Alexey Fedorov

Mechanisms of neuroplasticity induced by permeable serotonergics

Started Apr. 8, 2025

Abstract or project description

Major depression affects about 280 million people worldwide and costs around 326 billion dollars per year in the United States, though the standard medications take 2-3 months to take effect, so faster and longer-lasting treatments are needed. Serotonergic psychedelics such as psilocybin, DMT or ayahuasca, LSD, and mescaline can reduce depression and anxiety symptoms after only one or two doses, with benefits that last from weeks to months. The persistence of psychedelic benefits points to real biological change, not just temporary drug action. Variants in the serotonin HTR2A gene can influence cortical serotonin 5-HT2A receptor density and may shape sensitivity. In cultured neurons, multiple psychedelic chemotypes and non-hallucinogenic analogs increase dendritic growth and synaptogenesis, while impermeable analogs fail unless forced into the cell, showing that intracellular permeability is required. In cortical circuits, 5-HT2A stimulation increases glutamatergic drive and AMPA signaling, triggers gene programs linked to plasticity, and supports extinction learning. Across species, these changes align with antidepressant and anxiolytic-like behaviors that can last days to weeks and may not require hallucinogenic effects. Here, I discuss genetics, cellular and systems research, animal behavior, and recent human data to explain how membrane-permeable serotonergics act as neuroplastogens, which help build out neural synapses. I propose a permeability plus mechanism model; The serotonergic mechanism must be both cell-permeable and engage 5-HT2A. A permeable psychedelic reaches intracellular 5-HT2A pools, then 5-HT2A activation quickly boosts plasticity related gene expression and causes structural change, 5-HT2A signaling raises BDNF and engages TrkB to support neuronal growth, and 5-HT2A activation in cortex increases glutamate and AMPA signaling that helps stabilize new synapses, together linking permeability, receptor engagement, and circuit activity to durable neuroplasticity.