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Johannes G. Ramaekers

Maastricht University

56 papers in the library · 2,553 citations · publishing 2003-2026

Papers

Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution

Psychopharmacology August 13, 2018 Malin V. Uthaug, Kim van Oorsouw, Kim P. C. Kuypers et al. 213 citations

Ayahuasca, a psychotropic plant tea used ceremonially in South America, produces sub-acute and long-term improvements in affect and cognitive thinking style. In 57 ceremony attendees in the Netherlands and Colombia, ratings of depression and stress significantly decreased the day after the ceremony and these changes persisted for 4 weeks. Convergent thinking also improved post-ceremony and was maintained at 4 weeks. Satisfaction with life and several aspects of mindfulness increased the day after but were not significantly different from baseline at 4 weeks. Changes in affect, satisfaction with life, and mindfulness correlated with the degree of ego dissolution experienced during the ceremony, not with prior ayahuasca experience. These findings highlight ayahuasca's therapeutic potential for mental health disorders like depression.

Psychedelic-Assisted Psychotherapy—A Systematic Review of Associated Psychological Interventions

Frontiers in Psychology June 10, 2022 Mauro Cavarra, Alessandra Falzone, Johannes G. Ramaekers et al. 156 citations

Modern clinical research on psychedelics shows promising outcomes for psychedelic-assisted psychotherapy with appropriately screened participants in controlled settings, though some patients relapse or respond poorly. Individual and contextual factors (set and setting) appear to shape the psychedelic experience and clinical outcomes, suggesting the therapeutic context may moderate efficacy. This review searched PubMed/Medline and Scopus for clinical studies describing structured psychotherapeutic interventions alongside psychedelics. Ad-hoc and adapted therapeutic methods were identified. Common principles, points of divergence, and future directions are discussed, focusing on therapeutic stance, degree of directiveness, and potential suggestive effects of information provided to patients.

Low Doses of LSD Acutely Increase BDNF Blood Plasma Levels in Healthy Volunteers

ACS Pharmacology & Translational Science August 31, 2020 Nadia R. P. W. Hutten, Natasha L. Mason, Patrick C. Dolder et al. 134 citations

Low doses of LSD (5, 10, and 20 μg) increase brain-derived neurotrophic factor (BDNF) levels in blood plasma, a marker of neuroplasticity. In a placebo-controlled within-subject study with healthy volunteers, BDNF levels rose at 4 hours after 5 μg and at 6 hours after both 5 and 20 μg, compared to placebo. This suggests that even low doses of LSD can acutely enhance neuroplasticity, supporting further research in patient populations for psychiatric conditions.

Spontaneous and deliberate creative cognition during and after psilocybin exposure

Translational Psychiatry April 8, 2021 Natasha L. Mason, Kim P. C. Kuypers, Johannes T. Reckweg et al. 132 citations

A double-blind, placebo-controlled experiment with 0.17 mg/kg psilocybin shows that the drug affects creative thinking in time-dependent and task-specific ways. Immediately after consumption, psilocybin increased spontaneous creative insights but decreased deliberate, task-based creativity. Seven days later, participants generated more novel ideas. Brain imaging revealed that both acute and persisting effects were predicted by connectivity within and between networks of the default mode network. These results support historical claims that psychedelics can influence aspects of the creative process and may serve as tools for investigating creativity and its neural basis.

Mood and cognition after administration of low LSD doses in healthy volunteers: A placebo controlled dose-effect finding study

European Neuropsychopharmacology October 17, 2020 Nadia R. P. W. Hutten, Natasha L. Mason, Patrick C. Dolder et al. 121 citations

Taking very low doses of LSD, known as microdosing, can selectively improve mood and cognition. In a placebo-controlled experiment with 24 healthy adults, doses of 5, 10, and 20 micrograms of LSD were tested. The 20 mcg dose increased positive mood, while 5 mcg and 20 mcg increased friendliness and reduced attentional lapses. Arousal increased at 5 mcg. Negative effects included increased confusion at 20 mcg and increased anxiety at both 5 and 20 mcg. Altered states of waking consciousness occurred at 10 and 20 mcg. The minimal dose producing noticeable effects was 5 mcg, with the clearest effects at 20 mcg.

