BJPsych Open
June 1, 2025
Ranjini Rao
A prospective review of 60 patients receiving off-label sublingual ketamine for depression found that nearly half of those with moderate to severe depression showed improvement on clinician-rated scales after four weeks of treatment, with the improvement rate rising to 60% among those who completed a recommended 12-dose course. A moderately strong correlation between dissociation during treatment and reduction in depressive symptoms was not statistically significant. No patients dropped out or were hospitalized. Minor side effects such as nausea and dizziness were self-limited. The authors suggest that additional treatments might maintain improvement.
BJPsych Open
June 1, 2025
Minna Chang, Allan Young, Mario Juruena
A 28-year-old woman receiving ketamine for depression developed ulcerative cystitis, a complication previously seen only in recreational users. Ketamine-induced cystitis (KIC) causes lower urinary tract symptoms—dysuria, urgency, nocturia, frequency—and can progress to incontinence, hematuria, bladder fibrosis, and kidney damage. The exact cause is unknown, but theories include direct toxicity from ketamine metabolites, an IgE-mediated allergic response, and other inflammatory pathways. Early diagnosis and stopping ketamine can reverse symptoms and prevent further harm. This is the first reported case of KIC from therapeutic-dose ketamine for depression.
BJPsych Open
June 1, 2025
Anna Borissova, Allan H. Young, Mitul A. Mehta et al.
In interviews with seven people who had previously received ketamine for treatment-resistant depression, participants were motivated by hope for symptom improvement and a desire to support depression research. They described feeling more open and involved after ketamine and thought it could enhance therapy sessions. They suggested clearer communication that mood changes may not last, providing audiovisual materials to prepare for the infusion experience, and offering check-ins between sessions plus a final session for referrals and support. These insights informed a planned feasibility randomized controlled trial comparing intravenous ketamine plus behavioral activation (n=20) against midazolam plus behavioral activation (n=20) for major depressive disorder with anhedonia.
BJPsych Open
March 9, 2023
Yonas Baheretibeb, Dawit Wondimagegn, Samuel Law
A collaboration between religious healers and psychiatrists in Addis Ababa, Ethiopia, proved feasible and has operated successfully for 8 years. Over half (54%) of the 1888 patients seen were first-time users of biomedical services, and 26% were referred directly by priest healers. Most patients had severe mental illness: schizophrenia (40%), substance misuse (24%), and mood disorders (30%). A vast majority (92.2%) were comfortable receiving holy water and prayers alongside medication, and 73.6% attributed their illness to evil spirit possession. The cross-system model can help scale up mental healthcare where biomedical resources are limited, provided practitioners accept the cultural strengths of traditional healing.
BJPsych Open
June 1, 2026
Aleeha Batool, Chaitanya Morey
Hallucinogen Persistent Perception Disorder (HPPD) involves recurring perceptual symptoms after hallucinogen use stops, causing significant impairment. Diagnosis is difficult due to poor understanding and comorbid conditions, leading to low documented incidence. No established treatment guidelines exist. This review of 34 studies finds that α2 adrenergic agonists (especially clonidine) and benzodiazepines (especially clonazepam) may reduce distress and anxiety. Anti-epileptic drugs (particularly lamotrigine) have shown good response for perceptual symptoms in case reports. Antipsychotic agents worsened perceptual symptoms. Combination therapy with olanzapine and fluoxetine or risperidone and escitalopram showed improvement in two cases, but selective serotonin reuptake inhibitors alone did not. Neuromodulation (transcranial direct current stimulation and repetitive transcranial magnetic stimulation) showed sustained responses in two case reports. The evidence base is weak, and larger studies are needed.
BJPsych Open
June 1, 2022
J. Raphael
People in the psychedelic community understand decolonization in varied ways, with some arguing that the space can never be fully decolonized due to ongoing capitalist and neo-colonial forces. Interviews with 10 participants generated four main themes: the making of a 'new' medicine, tensions between scientism and spirituality, appreciation versus appropriation, and limits of decriminalization. The findings highlight calls not to misuse the term decoloniality and point to the need for critical indigenous methodologies to address epistemic, material, and geopolitical injustices in psychedelic research.