PSILOCD

  • Research type

    Research Study

  • Full title

    Evaluating the effects of the 5-HT2A agonist psilocybin on the neurocognitive and clinical correlates of compulsivity: a pharmacological-challenge feasibility study

  • IRAS ID

    298206

  • Contact name

    David Nutt

  • Contact email

    d.nutt@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    5 years, 0 months, 1 days

  • Research summary

    Case studies and small clinical trials in the literature have shed light on the possibility of a novel tool to investigate OCD. The potential for an enduring effect of psilocybin, independent of its hallucinogenic effect, is particularly interesting and may reflect its central actions as a 5-HT2A agonist. We intend to test the hypotheses that psilocybin exerts an enduring effect on OCD symptoms by activating the 5-HT2A receptor mechanisms in the relevant corticostriatal brain circuitry to restore OCD-related deficits in behavioural inhibition (attentional set shift, reversal learning), the balance between goal directed behaviour and habit, and by inducing plasticity (assessed using EEG paradigms and plasma BDNF measures). To this end, we plan to do a single-blind pharmacological-challenge study on 20 patients with OCD (scoring at least 16 on the Yale-Brown Obsessive Compulsive Scale, Y-BOCS), where every patient receives 2 doses of psilocybin, maximum dose of 10mg (considered small-moderate). The study will involve 3 visits to the CNWL-Imperial Psychopharmacology and Psychedelic Research (CIPPRes) Clinic at St. Charles Hospital (Central and North West London NHS Trust, CNWL), including screening, as well as 12 remote calls involving preparation, psychological debriefing (psychedelic "integration") and data collection in the form of psychiatric interviews, questionnaires and cognitive tasks. This study has three primary outcomes, comparing scores at 1 week pre-psilocybin, 4 weeks after the first psilocybin dose and 4 weeks after the second: changes in the ID-ED set shifting task, changes in Y-BOCS scores and changes in the visual long-term potentiation (vLTP) EEG task.

  • REC name

    London - Surrey Research Ethics Committee

  • REC reference

    21/LO/0804

  • Date of REC Opinion

    14 Dec 2021

  • REC opinion

    Further Information Favourable Opinion