Are psychedelics the next frontier of brain injury therapies? A growing number of athletes are publicly speaking about how psychedelics have helped them heal—and current theories suggest that psychedelics and traumatic brain injury (TBI) treatment is a promising area for future research.
Currently, psilocybin and MDMA are making headway as treatments for depression and PTSD, respectively. Psychedelic clinical trials also investigate hallucinogens’ role in other conditions, such as LSD for cluster headaches and ketamine for consciousness disorders.
But in an already-new field of study, psychedelics and head trauma is largely unexplored territory in clinical research. Here’s a look at theories and early findings.
What Is a Traumatic Brain Injury (TBI)?
A TBI is a disruption in normal brain function caused by a hit, jolt, or penetrating injury to the head. In 2017, an estimated 1 million patients were diagnosed with TBIs. 1
Any sudden, violent head injury can lead to a TBI. Some common causes include: 2
- An unintentional fall
- Firearm-related injury
- Motor vehicle crash
According to a review published in 2012, approximately 10 percent of TBIs are due to sports and recreational activities. 3
TBIs are tricky because they can cause short- and long-term consequences, such as headaches, fatigue, memory loss, and mood disorders.4
TBIs can range in severity, from a mild concussion to a severe injury that results in a coma. The effects of TBIs vary, depending on the severity of the injury and the person’s age and medical history. Plus, no two brains are the same. People experience and recover from TBIs differently.
Talk with a healthcare provider if you think you’re dealing with a TBI.
There are many variabilities in TBI treatments, partly because TBIs can have such varied effects. One person might experience headaches and nausea for a few days; another may experience a cascade of physical and cognitive symptoms that linger for months.
- Mild TBI: Rest is the primary treatment. Your doctor might recommend reducing or avoiding screen time, intense physical activity, and alcohol or other drugs.
- Moderate to severe TBI: Once your provider determines that you’re stable, treatment might include medications and rehabilitation therapies. Medications may include antidepressants, diuretics, and muscle relaxants. Rehabilitation therapies help people recover and relearn skills, such as speech, memory, and balance. 7
There isn’t a single drug that mitigates the effects of TBI, according to Dr. Julian Bailes, renowned neurosurgeon and chief medical officer of Psycheceutical. “If someone gets into a car accident today and is brought into our level one trauma center, we have the ability to take out blood clots, put pressure monitors in, and treat swelling, but we don’t have a specific, targeted drug,” Bailes said.
However, researchers are investigating alternative therapies to help treat the complex, multifaceted effects of TBIs. These experimental treatments include nutritional supplementation (such as lithium, magnesium, and zinc), mindfulness exercises, progesterone, and dexanabinol, a non-psychotropic analog of tetrahydrocannabinol (THC). 8 9 10
Can psychedelics play a role in this burgeoning field of experimental brain injury treatments?
Psychedelics and Traumatic Brain Injury
Most psychedelics work by activating serotonin receptors in the brain. These receptors influence your consciousness, sense of self, and world perception. All of that serotonin activity influences aspects of a psychedelic trip, such as dissociation and hallucinations.
Psychedelics are promising forms of treatment because they have multiple mechanisms of action. In 2021, researchers published a mini-review of psychedelics and brain injury studies in the journal Frontiers in Neurology. 11 According to the authors, psychedelics may influence the future of head trauma treatment through their effects on neuroinflammation, neurogenesis, neuroplasticity, and brain complexity.
- Neuroinflammation: Inflammation is a normal response to injury. But when inflammation sticks around in the brain, it can exacerbate a person’s TBI symptoms. For example, in rodent and in vitro studies, DMT has been shown to help regulate inflammation. 12 MDMA was shown to have neuroprotective effects after rodents sustained a TBI. 13
- Neurogenesis: This term refers to the creation of new brain cells (neurons). In rodents, psilocybin has been shown to alter neurogenesis in the hippocampus, an area of the brain involved in emotions, learning, and memories. 14
- Neuroplasticity: AKA your brain’s ability to adapt and change, neuroplasticity plays a role in TBI recovery. 15 Currently, the relationship between psychedelics and neuroplasticity is based on theory. But emerging evidence suggests that psychedelics may increase neural plasticity.
