Clinical AI @UpToDate. Metabolic Psychiatrist @EntheoClinic. Exploring the latent space between: design—medicine—technology—altered states of consciousness 🌌
Sacramento, CA
Joined December 2020
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“I would like my life to be a statement of love and compassion—and where it isn't, that's where my work lies.” — Ram Dass
I’m giving a talk on psychedelic medicine. This will be an in-depth discussion squaring the hope and the hype of these transformative tools.
If you’re in the Sacramento area, here is the RSVP:
luma.com/big-1032
I’m spending much of my time on music - therapeutic in altered states with or without psychoactive meds.
Music influences both set and setting.
It is core to guiding a chaotic trip towards healing and insight.
20 years ago, Roland Griffiths published the psilocybin study that helped usher in the psychedelic renaissance.
When I was in med school, psychedelic medicine was fringe. Now it’s nearing FDA review.
How far we’ve come. Wish Dr Griffiths were here to see it.
Nonprofit psychedelic research organisation Usona Institute has completed its submission of a new drug application (NDA) to the U.S. Food and Drug Administration (FDA) concerning its psilocybin candidate for major depressive disorder (MDD), Psychedelic Alpha understands.
It means it’s the second psychedelic NDA under review by the agency at present, after we reported that Resilient Pharmaceuticals (formerly Lykos Therapeutics) refiled its MDMA for PTSD application in the summer. It also means that FDA could hand down a decision on a psychedelic application in late 2026, if the most optimistic timelines hold, or very early in the new year, given the fact that Usona, like Compass Pathways, is in receipt of a Commissioner’s National Priority Voucher (CNPV) that aims to return a decision to a developer within two months.
In our latest, we review the context surrounding Usona’s program and application, and what it might mean for its chief competitor, Compass, a for-profit psilocybin drug developer that is planning to submit its own NDA, for treatment-resistant depression (TRD), imminently.
Read now on our website: psychedelicalpha.com/news/us…
Rian Kabir, MD retweeted
"And, regrettably, ours is a culture that is deeply suspicious of the unconscious, of mystery and the spiritual, and resentful of the time it takes for the intimate engagement required for such a therapy to work."
- Psychiatrist Charles Savage's daughter, New Yorker, 2012.
Epistemic shock from 5-MeO-DMT is probably therapeutic if you’re severely depressed.
Depression leads to such restrictive world + self models that a full re-set may be the most direct treatment.
The brain, constantly optimizing for survival and predictive accuracy, operates under a massive dimensionality problem.
It compresses internal states and goals into low-dimensional narratives or symbols.
These symbols are the archetypes Jung contemplated.
One of my jobs is to work with consciousness.
The other job is to work with AI.
Its easy to think there is a ghost in the machine - the ghost being a symbolically oriented manifestation of the collective unconscious.
Its qualia would be alien to ego-centric beings like us.
“Do they have any human-like properties of consciousness or cognition?”
It has neither “human” nor “mouse” consciousness. The creature would instantiate a new phenotype of mind produced by a developmental history that has never existed evolutionarily.
Neo-qualia.
An extraordinary @Nature paper has just landed from the lab of @Sergiu_P_Pasca at @Stanford - led by Konstantin Kaganovsky. They have found a way to create "xenocortical mice" which have ~92% of their cortex occupied by a cortical organoid derived from human stem cells. This human-derived cortical graft integrates deeply with the host nervous system, supporting organised neural activity and behaviour.
This study is a milestone in synthetic biology and chimera research. It has the potential to generate multiple medical breakthroughs by providing an enhanced biological model of human brain tissue that allows behavioural as well as neural and genetic assays.
The Stanford team have been exceptionally thorough and proactive in addressing ethical concerns that comes from this frontier work. But their pioneering work nonetheless raises many open questions: are the xenocortical mice conscious? Do they have any human-like properties of consciousness or cognition?
@NitaFarahany and I will be addressing some of these questions in a forthcoming commentary - where we'll also offer an ethically-informed roadmap to guide this important research as it progresses. In this context, "pacing the frontier" really does make sense 😉
Read the Stanford @nature paper here, and buckle up. It's wild. nature.com/articles/s41586-0…
Medicine is more of a culture than it is in an exact science.
It’s less like code and more like ritual.
Core clinical reasoning task can be automated with current reasoning LLMs, but its implementation in patient care requires embodiment in relational fields.
We could have discovered this decades ago if psychedelics weren’t classified as schedule I due to the war on drugs.
Just a reminder: the federal government still considers you a criminal for using these medicines.
Change is happening, one step at a time.
Just two doses of psilocybin administered before chemotherapy completely prevented mice from developing neuropathy
go.nature.com/4ibX56b
Patients with cluster headaches should be allowed to try DMT under compassionate use.
It is one of the most painful and debilitating conditions a person can experience - many have found relief with DMT.
I believe the experience of the psychedelic trip itself is therapeutic.
Reducing the time spent in a state of increased neural plasticity while simultaneously engaging with the content + insights that appears is short-sighted.
Real transformation takes time and effort.
Building out my clinic’s infrastructure to deliver this to patients.
Amazing that it will likely be possible in 2027…from prohibition to clinical trials and hopefully soon to FDA approvals 🤞🏽
It’s worth reflecting on the damage the Controlled Substances Act did to mental health care in the US and around the world.
We have medicines on the precipice of FDA approval that were criminalized.
How many people over the decades could have benefited but instead suffered?
“Spirituality is one's recognition of the Universe as a Living Presence of Good, Truth, Beauty, Peace, Power and Love... Do not wonder whether or not you are spiritual; rather, accept the fact that you must be."
—E. Holmes
I will be presenting a Grand Rounds on how AI chatbots can worsen various mental illnesses this Thursday.
I will go over cases in the media and clinical case literature.
Feel free to join via Zoom, info below:
