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Johannes G. Ramaekers

Maastricht University

95 papers in the library · 3,866 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.

Ayahuasca enhances creative divergent thinking while decreasing conventional convergent thinking

Psychopharmacology July 19, 2016 Kim P. C. Kuypers, Jordi Riba, Mario de la Fuente Revenga et al. 204 citations

Ayahuasca, a psychedelic plant tea used in Amazonian shamanism, may enhance creative divergent thinking—the ability to generate new ideas and strategies—while decreasing convergent thinking, which focuses on a single correct answer. In a study of 26 participants at two spiritual workshops, creativity tests before and during the acute effects of ayahuasca showed that the tea significantly increased divergent thinking and decreased convergent thinking, as measured by the picture concept test. No significant effects were found on the pattern/line meanings test. These results suggest ayahuasca increases psychological flexibility, potentially aiding psychotherapeutic interventions.

Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition

Psychopharmacology May 1, 2019 Thomas R. Arkell, Nicholas Lintzeris, Richard C. Kevin et al. 177 citations

Both THC-dominant and THC/CBD equivalent cannabis increased lane weaving during simulated driving but had little effect on other driving measures. Impairment on the Digit Symbol Substitution Task, Divided Attention Task, and Paced Auditory Serial Addition Task occurred with both active cannabis types, with worse performance on the latter two tasks after THC/CBD equivalent cannabis. Subjective feelings of being "stoned" and confidence in driving ability did not differ by CBD content. Peak plasma THC concentrations were higher after THC/CBD equivalent cannabis, suggesting a possible pharmacokinetic interaction. Cannabis with equivalent CBD and THC appears no less impairing than THC-dominant cannabis, and CBD may exacerbate THC-induced impairment in some circumstances.

Tolerance and cross-tolerance to neurocognitive effects of THC and alcohol in heavy cannabis users

Psychopharmacology October 30, 2010 Johannes G. Ramaekers, Eef L. Theunissen, Marjolein de Brouwer et al. 168 citations

Heavy cannabis users develop tolerance to the impairing effects of THC on neurocognitive tasks, but they do not develop cross-tolerance to the impairing effects of alcohol. In a double-blind study, 21 heavy cannabis users received alcohol at three levels (targeting blood alcohol concentrations of 0, 0.5, and 0.7 mg/ml) and smoked a THC cigarette (400 μg/kg) 3 hours after drinking began. Alcohol alone impaired performance on tests of perceptual motor control, divided attention, and motor inhibition, while THC alone generally did not affect performance. However, combining THC and alcohol produced greater impairments in divided attention than alcohol alone, indicating that alcohol can potentiate THC effects in tolerant users.

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.

Smoked Cannabis' Psychomotor and Neurocognitive Effects in Occasional and Frequent Smokers

Journal of Analytical Toxicology March 4, 2015 Nathalie A. Desrosiers, Johannes G. Ramaekers, Émeline Chauchard et al. 136 citations

THC, the main psychoactive compound in cannabis, impairs psychomotor performance, cognition, and driving ability. Occasional cannabis smokers showed significantly more difficulty compensating for tracking error and greater decline in divided attention performance than frequent smokers after smoking one 6.8% THC cigarette. No differences between groups were found on working memory or risk-taking tasks. The results suggest that frequent users develop some tolerance to psychomotor impairment, with implications for driving under the influence cases.

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 Szabo 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 Szabo 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 Szabo, 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.

Neurophysiological functioning of occasional and heavy cannabis users during THC intoxication

Psychopharmacology October 5, 2011 Eef L. Theunissen, Gerold F. Kauert, Stefan W. Toennes et al. 82 citations

Heavy cannabis users develop tolerance to some impairing effects of cannabis, observable both in behavior and in brain electrical activity. In a double-blind, placebo-controlled crossover study, 12 occasional and 12 heavy cannabis users smoked a joint containing either 0 or 500 μg/kg body weight THC. During a divided attention task, THC reduced P100 amplitude in occasional users but not in heavy users, indicating tolerance at the neural level. P300 amplitude decreased in both groups. Performance on the stop signal task was impaired in both groups after THC, while divided attention task performance was impaired only in occasional users. Tolerance was evident in event-related potentials, suggesting it is not solely due to behavioral compensation.

Cannabis and tolerance: acute drug impairment as a function of cannabis use history

Scientific Reports May 26, 2016 Johannes G. Ramaekers, J. H. van Wel, Desirée Spronk et al. 81 citations

Acute cannabis intoxication impairs executive function, impulse control, attention, and psychomotor function, and increases subjective intoxication, regardless of how frequently a person uses cannabis. In a study of 122 drug users with cannabis use histories ranging from infrequent to daily, cannabis (300 μg/kg THC) produced these deficits compared to placebo, while cocaine (300 mg) improved psychomotor function and attention but impaired impulse control. The absence of tolerance to cannabis's neurocognitive effects suggests that frequent use and intoxication can interfere with performance in daily environments such as school, work, or traffic.

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.

Cannabis and cocaine decrease cognitive impulse control and functional corticostriatal connectivity in drug users with low activity DBH genotypes

Brain Imaging and Behavior December 14, 2015 Johannes G. Ramaekers, J. H. van Wel, Desirée Spronk et al. 61 citations

The dopamine β-hydroxylase (DβH) enzyme converts dopamine into noradrenaline. People with low-activity DBH genotypes (rs1611115 CT/TT) appear more sensitive to cannabis and cocaine's effects on cognitive impulse control and brain connectivity. In 122 regular drug users, acute doses of cannabis (450 μg/kg THC) and cocaine (300 mg) increased cognitive impulsivity and reduced functional connectivity between the nucleus accumbens and limbic, prefrontal, striatal, and thalamic areas, primarily in those with CT/TT genotypes, not in those with the CC genotype. A negative association emerged between impulsivity and subcortical connectivity. The findings suggest DBH genotype influences how these drugs affect impulse control and brain networks, potentially explaining progression to drug seeking and informing targeted pharmacotherapy.

Reduced responsiveness of the reward system is associated with tolerance to cannabis impairment in chronic users

Addiction Biology December 22, 2019 Natasha L. Mason, Eef L. Theunissen, Nadia R. P. W. Hutten et al. 58 citations

Regular cannabis users develop tolerance to the drug's impairing and rewarding effects, but the underlying brain changes are unclear. In a double-blind, placebo-controlled study, 12 occasional and 12 chronic cannabis users received acute doses of cannabis (300 μg/kg delta-9-tetrahydrocannabinol) or placebo. In occasional users, cannabis decreased functional connectivity and increased striatal glutamate levels in reward circuitry, linked to greater subjective high and worse attention performance. Chronic users showed none of these changes, indicating reduced responsiveness of reward circuitry to cannabis intoxication, suggesting a pharmacodynamic mechanism for tolerance development.

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.