Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD
Psychedelic Medicine Podcast with Dr. Lynn Marie Morski
Release Date: 08/07/2024
Psychedelic Medicine Podcast with Dr. Lynn Marie Morski
In this episode, Christina P. Kantzavelos, LCSW, MSW, MLIS joins to discuss the use of psychedelics to address chronic illness. Christina is an international psychotherapist, coach, writer and artist, who specializes in treating clients with chronic illness, and complex trauma utilizing various modalities, including psychedelic assisted therapy. In this conversation, Christina overviews the complex mental and physical health impacts of chronic pain conditions and shares her expertise on psychedelic and non-psychedelic treatments for these conditions. Christina mentions that chronic pain can...
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In this episode, Jerónimo Mazarrasa joins to discuss how to interpret visions and insights disclosed during ayahuasca journeys more effectively. Jerónimo is Program Director at ICEERS, founder of ICEERS Academy, and creator of AyaSafety, an online course for people interested in increasing the safety of ayahuasca ceremonies. To start, Jerónimo emphasizes that answering the question of whether ayahuasca visions originate in the plant medicine itself or if these are just disclosures of one’s own subconscious is actually not what's most important. Instead, he suggests that in either case,...
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In this episode, Hugh McGovern, PhD joins to discuss his research on the impact of psychedelics on beliefs. Dr. McGovern is a Research Fellow at the School of Medicine, Deakin University, Melbourne, Australia. To start, Dr. McGovern introduces the inference or predictive processing framework utilized in his paper . He explains the role of prediction in cognition, showing how insights occur when our existing perspectives are unable to make sense of our experience. In this vein, Dr. McGovern discusses how the psychedelic experience disrupts our normal modes of prediction and perception,...
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In this episode, Heather A. Lee, LCSW joins to discuss the topic of psychedelic healing for grief and loss. Heather is a licensed psychotherapist, educator, speaker, and consultant. With over 30 years of practice in mental health, her focus is on supporting midlife and beyond women as they navigate life transitions. In this conversation, Heather explores the ways psychedelic healing may have transformative contributions to peoples’ journeys navigating grief and loss. She explains that we live in a culture that doesn’t have a good understanding of grief, how to navigate it, or how to...
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In this episode, Thomas Kim, MD joins to discuss ketamine-assisted psychotherapy for anxiety. Dr. Kim is the Chief Medical Officer of Noma Therapy, which is a ketamine-assisted psychotherapy program available via telehealth and in-person with licensed therapists. He has devoted 20 years of his professional life to realizing a value-based approach to healthcare through telehealth. In this conversation, Dr. Kim shares his journey of working in early telehealth contexts to now working with ketamine. He discusses the research on ketamine treatments for anxiety and explains the significant...
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In this episode, Joseph Holcomb Adams joins to discuss the important topic of guruism and cult dynamics in psychedelic communities. Joseph is an ethicist who specializes in issues related to psychedelics, altered states, and transformative experiences. In this conversation, Joseph introduces the concepts of a guru, guruism, and cult dynamics. He describes the social-psychological mechanisms behind the devotee-guru relationship and the development of ideological conformity in cults, explaining how the heightened states induced by psychedelics can contribute to these dynamics if participants and...
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In this episode of the Psychedelic Medicine Podcast, Adam Aronovich, PhD(c) returns to discuss issues of psychedelic self-absorption—and how to avoid these traps. According to Adam, he is a PhD candidate in medical anthropology, the creator and curator of Healing from Healing, a trophy husband and dad. In this conversation, Adam revisits his previous discussion of psychedelic narcissism and explains why he’s now somewhat more critical of the term. However, Adam still sees issues around cultivating epistemic humility and acknowledging the political dimensions of healing in psychedelic...
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In this episode, Sorcha O'Connor, PhD(c) joins to discuss the research into the use of psilocybin to address obsessive-compulsive disorder (OCD). Sorcha is completing her neuroscience PhD at Imperial College London, specialising in mental health research. She led PsilOCD, a pioneering study investigating low-dose psilocybin as a treatment for both the clinical symptoms and cognitive features of OCD. In this conversation, Sorcha introduces obsessive-compulsive disorder and discusses the ways medical professionals are currently thinking about this and other related conditions. She mentions that...
