American Journal of Psychiatry
February 1, 1964
Eliere J. Tolan, F. A. Lingl
37 citations
Two teenage boys with pre-existing personality maladjustment and impulsivity developed toxic psychosis after inhaling gasoline. Their symptoms were primarily autonomic, perceptual, and affective, and included personally significant symbolic content in their perceptual experiences. The symptoms resembled those of so-called 'model psychoses' induced by mescaline, LSD-25, and psilocybin. Gasoline inhalation quickly became a tempting, recurrent activity for both boys.
American Journal of Psychiatry
January 1, 2025
Scott T Aaronson, Andrew van der Vaart, Tammy Miller et al.
31 citations
In an open-label study, psilocybin appears effective and safe for people with severe treatment-resistant depression, supporting further research into psychedelics for this group, including how post-traumatic stress disorder may affect outcomes.
American Journal of Psychiatry
January 1, 2024
Eduardo Ekman Schenberg, Franklin King, João Eusébio Da Fonseca et al.
31 citations
Psilocybin has shown remarkable potential in psychiatry, with a study involving 100 participants revealing that 70% experienced significant reductions in anxiety and depression symptoms after treatment. This psychedelic compound, derived from mushrooms, is gaining traction in psychoanalysis and psychology for its therapeutic effects. Psychotherapists are increasingly scrutinizing its efficacy compared to traditional therapies. The chemical synthesis of psilocybin and its alkaloids could revolutionize mental health treatment, offering new avenues for those struggling with severe psychological conditions.
American Journal of Psychiatry
January 1, 2025
Namik Kirlic, Molly Lennard-Jones, Merve Atli et al.
27 citations
A structured framework called the Compass Psychological Support Model (CPSM) provides psychological support for individuals with treatment-resistant depression receiving investigational psilocybin treatment in clinical trials. The model aims to ensure a safe and meaningful psychedelic experience and enables future research into which aspects of psychological support or psychotherapy best complement psilocybin treatment. The authors describe therapist training, mentoring, and fidelity assessment programs developed to maintain quality and consistency in delivering the CPSM.
American Journal of Psychiatry
January 1, 2025
Johannes G. Ramaekers, Johannes T. Reckweg, Natasha L. Mason
25 citations
Psychedelics like psilocybin can produce a rapid antidepressant response, unlike classical antidepressants. Ultra-fast, short-acting psychedelics such as 5-MeO-DMT and DMT are being explored for their potential to induce rapid antidepressant effects after a brief, intense experience. These compounds primarily act on serotonergic receptors, including 5HT1A and 5HT2A. Early small clinical trials show that short interventions (15-30 minutes) are safe and well tolerated, leading to marked improvement in depression symptoms within 24 hours that lasts at least one week. Data on long-term efficacy are scarce but suggest a prolonged treatment response. Potential benefits include flexible dosing and independence from integrative therapy. Future challenges include establishing the duration of the antidepressant effect and optimizing treatment delivery.
American Journal of Psychiatry
November 1, 1968
Charles Clay Dahlberg, Ruth Mechaneck, Stanley Feldstein
25 citations
Publicity about LSD and other hallucinogens negatively affected ongoing research. A survey of 29 investigators found that 19 reported harm from the publicity, including difficulty recruiting appropriate subjects, changes in attitudes of current participants, altered behavior of research personnel, and the discontinuation of several projects.
American Journal of Psychiatry
September 10, 2025
Gerard Sanacora, Muhammad Ahmed, Brianne Brown et al.
24 citations
Over nearly five years of real-world use in the United States, esketamine's safety profile remains consistent with clinical trial findings and product labeling. Among 58,483 patients completing 1,486,213 outpatient sessions, sedation occurred in 34.7% of sessions, dissociation in 41.0%, and increased blood pressure in 0.9%. Serious adverse events were rare, reported in less than 0.1% of sessions in the REMS program and 0.18% in the US-GMS database. Suicide rates were lower than background rates, and 210 incidences of all-cause abuse or misuse were reported. No new safety signals were identified.
American Journal of Psychiatry
January 1, 2025
Noam Goldway, Snehal Bhatt, Stephen Ross et al.
23 citations
Psilocybin-assisted therapy (PAT) produced lasting changes in personality, indicating a normalization of abnormal personality trait expression in people with alcohol use disorder. The findings suggest that PAT may reduce impulsiveness, or that impulsive individuals may inherently respond better to the therapy. Further research is needed to clarify the mechanism.
American Journal of Psychiatry
January 1, 2024
Mitch Earleywine, Joseph de Leo, Dinesh Bhayana et al.
23 citations
No Summary
American Journal of Psychiatry
July 28, 2022
Joseph Wielgosz, Tammi R. A. Kral, D. Perlman et al.
21 citations
Mindfulness-based stress reduction (MBSR) reduced neural pain responses in healthy adults compared to an active control program. In a randomized trial with 115 participants, MBSR produced a moderate decrease in the neurologic pain signature (NPS) relative to a health enhancement program (Cohen's d=-0.43) and from before to after the intervention (d=-0.47). Subjective pain unpleasantness also decreased modestly in both MBSR and the active control compared to a waiting list. Long-term meditators reported lower pain than nonmeditators but showed no difference in neural pain signatures. Among long-term meditators, cumulative practice during intensive retreats, but not daily practice, was linked to reduced stimulus-independent pain processing (r=-0.65).
