've seen worldwide is, you know that we have these dosing days that can last between eight and ten hours.
Speaker 2:That's obviously, you know, hard work for the participant but also very expensive in terms of making sure that you have the medical staff and the diet there to monitor that person for the participant, but also very expensive, um in terms of making sure that you have the medical staff and that and the diet there to to to to monitor that person for the day.
Speaker 2:So, um, we're currently working uh with a company that has perfected iv delivery um, so it will basically the uh, the effect, the psychedelic effect, is turned on within minutes rather than having to wait 90 minutes, and you can switch it off if they're having a bad time and you can just allow them to have that intense psychedelic experience over two hours because you can stop the IV and flush the system out, and so there's a potential there to really improve the amount of time, and the expense as well as the quality of the psychedelic experience make it very intense for the period of time that we need person to work through something. So I would definitely say watch the space for that um I I know a lot of people around the world are getting very excited about that to to to try and make this um a little bit more cost effective and that's interesting as well because it cuts out the person's digestive system, which may play a role in sort of altering the way they experience the trip or even digest the psilocybin.
Speaker 1:I would have thought you know, everyone's gut bacteria is different. Everyone's stomach acid is different.
Speaker 2:So maybe more accurate.
Speaker 1:What sort of dosages were or are you giving to people in the trials?
Speaker 2:Is it sort of a micro dose or a gram dose, or no, so, um, yeah, and so that would be the third thing that I mean. There's still quite an interest in micro dosing, but so, but the for a full psychedelic experience, we give people 25 milligrams. Um, there's the, there's this. There's actually um been a little bit of work looking at the dosage, you know so. So seeing if it uh, whether people's body weight makes any difference, but that that hasn't really been the evidence for that and most uh studies stick with 25 milligrams interesting.
Speaker 1:While I have you here, I want to ask you about some other psychedelics. So ayahuasca is one that's seemed to be quite popular as well. Have you looked into that and how that is being researched with things like depression and addictive disorders as well?
Speaker 2:Yes, we are about to kick off a synthetic ayahuasca study next year. So this is where we've compounded the DMT component of the ayahuasca and that is for depression and alcohol use disorder. So I think you know these plant-based medicines that people have used traditionally, we really need to, like, embrace them, to explore them, like, embrace them, uh, to, to explore them. I think, uh, the, the, the, the ayahuasca and the dmt is quite different and I'm I'm sort of still scratching my head a little bit as to uh, uh, protocols and and making sure that we, um, uh are as safe as we possibly can be, um, because, uh, for, for listeners that aren't aware, uh, ayahuasca and the, the deity, can make you incredibly nauseous, um, which, um, and and and like digestive issues, where psilocybin hasn't really been shown to do that, um, that we, we get people vaguely feeling nauseous, you know, as they start to go in, but it's more like it's more because they're floating and they feel a little bit lightheaded, rather than an actual physiological kind of nausea, whereas the ayahuasca compounds do actually make people very nauseous. So there's a whole lot of safety kind of issues with that regard, lot of safety kind of um issues, um, with that regard. But you know, um, uh, in in traditional, um indigenous cultures they they do use ayahuasca all the time to help people with addictive um conditions, so that there is kind of like this naturalistic evidence that that we should be thinking about these compounds.
Speaker 2:I guess one of the things that I have heard a lot of debate about over the years and I kind of don't quite know where I stand on this, I sort of oscillate a little bit is you know that in the Western world we synthesise everything and make it, you know, to universal, what we call GMP standards. So it's these clean compounds and we know exactly how much dosage we're giving people, whereas out there, in naturalistic settings, they're plant-based medicines and there's a guesstimate how much of the vine to pick down and how many leaves and all of the these things, and so the exact dosage is is it's not really precise, um, and there's some purists that say, well, by synthesizing some of these compounds, you're also getting rid of some of the other elements that are therapeutic and it's the total plant medicine that is having the effect. So I see it both ways, you know. I agree, you know plants are plants and all the constitutes of plants, you know, are obviously why the people harness the power of those.
Speaker 2:Uh, initially, and by synthesizing it we are getting rid of some of the some of the elements of it. But I, I guess, as a western scientist, I wouldn't be able to do it any other way than using the synthetic compound. So it's kind of like yeah, yeah, I agree, and I, I'm also caught.
Speaker 1:we're doing it the western way yeah, that's true, but that is the western way and it's also a cycle. I think we go through this. It's like when we synthesize vitamins and minerals out of the plants and then we now can take. We can take a supplement, which is great. But you know, nutrition is saying, well, actually, if you eat the whole plant, it's better, and so it's like we come sort of full circle. You know so nutrition is saying, well, actually, if you eat the whole plant, it's better, and so it's like we come sort of full circle.
Speaker 2:You know so, maybe in the future you'll be with a tambourine and some drums and everyone will be lying in a circle.
Speaker 1:Well, there's a lot to be said, for some people is just as therapeutic as as some of these uh medicines that we've been talking about well, you mentioned at the beginning, when you, when you go through the protocol, there's music at the beginning and a sort of a calming state, and I was thinking about the ceremonies from some of the indigenous people. There's usually some sort of drum beat that helps move a person to a different way brain state, I think yeah, it's to get you out of your, your chatter brain yeah yeah, yeah.
Speaker 2:So you know that when you close your eyes, you you've still got this in a, in a, in a speech kind of thing.
Speaker 1:We need to get you away from that um, and and and go deeper, uh, into into your own consciousness, and and music is very good at moving people through that okay, doctors, I know it's super early for you and I really appreciate you coming on the show and giving us your time this morning, so I'm gonna, I'm gonna let you go and get on with your day. Thank you so much for giving us your time no, no problem at all, it's been been delightful.
Speaker 2:Thank you for uh, your wonderful been delightful. Thank you for your wonderful questions this morning.
Speaker 1:Thank you for joining me in my conversation with Dr Susan Russell. Now, if you've enjoyed listening to and learning from this podcast, please leave a comment, and you can also leave a suggestion for a future podcast guest that you would like us to feature. If you're an Apple, you can leave us a comment and up to a five-star review if you're so inclined. Remember, if you want my direct help, or send me an email, ed at edpadgettcom, or visit my website, edpadgettcom, where you can learn a little bit more about how I can help you make your lifestyle your medicine.