University of Maryland School of Medicine, 701 W. Pratt St, Rm 454 Baltimore, MD 21201, United States of America. Electronic address: cwtmiller@gmail.com.
2 papers in the library · 11 citations · publishing 2024-2025
Psychedelic compounds are gaining interest as potential treatments for psychiatric disorders. Although most psychiatrists will not directly administer these drugs, psychedelic research offers lessons that can improve conventional care. Central to this is the concept of 'set and setting'—the importance of mindset and environment for therapeutic outcomes. New findings suggest mechanistic overlap between psychedelics and serotonergic antidepressants: both modulate neurotrophins, enhance neuroplasticity, and reopen critical learning periods, shaped by environmental context. The paper argues that integrating insights from psychedelic research, particularly set and setting, can improve depression treatment in traditional psychiatric settings by optimizing non-pharmacological factors such as high-quality psychotherapy.
Guidelines for managing agitation in emergency and psychiatric emergency settings have been updated since the 2012 Project BETA recommendations. This paper synthesizes current guidelines, explains the neurobiology of agitation, and links brain mechanisms to the pharmacological profiles of recommended drugs, including ketamine and droperidol, which have seen increased use. Clinicians are given treatment strategies tailored to specific causes of agitation.