Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

In this episode of the Psychedelic Medicine Podcast, Alexander Lebedev, MD, PhD joins to discuss psychedelic medicine and psychosis. Dr. Lebedev is a physician-scientist, medical AI engineer, and entrepreneur working at the frontier of health and technology. His work spans collective societal dynamics, psychedelics, and medical AI; he leads Lebedev Labs and is co-founder of Dreamseer and Once Wellbeing Center.
In this conversation, Dr. Lebedev explores the complex relationship between psychedelics and psychosis, examining what decades of research—and more recent clinical evidence—actually tell us about the risks. He explains why individuals with personal or family histories of psychotic disorders are typically excluded from clinical trials, clarifies the distinction between transient psychotic experiences and chronic psychotic disorders, and discusses why current evidence has not established a causal link between psychedelic use and persistent psychosis in screened populations. Throughout the discussion, Dr. Lebedev emphasizes the importance of careful screening, preparation, integration, and context, arguing that psychedelics should be understood through both scientific and phenomenological lenses rather than simplistic assumptions about safety or danger.
 
In this episode, you'll hear:
What inspired Dr. Lebedev to study psychedelics and psychosis
Why psychedelics became associated with psychosis and how that perception developed historically
Why case reports of psychotic episodes following psychedelic use are not definitive to establish a causal link between the two
How the lenses and frameworks we employ can significantly color how we understand psychosis and altered states of consciousness
The role of set, setting, sleep, substance use, and integration in reducing psychological risks
How psychedelic experiences overlap with—and differ from—psychotic states from a phenomenological perspective
The intersection of psychosis and bipolar disorder and the relevance of this overlap to psychedelic medicine
Why researchers are beginning to reconsider whether certain psychosis-spectrum populations should eventually be studied under carefully controlled conditions
 
Quotes:
"The first framework within which psychedelics were studied and considered was the psychotomimetic framework, meaning that they were considered as tools that are supposed to mimic psychotic states." [9:22]
"In the pre-prohibition era, psychedelics were tested on very large populations of different patients—including people with psychosis spectrum disorders, including people with schizophrenia spectrum disorders—with some mixed results. But there was already some data indicating that from a populational perspective, from a statistical link, we didn't have clear indication, even back then, that that link [between psychedelics and psychosis] exists." [12:48] 
"Interestingly, unlike for cannabis, for tobacco, for some other substances, this link [with psychosis] was not verified in these large studies for psychedelics." [15:54]
"If the only lens that you have is pathology, you can pathologize transformation as well. On the other hand, if the only lens that you have is spirituality, you can spiritualize the compensation that can come with the psychotic experience." [20:21]
"From a phenomenological perspective, there are, of course, clear similarities [between psychedelic experiences and psychosis] . But of course, the background, the emotional content is very different. … If you read sometimes descriptions of people's mystical experiences or bad trips, sometimes they can actually on the surface look remarkably similar. What is different is the affective balance of it. And that's true for psychedelic experiences and also for psychotic experiences." [40:37]
 
Links:
Dr. Lebedev on LinkedIn 
Dr. Lebedev on Instagram 
Dr. Lebedev on Threads
Once Wellbeing Center website
Once Wellbeing Center on Instagram
Once Wellbeing Center on LinkedIn
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Arsalan Azam, MD joins to unpack the intersection between psychedelics and GLP-1s. Dr. Azam, founder of Daydream MD, completed his residency in Emergency Medicine at the Metropolitan/Harlem Emergency Medicine Residency program in New York before practicing emergency medicine nationwide. Drawing on that experience, he developed a comprehensive ketamine-assisted therapy practice and now blends functional medicine with personalized GLP-1 services to help patients achieve sustainable, biologically tailored health outcomes.
In this conversation, Dr. Azam explores the emerging intersection of GLP-1 medications and psychedelic therapies, arguing that both create temporary windows for behavioral change that can be leveraged to improve long-term mental and metabolic health. He explains how GLP-1 medications act primarily on the brain's reward and craving circuits, reducing "food noise" while creating opportunities to reshape habits and addictive behaviors. The discussion also covers how GLP-1s may complement psychedelic-assisted therapies for conditions such as addiction and PTSD, potential interactions with ketamine and classic psychedelics, and important clinical considerations, including nausea, delayed gastric emptying, medication dosing, and the importance of individualized treatment strategies.
 
