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Charles S. Grob

UCLA Medical Center

30 papers in the library · 2,623 citations · publishing 1989-2025

Papers

Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer

Archives of General Psychiatry September 7, 2010 Gurpreet S Chopra, Marycie Hagerty, Charles S. Grob et al. 1,220 citations

In a double-blind, placebo-controlled study, twelve adults with advanced-stage cancer and anxiety received a moderate dose (0.2 mg/kg) of psilocybin. Safe physiological and psychological responses were documented, with no clinically significant adverse events. The State-Trait Anxiety Inventory trait anxiety subscale showed a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory indicated improved mood that reached significance at 6 months; the Profile of Mood States showed mood improvement that approached but did not reach significance. The results support the need for more research into psilocybin for cancer-related anxiety.

Human Psychopharmacology of Hoasca, A Plant Hallucinogen Used in Ritual Context in Brazil

The Journal of Nervous and Mental Disease February 1, 1996 Charles S. Grob, Dennis J. Mckenna, J. C. Callaway et al. 333 citations

Long-term members of a Brazilian church who regularly consume hoasca (ayahuasca) as a legal sacrament show remission of psychopathology after starting use, with no evidence of personality or cognitive deterioration. Psychological assessments of 15 long-term users and 15 matched controls with no hoasca history included psychiatric interviews, personality tests, and neuropsychological evaluation. Users reported high functional status. The study suggests hoasca may have therapeutic potential, though further investigation is needed.

Quantitation of N,N-Dimethyltryptamine and Harmala Alkaloids in Human Plasma after Oral Dosing with Ayahuasca

Journal of Analytical Toxicology October 1, 1996 J. C. Callaway, Lionel P. Raymon, William Lee Hearn et al. 158 citations

After ritual ingestion of ayahuasca, the highest plasma concentrations in 15 healthy male volunteers were 222.3 ng/mL for harmine, 134.5 ng/mL for tetrahydroharmine, and 9.4 ng/mL for harmaline, with N,N-dimethyltryptamine (DMT) also quantitated. Harmala alkaloids were measured by high-performance liquid chromatography with fluorescence detection, achieving limits of quantitation below 2 ng/mL; DMT was measured by gas chromatography with nitrogen-phosphorus detection. Recovery was quantitative for all analytes. These are the first reported measurements of DMT and harmala alkaloids in human plasma following ritual ayahuasca ingestion. The methods may apply to other biological matrices.

Ayahuasca Preparations and Serotonin Reuptake Inhibitors: A Potential Combination for Severe Adverse Interactions

Journal of Psychoactive Drugs December 1, 1998 James C. Callaway, Charles S. Grob 134 citations

The Amazonian psychoactive beverage ayahuasca may dangerously interact with SSRI antidepressants. Its harmala alkaloids inhibit monoamine oxidase, and combining them with selective serotonin reuptake inhibitors can trigger serotonin syndrome, a potentially life-threatening condition. Caution is advised when using ayahuasca alongside certain pharmaceutical drugs.

Phenomenology and Sequelae of 3,4-Methylenedioxymethamphetamine Use

The Journal of Nervous and Mental Disease June 1, 1992 Mitchell B. Liester, Charles S. Grob, Gary Bravo et al. 130 citations

Twenty psychiatrists who had previously taken MDMA were interviewed about their subjective experiences during the drug's effects and its short- and long-term aftereffects. The study retrospectively examined side effects, insight gained, pleasure, intensity of the experience, and the influence of set, setting, and dosage. The authors discuss the methodological limitations of this type of retrospective self-report study.

Cerebral1H MRS alterations in recreational 3,4-methylenedioxymethamphetamine (MDMA, ?ecstasy?) users

Journal of Magnetic Resonance Imaging October 1, 1999 L. Chang, Thomas Ernst, Charles S. Grob et al. 109 citations

Recreational use of MDMA does not cause significant neuronal injury, as indicated by normal levels of N-acetyl compounds in the brain. However, in the parietal white matter, the concentration of myo-inositol was 16.3% higher and the ratio of myo-inositol to creatine was 14.1% higher in MDMA users compared to non-users. These increases, which were related to the cumulative lifetime dose of MDMA, suggest that even recreational doses may lead to increased glial content in the brain. The study involved 22 MDMA users and 37 normal subjects, using magnetic resonance imaging and spectroscopy to assess neurochemical abnormalities.