- Brain complexity: The term “brain complexity” is a way to measure a person’s consciousness level (such as wakefulness, deep sleep, or comatose). Psilocybin, ketamine, and LSD increased brain complexity in a small controlled study. 16 Researchers propose that psilocybin should be explored as a possible treatment for patients in vegetative states. 17
It’s important to note that this is a highly speculative area of research, and there isn’t enough evidence yet to get a clinical trial studying psychedelics and severe TBI approved. Bailes said there are some preliminary studies about cannabinoids and ketamine. “But they’re not really the sorts of trials that we’d like to hang our hat on for definitive benefit,” Bailes said.
Part of the issue is that experimental treatments are difficult to fund, which limits the available body of evidence to understand psychedelics for people with brain injuries and other chronic neurodegenerative conditions. According to Dr. Aric Logsdon, a biomedical researcher and scientific director at Psycheceutical, there’s an opportunity for future research to explore whether psychedelics lead to structural changes in the brain.
“If we can discover ways that psychedelics are altering brain structure, that would allow for the medical community to start to appreciate them in ways that make them a viable therapeutic,” Logsdon said.
Athletes Who Turned to Psychedelics for Their TBI
A growing number of athletes have commented publicly about their therapeutic use of hallucinogens for TBI recovery. Anecdotes aren’t the same as clinical research, but these experiences add to the consensus that psychedelics are worth more rigorous study.
Here are a few notable interviews:
- Former NHL enforcer Riley Cote spoke with Rolling Stone about his experience using hallucinogens to heal from a career’s worth of head trauma. Cote advocates for the therapeutic capacity of plant medicines (such as cannabis, DMT, and psilocybin) to treat post-concussion symptoms, such as headache, depression, and CTE (chronic traumatic encephalopathy).
- Sports Illustrated reports that Daniel Carcillo, also a former NHL enforcer, used psilocybin to recover from a TBI and suicidal ideation. His life-science company Wesana Health is developing a psychedelic-based treatment for people with TBIs.
- Over at the Athletic, former NFL player Kerry Rhodes credits Ayahuasca and psilocybin with improving his short-term memory and brain fog, both symptoms of repeated head trauma.
- In an interview with Forbes, retired MMA fighter Ian McCall said that high doses of psilocybin helped him recover from symptoms of CTE.
However, this increased visibility has to be balanced by the limitations of current psychedelic research. Their evidence behind psychedelics for brain injury treatment isn’t substantial enough yet, and it’s damaging to place too much value on an alternative therapy that is still experimental and poorly understood. “I think the awareness that’s starting to come out is important,” Logsdon said, “but it’s also important for us to understand that [psychedelics] are not for everyone.”
It’s too early to say whether or not psilocybin mushrooms for brain damage will be added to concussion protocols anytime soon. Current research is based on results from test tubes and rodents. We need clinical trials to support—or refute—existing evidence.
However, psychedelics are interesting in the field of TBI treatment. TBIs are difficult to treat because they can have so many lingering effects. But in comparison to other medications, psychedelic drugs work in multiple ways and on many different parts of the brain. That activity might be key to unlocking new, effective therapies for brain injuries.