Effects of Acute MDMA Intoxication on Mood and Impulsivity: Role of the 5-HT2 and 5-HT1 Receptors

PLoS ONE July 10, 2012 Janelle H. P. van Wel, Kim P. C. Kuypers, Eef L. Theunissen et al. 121 citations

MDMA increases both positive moods (vigor, arousal, friendliness, elation) and negative moods (anxiety, confusion) while also slowing reaction times on impulsivity tasks, indicating greater impulse control. Blocking 5-HT(2) receptors with ketanserin prevented the positive mood effects but not the negative mood or impulsivity changes. Blocking 5-HT(1) receptors with pindolol had no effect on any MDMA-related mood or impulse measures. Thus, 5-HT(2) receptors are specifically involved in MDMA's positive mood enhancement, while 5-HT(1) receptors do not appear to play a role in these effects.

A placebo-controlled study of the effects of ayahuasca, set and setting on mental health of participants in ayahuasca group retreats

Psychopharmacology March 10, 2021 Malin V. Uthaug, Natasha L. Mason, Stefan W. Toennes et al. 116 citations

Ayahuasca, a plant mixture containing DMT and β-carboline alkaloids, has been linked to mental health improvements in naturalistic settings, but prior studies lacked placebo controls. In this observational study, 30 experienced participants at ayahuasca retreats in the Netherlands, Spain, and Germany were assessed before and after sessions; 14 consumed ayahuasca and 16 a placebo. Symptoms of depression, anxiety, and stress reduced over time in both groups, independent of treatment. However, ayahuasca specifically increased implicit emotional empathy to negative stimuli. The findings indicate that mental health improvements can arise from both placebo effects and pharmacological actions of ayahuasca, highlighting the need for placebo-controlled designs.

Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment

Psychopharmacology December 10, 2019 Malin V. Uthaug, Rafael Lancelotta, Attila Szabó et al. 116 citations

Inhalation of vaporized synthetic 5-methoxy-N,N-dimethyltryptamine significantly increased cortisol levels and decreased IL-6 concentrations in saliva immediately after the session. These biomarker changes were not correlated with ratings of mental health or the psychedelic experience. Ratings of non-judgment increased and depression decreased from baseline to immediately post-session and at 7-day follow-up. Anxiety and stress ratings decreased from baseline to 7-day follow-up. Participant ratings of the psychedelic experience correlated negatively with affect ratings and positively with non-judgment ratings. The findings suggest that 5-methoxy-N,N-dimethyltryptamine produces changes in inflammatory markers and improves affect and non-judgment.

The clinical pharmacology and potential therapeutic applications of 5‐methoxy‐N,N‐dimethyltryptamine (5‐MeO‐DMT)

Journal of Neurochemistry February 12, 2022 Johannes T. Reckweg, Malin V. Uthaug, Attila Szabó et al. 108 citations

5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring tryptamine that acts primarily as an agonist at 5-HT1A and 5-HT2A receptors, with highest affinity for the 5-HT1A subtype. Its subjective effects include distortions in auditory and time perception, amplification of emotional states, and feelings of ego dissolution that are usually short-lasting depending on route of administration. Individual dose escalation reliably induces a peak experience thought to be a core predictor of therapeutic efficacy. Observational studies and surveys suggest single exposure can cause rapid and sustained reductions in symptoms of depression, anxiety, and stress.