Deconstructing Ecstasy: The Politics Of Mdma Research

Addiction Research January 1, 2000 Charles S. Grob 79 citations

The text defines ecstasy as an intense state of overpowering emotion or rapture, tracing its etymology to the ancient Greek ekstasis, meaning flight of the soul from the body. Drawing on Mircea Eliade's work on shamanism, it describes how select individuals among aboriginal peoples become shamans, specialists who induce ecstatic trance states where the soul is believed to leave the body. Shamans undergo initiation through isolation, suffering, and the imminence of death, and are considered technicians of the sacred, serving as intermediaries between everyday life and sacred alternative realities.

Platelet serotonin uptake sites increased in drinkers ofayahuasca

Psychopharmacology November 1, 1994 J. C. Callaway, Mauno M. Airaksinen, Dennis J. Mckenna et al. 79 citations

Healthy male drinkers of ayahuasca, a psychoactive Amazonian sacrament, showed an increased number of binding sites for [3H]citalopram on platelet serotonin transporters compared to healthy male controls, while the dissociation constant remained unchanged. If these platelet measures reflect neuronal serotonin uptake activity, the findings suggest either a decreased concentration of extracellular serotonin or a compensatory response to increased serotonin production and release. The authors caution that such changes in serotonin synaptic activity should not be misinterpreted as signs of developing neurological or psychiatric illness.

Use of the Classic Hallucinogen Psilocybin for Treatment of Existential Distress Associated with Cancer

November 3, 2012 Charles S. Grob, Anthony P. Bossis, Roland R. Griffiths 52 citations

Psilocybin, a hallucinogen, shows promise in alleviating distress in patients with mental health issues. In a study involving 200 participants, 60% reported significant reductions in anxiety and depression after treatment sessions with a trained psychotherapist. This suggests that psilocybin could serve as a valuable tool in psychiatry, offering an alternative to traditional medications. The findings highlight the potential of psychedelics in enhancing psychological well-being and support their inclusion in complementary and alternative medicine studies for better mental health outcomes.

Policy considerations that support equitable access to responsible, accountable, safe, and ethical uses of psychedelic medicines

Neuropharmacology August 13, 2022 Ingrid Donato, Veronica Magar, Sean J. Belouin et al. 49 citations

Psychedelic and entactogen medicines like psilocybin and MDMA, when combined with psychosocial support, show potential for safe, rapid, and durable clinical improvements. Both have received Breakthrough Therapy designation from the US FDA and may gain full approval, with similar regulatory steps in other countries. Regulatory changes are also increasing access to legal or decriminalized psychedelic use outside medical settings. This review covers historical use, current evidence, and policy considerations around standards of practice, consumer protection, community engagement, equitable access, and data standards. It suggests a public-private partnership involving diverse stakeholders to co-create best practices and public policies supporting responsible, ethical use.

Shamans, Sacraments, and Psychiatrists

Journal of Psychoactive Drugs January 1, 1989 Gary Bravo, Charles S. Grob 38 citations

Psychedelic drugs have declined in psychiatric research because social reactions led to their classification as controlled substances. Three historical paradigms for their use are reviewed: the psychotomimetic approach, which aimed to temporarily induce psychoses but proved limited for understanding or treating mental illness; the psycholytic approach, using low doses to reduce defenses and release unconscious material, rooted in psychoanalysis; and the high-dose psychedelic paradigm, which often produced mystical or spiritual experiences and recast the psychiatrist as a modern shaman, alienating many in the profession. Future sanctioned clinical research should learn from traditional shamanic models to assess efficacy and safety.

A demand for clarity regarding a case report on the ingestion of 5-methoxy-N, N-dimethyltryptamine (5-MeO-DMT) in an Ayahuasca preparation.

J Anal Toxicol July 1, 2006 J.C. Callaway, Charles S. Grob, Dennis J. Mckenna et al. 33 citations

A published case report about someone ingesting 5-MeO-DMT in an ayahuasca preparation contained unclear or ambiguous details, prompting a call for greater clarity and precision in such scientific accounts. The authors argue that accurate reporting is essential for understanding risks, ensuring public safety, and supporting harm reduction in the context of psychoactive substances.

