An article published in Frontiers in Psychiatry, authored by researchers from the New York State Psychiatric Institute and Columbia University, argues that psychedelic-assisted therapy should combine two dimensions: neuroplasticity and subjective experience.

The idea is that this alignment can generate better clinical outcomes and guide more personalized protocols in mental health.

According to the authors, compounds like psilocybin, LSD, DMT, and mescaline have rapid effects on functional connectivity and synaptic plasticity. However, therapeutic efficacy would not be explained solely by the serotonergic action of these substances. The phenomenology of the so-called “trips” would be crucial to understand why some patients consistently respond while others do not.

Paths to more precise protocols

The article proposes that psychedelics be seen as part of a class of drugs capable of promoting structural and functional changes in the brain in short periods of time, which opens up thinking about more individualized psychiatric interventions.

In practice, the study authors suggest protocols that integrate not only biological profiles but also psychological and contextual factors, such as trauma history, attachment style, culture, and support network.

Nevertheless, the study highlights limitations to be addressed, such as the lack of robust evidence on the duration of brain changes and the need for more rigorous clinical trials. The regulatory and ethical debate also remains open, between promising advances in the treatment of depression and other disorders and the urgency to establish methodological standards and policies that prioritize harm reduction.

For the researchers, precision psychiatry with psychedelics can only fulfill its potential if it can combine solid scientific evidence, appropriate clinical training, and public policies that overcome prohibitionism. After all, if neuroplasticity opens the door, it is the lived experience that defines how far the patient can go.
 

With information from Cañamo.