Dissociable Effects of a Single Dose of Ecstasy (MDMA) on Psychomotor Skills and Attentional Performance

Journal of Psychopharmacology December 1, 2003 C. T. J. Lamers, Johannes G. Ramaekers, N. D. Muntjewerff et al. 105 citations

A single 75 mg dose of MDMA improved psychomotor performance, including movement speed and tracking in both single and divided attention tasks, but impaired the ability to predict object movement under divided attention, which may indicate impairment of driving-relevant skills. No effect was found on visual search, planning, or semantic memory retrieval. Alcohol 0.5 g/kg was also tested but its effects are not described here. The findings suggest MDMA can both enhance and impair specific cognitive and motor functions relevant to driving.

A low dose of lysergic acid diethylamide decreases pain perception in healthy volunteers

Journal of Psychopharmacology August 25, 2020 Johannes G. Ramaekers, Nadia R. P. W. Hutten, Natasha L. Mason et al. 95 citations

A low dose of LSD (20 micrograms) that does not cause a psychedelic experience can increase pain tolerance and reduce the unpleasantness of pain in healthy volunteers. In a controlled experiment with 24 participants, those given 20 µg of LSD kept their hand in cold (3°C) water longer and reported less pain than when given a placebo. Smaller doses (5 and 10 µg) did not produce the same effect. The 20 µg dose caused slight increases in blood pressure, anxiety, and dissociation, but no profound mind-altering effects. These findings suggest that very low doses of LSD may offer a new approach to pain management without the intense psychological effects of higher doses.

Multifaceted empathy of healthy volunteers after single doses of MDMA: A pooled sample of placebo-controlled studies

Journal of Psychopharmacology April 3, 2017 Kim P. C. Kuypers, Patrick C. Dolder, Johannes G. Ramaekers et al. 88 citations

A pooled analysis of six placebo-controlled studies with 118 participants confirmed that a single dose of MDMA (75 or 125 mg) increases emotional empathy—the ability to share and understand others' feelings—without affecting cognitive empathy, which involves recognizing others' emotions. The empathy boost was strongest for positive emotions and was linked to higher MDMA blood levels before testing. The effect was consistent across different labs and doses, and was not influenced by sex, prior drug use, or participants' baseline trait empathy. Although MDMA raised oxytocin levels, those increases did not explain the empathy changes.

No Evidence that MDMA-Induced Enhancement of Emotional Empathy Is Related to Peripheral Oxytocin Levels or 5-HT1a Receptor Activation

PLoS ONE June 27, 2014 Kim P. C. Kuypers, Rafael de la Torre, Magı́ Farré et al. 88 citations

A single 75 mg dose of MDMA selectively enhances emotional empathy—the ability to share and understand others' feelings—without affecting cognitive empathy (understanding others' mental states), trust, or reciprocity in social interactions. This effect was not altered by adding pindolol, a drug that blocks the 5-HT1A serotonin receptor. Oxytocin nasal spray, a hormone often linked to social bonding, had no effect on any empathy or social interaction measure. Changes in emotional empathy were unrelated to oxytocin levels in the blood. The findings suggest that MDMA's empathy-enhancing effects do not depend on peripheral oxytocin and may instead involve other receptors such as serotonin 2A or vasopressin 1A.

Psilocybin induces acute and persisting alterations in immune status in healthy volunteers: An experimental, placebo-controlled study

Brain Behavior and Immunity September 7, 2023 Natasha L. Mason, Attila Szabó, Kim P. C. Kuypers et al. 83 citations

A single dose of psilocybin (0.17 mg/kg) in 60 healthy participants immediately reduced the pro-inflammatory cytokine tumor necrosis factor-α (TNF-α), while interleukin-1β, interleukin-6 (IL-6), and C-reactive protein (CRP) were unchanged. Seven days later, TNF-α returned to baseline, but IL-6 and CRP were persistently reduced. Greater reductions in IL-6 and CRP at seven days correlated with more positive mood and social effects. Acute TNF-α reductions linked to lower hippocampal glutamate. Psilocybin did not significantly alter the stress response to a psychosocial stressor. The findings suggest psilocybin has persisting anti-inflammatory effects that may relate to its therapeutic benefits.