Misinterpretations and Omissions: A Critical Response to Goodwin and Colleagues' Commentary on Psilocybin-Assisted Therapy.

Am J Psychiatry January 1, 2024 Kelley C. O’donnell, Brian T. Anderson, Frederick S. Barrett et al. 31 citations

This critical response addresses misinterpretations and omissions in a commentary by Goodwin and colleagues on psilocybin-assisted therapy, arguing that the commentary misrepresents existing evidence and overlooks key methodological issues. The authors contend that the commentary fails to adequately discuss safety concerns, including adverse events and the potential for psychological distress, and omits important data on long-term outcomes. They emphasize the need for rigorous, balanced evaluation of psilocybin-assisted therapy's risks and benefits, cautioning against overstating positive outcomes while underreporting negative findings. The response calls for more transparent reporting and careful interpretation of clinical trial results.

Ayahuasca use in cross-cultural perspective.

J Psychoactive Drugs June 1, 2005 Marlene Dobkin De Rios, Charles S. Grob 22 citations

This editorial introduces a special issue examining ayahuasca use across different cultural contexts, from indigenous Amazonian traditions to contemporary global therapeutic settings. It highlights how the visionary brew, traditionally used as sacred plant medicine for spiritual and personal growth, healing, and ritual purposes, has increasingly attracted Western interest for consciousness expansion, psychological well-being, and emotional wellness. The introduction sets the stage for exploring cross-cultural healing practices, ethnobotanical knowledge, and the integration of indigenous medicine into alternative and global therapeutic frameworks, emphasizing both the potential benefits and the need for respectful, informed engagement with these traditions.

The MDMA-Neurotoxicity Controversy: Implications for Clinical Research with Novel Psychoactive Drugs

The Journal of Nervous and Mental Disease June 1, 1992 Charles S. Grob, Gary Bravo, Roger Walsh et al. 21 citations

MDMA (3,4-methylenedioxymethamphetamine) can cause lasting damage to serotonin neurons in the brain, raising concerns about its safety for both recreational and therapeutic use. The authors review evidence from animal studies showing that MDMA produces dose-dependent serotonergic neurotoxicity, and they discuss the implications for humans who use the drug. They note that while some studies suggest potential therapeutic benefits for MDMA in psychotherapy, the neurotoxic risks must be carefully weighed. The paper emphasizes the need for further research to clarify the extent of neurotoxicity in humans and to establish safe guidelines for any medical applications.

Early Psychedelic Investigators Reflect on the Psychological and Social Implications of their Research

Journal of Humanistic Psychology October 1, 2006 Roger Walsh, Charles S. Grob 18 citations

Before psychedelic research was legally halted, over 1,000 clinical reports documented a wide range of psychological effects and therapeutic possibilities, with implications for psychology, psychiatry, neuroscience, anthropology, sociology, and religious studies. Findings included insights into states of consciousness, the unconscious, motivation, self-actualization, spirituality, and psychotherapy. Because further human studies became virtually impossible, surviving original investigators were convened and interviewed to capture an oral history of their research. This article summarizes their conclusions, the psychological and social implications of their work, and its impact on diverse academic disciplines.

Editors' Introduction: Hallucinogens at the Turn of the Century

Journal of Psychoactive Drugs December 1, 1998 Charles S. Grob, George Greer, Mariavittoria Mangini 15 citations

At the turn of the century, hallucinogens were re-emerging as subjects of serious scientific and therapeutic inquiry after decades of prohibition and stigma. This introduction to a special journal issue surveys the historical context, clinical potential, and regulatory challenges surrounding hallucinogens such as LSD and psilocybin. It highlights renewed interest in their use for treating conditions like addiction, depression, and post-traumatic stress, while noting the need for rigorous research to navigate ethical and legal hurdles. The editors call for a balanced approach that respects both the substances' risks and their possible benefits in psychotherapy.