In this episode, you'll hear:
How GLP-1 medications influence the brain's reward, craving, and motivation circuits
Why Dr. Azam views GLP-1s and psychedelics as complementary therapies that each create windows for lasting behavioral change
The potential role of GLP-1 medications in treating addiction alongside psychedelic-assisted psychotherapy
What patients and clinicians should know about combining GLP-1 medications with ketamine and classic psychedelics
How delayed gastric emptying may alter the timing, intensity, and safety of orally administered psychedelic experiences
Why careful dosing of GLP-1 medications is important to avoid emotional blunting while preserving their therapeutic benefits
The importance of using both psychedelic and metabolic therapies as opportunities to build healthier long-term habits rather than relying on medication alone
 
Quotes:
"Not all behavioral health symptoms are driven purely by things going on in the brain and the nervous system and mood and whatnot. Sometimes it's well outside that. And so that's where, naturally, GLP-1s caught our gaze. Here's a medicine that treats probably one of the biggest of the two health crises I think right now facing America: one is—I do think—mental health, but the other is metabolic health." [4:52]
"Just like psychedelics create a window [of transformation], GLP-1s create a window. It's this pharmacologic scaffolding that you can use to start to really reexamine your relationship with food, with craving, how you've been eating, why you've been eating. And you can essentially use GLP-1s to hit the pause button on that noise, and that makes it easier to eat less. But it also makes it easier to start to ask the questions of why? Why was I eating the way I was eating?" [9:59]
"In general, GLP-1s seem to play pretty nicely [with ketamine]. I'd say the bigger thing that I've observed that doesn't get named all that much is that craving and reward are important. They're part of how we see salience in the world and also derive pleasure from it, and if you go too high on a GLP-1, people experience a flattening. They feel kind of blah, and it's not in their head. It's because you've over-damped the salience and reward circuitry. And so it's about finding the sweet spot where there's enough to motivate you in life without being noisy." [20:13]
 
Links:
Daydream MD website
Daydream MD on Instagram
Daydream MD on Facebook
Dr. Azam on LinkedIn
Psychedelic Medicine Association webinar: GLP-1s and Psychedelics: Clinical Considerations, Interactions, and Emerging Questions
Psychedelic Medicine Association
Porangui

In this episode of the Psychedelic Medicine Podcast, Dori Lewis, MA, MEd, LPC-S returns to discuss the differences between psilocybin and ketamine. Dori is the Clinical Director of Elemental Psychedelics and Owner/Operator of Reflective Healing in Fort Collins Colorado. As a clinician, she blends transpersonal psychology, depth work, and psychedelic-assisted therapy within a model that centers the therapeutic relationship. To date, she has stewarded over 100 ketamine therapy sessions, more than 200 mushroom sessions, and numerous group ceremonies.
In this conversation, Dori explores how clinicians and facilitators can thoughtfully decide when ketamine or psilocybin may be the more appropriate therapeutic option, emphasizing that the two medicines are complementary rather than competing approaches. She explains how factors such as current medications, trauma history, substance use, prior experience with altered states, therapeutic readiness, and available social support all shape this decision. Throughout the discussion, Dori argues that ketamine often serves as an accessible and effective introduction to psychedelic-assisted therapy, while psilocybin may be especially valuable for addressing grief, attachment and religious trauma, and deeper existential questions when paired with sufficient preparation, integration, and a strong therapeutic relationship.
 
