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How Psilocybin Can Rewire Our Brain, Its Therapeutic Benefits & Its Risks

In this episode, I discuss what psilocybin is (chemically) and how it works at the cellular and neural circuit level to trigger neuroplasticity, which is our brain’s ability to rewire itself in ways that lead to long-lasting shifts in our emotional, cognitive and behavioral patterns and abilities. I discuss the emerging clinical trial evidence for the use of psilocybin in the treatment of depression, addictions and other psychiatric challenges. I explain the typical duration and phases of a psilocybin journey, the different categories of dosages often used and I explain the importance of set, setting and support when using psychedelics. I explain which groups of people place themselves at great risk by taking psilocybin as well as groups that could benefit, and I highlight the rapidly changing legal and medical landscape around psilocybin. This episode is a thorough exploration of psilocybin from the scientific and clinical literature perspective and ought to be of interest to anyone curious about psilocybin, mental health, neuroplasticity and/or psychedelics more generally. #HubermanLab #Science Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Eight Sleep: https://eightsleep.com/huberman ROKA: https://roka.com/huberman HVMN: https://hvmn.com code: “Huberman” LMNT: https://drinklmnt.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman Social & Website Instagram: https://www.instagram.com/hubermanlab Twitter: https://twitter.com/hubermanlab Facebook: https://www.facebook.com/hubermanlab LinkedIn: https://www.linkedin.com/in/andrew-huberman Website: https://hubermanlab.com Newsletter: https://hubermanlab.com/neural-network Articles The neural basis of psychedelic action: https://go.nature.com/3VInMlE The effects of psilocybin and MDMA on between-network resting state functional connectivity in healthy volunteers: https://bit.ly/3VW8iL7 Increased low-frequency brain responses to music after psilocybin therapy for depression: https://bit.ly/3LKj6XK Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression: https://bit.ly/42c7y6x Brief structured respiration practices enhance mood and reduce physiological arousal: https://bit.ly/3wEvGRf Therapeutic use of psilocybin: Practical considerations for dosing and administration: https://bit.ly/3HPHLZM Psilocybin induces rapid and persistent growth of dendritic spines in frontal cortex in vivo: https://bit.ly/3HQ8J3z Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics: https://bit.ly/44Gpwjx Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression: https://bit.ly/3pjvu9N Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: https://bit.ly/3sFSGMM The costs and benefits of psychedelics on cognition and mood: https://bit.ly/3NNyEwI Other Resources The Physiological Sigh: https://youtu.be/rBdhqBGqiMc Dr. Matthew Johnson: Psychedelic Medicine: https://hubermanlab.com/dr-matthew-johnson-psychedelic-medicine Timestamps 00:00:00 Psilocybin, Legal Considerations 00:08:32 Sponsors: Eight Sleep, ROKA, HVMN 00:12:00 Psilocybin Becomes Psilocin in the Gut, Serotonin 00:17:00 The Serotonin 2A Receptor, Therapeutic Outcomes SSRIs vs. Psilocybin 00:21:40 Serotonin Receptor Expression; Visual Hallucinations & Eyes Closed 00:27:21 Safety & Cautions for Specific Patient Populations 00:29:13 Sponsor: AG1 (Athletic Greens) 00:30:28 Psilocybin, “Magic Mushrooms” Dosing, Micro-Dosing, “Heroic Doses” 00:36:21 Psychedelic Journey: Set, Setting & Support 00:43:43 Music & the Psilocybin Journey; Duration of Effects 00:48:58 Psilocybin & the Brain: Subjective Experiences, Perception 00:58:36 Sponsor: LMNT 00:59:48 Brain Networks & Therapeutic Outcomes 01:05:23 Creativity; Music, Emotionality & Psychedelic Journeys 01:12:39 Depression & Psychedelics as Neuroplasticity “Wedge” 01:16:53 Positive Psychedelic Journeys, Unity, “Oceanic Boundlessness” 01:25:23 “Bad Trips”, Anxiety & Physiological Sighs 01:32:57 Therapeutic Use of Psilocybin 01:36:11 Neuroplasticity, Structural Brain Changes & Psilocybin 01:48:08 Psychedelics: Therapeutic Breakthroughs & Depression 01:56:37 Combining Psilocybin Therapy & Talk Therapy, Antidepressant Effects 02:03:11 Psilocybin Experience & Mental Health 02:06:42 Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Neural Network Newsletter, Social Media Title Card Photo Credit: Mike Blabac - https://www.blabacphoto.com Disclaimer: https://hubermanlab.com/disclaimer

Andrew Hubermanhost
May 7, 20232h 9mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

Psilocybin’s Power: Targeted Neuroplasticity, Profound Journeys, And Real Risks

  1. Andrew Huberman explains how psilocybin, a serotonin‑like tryptamine, selectively activates the 5‑HT2A receptor to expand brain connectivity and drive neuroplasticity. He details how this underlies acute psychedelic effects—hallucinations, ego dissolution, synesthesia—and the longer‑term rewiring that can improve mood, addiction, and compulsive disorders. The episode emphasizes that outcomes depend heavily on dose, set and setting, music, eyes‑closed protocols, and skilled guides, and that psilocybin remains illegal (Schedule I) with serious contraindications for youth and anyone prone to psychosis. Huberman reviews human and animal data showing structural and functional brain changes, highlights clinical trials where one or two high‑dose sessions outperform SSRIs for treatment‑resistant depression, and stresses that plasticity is only beneficial if it leads to adaptive, not maladaptive, behavioral change.

