Ketamine beats ECT for suicidal depression, while psychedelics rewire brain myelin in rats

Key Findings

🐭 MDMA and psilocybin physically rewire brain insulation in rats

• Both drugs reduced anxiety-like behaviors in 210 fear-conditioned rats while triggering changes in oligodendrocytes—the brain cells that create myelin insulation around neurons

• When researchers disrupted the rats' myelin, the anxiety-reducing effects completely disappeared, suggesting myelin remodeling is essential for the drugs' benefits

• Psilocybin boosted early myelin development genes, while MDMA enhanced markers of mature myelin—and blocking serotonin receptors eliminated all the myelin and behavioral improvements

🧪 Swiss clinic reports real-world success with LSD and psilocybin therapy

• 115 patients with treatment-resistant depression and anxiety received either 100 µg LSD or 25 mg psilocybin in routine clinical care, with depression scores improving significantly over 1-3 months post-treatment

• Both substances produced comparable clinical outcomes and subjective effects, though LSD and psilocybin showed distinct intensity patterns during treatment sessions

• Adverse events were mostly mild and temporary, with no serious complications or patients dropping out of treatment

📊 Ketamine use rising while LSD declines in US surveys

• National data from 2021-2023 shows ketamine use increased from 1.61% to 1.91% of the population, while LSD dropped from 0.88% to 0.58%—even as overall hallucinogen use stayed flat around 2.8%

• MDMA and tryptamines like DMT remained stable, while PCP and Salvia stayed rare across all years

• Use concentrated among young adults, males, uninsured people, and those below the poverty line

💊 Childhood trauma predicts better ketamine response

• 224 patients receiving five ketamine infusions showed greater depression improvement if they had higher childhood trauma scores, independent of whether they received therapy alongside treatment

• Younger adults responded better to ketamine alone, while older adults benefited more when therapy was included—suggesting age affects optimal treatment approach

• The trauma-response relationship was strongest in younger patients and actually reversed in older adults

🫀 LSD and MDMA may pose heart valve risks with chronic use

• Both drugs show high affinity for serotonin 2B receptors—the same pathway that causes heart valve disease from diet drugs and other medications

• Lab studies confirm both substances trigger cellular changes in valve tissue that could lead to scarring and dysfunction over time

• While no clinical cases of LSD valve damage exist yet, chronic MDMA use has been linked to valve problems in humans

🔬 New brain imaging reveals how 2C-B compares to psilocybin

• 22 volunteers underwent 7T brain scans after receiving 20 mg 2C-B, 15 mg psilocybin, or placebo—both psychedelics reduced within-network connectivity while increasing between-network communication

• 2C-B produced less reduction in dynamic brain connectivity compared to psilocybin but showed unique increases in high-level brain network connections

• The spatial patterns of brain changes matched each drug's different receptor binding profiles beyond just serotonin, suggesting pharmacology shapes neural effects