In this episode, you'll hear:
Why ketamine is often recommended before psilocybin for people new to psychedelic therapy
How SSRIs and other medications influence the choice between ketamine and psilocybin
What personal history, symptoms, and therapeutic readiness clinicians should evaluate before recommending either medicine
Which conditions and life experiences may be particularly well-suited for psilocybin-assisted therapy, including grief, attachment trauma, and existential distress
How cannabis use, substance use disorders, and suicidal ideation can affect treatment planning
Why community support, integration resources, and a trusting relationship with a facilitator are critical for successful psychedelic experiences
The importance of cultivating self-awareness before engaging in psychedelic-assisted therapy
 
Quotes:
"How do we help somebody who is on these [SSRI] medications, has been on them for a really long time and is actually doing well with them? The answer is not to get someone to stop taking their meds just to have a psilocybin experience. That's actually really reckless, in my opinion. What I would say is, why don't we start with ketamine and see how that affects you." [7:59]
"There's another important piece here: What [does the patient] want? If this person says, 'Dori, I really don't want to do ketamine. I want to work with a plant medicine. That's what I'm feeling really called to.' I might say, 'okay, then let's explore that.' But if they're open [to either], I might say, 'why don't we start with [ketamine]?'" [15:50]
"There are very few cases that I would say, 'don't start with ketamine' unless somebody says 'I've already done ketamine' … or they say 'I don't want to do ketamine' but in most cases I'm going to recommend just start with ketamine" [23:05]
 
Links:
Dori on LinkedIn 
Elemental Psychedelics website
Elemental Psychedelics on LinkedIn
Reflective Healing website
Reflective Healing on LinkedIn
Reflective Healing on Instagram
Fireside Project website
Previous episode: Common Psilocybin Myths & Misconceptions with Dori Lewis, LPC
Previous episode: How Psychedelics & Pharmaceuticals Can Both Aid Healing with Erica Zelfand, ND
Psychedelic Medicine Association
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In this episode of the Psychedelic Medicine Podcast, Katie Fassbinder, MD joins to explore how to choose the right ketamine clinic. Dr. Fassbinder is the Faculty Medical Lead for ketamine-assisted psychotherapy training at Elemental Psychedelics and a practicing psychiatrist based in Wisconsin with over 20 years of experience. She also directs mental health and KAP programming at Promega and has worked extensively in public-sector mental health systems.
In this conversation, Dr. Fassbinder explores how patients can make informed decisions when choosing a ketamine clinic, emphasizing that safety, therapeutic support, and personal fit should guide the process. She discusses the differences between medical ketamine treatment and ketamine-assisted psychotherapy, highlighting how factors such as trauma history, treatment goals, medical complexity, and access to integration support can influence the most appropriate model of care. The conversation also examines the strengths and limitations of various routes of administration, including IV, intramuscular, sublingual, and at-home ketamine programs. Throughout, Dr. Fassbinder stresses the importance of preparation, integration, set and setting, and finding a treatment environment that feels safe and supportive, noting that ketamine's benefits are often maximized when paired with meaningful therapeutic relationships and ongoing psychological support.
 
In this episode, you'll hear:
Key factors to consider when evaluating the safety of a ketamine clinic
How medical and psychological needs influence the type of ketamine treatment that may be most appropriate
The differences between ketamine-assisted psychotherapy and more medically oriented ketamine treatment models
How IV, intramuscular, sublingual, and at-home ketamine approaches compare
Why set, setting, preparation, and integration are critical components of successful treatment
Who may be a good candidate for at-home ketamine programs and what risks to consider
The distinction between psycholytic and psychedelic ketamine dosing and how each supports different therapeutic goals
Resources and community-based options for psychedelic integration when ongoing therapy is not available
 
Quotes:
"[Ketamine] is one of those medicines that's very much a shape shifting medicine and it can meet people for different types of concerns or goals at different levels and different routes. So it's so good we have such a breadth of options—and very complicated if you're a patient trying to figure out where to begin."  [7:55]
"Those challenging psychedelic experiences, when well integrated, typically provide even more benefit for the person than the sort of bliss journeys that we all hope everybody gets to have, you know? So having a challenging journey, if well supported and integrated, is also a gift that's very potent for somebody that's really ready to do that work." [21:52]
"Ego dissolution or that sort of loss of concept of self can be extremely liberating for some people. For others, coming back from that can be very discombobulating and even traumatic. So this really comes down to patient selection and helping people make a safe choice for what they're looking to do in their recovery and also what they're bringing in as risk factors for helping choose that safe dose range." [31:15] 
"While we don't have clarity about cognitive impacts of ketamine in the long run, it seems like when done therapeutically in pulses it's pro-cognitive. … But when done daily, what we've seen in recreational ketamine use—or misuse—is that it does have some cognitive impairment that's perhaps difficult to reverse." [42:58]
"The dose of ketamine has so much to do with the preparation of your system more than the number of milligrams. … If you've done the at home course and you're not getting the sustained benefit or you're not journeying, it might be that that's a cue that you need more support for your actual sessions." [45:01]
"Psychedelics and ketamine included, create a nonspecific amplification of everything. Everything feels bigger. And part of meeting with the ketamine provider is for them to really assess: Is this a good time in your life? Do you have the outside support, the inner resourcing to do this work safely?" [47:09]
 
