Frontiers in Psychiatry
June 27, 2023
Irene Li, Rodney Fong, Molly M. Hagen et al.
25 citations
Medical students in Nevada hold generally positive attitudes toward psychedelics and psychedelic-assisted therapies but lack knowledge about them. In a survey of 132 students (22.7% response rate), 78.6% agreed that psychedelics have therapeutic potential, and 95.2% agreed they deserve further research. Students expressed uncertainty about neurocognitive risks. Demographic factors such as age, sex, and level of training did not significantly affect attitudes. The authors suggest that as psychedelic therapies may soon gain federal approval for psychiatric conditions, medical training should include early education on these agents to prepare future clinicians.
American Journal of Therapeutics
March 1, 2024
Kirsten Cherian, Kenneth Shinozuka, Burton J. Tabaac et al.
9 citations
Ibogaine, a plant-derived alkaloid used for millennia in West-Central African ceremonies, shows promise for treating opioid dependence and other neuropsychiatric conditions like PTSD, depression, and anxiety. However, it poses significant safety risks, including potentially fatal cardiac arrhythmias due to QT prolongation, which co-administration with magnesium may reduce. Dangerous interactions with opiates require full opioid withdrawal before treatment. Rare mania or psychosis can occur, and transient effects include ataxia, tremors, and gastrointestinal issues. In open-label and randomized controlled trials, a single ibogaine dose reduces heroin and opioid cravings by over 50% for up to 24 weeks.
December 20, 2024
Amna Aslam, Kenneth Shinozuka, Owen S. Muir et al.
2 citations
preprint
Ketamine, particularly intravenous (IV) ketamine, is increasingly used off-label for treatment-resistant depression (TRD), despite only esketamine being FDA-approved. A scoping review of two survey-based studies found IV administration is the most common method, with intramuscular and sublingual routes used less often. Patients are predominantly middle-aged (36-64 years), and financial barriers are notable due to limited insurance coverage and out-of-pocket costs. Geographic disparities limit access in rural areas. Private clinics offer more flexible treatment approaches than hospitals. The review emphasizes the need for standardized protocols, expanded insurance coverage, and further research due to variability in practices and absence of long-term outcome data.
Frontiers in Pharmacology
June 3, 2026
Burton J. Tabaac, Robin L. Carhart-Harris, Teresa Yung
Three individuals with persistent symptoms after traumatic brain injury or hypoxic-ischemic brain injury completed a six-week protocol combining a participant-directed iboga-containing microdosing regimen (using whole root bark biomass with about 3.845% ibogaine content, yielding an estimated 3.8–38.5 mg/day ibogaine equivalent) with weekly Accelerated Experiential Dynamic Psychotherapy and supportive nutraceuticals. All three showed progressive neurological recovery; two reported complete symptom remission at long-term follow-up. Participants discontinued all prescription medications and reported resolution of headaches, brain fog, fatigue, irritability, and mood swings, with a return to regular activities and renewed enthusiasm. The authors note that the findings do not establish causality or iboga-specific efficacy due to the multimodal intervention and methodological limitations.
February 28, 2026
Burton J. Tabaac, Kenneth Shinozuka, Fadel et al.
preprint
Mescaline, a classic serotonergic psychedelic used ceremonially by Indigenous peoples, shows preliminary safety in healthy humans under controlled conditions, producing dose-dependent subjective effects with moderate, transient autonomic stimulation and no serious medical complications. Adverse effects are generally self-limited, and pooled safety analyses and observational data support an overall favorable safety profile in screened populations. However, there is a lack of controlled clinical trials evaluating mescaline in patient populations, so its safety in individuals with cardiovascular, metabolic, or psychiatric comorbidities remains unclear. Controlled clinical trials are needed to establish its safety and therapeutic potential.
American Journal of Therapeutics
February 20, 2026
Burton J. Tabaac, Kenneth Shinozuka, Anne Weisman et al.
5-MeO-DMT, an ultra-short-acting psychedelic, shows promise for treating depression that does not respond to other therapies, as well as other psychiatric conditions. This evidence supports the need for larger randomized controlled trials to further investigate its effectiveness.
Dialogues in Clinical Neuroscience
September 2, 2024
Shiven Chaudhry, Anne Weisman, Molly M. Hagen et al.
A two-hour team-based learning curriculum improved medical students' knowledge, comprehension, and ethical understanding of psychedelic therapies. Pre- and post-surveys from 63 and 50 students, respectively, showed significant gains in perceived knowledge and attitudes, while 48 matched pre/post-knowledge tests demonstrated enhanced comprehension. Qualitative feedback indicated greater comfort discussing psychedelics clinically, though some students expressed reservations about psychedelic-assisted therapy. The curriculum addresses an educational gap as psychedelic medicine becomes more relevant.
December 27, 2023
Owen S. Muir, Kenneth Shinozuka, Bryce D. Beutler et al.
preprint
Psychedelic compounds may offer more potent and rapidly-acting treatments for psychiatric conditions compared to traditional small-molecule drugs, which often have limited effect sizes and adverse effects. Only one such compound, esketamine, is currently FDA-approved for depression; the others remain investigational. This article reviews six psychedelic compounds using a strengths, weaknesses, opportunities, and threats (SWOT) framework to assess their potential role in medicine.
