Behavioral Sleep Medicine Research Laboratory, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Suite 100, Baltimore, MD, 21224, USA. mreid27@jhmi.edu.
3 papers in the library · 42 citations · publishing 2023-2026
A systematic review of 69 neuroimaging studies (1751 participants) found no well-replicated biomarker for ketamine's antidepressant response, but identified several promising candidates. Response to ketamine was associated with post-treatment increases in gamma power in frontoparietal regions, increased functional connectivity within the prefrontal cortex, and increased functional activation of the striatum. The review highlights substantial methodological heterogeneity across studies and calls for further investigation of these biomarkers.
Psilocybin is an emerging treatment for depression, but its effects on sleep are not well understood. Clinical trials show large improvements in depressive symptoms, but sleep quality or insomnia symptoms have not been directly studied. Preliminary data indicate that both depressive symptoms and sleep disturbances decreased significantly after psilocybin use, though sleep improvements were smaller than those for depression. More severe sleep disturbances at baseline were linked to a lower probability of depression remission, suggesting a potential interaction between sleep and psilocybin's efficacy. Addressing sleep disturbances could enhance therapeutic outcomes and lead to more personalized treatment strategies.
Clinical trials of classical psychedelics like psilocybin for mental health conditions face unique challenges that may persist if these treatments enter clinical practice. Four categories of challenges with trial participants are identified: treatment nonresponse, expectancy effects and functional unblinding, post-session psychological difficulties, and contagion effects. Management strategies for study teams to mitigate these risks are described. The National Network of Depression Centers and similar organizations can guide best practices to responsibly advance this promising field.