Focus (American Psychiatric Publishing)
October 1, 2022
Jenna M Traynor, Daniel E Roberts, Stephen Ross et al.
14 citations
Borderline personality disorder is a complex psychiatric condition with limited and often ineffective treatment options, high variability in patient response, and frequent dropout from therapy. This review considers the potential of MDMA-assisted psychotherapy (MDMA-AP) as a new or complementary treatment. Based on MDMA-AP's promise in treating overlapping disorders like posttraumatic stress disorder, the authors propose initial treatment targets and hypothesized mechanisms of change grounded in prior literature and theory. They also outline considerations for designing clinical trials to investigate the safety, feasibility, and preliminary effects of MDMA-AP for borderline personality disorder.
PsyArXiv
October 17, 2023
Alessia Marrocu, Hannes Kettner, Brandon Weiss et al.
9 citations
preprint
About 16% of people who used psychedelics in naturalistic settings experienced a clinically meaningful decline in psychological well-being four weeks later. Those with a prior personality disorder diagnosis were disproportionately affected, making up 31% of negative responders and facing more than a four-fold elevated risk of adverse psychological responses. The findings suggest that personality disorders may heighten vulnerability to negative outcomes from psychedelic use, highlighting the need for careful screening and robust psychological support.
June 17, 2024
Richard Zeifman
1 citation
Psilocybin therapy may improve mental health by reducing experiential avoidance—the tendency to suppress or avoid distressing thoughts and feelings. In a quasi-experimental study with 28 healthy individuals, a high dose (25 mg) of psilocybin led to significant reductions in experiential avoidance at 2 and 4 weeks, sustained at 3 months but not at 6 months, while a very low dose (1 mg) did not. These reductions predicted improvements in well-being and decreases in depressed and anxious mood. In a randomized controlled trial with 59 people with major depressive disorder, psilocybin therapy reduced experiential avoidance more than the antidepressant escitalopram, and these reductions indirectly improved well-being, depression severity, suicidal ideation, and trait anxiety. The findings suggest experiential avoidance is a key mechanism in psilocybin therapy's effects.
May 13, 2026
Robin Carhart-Harris, Richard Zeifman, Lorenzo Pasquini et al.
preprint
The paper argues that the term 'plasticity' in neuroscience refers to induced changes in brain function or structure, which differs from the dictionary definition of plasticity as the ability to be shaped or molded. Many biomarkers of neuroplasticity actually index processes that bias phenotypic canalization, the opposite of phenotypic plasticity, creating a paradox. The authors question extrapolating from these biomarkers to improved mental health, as the relationship is context dependent. They propose a new construct, 'mediational and recalibrative plasticity' (MR-P), which aligns with plasticity proper and can describe and predict phenotypic changes relevant to mental health.
PsyArXiv
March 26, 2026
Broc A Pagni, Stephen Ross, Sarah Mennenga et al.
preprint
An open-label extension of a Phase II randomized controlled trial examined the safety and efficacy of psilocybin-assisted therapy for alcohol use disorder. Participants who had received either psilocybin or placebo in the main trial were offered two open-label psilocybin sessions. The treatment was well tolerated, with no serious adverse events attributed to psilocybin. Heavy drinking days decreased substantially from baseline, and the reduction was sustained through the 32-week follow-up. The findings suggest that psilocybin-assisted therapy may produce durable reductions in alcohol consumption among individuals with alcohol use disorder.