December 26, 2023
Kirsten Cherian, Kenneth Shinozuka, Burton J. Tabaac et al.
preprint
Ibogaine, a plant-derived alkaloid used for millennia in West-Central African ceremonies, shows promise for treating opioid addiction, PTSD, depression, and traumatic brain injury. It reduces heroin and opioid cravings by over 50% for up to 24 weeks after a single dose in open-label and randomized trials. Combined with 5-MeO-DMT, it significantly lessens PTSD and depression symptoms. However, ibogaine poses serious risks, including cardiotoxicity, fatal arrhythmias, dangerous opioid interactions, and rare mania or psychosis. Rigorous double-blind, placebo-controlled research is lacking, and safer practices are needed given high trafficking rates.
December 26, 2023
Burton J. Tabaac, Kenneth Shinozuka, Alejandro Arenas et al.
preprint
Psychedelic drugs show promise for treating depression, anxiety, and other neuropsychiatric conditions that have not responded to prior interventions. While initial trials were very promising, larger studies of psilocybin with over 100 participants suggest it may not be more effective than standard antidepressants. Esketamine was approved for major depressive disorder in 2019. Two Phase III trials of MDMA for post-traumatic stress disorder found it superior to existing treatments. A Phase III trial of psilocybin is underway. The review covers LSD, DMT, ayahuasca, psilocybin, ibogaine, MDMA, and ketamine, concluding that these agents offer promise and clinicians should learn to implement them in patient-centered care.
December 26, 2023
Burton J. Tabaac, Kenneth Shinozuka, Alejandro Arenas et al.
preprint
Psilocybin, the psychoactive compound in magic mushrooms, alters consciousness by acting on the 5-HT2A receptor. Contrary to early fears of lasting mental health problems like psychosis, controlled clinical trials show it is psychologically and physiologically safe. Initial small trials reported remission rates of 42-57% for major depressive disorder and treatment-resistant depression, suggesting greater effectiveness than standard antidepressants. However, larger Phase II trials with over 100 participants found a lower remission rate of 25-29%, though a significant reduction in depressive symptoms remained. Psilocybin also shows promise for substance use disorders and end-of-life anxiety. Phase III trials are underway to confirm these findings.
Burton J. Tabaac, Kenneth Shinozuka, Anne Weisman et al.
preprint
5-MeO-DMT, a psychedelic found in toad venom and some plants, shows rapid antidepressant effects in early clinical trials. A Phase 2b trial reported that 57.5% of participants with treatment-resistant depression achieved remission within eight days. Other Phase 2a and 2b trials suggest it may reduce depressive symptoms more effectively than existing treatments like SSRIs. The substance appears low-risk in controlled settings, though most studies are small and only two double-blind randomized controlled trials have been conducted in clinical populations. Long-term effects need further study, and its possible link to near-death experiences remains debated.
Kenneth Shinozuka, Burton J. Tabaac, Alejandro Arenas et al.
preprint
MDMA, known as a party drug in the 1980s, is emerging as a powerful treatment for PTSD. Phase III FDA trials show MDMA-assisted psychotherapy has an effect size of 0.7-0.91, two to three times larger than existing antidepressants. Within 18 weeks, 67 to 71% of patients no longer meet PTSD diagnostic criteria. The literature is biased: animal studies used doses far above human levels, and human samples often involve recreational users of multiple substances. Only six clinical trials, all by MAPS, have been conducted, but preliminary evidence suggests MDMA is much more effective than current antidepressants for PTSD.
Viviana D. Evans, Alejandro Arenas, Kenneth Shinozuka et al.
preprint
Ketamine, originally a dissociative anesthetic, is now used for treatment-resistant depression and major depressive disorder with suicidal ideation. A single intravenous infusion shows antidepressant effects within hours, with a large effect size on depression scores. It also reduces PTSD symptom severity and suicidal ideation in emergency settings. However, therapeutic effects often subside within weeks, requiring repeated doses. Risks include temporary or persistent memory impairment, cardiovascular issues, liver toxicity, and bladder inflammation. Ketamine's opioid-sparing effect improves postoperative pain management.
Kenneth Shinozuka, Burton J. Tabaac, Alejandro Arenas et al.
preprint
DMT, the psychedelic in ayahuasca, is being studied for depression. In a double-blind, placebo-controlled trial, ayahuasca led to remission in 36% of patients with treatment-resistant depression within one week. A Phase IIa trial reported that 57% of patients with major depressive disorder experienced remission 12 weeks after a single dose of DMT. DMT is naturally produced in the body, but likely at insignificant levels. The idea that DMT is released during death remains unproven. Ayahuasca can cause temporary vomiting but appears generally safe. More research is needed on DMT's therapeutic and biological roles.
Bryce D. Beutler, Kenneth Shinozuka, Burton J. Tabaac et al.
preprint
Lysergic acid diethylamide (LSD) shows promise for treating alcohol use disorder, anxiety, and depression, though its therapeutic potential remains incompletely understood. In clinical trials, adverse events have almost always been mild and transient, with serious events reported in none or very few participants. For anxiety and depression associated with life-threatening illnesses, 77% of participants demonstrate durable relief at one year post-treatment. A meta-analysis of randomized controlled trials found that single-dose LSD significantly improves alcohol use disorder with an odds ratio of 1.96. Large-scale prospective studies are needed to explore potential clinical applications.