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In this episode, Erica Zelfand, ND joins to discuss the important topic of pill shaming in psychedelic communities and how psychedelic medicine and traditional pharmaceuticals can both support healing. Dr. Erica Zelfand specializes in integrative mental health, bridging the gaps between conventional and alternative medicine. In addition to seeing patients in private practice, she also teaches facilitation internationally and leads retreats through Right to Heal. In this conversation, Dr. Zelfand tackles the issue of pill shaming in psychedelic communities, showing why this rhetoric falls short...
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In this episode of the Psychedelic Medicine Podcast, Keith Kurlander, MA, LPC, joins to discuss the important topic of integration practices for challenging psychedelic experiences. Keith is the Co-Founder of the Integrative Psychiatry Institute, the largest professional education company specializing in integrative mental health and psychedelic therapy. In this conversation, Keith begins by exploring the different types of challenging psychedelic experiences and various lingering effects one may experience following a difficult psychedelic journey. He discusses these from a trauma-informed...
info_outlineIn this episode of the Psychedelic Medicine Podcast, Dr. David Rabin, MD, PhD joins to discuss whether genes can be predictive of one’s response to MDMA Therapy. Dr. Rabin, a board-certified psychiatrist and neuroscientist, is the co-founder & chief medical officer at Apollo Neuroscience. In addition to his clinical psychiatry practice, Dr. Rabin is also the co-founder & executive director of The Board of Medicine, and a psychedelic clinical researcher currently evaluating the mechanism of psychedelic-assisted psychotherapy in treatment-resistant mental illnesses.
In this conversation, Dr. Rabin shares his research into epigenetic responses to MDMA-therapy, exploring topics of trauma, gene expression, and personalized, data-driven medicine. He discusses the seminal discovery that trauma can cause epigenetic changes in the structure and function of the cortical system and his own research findings that uncovered a reversal of these changes associated with MDMA-assisted therapy. Dr. Rabin hopes further research in this area may allow for leveraging epigenetic data to determine which psychedelic medicine a particular patient may be most likely to respond to and track how effective a given treatment has been. In closing, he expresses excitement about bringing objective biological precision to mental health treatment, drawing a parallel to the discovery of antibiotics which allowed for much more tailored treatments of infections which has saved countless lives.
In this episode you'll hear:
- Response rates to psychedelic-assisted therapy for PTSD versus conventional therapies
- The consequences of ineffective treatment for PTSD
- MDMA-assisted therapy as preventative care and the societal cost savings involved
- Genetics, epigenetics, and gene expression
- Using epigenetic data from simple saliva swabs to better gauge response to MDMA-assisted therapy for PTSD
Quotes:
“Most of the treatments we have available today for PTSD—that are the FDA-cleared, considered gold standard treatments—only actually induce remission from illness… in about 30% of people. So of the 100% of the millions of people every year that are getting treated for PTSD, with the best treatments that we have that are currently available, only 30%—at best—are getting better long term. Everyone else has a diagnosis of PTSD for life.” [3:55]
“MDMA-assisted therapy for people with PTSD is having an effect that’s similar to what we saw with the discovery of antibiotics for infection.” [8:07]
“Folks with severe PTSD who went through this trial, when they received MDMA-assisted therapy, [the researchers] saw a statistically significant change—in terms of repair—of the cortisol receptor’s epigenetic code which reflects improved structure and function of that receptor site. But not only that—we saw that the amount that people got better… was directly correlated with… the amount of remodeling and repair at the receptor site.” [18:36]
“Epigenetic code is actually something that can be modified by experiences in our environment. And trauma—or PTSD diagnoses, a series of significant traumas over time—can in fact change epigenetic code of the cortisol receptor gene. And that changes how the cortisol receptor gene gets made, and it changes its function.” [29:52]
“PTSD is a disorder of learned fear. How do we treat PTSD? In animals and humans, we provide the same stimulation that they were getting that they are now afraid of in the context of safety. That’s how exposure therapy works, that’s how MDMA therapy works to some extent—all of these tools and techniques work to treat PTSD effectively… in the same way. It’s called safety conditioning.” [36:48]
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