- New Data: Hospitalizations and Emergency Department Visits for Traumatic Brain Injury | Agency for Healthcare Research and Quality. Accessed September 22, 2022. https://www.ahrq.gov/news/hcup-stat-brief-traumatic-brain-injury.html
- Get the Facts About TBI | Concussion | Traumatic Brain Injury | CDC Injury Center. Accessed September 22, 2022. https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
- Sahler CS, Greenwald BD. Traumatic brain injury in sports: a review. Rehabil Res Pract. 2012;2012:659652. doi:10.1155/2012/659652 https://pubmed.ncbi.nlm.nih.gov/22848836/
- Bramlett HM, Dietrich WD. Long-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurological Outcomes. J Neurotrauma. 2015;32(23):1834-1848. doi:10.1089/neu.2014.3352 https://pubmed.ncbi.nlm.nih.gov/25158206/
- What are the possible effects of traumatic brain injury (TBI)? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development. Accessed September 22, 2022. https://www.nichd.nih.gov/health/topics/tbi/conditioninfo/effects
- Laskowski RA, Creed JA, Raghupathi R. Pathophysiology of mild TBI: implications for altered signaling pathways. In: Kobeissy FH, ed. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. Frontiers in Neuroengineering. CRC Press/Taylor & Francis; 2015. https://pubmed.ncbi.nlm.nih.gov/26269903/
- What are the treatments for traumatic brain injury (TBI)? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development. Accessed September 22, 2022. https://www.nichd.nih.gov/health/topics/tbi/conditioninfo/treatment
- Keenan A, Mahaffey B. Concussion care: moving beyond the standard. Mo Med. 2017;114(5):340-343. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140182/
- Acabchuk RL, Brisson JM, Park CL, Babbott-Bryan N, Parmelee OA, Johnson BT. Therapeutic Effects of Meditation, Yoga, and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Appl Psychol Health Well Being. 2021;13(1):34-62. doi:10.1111/aphw.12244 https://pubmed.ncbi.nlm.nih.gov/33136346/
- Vink R, Nimmo AJ. Multifunctional drugs for head injury. Neurotherapeutics. 2009;6(1):28-42. doi:10.1016/j.nurt.2008.10.036 https://link.springer.com/article/10.1016/j.nurt.2008.10.036
- Khan SM, Carter GT, Aggarwal SK, Holland J. Psychedelics for Brain Injury: A Mini-Review. Front Neurol. 2021;12:685085. doi:10.3389/fneur.2021.685085 https://www.frontiersin.org/articles/10.3389/fneur.2021.685085/full
- Nardai S, László M, Szabó A, et al. N,N-dimethyltryptamine reduces infarct size and improves functional recovery following transient focal brain ischemia in rats. Exp Neurol. 2020;327:113245. doi:10.1016/j.expneurol.2020.113245 https://pubmed.ncbi.nlm.nih.gov/32067950/
- Edut S, Rubovitch V, Rehavi M, Schreiber S, Pick CG. A study on the mechanism by which MDMA protects against dopaminergic dysfunction after minimal traumatic brain injury (mTBI) in mice. J Mol Neurosci. 2014;54(4):684-697. doi:10.1007/s12031-014-0399-z https://pubmed.ncbi.nlm.nih.gov/25124230/
- Catlow BJ, Jalloh A, Sanchez-Ramos J. Hippocampal Neurogenesis. In: Neuropathology of Drug Addictions and Substance Misuse. Elsevier; 2016:821-831. doi:10.1016/B978-0-12-800212-4.00077-7 https://www.sciencedirect.com/science/article/pii/B9780128002124000777
- Sophie Su Y, Veeravagu A, Grant G. Neuroplasticity after Traumatic Brain Injury. In: Laskowitz D, Grant G, eds. Translational Research in Traumatic Brain Injury. Frontiers in Neuroscience. CRC Press/Taylor and Francis Group; 2016. doi:10.1201/b18959-9 https://www.taylorfrancis.com/books/mono/10.1201/b18959/translational-research-traumatic-brain-injury-gerald-grant-daniel-laskowitz
- Schartner MM, Carhart-Harris RL, Barrett AB, Seth AK, Muthukumaraswamy SD. Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin. Sci Rep. 2017;7:46421. doi:10.1038/srep46421 https://www.nature.com/articles/srep46421
- Scott G, Carhart-Harris RL. Psychedelics as a treatment for disorders of consciousness. Neurosci Conscious. 2019;2019(1):niz003. doi:10.1093/nc/niz003. https://pubmed.ncbi.nlm.nih.gov/31024740/