ISSN 0160-6689
19 papers in the library · 2,782 citations · publishing 2004-2025
The Journal of Clinical Psychiatry November 15, 2006 Francisco Moreno, Christopher B. Wiegand, E. Keolani Taitano et al. 786 citations
In a controlled clinical setting, psilocybin was safely administered to individuals with obsessive-compulsive disorder (OCD) and was linked to immediate decreases in core OCD symptoms in several participants.
The Journal of Clinical Psychiatry July 13, 2010 Nancy Diazgranados, Lobna Ibrahim, Nancy E. Brutsché et al. 563 citations
A single infusion of ketamine (0.5 mg/kg) rapidly reduced suicidal thoughts in people with treatment-resistant major depression. Suicidal ideation scores dropped significantly within 40 minutes and remained lower for at least 4 hours. Among the 10 participants who had a score of 4 or higher on the Scale for Suicide Ideation at the start, all dropped below 4—9 within 40 minutes and 1 by 80 minutes. Depression, anxiety, and hopelessness also improved substantially at all measured time points. The findings suggest ketamine may offer a fast-acting intervention for suicidal ideation, a medical emergency with few pharmacologic options.
The Journal of Clinical Psychiatry May 11, 2020 Dong-Jing Fu, Dawn F. Ionescu, Xiang Li et al. 367 citations
In adults hospitalized for major depressive disorder with active suicidal thoughts, adding esketamine nasal spray to standard treatment (antidepressants and hospitalization) reduced depression symptoms more than placebo plus standard treatment within 24 hours, with benefits persisting over four weeks. The difference in suicidal ideation severity between groups was not statistically significant. Common side effects of esketamine included dizziness, dissociation, headache, nausea, and drowsiness.
The Journal of Clinical Psychiatry April 20, 2020 Ewa Wajs, Leah Aluisio, Richard Holder et al. 288 citations
In a year-long open-label study of 802 adults with treatment-resistant depression, esketamine nasal spray combined with a new oral antidepressant showed a manageable safety profile and sustained improvement in depressive symptoms. Common side effects included dizziness, dissociation, nausea, and headache, mostly mild or moderate and resolving the same day. Two deaths occurred, neither linked to the drug. Cognitive performance remained stable or improved. Depression scores dropped during the first four weeks and stayed lower through the maintenance phase.
The Journal of Clinical Psychiatry May 15, 2014 Mark J. Niciu, David A. Luckenbaugh, Dawn F. Ionescu et al. 167 citations
Higher body mass index and a family history of alcohol use disorder in a first-degree relative were associated with greater improvement in depression symptoms after a single ketamine infusion. Patients with no prior suicide attempts also showed greater improvement, but only at day 7. The analysis combined data from four studies of treatment-resistant inpatients with major depressive disorder or bipolar depression who received a single 0.5 mg/kg ketamine infusion over 40 minutes. The findings suggest that certain clinical characteristics may help predict who benefits most from ketamine's rapid antidepressant effects, though the analysis was post hoc and the models explained only 13% to 36% of the variation in symptom improvement.
The Journal of Clinical Psychiatry September 8, 2009 Rodrigo Machado‐Vieira, Peixiong Yuan, Nancy E. Brutsché et al. 154 citations
Ketamine produces rapid antidepressant effects in people with treatment-resistant major depressive disorder, but these effects are not linked to changes in brain-derived neurotrophic factor (BDNF) levels. In 23 adults aged 18 to 65, a single intravenous infusion of ketamine (0.5 mg/kg) significantly improved depression scores on the Montgomery-Asberg Depression Rating Scale within 230 minutes. However, BDNF levels measured at the same time points did not change from baseline, and no association appeared between antidepressant response and BDNF. The findings indicate that ketamine's initial antidepressant action operates through mechanisms other than BDNF.