Links:
Elemental Psychedelics website
Elemental Psychedelics on LinkedIn
Promega website
Healing Maps website
Fireside Project website
ACER Integration website
Journey Clinical website
Usona Institute website
"Psilocybin vs. Ketamine Training: Which is Right For Your Practice?" blog by Shannon Hughes and Dori Lewis
Previous episode: Fireside Project: The World's First Psychedelic Hotline with Joshua White and Hanifa Nayo Washington
Psychedelic Medicine Association
Porangui

In the 200th episode of the Psychedelic Medicine Podcast, Ismail Lourido Ali, JD joins to discuss the future of psychedelic medicine. Ismail serves as MAPS Co-Executive Director and has been actively participating in the drug policy reform movement for over a decade, informed by half a lifetime of diverse personal experience with psychedelics and other substances.
In this conversation, Ismail explores the rapidly evolving landscape of psychedelic medicine, reflecting on the field's major milestones, challenges, and future possibilities. He discusses how public perception has shifted over the past decade, the role of state-level psychedelic reforms, and the tensions created by commercialization, overhype, and competing regulatory models. Much of the discussion focuses on the recent federal executive order related to psychedelic research and drug development, including what it may mean for FDA approval timelines, right-to-try access, rescheduling, and public health standards. Throughout, Ismail emphasizes that psychedelics are not a "silver bullet," but tools that require strong systems of care, thoughtful policy, and community support to be integrated responsibly into healthcare and society.
 
In this episode, you'll hear:
How public attitudes toward psychedelics have shifted over the past decade
Major milestones that expanded psychedelic policy reform beyond federal drug approval
The promises and pitfalls of increased visibility, commercialization, and hype in the psychedelic field
What the recent federal executive order on psychedelics actually does and does not do
An explanation of right-to-try laws, FDA approval pathways, and the complexities of rescheduling psychedelic medicines
Why maintaining rigorous evidentiary standards is essential for the long-term credibility of psychedelic medicine
MAPS' vision for the future of psychedelic access, including regulated adult use, professional education, and community safety infrastructure
How psychedelic policy reform could evolve to include broader systems of mental health care, crisis response, and social healing
 
Quotes:
"[Federal funding for psychedelic research] will only be so effective unless there is a massive reinvestment in mental health, harm reduction, and social services that actually ground—and one could say integrate—this medicine into like the continuum of care and the fabric of community that people are actually in." [25:07]
"Even though those of us in the psychedelic advocacy field do want to see drugs like MDMA and others be approved by the FDA for medical use in these controlled clinical settings… At the same time, we don't want medical access to be accelerated so much that it's at the expense of public health or consumer protection or an evidentiary standard that other drugs are being held to." [37:59]
"Medical professionals are not just prescribing things because they're approved. Many of them want to look at the evidence themselves. They want to look at the clinical trials. They want to understand 'is this the right choice for my patient?' But you can only know if [psychedelics] are being held to a comparable standard." [39:31]
"What's MAPS' vision for ten years from now or 40 years from now for that matter? I like to think of it as lots of on ramps and lots of off ramps. It's that people who are seeking access to psychedelics for any beneficial purpose—for their own treatment or healing, for their own spiritual growth, for their personal development, for their for improving of their relationships with their loved ones or with nature or with spirituality, whatever that cosmology is that they hold—that they have safe, responsible methods of doing so." [44:47]
 
Links:
Ismail on Instagram
Psychedelic Medicine Association
Porangui