Frontiers in Psychiatry
September 19, 2023
Hillary Jackson, Sara So, Abigail Yaffe et al.
87 citations
A large prospective survey of adults planning to take psilocybin outside clinical settings found that, on average, participants reported lasting reductions in anxiety, depression, and alcohol misuse, along with improvements in cognitive flexibility, emotion regulation, spiritual wellbeing, and extraversion, and decreases in neuroticism and burnout after use. However, a minority reported persisting negative effects: 11% at 2–4 weeks and 7% at 2–3 months after use, including mood fluctuations and depressive symptoms. The study included 2,833 respondents at baseline, 1,182 at 2–4 weeks, and 657 at 2–3 months post-use. Participants were primarily college-educated White men in the United States, mean age 40, who used dried psilocybin mushrooms (mean dose 3.1 grams) for self-exploration.
Frontiers in Psychology
March 25, 2022
David S. Mathai, Victoria Mora, Albert Garcia‐romeu
51 citations
Ketamine, a dissociative drug used as an anesthetic since the 1970s, also shows promise for psychiatric applications, especially when combined with psychological interventions. A review of historical and modern approaches discusses the clinical relevance of ketamine's acute psychoactive effects and proposes a unique model for using esketamine with Acceptance and Commitment Therapy (ACT). The authors suggest considerations for advancing medication-assisted psychotherapy as a field.
Journal of Psychoactive Drugs
February 7, 2025
Amy Lehrner, Heather Jackson, David S. Mathai et al.
11 citations
Among 679 adults using psilocybin in naturalistic settings, 68.2% reported acute feelings of shame or guilt during the experience, which were difficult to predict. The ability to constructively work through these feelings predicted wellbeing 2-4 weeks later. On average, psilocybin produced a small but significant decrease in trait shame maintained 2-3 months after use (Cohen's dz = 0.37), though trait shame increased in 29.8% of participants. The activation of self-conscious emotions with psychedelics warrants further attention as a challenging experience subcategory relevant to psychological outcomes, potentially creating a unique learning condition for shame-related memory reconsolidation.
Psychedelic Medicine
August 30, 2023
Samantha Hilbert, David S. Mathai, Nathan D. Sepeda et al.
10 citations
Dissociatives like dextromethorphan may have clinical applications when used in supportive settings similar to those in psychedelic research, which prioritize optimizing psychologically valuable drug experiences. The analysis suggests that such contexts could enhance therapeutic outcomes.
International review of psychiatry (Abingdon, England)
December 1, 2024
David S. Mathai
3 citations
Dissociative therapies are increasingly studied for psychiatric use, but key clinical questions remain. This review identifies six areas: whether functional unblinding skews efficacy data; how therapeutic effects differ from recreational drug relief; how the concept of dissociation applies to these drugs; whether subjective drug effects predict outcomes; how dissociative and classic psychedelics compare; and the need for prescribing and deprescribing guidelines as these treatments become more common.
October 14, 2023
David S. Mathai, Daniel E. Roberts, Sandeep M. Nayak et al.
preprint
A longitudinal study of 679 adults planning to use psilocybin in naturalistic settings found that while most users (89.7%) described the experience as positive, acute feelings of shame or guilt were commonly reported (68.2% of users) and difficult to predict. The ability to constructively work through these feelings predicted wellbeing 2-4 weeks after use. Psilocybin produced a small but significant average decrease in trait shame that lasted 2-3 months, but trait shame increased in a notable minority (29.8%) of participants. The activation of shame-related experiences with psychedelics may pose a unique learning condition for both therapeutic and detrimental forms of memory reconsolidation.