The Journal of Clinical Psychiatry April 15, 2019 Joshua D. Rosenblat, André F. Carvalho, Madeline Li et al. 111 citations
Oral ketamine shows significant antidepressant effects with good tolerability, but its effects are not as rapid as intravenous ketamine. In two randomized controlled trials, significant reductions in depressive symptoms were observed only after 2-6 weeks of treatment. Rapid antidepressant effects within 24 hours, antisuicide effects, and efficacy in treatment-resistant depression were reported only in retrospective studies. Dosages ranged from 0.5 to 7.0 mg/kg, with most studies using 1-2 mg/kg every 1-3 days. No clinically significant adverse effects were reported. The review concludes that antisuicide effects and efficacy in treatment-resistant depression have yet to be demonstrated in well-designed trials.
The Journal of Clinical Psychiatry September 25, 2014 Dawn F. Ionescu, David A. Luckenbaugh, Mark J. Niciu et al. 111 citations
Patients with treatment-resistant major depressive disorder who also have high anxiety (anxious depression) responded better to a single infusion of ketamine than those without high anxiety, contrary to expectations based on traditional antidepressants. Over 28 days of follow-up, the anxious group showed significantly fewer depression symptoms at multiple time points and relapsed much later (median 19 days versus 1 day). No significant differences in side effects were observed. These results suggest that ketamine, an NMDA receptor antagonist, may be especially effective for the anxious depression subtype, which is typically difficult to treat with standard antidepressants.
The Journal of Clinical Psychiatry May 26, 2020 George I. Papakostas, Naji C. Salloum, Rebecca S. Hock et al. 107 citations
Adjunctive intranasal esketamine is more effective than placebo for treating major depressive disorder. Pooling five randomized, double-blind trials with 774 patients, esketamine outperformed placebo on depression rating scale score change, response, and remission. The effect was statistically significant across different study samples and baseline antidepressant regimens. Esketamine appears to be an effective treatment strategy for patients who are treatment-resistant or acutely suicidal.
The Journal of Clinical Psychiatry May 4, 2023 Sandeep M. Nayak, Melissa K Bradley, Bethea A. Kleykamp et al. 38 citations
A systematic review of randomized trials of psychedelics in humans found that most studies use inert placebos rather than active comparators, and very few assess whether blinding was successful. Of 86 unique studies, 61.2% used an inert placebo, 20.0% used active comparators, and only 17.3% included any assessment of blinding; when assessed, blinding success was generally poor. Only 3 of 21 therapeutic trials compared psychological support to a minimally supportive condition. The review concludes that randomized psychedelic trials underutilize blind assessment, active drug controls, and adequate control conditions for psychological support, and recommends improvements to trial methods.
The Journal of Clinical Psychiatry October 15, 2004 Nicholas Weiss, Lee Jones, John Chamberlain 33 citations
A case of prolonged psychosis and sleep deprivation triggered by peyote, a hallucinogen containing mescaline, was resolved by initiating sleep. While peyote's effects typically subside within 10 to 12 hours, this instance involved extended symptoms. The report highlights that sleep deprivation may contribute to psychosis beyond the direct drug effects.
The Journal of Clinical Psychiatry September 30, 2008 Michael Paulzen, Gerhard Gründer 32 citations
The hallucinogenic sage Salvia divinorum, known by many names including ska Maria and ska Pastora, was first identified in 1962 by Wasson and Hofmann among the Mazatec people of Oaxaca, Mexico, who recognized its psychoactive properties. In recent years, the plant has become widely available globally through internet suppliers, sold as leaves or concentrated extracts.
The Journal of Clinical Psychiatry January 13, 2022 Richard J. Zeifman, Dengdeng Yu, Nikhita Singhal et al. 18 citations
A meta-analysis of 7 psychedelic therapy clinical trials found that, relative to baseline, psychedelic therapy was associated with large decreases in suicidality acutely (80–240 minutes) and at 1 day, 1–8 weeks, and 3–4 months (standardized mean differences ranging from −1.48 to −2.36). At 6 months, the effect was medium (SMD = −0.65). Reductions were significant at all time points except 7–8 weeks. Acute and post-acute elevations in suicidality were rare (6.5% and 3.0%, respectively). The authors note limitations including heterogeneous samples and interventions, and suggest that controlled trials specifically evaluating psychedelic therapy for suicidality may be warranted.