Persisting Effects of Ayahuasca on Empathy, Creative Thinking, Decentering, Personality, and Well-Being

Frontiers in Pharmacology October 1, 2021 Maggie Kiraga, Natasha L. Mason, Malin V. Uthaug et al. 83 citations

A single ayahuasca ceremony is associated with lasting improvements in cognitive empathy, satisfaction with life, and the ability to take a non-judgmental stance toward oneself (decentering), while decreasing neuroticism and divergent thinking. In a naturalistic study of 43 ceremony attendees, 20 completed the morning-after assessment and 19 completed the one-week follow-up. Compared to baseline, cognitive empathy, satisfaction with life, and decentering increased at both one day and one week post-ceremony; implicit emotional empathy increased only at one week; and trait neuroticism decreased. Divergent thinking (fluency corrected for originality) decreased. The findings suggest ayahuasca may enhance well-being and social cognition, but clinical trials are needed to confirm therapeutic potential.

Pharmacokinetics and Pharmacodynamics of Lysergic Acid Diethylamide Microdoses in Healthy Participants

Clinical Pharmacology & Therapeutics September 25, 2020 Friederike Holze, Matthias E. Liechti, Nadia R. P. W. Hutten et al. 63 citations

Very low doses of LSD (5, 10, and 20 µg) were given to 23 healthy participants in a double-blind, placebo-controlled crossover trial. LSD concentrations in the blood increased in proportion to dose, with maximal levels reached after about 1.1 hours and an average elimination half-life of 2.7 hours. The 5 µg dose produced no significant subjective effects. The 10 µg dose significantly increased feelings of being under the influence and good drug effect, starting at 1.1 hours, peaking at 2.5 hours, and lasting until 5.1 hours. The 20 µg dose also increased bad drug effects. The threshold for psychotropic effects was 10 µg.

Blockade of 5-HT2 Receptor Selectively Prevents MDMA-Induced Verbal Memory Impairment

Neuropsychopharmacology May 11, 2011 Janelle H. P. van Wel, Kim P. C. Kuypers, Eef L. Theunissen et al. 52 citations

Blocking the 5-HT(2A) receptor with ketanserin prevented MDMA-induced impairment on a word-learning task, but not on spatial or prospective memory tasks. Blocking the 5-HT(1A) receptor with pindolol had no effect on any memory task. MDMA alone significantly impaired performance in all three memory tasks. The findings indicate that MDMA-induced verbal memory impairment is mediated by 5-HT(2A) receptor stimulation.

LSD and creativity: Increased novelty and symbolic thinking, decreased utility and convergent thinking

Journal of Psychopharmacology February 1, 2022 Isabel Wießner, Marcelo Falchi-Carvalho, Lucas Oliveira Maia et al. 43 citations

A randomized, double-blind, placebo-controlled crossover study gave 24 healthy volunteers 50 micrograms of LSD or an inactive placebo and tested creativity near the drug's peak using multiple tasks. LSD changed creativity in three ways: it increased novelty, surprise, originality, and semantic distances (pattern break); decreased utility, convergent thinking, and marginally elaboration (disorganization); and increased symbolic thinking and ambiguity (meaning). The findings suggest LSD shifts cognitive resources away from normal patterns toward new ones, and that LSD-induced symbolic thinking might aid psychedelic-assisted therapy.

