The British Journal of Psychiatry
March 31, 2009
Sudhakar Selvaraj, Rosa Hoshi, Zubin Bhagwagar et al.
59 citations
Former MDMA users show no significant difference in serotonin transporter binding compared to non-users, suggesting that recreational MDMA use may not cause long-term damage to serotonin neurons in humans. The study measured serotonin transporter binding with PET imaging in 12 former MDMA users, 9 polydrug users who never took MDMA, and 19 controls with no illicit drug history. No differences in binding potential were found across any brain regions examined. These results challenge concerns from animal studies that MDMA use leads to persistent serotonin neurotoxicity in humans.
Psychological Medicine
August 25, 2017
Philip J. Cowen
38 citations
About 15% of depressed patients who do not respond to two antidepressant trials achieve remission with subsequent therapies. For treatment-resistant depression, augmentation with atypical antipsychotics quetiapine and aripiprazole has the strongest evidence, though lithium and triiodothyronine remain useful. Ketamine shows striking antidepressant effects in resistant depression, but developing similar glutamatergic drugs for continuous use is challenging. Growing understanding of inflammation's role in depression may allow repurposing anti-inflammatory agents and stratifying patients who would benefit. The dopamine agonist pramipexole, used carefully, could improve outcomes for refractory patients.
British Journal of Clinical Pharmacology
April 1, 1985
Michael Schächter, D.p. Geaney, Dg Grahame‐smith et al.
20 citations
Schizophrenic patients treated with depot thioxanthenes and phenothiazines showed an approximately 30% increase in platelet 5-HT receptor number and a roughly 30% decrease in receptor affinity compared to controls. The decrease in affinity likely resulted from residual neuroleptic in the platelet membrane preparation. A weak positive correlation existed between receptor number and total neuroleptic dosage. The increased receptor number aligns with earlier reports of enhanced 5-HT-induced platelet aggregation in patients on long-term phenothiazines and thioxanthenes, suggesting 5-HT up-regulation in human platelets from depot neuroleptic therapy. Whether parallel changes occur in brain 5-HT receptors remains unknown.
The Lancet Psychiatry
May 17, 2016
Philip J. Cowen
13 citations
A commentary discusses a study of psilocybin for treatment-resistant depression, an uncontrolled trial in which 12 patients received two doses of psilocybin 7 days apart. The study supported the feasibility and safety of this protocol, with preliminary efficacy data suggesting an antidepressant effect. The commentary notes that patients were better educated than average, with ten of 12 having at least an undergraduate degree, and five had previously used psilocybin, increasing the likelihood of expectancy effects. At 3-month follow-up, about half the group still showed significant depressive symptoms. The commentary also discusses the need for longer-term outcomes and the importance of controlling for expectancy in future studies.