Beyond the Veil: Unpacking the Findings of Extended-State DMT

The Imperial College Centre for Psychedelic Research recently published a pre-print of the world's first pilot study of extended-state DMT, also known as DMTx. DMTx is a technique borrowed from anaesthesiology that involves delivering DMT into the bloodstream at a variable rate, designed to maintain a stable brain DMT concentration over time. This allows an individual to be inducted into the DMT space and held there for an indefinite period of time, potentially for hours or longer.

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This concept of extended-state DMT was initially proposed by psychiatrist and DMT expert Dr. Rick Strassman and neurobiologist, pharmacologist, and chemist Dr. Andrew Gallimore almost seven years ago, as a retooling of target-controlled intravenous infusion (TCI) used in surgery to maintain a stable brain concentration of anesthetic drugs. DMTx is a variation of this technology that replaces the short-acting anesthetic with DMT, allowing for prolonged immersion in the DMT state.

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Led by Ph.D. student Lisa Luan, the study aimed to develop a systematic protocol for the continuous intravenous infusion of DMT and tested its effectiveness in healthy volunteers. The main goal of the study was to establish infusion parameters for maintaining a steady state of DMT effects for a chosen length of time.

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DMTx: Study Design and Setting

The study involved 11 healthy volunteers who received up to four different doses of DMT through bolus plus slow-rate infusions over 30 minutes. The term “bolus” refers to a single, concentrated dose of a substance that is administered intravenously as a discrete amount rather than a gradual infusion.

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The dosing sessions were separated by at least two weeks, and four dose levels were tested with the aim of inducing and sustaining moderate-to-high intensity of effects over 30 minutes while maintaining low levels of anxiety.

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During the dosing sessions, participants were in a calm, decorated hospital room at the Imperial College Research Facility. They wore an eye mask and were instructed to keep their eyes closed, and low-volume ambient music was played through headphones to ensure psychological comfort.

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The researchers measured the intensity of subjective effects and ratings of anxiety using audio prompts and verbal ratings from participants. Heart rate was monitored, and blood samples were collected for pharmacokinetic purposes to assess the plasma levels of DMT at different time points.

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Once the acute drug effects had subsided, participants completed the Altered States of Consciousness (ASC) Scale and the Mystical Effects Questionnaire (MEQ-30), which assess altered states of consciousness and mystical-type experiences, respectively. Participants were also asked to provide retrospective ratings of various dimensions of their experience over time.

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The Subjective Effects of DMTx: Intensity, Experience, and Tolerance 

The subjective effects of DMT were found to be intense and rapid in onset, with substantial increases in intensity ratings observed for all tested doses. These effects remained relatively stable throughout the continuous infusion after an initial peak, and participants were maintained at relatively stable levels of drug effects over the infusion period.

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Participants experienced low levels of anxiety before and throughout dosing, indicating that extended administration of DMT was well tolerated. There was an initial increase in anxiety, likely related to psychological anticipation rather than direct dose-dependent drug effects. Heart rate and anxiety levels increased at the beginning of the DMT infusion but soon settled at normal levels, indicating that extended-state DMT was well-tolerated and not overwhelming physiologically or psychologically.

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Participants reported significant increases in certain subjective experiences with DMT compared to placebo. These experiences included a sense of boundlessness and restructuring of visual perception, as well as positive changes in unity, meaning, spiritual experiences, blissful state, insightfulness, complex imagery, and elementary imagery.

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Some doses of DMT also increased feelings of dread of ego-dissolution and auditory alterations. Retrospective assessment of different dimensions of the DMT experience showed that certain aspects, such as immersion and visual imagery, largely followed the subjective intensity scores over time, while other aspects, such as entity encounters, increased during the latter part of the infusion for some doses of DMT.

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Participants reported minimal ego dissolution during the DMT infusion, and experiences of bodily sensations, visual richness, overall richness, emotional experience, and meaningfulness of the experience largely followed subjective intensity scores over time.

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One somewhat controversial result from the study was the claim of "short-term psychological tolerance," where the intensity of subjective effects remained stable despite slight increases in blood plasma DMT concentration during the infusion. This finding is in conflict with the results of previous DMT studies conducted by Dr. Strassman, which indicated that there was no evidence of subjective tolerance to closely-spaced bolus doses.

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Experts, including Dr. Galimore, have cautioned that the interpretation of this finding should be approached with caution. It's possible that the decrease in perceived intensity of DMT effects compared to the concentration of DMT in the brain is due to psychological habituation rather than physical tolerance, meaning that as participants get used to the DMT state, the intensity of effects stays the same or decreases slightly, even as the level of DMT in the brain increases. Furthermore, the relatively low variability between individuals response to different doses of DMT compared to the variability in blood plasma DMT concentration makes it difficult to draw conclusive conclusions.

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Insights and Implications of Extended-State DMT Infusion

This pilot study represents an important step in the development of the DMTx technique for extended-state DMT infusion. The results of the study will help establish infusion parameters for maintaining a steady state of DMT effects and provide valuable insights into the phenomenology and brain activity related to prolonged immersion in the DMT state.

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Further research using this technique may contribute to our understanding of the therapeutic potential of DMT and its effects on consciousness.

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Overall, the study findings suggest that DMT caused intense and rapid subjective effects, with some variations in different dimensions of the experience, but was well-tolerated in terms of physiological and psychological responses in the study participants.

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