Journal of Clinical Medicine
February 11, 2022
Chia‐ling Yu, Chih‐sung Liang, Fu‐chi Yang et al.
37 citations
A meta-analysis of ten studies found that one or two doses of psilocybin produce rapid and sustained antidepressant effects lasting up to six months. Depressive symptoms decreased substantially, with the largest effect at one week (standardized mean difference -1.74) and a still-large effect at six months (-1.12). Higher doses and two sessions were linked to greater improvement. Psilocybin raised systolic blood pressure by 19.00 mmHg and diastolic by 8.66 mmHg, but discontinuation rates and heart rate changes were similar to placebo. The findings suggest psilocybin has favorable cardiovascular safety and acceptability for treating depression.
Journal of Clinical Medicine
June 7, 2022
Mitchell Arnovitz, Andrew Spitzberg, Ashkhan J. Davani et al.
29 citations
Negative symptoms of schizophrenia, such as social withdrawal and lack of motivation, contribute heavily to the economic burden of the disease and have no FDA-approved treatments. This review argues that MDMA, a schedule I substance known to enhance social interaction and empathy, may offer a novel therapeutic approach. The authors examine literature on negative symptoms, existing treatments, and MDMA-assisted therapy, concluding that recent evidence suggests MDMA can be safe and potentially effective for treating negative symptoms. The review also discusses safety considerations and possible mechanisms of action, including MDMA's ability to induce metaplasticity in the brain.
Journal of Clinical Medicine
February 21, 2022
Ľuboš Nižňanský, Žofia Nižnanská, Roman Kuruc et al.
11 citations
Ayahuasca is a decoction made from the liana Banisteriopsis caapi, which contains β-carbolines, often combined with Psychotria viridis leaves containing DMT. Over 100 plants can supply these active alkaloids, making precise compositional analysis crucial for pharmacological study. This review summarizes sensitive methods for analyzing the beverage and biological matrices, comparing pharmacokinetic parameters across studies with known composition and minimal adverse effects. Therapeutic benefits remain unclear, with side effects possibly linked to pre-existing psychiatric disorders. Toxicological risks and clinical benefits require accurate alkaloid concentrations for evaluation. No post-mortem study has suggested potential lethality from ayahuasca.
Journal of Clinical Medicine
February 20, 2026
Vassilis Martiadis, Fabiola Raffone, Serena Testa et al.
7 citations
Intranasal esketamine provides rapid symptom relief for treatment-resistant depression when standard antidepressants fail, but its real-world effectiveness depends on organizational and multidisciplinary factors beyond pharmacology. This narrative review synthesizes clinical and real-world evidence to propose a phase-based integration framework that specifies complementary roles for psychiatry, nursing, and psychotherapy across pre-treatment assessment, induction, session delivery, post-session integration, and maintenance phases. The framework emphasizes safety, continuity of care, and patient-centred monitoring, with measurable implementation indicators. While evidence supports esketamine's efficacy in reducing depressive symptoms, anhedonia, and suicidality, prospective implementation studies are needed to evaluate clinical effectiveness, feasibility, and cost-effectiveness of the proposed multidisciplinary approach.
Journal of Clinical Medicine
September 15, 2024
Maria Margariti, Ilias I. Vlachos, Dimitra Mpourazana et al.
4 citations
An emotional state called psychotic arousal (PA) may be a distinct feature of acute psychosis, involving abnormal experiential feelings that are often overlooked in schizophrenia research. In a study of 55 patients hospitalized for acute schizophrenia, a new Psychotic Arousal Scale showed good internal consistency (Cronbach's alpha reported for the scale). PA severity was linked to the strength of delusional beliefs and to other measures of anxiety and depression. The state also responded to antipsychotic medication within the first weeks of treatment. These findings suggest that emotional arousal with abnormal feelings is a measurable and clinically important component of acute psychosis.
Journal of Clinical Medicine
February 20, 2025
Shakila Meshkat, Taha Malik, Jennifer Swainson et al.
3 citations
A systematic review examined whether psychedelic therapies can rapidly reduce suicide risk. Four randomized controlled trials reported significant reductions in suicidal ideation with psilocybin (three studies) and MDMA-assisted therapy (one study), with effect sizes (Cohen's d) ranging from 0.52 to 1.25 and no safety issues. Five additional randomized trials also showed reductions. Among 24 non-randomized and cross-sectional studies, results were mixed: psilocybin reduced suicidal ideation (odds ratios 0.40–0.75), MDMA-assisted therapy for PTSD showed a pooled effect of d = 0.61, while LSD was associated with increased odds of suicidality (odds ratios 1.15–2.08). DMT studies showed no significant effects. The evidence remains inconclusive, underscoring the need for further trials.
Journal of Clinical Medicine
December 29, 2025
Monika Dominiak, Adam Gędek, Szymon Modrzejewski et al.
2 citations
Psychedelic-assisted therapy shows short-term efficacy and safety for selected psychiatric disorders, particularly depression and PTSD. Psilocybin produced large effects in major depression (Hedges’ g ≈ 1.05), with some benefits lasting up to six months. MDMA showed very large reductions in PTSD symptoms (Hedges’ g ≈ 1.24) after 2–3 sessions. LSD yielded short-term benefits for alcohol use disorder (odds ratio ≈ 2.0), though effects declined over time. Adverse events were generally mild and transient, with no consistent signal for serious harm. However, considerable methodological variability, small and overlapping samples, risk of bias, and limited long-term data constrain the findings.
Journal of Clinical Medicine
December 25, 2025
Michał Walaszek, Wiesław Jerzy Cubała, Zofia Kachlik
1 citation
Patients with treatment-resistant depression report a range of experiences with ketamine therapy that go beyond symptom scores. Motivations, expectations, the subjective treatment experience, post-treatment changes, side effects, reasons for stopping, and the importance of the treatment setting and relationship with clinicians all shape how patients perceive the value and acceptability of ketamine. These findings highlight the need for patient-centered service design that aligns with what matters most to those receiving the treatment.
Journal of Clinical Medicine
December 29, 2025
Matteo Leonardi, Alice Frediani, Mauro Angeletti et al.
Intranasal esketamine rapidly reduces suicidal ideation and depressive symptoms in patients with treatment-resistant depression. Suicidal ideation scores dropped from 1.56 at baseline to 0.78 after one week and to 0.12 after six months. Depressive symptoms improved from a mean Montgomery-Åsberg Depression Rating Scale score of 30.9 at baseline to 17.5 after one week and 9.8 after six months. Male gender was a negative predictor of response; no other baseline variable predicted outcomes. The findings suggest intranasal esketamine is effective for rapid reduction and resolution of suicidal ideation in this population, and gender differences should be considered in treatment planning.
Journal of Clinical Medicine
September 19, 2025
Ana Flavia Burlec, Cornelia Mircea, Irina Macovei et al.
Psilocybin clinical trials are advancing more rapidly in the United States than in the European Union, driven by stronger research infrastructure, greater financial investment, and more favorable regulatory and cultural attitudes. The EU has fewer trials and slower progress, reflecting a cautious approach focused on patient safety and therapeutic efficacy. Harmonizing policies and fostering international collaboration are essential to ensure scientific rigor and patient protection as psilocybin-assisted therapies are integrated into psychiatric care.