The Journal of Clinical Psychiatry August 25, 2024 Mark A. Frye, Balwinder Singh, Scott Breitinger et al. 2 citations
A man with alcohol use disorder (AUD) maintained sobriety while taking an SSRI and naltrexone, but stopped the SSRI to take part in a psilocybin ceremony, after which he relapsed to alcohol use. The case examines factors that likely contributed to the relapse, including the discontinuation of the SSRI, the context of the psilocybin experience, and the absence of structured follow-up care.
The Journal of Clinical Psychiatry May 9, 2022 Richard J. Zeifman, Dengdeng Yu, Nikhita Singhal et al. 2 citations correction
In a meta-analysis of patient-level data on psychedelics and suicidality, two serious adverse events occurred that the original study authors deemed unrelated to the drug. One participant in a very low-dose psilocybin condition (1 mg/70 kg) completed suicide 11 days after administration, having reported boredom and left the session early. Another participant attempted suicide about two months after an active psilocybin dose (21–25.2 mg/70 kg), following a partner's sudden death and subsequent methamphetamine and crack cocaine use, with a brief psychotic episode. These events highlight the need for close monitoring of all participants during and after psychedelic therapy trials.
The Journal of Clinical Psychiatry September 17, 2025 Liliana Patarroyo-Rodriguez, Vanessa K. Pazdernik, Jennifer L. Vande Voort et al. 1 citation
Ketamine and esketamine reduced long-term emergency department visits for suicidality among individuals with treatment-resistant depression. Further research with longer follow-up is needed to determine whether these benefits depend on mood state or reflect an independent mechanism.
The Journal of Clinical Psychiatry August 3, 2023 Ayana Jordan 1 citation
Alcohol and tobacco are legal but carry well-documented risks of misuse and disease, with alcohol dependence also contributing to opioid overdoses that kill 130 people daily. Despite growing awareness of the opioid epidemic, most Americans do not receive FDA-approved addiction medications. Effective medications exist for alcohol use disorder, and medications for opioid use disorder have validated benefits. Recently, psychedelic compounds like psilocybin have shown potential for alleviating depression, anxiety, alcohol use disorder, and opioid withdrawal symptoms. A comprehensive, integrated public health approach is essential for treating substance use disorders.
The Journal of Clinical Psychiatry February 23, 2021 Avinash Hosanagar, Joseph Cusimano, Rajiv Radhakrishnan 1 citation
Psychedelics are being studied as treatments for psychiatric disorders. The FDA has granted Breakthrough Therapy Designations for MDMA-assisted psychotherapy for PTSD and for psilocybin with psychotherapy for treatment-resistant depression and major depressive disorder. Clinical trials are also exploring psychedelics for eating disorders, cognitive impairment, and substance use disorders. This review covers evidence for psilocybin, LSD, MDMA, and ayahuasca. Open-label studies of psilocybin for obsessive-compulsive disorder, depression, and substance use disorders show promising results. Randomized controlled trials of psilocybin for depression and anxiety in advanced cancer found that high-dose psilocybin produced large decreases in depression and anxiety, increased quality of life, and decreased death anxiety, with about 80% of participants sustaining the response at 6-month follow-up.
The Journal of Clinical Psychiatry October 13, 2025 Pim B. van der Meer, Sebastiaan O Verboeket, Arjen J. C. Slooter et al.
NMDA receptor antagonists like ketamine may help treat catatonia. This systematic review evaluated the efficacy and safety of ketamine and esketamine for catatonia, finding that the available evidence suggests these drugs could be beneficial, but the data are limited and further research is needed to confirm their role.