Frontiers in Psychiatry
November 4, 2021
M.l. Williams, Diana Korevaar, Renee Harvey et al.
23 citations
After a 40-year research hiatus due to sociopolitical issues, psychedelic-assisted therapies are being reinvestigated for mental illness. Clinicians and researchers in Australia identified five categories of challenge to moving these therapies from clinical trials to community practice: inherent risks, poor clinical practice, inadequate infrastructure, problematic perceptions, and divisive relationships. They propose strategies including public-sector support for research and training to establish best practices, funding for equitable access, and a multidisciplinary advisory body to guide policy. While framed in Australia, the challenges and strategies may apply elsewhere.
Frontiers in Psychiatry
August 31, 2020
Giovanni Martinotti, Attilio Negri, Stefania Schiavone et al.
22 citations
Recreational drug use among holidaymakers in Ibiza often involves multiple substances, both traditional and novel, leading to acute psychiatric emergencies. The pattern of poly-substance use is linked to a range of psychopathological consequences. Better understanding of the specific effects of individual drugs, clearer diagnostic signs and symptoms, and long-term follow-up studies are needed.
Frontiers in Psychiatry
September 23, 2024
Zhan-Ming Shi, Yu-Ping Ning, Xin-Hu Yang et al.
21 citations
A systematic review of five randomized controlled trials involving 472 adults with major depressive disorder found that psilocybin improved depressive symptoms in three of the five studies and reduced anxiety symptoms in four of the five studies compared to controls. Suicidal ideation improved in only one trial. Discontinuation rates were similar between psilocybin (2–13%) and control groups (4–21%). The most common adverse drug reaction in both groups was headache. The authors conclude that psilocybin is effective for depressive and anxiety symptoms but note that long-term efficacy and safety require further investigation in larger trials.
Frontiers in Psychiatry
February 15, 2024
Shuping Fang, Xin Yang, Wei Zhang
21 citations
Psilocybin, a classic psychedelic, shows both short-term and long-term antidepressant effects for major depressive disorder and depression related to life-threatening diagnoses. A systematic review and meta-analysis of 10 clinical trials, including 524 adult patients, found a large effect size favoring psilocybin over control conditions. Therapeutic effects increase with higher doses. Adverse events are generally temporary and reversible, though serious events can occur. Psilocybin holds promise as a complementary or alternative therapy for depression.
Frontiers in Psychiatry
November 13, 2023
Tor-Morten Kvam, Malin V Uthaug, Kristoffer A A Andersen et al.
21 citations
In a survey of 770 Norwegian adults who had a memorable experience with a classic psychedelic substance like psilocybin or LSD, most used the substance for recreational (46.1%) or therapeutic (42.3%) reasons. Psilocybin was the most common substance for the memorable experience. Many participants reported self-perceived symptoms of mental disorders and substance use disorders, and most said their condition improved after the experience. Adverse reactions were usually mild and short-lived, but 4.2% lasted a year or more, and 2.9% had persisting flashbacks for a year or more. The findings highlight both benefits and long-term risks in a self-selecting sample.
Frontiers in Psychiatry
September 18, 2023
Karina Sergi, Micah Linton, Rhianna Rich et al.
21 citations
A nature-themed video intervention called Visual Healing, designed to optimize the environment during psilocybin-assisted therapy for alcohol use disorder, was tested in a pilot trial. Nineteen of 20 participants completed the study, and the video intervention was feasible, safe, and well-tolerated, with no video-related adverse events. During the first psilocybin session, participants viewed an average of 37.9 minutes of the 42-minute video. Peak increases in blood pressure after psilocybin were significantly smaller for those assigned to Visual Healing compared to standard procedures. Alcohol use decreased in both groups, and psychedelic effects, stress, and anxiety were similar. The intervention may reduce cardiovascular risks without interfering with treatment outcomes.
Frontiers in Psychiatry
September 30, 2021
James B. Close, Julia Bornemann, Maria Piggin et al.