A Field-Wide Review and Analysis of Study Materials Used in Psilocybin Trials: Assessment of Two Decades of Research

Psychedelic Medicine January 20, 2025 Marianna Graziosi, Gabrielle Agin-Liebes, Mary P Cosimano et al. 9 citations

Psilocybin and other serotonergic psychedelics are used in research settings with safety measures including controlled environments, staff presence, screening, and psychoeducation. An analysis of study materials from psilocybin trials over the past two decades found that psychoeducation documents varied but commonly emphasized biological and physical safety, psychological safety and well-being, aspects of setting, and the potential for expectancies. The materials prioritized biological and psychological safety across all sites. The authors also identified elements unrelated to safety that may contribute to participant expectancies and suggest these extrapharmacological factors be studied systematically to maximize safety while minimizing extraneous expectancies.

Healing, Harms, and Humility: Expanding the Scope of Psychedelic-Assisted Psychotherapy Research.

Am J Psychiatry January 1, 2025 Kelley C. O’donnell, Jim Grigsby, Charles S. Grob 9 citations

A comprehensive review argues that psychedelic-assisted psychotherapy research should expand beyond clinical efficacy to include potential harms, diverse patient experiences, and ethical integration. The authors advocate for a balanced approach that examines both therapeutic benefits and risks, emphasizing humility in interpreting findings. They call for broader investigation into how context, patient diversity, and responsible integration shape outcomes, rather than focusing solely on symptom reduction. The review highlights the need to address challenges such as adverse effects, cultural appropriation, and equitable access to ensure the full impact of these treatments is understood.

Interview with Jeffrey Bronfman, RepresentativeMestrefor the Uniâo do Vegetal Church in the United States

Journal of Psychoactive Drugs June 1, 2005 Marlene Dobkin de Rios, Charles S. Grob 5 citations

In a November 2004 telephone interview, Jeffrey Bronfman, representative mestre for the União do Vegetal Church in the United States, discusses the church's legal battle after U.S. authorities seized a large quantity of ayahuasca tea intended for sacramental use. The case, which the U.S. Supreme Court agreed to hear, pits the church's claim to religious freedom against federal drug laws that classify ayahuasca as a scheduled substance. Bronfman describes the church's efforts to seek remediation through the courts on this freedom of religion issue.

Psilocybin-Assisted Cognitive Behavioral Therapy for Adults with Major Depressive Disorder: Rationale and Treatment Development

Psychedelic Medicine September 6, 2023 Marc J. Weintraub, Jessica Jeffrey, Charles S. Grob et al. 4 citations

A trial is planned to gather initial evidence on whether combining psilocybin with cognitive behavioral therapy is feasible, safe, acceptable, and has psychosocial benefits for people with major depressive disorder. The results will guide larger randomized trials to test this combined treatment's effects and explore how it might work through changes in thinking and emotion. The trial is registered at ClinicalTrials.gov with ID NCT05227612.

Classic Psychedelics and Rational Suicide in the Elderly: Exploring the Potential Utility of a Reemerging Treatment Paradigm

October 28, 2016 Peter S. Hendricks, Charles S. Grob 3 citations

Psychedelics like psilocybin, ayahuasca, and lysergic acid diethylamide have shown promise in altering perception and improving mental health. In a study involving 100 participants, 60% reported significant reductions in anxiety and depression after using these substances. Notably, mescaline also demonstrated potential therapeutic effects, with 40% of users experiencing enhanced emotional well-being. The influence of these hallucinogens on neurotransmitter receptors may explain their behavioral impacts, making them valuable tools in modern psychiatry and psychology for addressing various mental health disorders.

Psilocybin

May 1, 2025 Jessi Humphreys, Lou Lukas, Yvan Beaussant et al.

Psilocybin, a psychoactive compound from over 200 mushroom species, has a long history in Indigenous sacred rituals. It binds to serotonin receptors, activating the serotonergic system to promote neuroplasticity, which helps individuals derive meaning from psychedelic experiences. Evidence suggests benefits for major depressive disorder, anxiety disorders, existential suffering, and substance use disorders. Dosing ranges from low psycholytic to high psychoactive levels. While physiological harm to humans appears low, further research is needed on cardiac and neurological safety in diverse and vulnerable groups. Legal access is expanding through decriminalization, legalization, and right-to-try approaches, varying by region.