Additional thoughts on OCD and 5-HT2A uptake regulation

I recently posted a chapter from Psychedelic Information Theory that deals with obsessive ideation in the psychedelic state. At the end of that chapter, I mention that although psychedelics can promote obsessive thoughts within the trip, they also have the ability to break the cycle of previous obsessive spirals and act as a temporary "cure" for OCD. Within days of writing that, a new psilocybin study on OCD was released showing that this was indeed the case.

I also received a note from a reader, excerpted below:

My partner's experience using mushrooms over the past year or so has [shown] a marked decrease in what she would call her obsessive thoughts. And a fairly significant compulsion she previously had (the need to check the stove burners knowing full well they were off) has disappeared over the course of our monthly psychedelic doses. Now I realize we won't likely be seeing a monthly four-to-five grams dry cubensis powder prescription anytime soon, but one can dream!

Yes, one can dream. However, amid all the press there has been very little discussion about how psychedelics can act as a temporary OCD cure. If I had to guess, I would say that the psychedelic event causes a short-term, reversible down-regulation of 5-HT2A receptor uptake, and that this down-regulation is enough to take the edge off obsessive thoughts mediated through these sites. Of course, this down-regulation is only temporary, and should wear off in two to six weeks, which is why follow-up treatment is recommended every three months or so if OCD symptoms return.

Another theory is that the psychedelic event causes a short-term release and quick metabolism of excess signaling amines in the brain, leaving the subject "low on juice" until their body can re-process the normal balance of transmitters in the brain. This would be like a "supply-side" down-regulation from the neurotransmitter source as opposed to a "demand-side" down-regulation at the uptake site itself.

These two theories are not mutually exclusive, of course, both of them may be accurate, and there may also be other factors that I am missing. However, this study shows that there is a medium-term change in the balance of chemistry in the brain following a psychedelic trip, which may be good for some who need a break from long term obsessive cycles.

• Psychedelic Information Theory
• UA study positive on psychedelic substance