IDEAS WORTH REMEMBERING

5 ideas

Psilocybin works mainly by strongly activating the serotonin 2A (5‑HT2A) receptor, not by globally boosting serotonin.

Although psilocybin/psilocin are structurally similar to serotonin, psilocybin is unusually selective for the 5‑HT2A receptor, which is densely expressed in neocortical regions like prefrontal and visual cortex. This receptor selectivity explains why psilocybin produces focused effects—hallucinations, altered cognition, and powerful plasticity—versus the broad, often side‑effect‑heavy modulation produced by SSRIs that generally increase serotonin at many receptor subtypes.

Adaptive outcomes depend on set, setting, and eyes‑closed, music‑guided sessions—not just taking the drug.

Clinical trials consistently use controlled indoor settings with one or two sober, trained guides, safety measures (no access to streets, windows, water), and an eye mask for most of the journey. Carefully curated music ramps from low‑intensity to percussive, emotionally intense tracks at the peak, then softer, nature‑like sounds as the journey tapers. This structure shifts attention away from external visual distortions toward internal emotions, memories, and insights, biasing plasticity toward therapeutic, not chaotic, rewiring.

Clinically effective doses are relatively high and sharply distinct from typical “microdoses.”

Microdosing in research is typically 1–3 mg psilocybin per day, whereas therapeutic macrodoses for depression are 25–30 mg per session, usually administered once or twice. Roughly, 1 g of dried mushrooms (~1% psilocybin) ≈ 10 mg psilocybin, but real mushroom content varies from 0.5–2%, so a 'gram' could mean 5–20 mg. Clinical trials show 25 mg produces robust antidepressant effects; 10 mg often performs no better than very low‑dose control, underlining that sub‑perceptual doses are not what’s driving the strong outcomes in current depression trials.

Psilocybin expands functional brain connectivity and induces concrete structural changes like new dendritic spines.

Imaging in humans shows reduced modularity and hierarchy—more cross‑talk between sensory, emotional, and higher‑order networks during and after sessions. Animal studies (e.g., Neuron paper on frontal cortex) reveal rapid, persistent growth of dendritic branches and mushroom‑shaped spines on pyramidal neurons after psilocybin, providing new synaptic sites. These changes likely underpin longer‑term shifts in mood, perception, and behavior, though doses in rodent work are often higher (per kg) than in human clinical practice.

The quality of the acute experience—especially ‘oceanic boundlessness’—predicts antidepressant response better than hallucinations per se.

In treatment‑resistant depression trials, higher ratings of unity, spirituality, bliss, and insight (often called 'oceanic boundlessness') correlate strongly with positive long‑term mood outcomes. Merely seeing complex imagery or having synesthesia does not predict benefit. Interestingly, while some anxiety and ego dissolution at the peak seem important to 'letting go,' very high subjective anxiety is negatively associated with therapeutic response, reinforcing the need for dosing, support, and in‑session tools (like controlled breathing) to keep arousal within a tolerable range.

WORDS WORTH SAVING

5 quotes

Just because something invokes neuroplasticity, changes in brain circuitry, does not mean that it's therapeutic.

Andrew Huberman

Psilocybin mainly binds to and activates the so-called serotonin 2A receptor... that's really the one responsible for triggering all the changes in neural circuitry.

Andrew Huberman

It is very clear that having an eye mask... for the majority, if not the entire psilocybin session is going to be very useful.

Andrew Huberman

You should think of psilocybin and other psychedelics as initiating the neuroplasticity process, but they are not the neuroplasticity process itself.

Andrew Huberman

The effect sizes reported in this study were approximately 2.5 times greater than psychotherapy, and more than four times greater than psychopharmacologic depression treatment studies.

Andrew Huberman (summarizing clinical trial findings)

Psilocybin chemistry, pharmacology, and its relationship to serotonin and psilocin5‑HT2A receptors, pyramidal neurons, and expanded brain network connectivitySet and setting: safety, guides, eyes‑closed protocols, and music designDosing frameworks: microdosing vs. clinical macrodosing and mushroom–milligram conversionsSubjective features of the journey: ego dissolution, oceanic boundlessness, synesthesiaNeuroplasticity mechanisms: dendritic spine growth, network reconfiguration, and moodClinical evidence and safety: depression, addiction, contraindications, and adverse events

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