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Expert review of clinical pharmacology

ISSN 1751-2433

6 papers in the library · 74 citations · publishing 2023-2026

Papers

Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study.

Expert review of clinical pharmacology January 1, 2024 Lucas F Borkel, Jaime Rojas-Hernández, Luis Alberto Henríquez-Hernández et al. 40 citations

Growth motivations for using psychedelics, natural settings, and the presence of significant others during use predict less psychopathology, greater wellbeing, and more meaningful experiences. Problematic motivations predict greater psychopathology, lower wellbeing, and do not predict meaningfulness. These findings come from an online survey of 1022 Spanish-speaking participants, using a newly developed Psychedelic Use Scale to measure use of nine substances including LSD, psilocybin, and MDMA. The results suggest experimental hypotheses for future clinical trials and longitudinal studies.

Clinical pharmacological innovation in the treatment of depression.

Expert review of clinical pharmacology April 1, 2023 Jeffrey M Witkin, Lalit K Golani, Jodi L Smith 18 citations

Standard antidepressants have limitations, driving the search for new drugs. Rapid-acting antidepressants, such as those based on ketamine, show promise for treatment-resistant depression. This review documents newly approved and emerging medicines for major depressive disorder, evaluating their efficacy, tolerability, and safety. Many new drugs rely on glutamatergic mechanisms, including mGlu2/3 receptor antagonists, AMPA receptor potentiators, and novel NMDA receptor modulators. Companies are also developing novel psychedelic drugs, though the necessity of psychedelic activity remains unclear. Gaps persist in matching patients to specific treatments and in developing medicines to prevent MDD or its progression.

The ketamine chameleon: history, pharmacology, and the contested value of experience.

Expert review of clinical pharmacology March 1, 2025 Danny Diep, Sara de la Salle, Julien Thibault Lévesque et al. 8 citations

Ketamine's subjective effects have been interpreted in three major ways since its 1962 synthesis: as dissociative, dream-like, or psychedelic, depending on the clinical context and dose. Biomedical frameworks often label its effects as dissociative or psychotomimetic, while psychedelic paradigms highlight potential therapeutic benefits. Factors such as language, dose, and environmental setting influence both the drug's effects and treatment outcomes. The authors argue that ketamine is best understood as a chameleon whose effects shift with context, rather than a tiger to be tamed. A nuanced, interdisciplinary approach is needed to maximize its clinical potential.

Challenges and considerations for treating PTSD with medicinal cannabis: the Australian clinician's perspective.

Expert review of clinical pharmacology January 1, 2023 Luke J Ney, Wole Akosile, Chris Davey et al. 8 citations

Preclinical and experimental research suggests medicinal cannabis may help treat posttraumatic stress disorder, but integrating it into routine clinical therapies poses clinical, practical, and safety challenges, especially when combined with trauma-focused psychotherapy. Key issues include dose timing and titration, addiction potential, product formulation, windows of intervention, and route of administration. Exposure therapy for PTSD involves recalling intense emotions, and the interaction between cannabis use and reliving trauma memories requires exploration for patient safety and therapeutic outcomes.

Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials.

Expert review of clinical pharmacology February 3, 2026 Kaitlin R Mcmanus, Lara A Ray

A review of current and emerging treatments for alcohol use disorder (AUD), which affects 27.1 million U.S. adults, argues that existing medications have mixed efficacy and that a shift toward precision medicine—identifying subgroups most responsive to existing or combination pharmacotherapies—is needed. The review also synthesizes novel agents on the treatment horizon, including glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Adopting precision medicine and these new compounds requires changes in healthcare systems, moving away from a one-size-fits-all model to improve cost-effectiveness and patient outcomes, though distribution challenges remain.

From molecules to meaning: unpacking the antidepressant mechanisms of psychedelic drugs.

Expert review of clinical pharmacology June 11, 2025 Victor Pablo Acero, Taylor A Flatt, Peter M Gooch et al.

Psychedelic compounds can produce rapid and lasting depression symptom reduction after one or two administrations paired with psychotherapy, unlike traditional antidepressants. Current evidence on their antidepressant mechanisms is fragmented across biological, psychological, social, and spiritual domains. This review identifies key mechanisms in each domain, comparing them with those of conventional antidepressants to highlight overlaps and differences. The authors caution that focusing too narrowly on discrete pathways may limit progress, as psychedelics likely work through complex, interwoven processes. Future research should examine how suprapharmacological factors—set, setting, therapy modality, and integration—shape outcomes, moving beyond frameworks used for standard antidepressants.