Dr. Rick Strassman | DMT Stroke Program Consultant, Algernon Pharmaceuticals

May 21, 2021
Spotlight

Rick Strassman is an American clinical associate professor of psychiatry at the University of New Mexico School of Medicine. He has held a fellowship in clinical psychopharmacology research at the University of California San Diego and was Professor of Psychiatry for eleven years at the University of New Mexico. In the early 90's, Dr. Strassman was the first person in the United States to conduct clinical human research with DMT in more than 20 years. Dr. Strassman is also the author of DMT: The Spirit Molecule, which summarizes his academic research on DMT and includes his own reflections and conclusions based on this research. He is now using his expertise in the field of psychedelics, especially DMT, to provide consultation to Algernon Pharmaceuticals as part of their DMT Stroke Program.

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As one of the most well-known researchers and authors on DMT, how did you first become interested in psychedelics and what drove you to pursue research into DMT?

My interest in psychedelics began in college. I was struck by the similarity between descriptions of psychedelic drug experiences and those resulting from certain Eastern meditation practices. I thought there might be some biological common denominator to the extent that the syndromes overlapped: visions, voices, out of body experiences, extreme emotions, and the like.

I began looking at melatonin and the pineal gland since the pineal had a long history of attention as a potential site of elevated spiritual states, and melatonin function in humans was not well understood at the time, in the mid-1980s. There were also some preliminary data indicating psychedelic effects of melatonin. We studied melatonin carefully in humans and found only sedating effects. By then I had learned about DMT, which is also endogenous and was well-known for its psychedelic effects from previous human studies.

My primary goal was to open the door to clinical research with psychedelics in the US, and that involved a rigorous and levelheaded psychopharmacological approach to the drug. On the other hand, to the extent that DMT effects resembled those occurring in nondrug highly altered states--spiritual ones as well as psychoses—one could argue for the role of endogenous DMT in them.

When you first began your research into DMT in the 1990’s as one of the first and only people to be studying the molecule in decades, did you ever expect this space to grow and evolve into what it is today? What has surprised you the most in that time?

Ours was the first new clinical psychedelic drug research in the US in a generation. While psilocybin and LSD have seen a lot of interest since the 2000s, DMT has remained relatively niche. A German study in the mid-2000s compared DMT’s and ketamine’s effects in normal volunteers, and the Imperial College group in London has correlated DMT’s subjective effects with sophisticated brain imaging data. Just this year a DMT-depression study began at Yale.

In general, the field of clinical psychedelic drug research has certainly blossomed, beginning maybe 10 years after we wrapped up our research in Albuquerque. That is, it took some time, but it is quite gratifying to see its growth and evolution. Perhaps the most surprising thing is how successful the mainstreaming and biomedicalization of the field has been.

On the other hand, the mainstreaming has had the effect of glorifying potential benefits and minimizing potential risks. There are an alarming number of armchair experts out there, with little training or background in research, therapy, or medicine. This needs to be countered with more caution and circumspection. In addition, there is a rush to explain mechanisms of action of psychedelics, a potential rigidifying of how the drugs work and how they ought to be applied.

A specific example is the insistence that attaining a particular state of consciousness is necessary for benefit, and without attainment of that state, or with the attainment of other states, benefit is less likely. We are at the earliest stages of understanding how psychedelics exert their effects. The most striking example of this is how non-psychedelic psychedelics—i.e., compounds that affect the same biological systems as mind-altering psychedelics, but without typical behavioral effects (in animals)—may be just as effective in terms of neuroplasticity and neurogenesis. And these latter effects may be as beneficial and spare one the “complicating” presence of a highly unusual altered state.

What has been the most exciting thing for you to see come out from recent psychedelic research?

One of the most interesting developments is the notion of non-psychedelic psychedelics.

It’s also exciting to see how mind-body, spirit-matter, religion-science dichotomies are being bridged in the study of the psychobiology of the psychedelic state.

How is Algernon Pharmaceuticals different from other pharmaceutical companies and what made you decide to get involved with Algernon?

Algernon has taken the interesting approach of repurposing previously neglected compounds. Repurposing DMT is a particularly intelligent approach to entering the burgeoning psychedelic therapeutics world. Early on, they saw the potential of DMT for treating conditions such as stroke and its sequelae and their farsightedness impressed me.

What is your role at Algernon Pharmaceuticals and what do you hope to contribute to their drug development?

I provide consultation regarding DMT doses and effects, side effects, pharmacokinetics, biological responses, regulatory and other issues. I’ve also made some key introductions to important colleagues. Naturally, I hope to contribute to the success of their DMT-stroke and stroke rehab projects

Can you talk about what Algernon is investigating with DMT?

Studies from Hungary—performed by Frecska, Szabo, Nagy, and others—indicate that ischemic stroke size can be reduced in lower animals using sub-psychedelic doses of DMT. In addition, rehabilitation from stroke is accelerated when animals are treated with DMT. Separately, data emerging from Olson’s lab at UC Davis have demonstrated that sub-psychedelic doses of DMT accelerate neurogenesis and neuroplasticity, which is one possible avenue by means of which beneficial effects on stroke and stroke sequelae might be explained.

Algernon is developing both preclinical and clinical research projectsthat will build upon these data. Working out optimal doses and routes of administration of DMT in lower animals and humans, and then segueing into the field of stroke and stroke rehab.

What is the importance of neuroplasticity as it pertains to DMT?

By stimulating nerve cell growth as well as reestablishment of functional connectivity among neurons, DMT may be providing critical support to the brain that has suffered injury. DMT’s effects may also have relevance to less catastrophic and acute brain injury, such as traumatic brain injury, for example. Other conditions marked by brain atrophy may also be considered as potential targets for the neuroplastogenic properties of DMT and related compounds; e.g., dementing illnesses.

How will Algernon Pharmaceuticals be applying DMT in a sub-hallucinogenic manner?

This will be worked out in clinical and pre-clinical studies Algernon is developing in the UK and elsewhere. Clinically, questions include whether DMT administration will be a single bolus injection, a continuous infusion, or whether intravenous administration can be dispensed with altogether and less invasive routes of administration prove equally effective at attaining desired blood levels.

In our DMT study from the 1990s, we administered four different doses of the drug and established biological and psychological dose-response data. We determined the threshold dose at which fully psychedelic effects occurred, and sub-psychedelic doses where psychoactive effects were noted, but were not fully psychedelic. We also administered doses that volunteers cannot distinguish from sailing placebo, but that nevertheless could be ascertained through effect on biological and rating scale values.

What other clinical trials have been done on DMT and how will those benefit Algernon’s research?

There have been no studies published on therapeutic effects of DMT. As I mentioned above, Yale just began a DMT depression study, and I understand that a comparable project is underway in London at Imperial College. There are a handful of ayahuasca therapy studies, and as DMT is the visionary ingredient in this Amazon brew, one could extrapolate regarding effects of pure DMT. However, the presence of the MAO-inhibiting beta-carbolines in ayahuasca complicate interpretation of these data.

What do you believe is the most important thing for people to understand about the future of psychedelics as medicine?

Psychedelics have medical value, that is becoming abundantly clear. However, they are not panaceas, and are not risk-free. And, we are only at the very beginning of understanding what psychedelics do and how they do it. We need to keep an open mind regarding both risks and benefits inherent in these compounds.

Who else is doing important work within psychedelics you think more people should be aware of?

Psychiatrist Michael Bogenschutz at NYU is probably the most levelheaded psychedelic psychotherapy researcher. Specifically regarding DMT, Cyril D’Souza at Yale doing the depression study is someone you may want to contact.
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