Assessment of the Acute Effects of 2C‐B vs. Psilocybin on Subjective Experience, Mood, and Cognition

Clinical Pharmacology & Therapeutics May 30, 2023 Pablo Mallaroni, Riccardo Paci, Sabrina Ritscher et al. 34 citations

2,5‐dimethoxy‐4‐bromophenethylamine (2C‐B), a hallucinogen derived from mescaline, produces psychedelic effects of moderate depth, shorter in duration than psilocybin. In a double‐blind, placebo‐controlled study of 22 healthy participants with prior psychedelic experience, 20 mg of 2C‐B elicited alterations of waking consciousness, though psilocybin (15 mg) caused greater dysphoria, subjective impairment, auditory alterations, and ego dissolution. Both compounds equally slowed psychomotor performance and impaired spatial memory compared with placebo, and neither produced empathogenic effects on the Multifaceted Empathy Test. 2C‐B raised blood pressure transiently, similar to psilocybin, and its effects largely resolved within six hours.

MDMA-Induced Dissociative State not Mediated by the 5-HT2A Receptor

Frontiers in Pharmacology July 11, 2017 Drew J. Puxty, Johannes G. Ramaekers, Rafael de la Torre et al. 33 citations

A single 75 mg dose of MDMA produces a dissociative state, marked by feelings of depersonalization and derealization, in healthy recreational users. Blocking the 5-HT2 receptor with ketanserin did not prevent this effect, indicating that the 5-HT2 receptor does not mediate MDMA-induced dissociation. Heart rate correlated with the dissociative state after MDMA alone, but not when ketanserin was given, suggesting heart rate changes do not directly cause dissociation. Cortisol levels and MDMA blood concentrations showed no clear relationship with dissociation. The exact neurobiological mechanism remains unknown and may be relevant to MDMA's therapeutic use.

Potential analgesic effects of psychedelics on select chronic pain conditions: A survey study

European Journal of Pain August 20, 2023 Mauro Cavarra, Amanda Feilding, Pamela Kryskow et al. 28 citations

A survey of people with chronic pain conditions found that, except for sciatica, those who used psychedelics (full doses or microdoses) reported better pain relief than with conventional medication. Full doses outperformed conventional medication for fibromyalgia, arthritis, migraine, and tension-type headache. Microdoses provided significantly better relief than conventional medication for migraines and comparable relief for the other conditions. The findings suggest that psychedelics may hold value for treating some chronic pain conditions.

The influence of ceremonial settings on mystical and challenging experiences occasioned by ayahuasca: A survey among ritualistic and religious ayahuasca users

Frontiers in Psychology July 15, 2022 Alexandre Augusto de Deus Pontual, Alexandre Augusto de Deus Pontual, Luís Fernando Tófoli et al. 27 citations

Setting characteristics—social context, comfort, infrastructure, and decoration—moderate the intensity of challenging experiences during ayahuasca ceremonies, explaining 41% of the variance in challenging experience ratings across three traditions (União do Vegetal, Santo Daime, and neo-shamanic groups). Mystical experiences were less strongly associated with setting, with leadership and comfort explaining only 14% of the variance. Social context was rated highest among União do Vegetal members. In neo-shamanic groups, infrastructure, comfort, and decoration correlated more consistently with mystical experiences than in the other traditions. Maximizing setting quality reduces the likelihood of challenging experiences and modestly supports mystical experiences.

Benefits and Challenges of Ultra-Fast, Short-Acting Psychedelics in the Treatment of Depression

American Journal of Psychiatry January 1, 2025 Johannes G. Ramaekers, Johannes T. Reckweg, Natasha L. Mason 25 citations

Psychedelics like psilocybin can produce a rapid antidepressant response, unlike classical antidepressants. Ultra-fast, short-acting psychedelics such as 5-MeO-DMT and DMT are being explored for their potential to induce rapid antidepressant effects after a brief, intense experience. These compounds primarily act on serotonergic receptors, including 5HT1A and 5HT2A. Early small clinical trials show that short interventions (15-30 minutes) are safe and well tolerated, leading to marked improvement in depression symptoms within 24 hours that lasts at least one week. Data on long-term efficacy are scarce but suggest a prolonged treatment response. Potential benefits include flexible dosing and independence from integrative therapy. Future challenges include establishing the duration of the antidepressant effect and optimizing treatment delivery.