21 citations
A co-designed guide for patient and public involvement (PPI) in psychedelic research addresses the lack of field-specific frameworks. Core values—trust, learning, purpose, and inclusivity—emerged from a workshop with public collaborators. The guidance aims to help researchers plan, evaluate, and improve PPI so that research is done with and by the public rather than on them, strengthening accountability and relevance as the field grows.
Frontiers in Psychiatry
November 23, 2023
Florian Buchmayer, Siegfried Kasper
19 citations
Intranasal esketamine, approved in 2019 and 2020 for treatment-resistant depression, helps more than half of non-responders after 2–4 failed antidepressant attempts. Guidelines recommend starting it as an add-on therapy in a medical setting for dose selection, monitoring, and managing adverse events. Long-term treatment is safe, with very rare severe side effects. This review critically evaluates published articles on preparation, management, and observation of the treatment, noting that psychiatrists face new but manageable procedures compared to standard prescribing.
Frontiers in Psychiatry
May 18, 2022
Joyce Huang, Michelle Pham, William J. Panenka et al.
19 citations
In a rat model of obesity, psilocybin—a prodrug for the serotonin receptor agonist psilocin—produced modest but significant reductions in weight gain compared to controls. Rats given a low (0.1 mg/kg) or high (5 mg/kg) dose of psilocybin gained less weight over 27 weekdays; the high dose also decreased consumption of a high-calorie diet and reduced central adiposity. Metformin (300 mg/kg) produced a greater decrease in weight gain than either psilocybin dose. A medium-dose psilocybin group was terminated early. Fasting glucose and glucose tolerance were also assessed. The authors recommend further study of psilocybin as a potential anti-obesity agent.
Frontiers in Psychiatry
January 24, 2022
Tigran Makunts, Lisa Jerome, Ruben Abagyan et al.
19 citations
MDMA, also known as ecstasy, is being studied as a treatment for PTSD and anxiety, with approval expected soon. Although MDMA affects serotonin and could theoretically cause serotonin syndrome—a potentially dangerous condition—no cases have occurred in clinical trials. A review of FDA adverse event reports found 20 cases of serotonin syndrome in people who took MDMA, but all had also used other serotonergic drugs such as amphetamines, stimulants, or opioids. No cases were linked to MDMA alone. These findings suggest that serotonin syndrome from MDMA alone is rare or absent in the available data.
Frontiers in Psychiatry
May 11, 2021
Ridge G. Weston, Paul J. Fitzgerald, Brendon O. Watson
19 citations
The anesthetic drug ketamine has been repurposed as a rapid-acting antidepressant for major depressive disorder (MDD), including treatment-resistant cases, unlike slower monoaminergic antidepressants. Its fast onset suggests a unique mechanism studied in reverse translational rodent models. Most research examines single ketamine doses, but MDD often requires ongoing treatment. This review of rodent studies using repeated ketamine dosing in the forced swim test (FST) found that repeated dosing can paradoxically increase immobility at high doses (50 or 100 mg/kg). However, several studies show repeated dosing more effectively decreases immobility than a single dose, with longer-lasting behavioral effects. The findings indicate repeated ketamine has prominent depression-related effects in rodents, which may help optimize human MDD treatment.
Frontiers in Psychiatry
December 10, 2020
Ove Heradstveit, Jens Christoffer Skogen, Marit Edland-Gryt et al.
19 citations
From 2014 to 2018, the proportion of Norwegian university and college students who had ever tried illicit drugs increased, from 30.8% to 36.7% among males and from 17.5% to 24.0% among females. Cannabis was the most commonly used drug in the past year (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use rose with age, peaking between ages 23 and 28, and was higher among males than females. Use also varied by geographic region, with the highest rates in the Oslo area. The findings point to a need for addressing illicit drug use in this population.
Frontiers in Psychiatry
June 16, 2023
Sean Matthew Viña, Amanda Layne Stephens
18 citations
Classic psychedelic use is associated with lower psychological distress among employed, volunteer, retired, or permanently disabled individuals, but with higher distress among unemployed people, full-time students, and homemakers. Data from 484,732 participants in the 2008–2019 National Survey of Drug Use and Health indicate that psychedelic users work longer hours per week before stress increases. Lifetime classic psychedelic use and employment are independently linked to better health, and psychedelics are unlikely to negatively affect employment outcomes.
Frontiers in Psychiatry
July 3, 2018
Joseph M. Barnby, Mitul A. Mehta
18 citations
The therapeutic potential of psilocybin, a psychedelic compound, is increasingly recognized in psychiatry, but its effects depend heavily on the context of use, known as 'set and setting.' This opinion article argues that the psychotherapeutic framework—including the relationship with therapists and the preparation and integration process—is as important as the drug itself for achieving positive outcomes. The authors suggest that neglecting the therapeutic context risks reducing psilocybin to a mere biological intervention, undermining its full potential for psychological healing and personal insight. The piece calls for careful integration of psychotherapeutic principles into psychedelic treatment models.
Frontiers in Psychiatry
February 1, 2024
Phil Wolfson, Gita Vaid
17 citations
Ketamine, the only legally prescribed psychedelic medicine in psychiatry, produces a spectrum of altered states at subanesthetic doses—from psychoactive to deep ego-dissolving experiences—that are intrinsic to its therapeutic effects. When these experiences occur within a therapeutic relationship that amplifies subjective consciousness, personal growth, inner healing, clarity, and better relationships may follow. Although the dissociative effects of ketamine have historically been labeled as side effects, in a conducive set and setting they can be positively used in psychiatry and psychotherapy, providing a time-out from usual states of mind to reshape self-experience and relieve symptoms. Ketamine-assisted psychotherapy (KAP) emphasizes recognizing experience, individuality, and imagination, with close attention to subjective experience, expression, and integration as essential for successful outcomes.
Frontiers in Psychiatry
November 23, 2023
Anya Ragnhildstveit, Ryan Khan, Paul Seli et al.
17 citations
A single dose of vaporized bufotoxin from the Sonoran Desert Toad, containing an estimated 10-15 mg of 5-MeO-DMT, produced clinically significant improvements in chronic, treatment-resistant PTSD in a 23-year-old female. Next-day effects included marked reductions in hopelessness and suicide risk, with improvements sustained at 1-, 3-, 6-, and 12-month follow-ups. The subject reported a complete mystical experience, which may underlie the therapeutic activity. No serious adverse events occurred, but acute nausea, overwhelming subjective effects, and late-onset night terrors were reported. Results suggest 5-MeO-DMT is generally tolerable and effective for PTSD, though the findings are non-generalizable and rely on methods not clinically accepted.
Frontiers in Psychiatry
March 8, 2022
Daniel Villiger
17 citations
Psychedelics are experiencing a renaissance in clinical research, with promising results for psychedelic-assisted treatment. This paper provides the first account of how pharmacological and psychological effects interact in such therapy. Building on the REBUS hypothesis and the contextual model, it argues that psychedelics amplify common factors of psychotherapy, particularly by attenuating the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy provides a safe environment and remedial expectations, which become incorporated during prediction revision—a process reinforced and accelerated by psychedelics, ultimately leading to symptom relief.
Frontiers in Psychiatry
March 14, 2023
Jonathan Brett, Elizabeth Knock, Paul Liknaitzky et al.
16 citations
Methamphetamine use disorder is a chronic condition with high relapse rates and limited effective treatments. Contingency management and psychotherapy show modest efficacy, while pharmacological options have little to no benefit. Psilocybin-assisted psychotherapy is emerging as a promising approach for substance use disorders, though no studies have yet examined it for methamphetamine use disorder. This review presents the rationale for using psilocybin-assisted psychotherapy to treat methamphetamine use disorder and describes practical considerations from early experience designing and implementing four clinical trials on this approach.
Frontiers in Psychiatry
November 4, 2021
16 citations
During the early COVID-19 pandemic, a survey of over 5,000 people across five languages found that among 1,375 who had used psychedelics in 2019 or 2020, 642 (46.6%) continued using them during the pandemic. Usage shifted away from settings outside the home, and motives changed: less curiosity, celebration, or social influence, more boredom. Positively connoted, often pro-social experiences increased, and two thirds of pandemic users said psychedelics helped them cope with the pandemic at least slightly. The changes likely reflect pandemic restrictions and a possible shift toward safer settings and self-selection.
Frontiers in Psychiatry
May 14, 2018
Ben J. A. Palanca, Hannah R. Maybrier, Angela M. Mickle et al.
16 citations
Electroconvulsive therapy (ECT) deliberately induces generalized seizures to treat severe psychiatric illness, offering a chance to study how consciousness, cognition, and brain activity recover after seizures. Fifteen patients with treatment-resistant major depressive disorder will receive right unilateral ECT under etomidate anesthesia. They will then undergo three treatments in randomized order: etomidate plus ECT, ketamine plus ECT, and ketamine plus sham ECT, repeated for six total sessions. Cognitive tests assess sensorimotor speed, working memory, and executive function before and after each treatment. The study will measure time to return of responsiveness, cognitive recovery trajectories, postictal delirium, and EEG changes. It aims to develop biomarkers for tailoring cognitive and emotional recovery in ECT patients.
Frontiers in Psychiatry
January 10, 2023
Jonina Rabinowitz, Raz Gross, Shaul Lev‐ran
15 citations
Past use of peyote or mescaline was associated with 32% lower odds of past-year substance dependence or abuse compared with people who had never used classic psychedelics, after controlling for sociodemographic factors, other illicit drug use, and mental health variables. In contrast, past use of LSD or psilocybin was associated with increased odds of substance use disorder, especially with more recent LSD use. No association was found between any classic psychedelic use and nicotine dependence. The authors suggest the difference may stem from pharmacological distinctions or the ceremonial context in which peyote or mescaline are traditionally taken.
Frontiers in Psychiatry
September 21, 2022
Laurent Elkrief, Olivier Payette, Jean-Nicolas Foucault et al.
15 citations
A patient with bipolar treatment-resistant depression who had not responded to medication, psychotherapy, or either repetitive transcranial magnetic stimulation (rTMS) or intravenous ketamine alone achieved complete and sustained remission when rTMS and ketamine were used together. The authors discuss how the two treatments may have complementary antidepressant mechanisms and call for further research on the combination's feasibility, tolerability, and efficacy.
Frontiers in Psychiatry
October 11, 2021
Sélim Benjamin Guessoum, Laelia Benoit, Sevan Minassian et al.
15 citations
Clinical lycanthropy is a rare syndrome in which a patient believes they are turning into a wolf. A systematic review of 43 cases found it is associated with schizophrenia, psychotic depression, bipolar disorder, and other psychotic disorders. Antipsychotic medication may be an effective treatment, with antidepressants or mood regulators used when depression or mania is present. Neuroscientific hypotheses include viewing it as a cenesthopathy, a delusional misidentification of the self, or involving impairments in sensory integration, belief evaluation, or right hemisphere anomalies. The syndrome overlaps with other delusional misidentification syndromes and may be a culture-bound syndrome influenced by Western myths and media. A cultural, narrative, and patient-centered approach is recommended for assessment and care.
Frontiers in Psychiatry
February 5, 2024
Rotem Petranker, Thomas Anderson, Youval Aberman et al.
14 citations
Microdosing, the practice of taking small, sub-hallucinogenic doses of psychedelics, has become popular, with users reporting benefits like improved mood and creativity. A review of 15 papers published before March 2022 critically analyzed the research practices in this field. The review concludes that it is premature to draw any conclusions about the efficacy or safety of microdosing because the quality of the research is not confirmatory. The authors propose potential causes for this state of the literature and offer suggestions for improvement.
Frontiers in Psychiatry
December 19, 2023
Jonathan David, José Carlos Bouso, Maja Kohek et al.
14 citations
More than half of people who participate in ayahuasca ceremonies report having a subjective sense of death during the experience, termed Ayahuasca-induced Personal Death (APD). These experiences are typically strong and transformative, associated with an increased sense of transcending death and greater certainty that consciousness continues after death. APDs are not linked to demographics, personality, or psychopathology, but are associated with greater environmental concern, improved ability to cope with life problems, and a heightened sense of life fulfillment. The findings suggest these death experiences may be a mechanism for psychedelics' long-term positive effects.