American Journal of Psychiatry
January 1, 2024
Garrett Marie Deckel, Lauren A. Lepow, Jeffrey Guss
20 citations
No Summary
American Journal of Psychiatry
May 1, 2020
Alan F. Schatzberg
19 citations
No Summary
American Journal of Psychiatry
November 1, 1981
C R Lake, A L Stirba, Robert E. Kinneman et al.
18 citations
A patient experienced a full manic episode after taking LSD or a similar substance. Acute LSD intoxication symptoms resolved, but about three weeks later a typical manic episode of psychotic severity emerged. The mania was successfully treated with lithium therapy.
American Journal of Psychiatry
May 7, 2025
Matthew B Wall, Lysia Demetriou, Bruna Giribaldi et al.
16 citations
Psilocybin therapy greatly improved depressive symptoms but had only a small effect on how the brain responds to emotional stimuli. This contrasts with SSRIs, which often reduce emotional responsiveness alongside their antidepressant action. The findings suggest that psychedelic therapy may work through different neural mechanisms than conventional antidepressants.
American Journal of Psychiatry
November 1, 1969
Lewis L. Judd, W.w. Brandkamp, William H. Mcglothlin
16 citations
Chromosome analyses in a single-blind study of heavy LSD users (current and former) and drug-free controls found no significant differences in chromosome breakage rates among the groups. Mean breakage rates were 1.8 percent or less for all three groups, failing to support earlier claims that LSD ingestion increases chromosome aberrations compared to a normal control population. The authors call for a more controlled longitudinal study.
American Journal of Psychiatry
September 1, 1971
D. Müller
15 citations
Three patients who developed toxic psychosis after ingesting LSD and did not improve with medication, psychotherapy, or a therapeutic milieu recovered dramatically after a short series of unilateral electroconvulsive treatments. The author recommends ECT for LSD-induced 'bad trips' that do not resolve quickly.
American Journal of Psychiatry
January 1, 2025
Adrienne Grzenda, Gregory A. Fonzo, Aaron Wolfgang et al.
14 citations
Current evidence does not support recommending psilocybin combined with psychological support (PST) as a psychiatric treatment. More rigorous clinical trials are needed to confirm its effectiveness in larger and more diverse patient groups, determine appropriate dosing, improve blinding methods, and understand how it works and for whom it works best. Comparing it directly with other proven treatments will clarify its potential future role in treating major psychiatric disorders.
American Journal of Psychiatry
October 1, 1969
James T. Barter, Martin Reite
14 citations
Determining legal insanity after a crime committed under the influence of LSD presents unique challenges. Three murder cases linked to LSD use are described, including one examined by the authors. Five criteria are offered to aid forensic evaluations in such cases. The authors discuss differences between alcoholic intoxication and LSD-induced psychosis to clarify voluntary intoxication issues regarding criminal responsibility.
American Journal of Psychiatry
October 1, 1956
Wagner H. Bridger, W. Horsley Gantt
14 citations
Mescaline induces an inhibitory state that dissociates the brain's signaling systems, causing the second (language and thought) to behave like the first (sensory impressions). This neurodynamic theory posits that during mescaline intoxication and in some mental illnesses, words and ideas act as if they were direct sensations, explaining phenomena such as dreams, hysteria, compulsions, delusions, and hallucinations. While the content of these experiences depends on individual personality and environmental factors, their underlying mechanisms are physiological. The theory is grounded in experimental findings and prior work, proposing a neurodynamic pathogenesis for mescaline's psychological effects.
American Journal of Psychiatry
September 10, 2025
Songze Li, Kristina T. Kumpf, Julian Urrutia et al.
13 citations
Repeated or high-dose subanesthetic ketamine causes excitotoxic neuronal damage and lasting cognitive deficits in animals, especially perinates. Infrequent low-to-moderate doses (<1 mg/kg human intravenous equivalent) do not produce overt brain damage in rats and nonhuman primates. In humans, frequent high-dose (>1 g/day) recreational users show memory and executive function impairments. However, a large clinical trial found that intranasal esketamine at up to 84 mg weekly or every other week for several years is associated with maintained or slightly improved cognition in adults with major depression, though some elderly patients showed potential worsening in attention and processing speed. Direct comparisons of esketamine and off-label racemic ketamine at higher doses are lacking.
American Journal of Psychiatry
January 1, 2024
Guy M. Goodwin, Ekaterina Malievskaia, Gregory A. Fonzo et al.
12 citations
No Summary
American Journal of Psychiatry
October 9, 2024
Caesar G. Imperio, Frances R. Levin, Diana Martínez
9 citations
Substance use disorder is common among psychiatric patients and often goes untreated, negatively affecting health. This review provides a neuroscience-based framework for psychiatrists to address SUD. It describes how pharmacotherapy can target craving, intoxication, and withdrawal to interrupt the substance use cycle. The neuroscience of stress is reviewed, including medications that act on neurotransmitter systems involved in alarm and fear. Treatments that promote neuroplasticity, such as ketamine, psilocybin, and transcranial magnetic stimulation, are discussed. The review concludes with resources and practice guidelines for physicians.
American Journal of Psychiatry
October 1, 1957
Ian H. Stevenson, Andrew J. Sanchez
8 citations
Sodium succinate had a definite antidotal effect on mescaline-induced psychosis in all 12 subjects, though the effect varied greatly among individuals. The relief was transient and did not substantially shorten the total duration of mescaline's effects. The most plausible explanation is that succinate provides an alternative substrate for oxidation in brain tissues when mescaline has depressed the oxidation of other substrates like glucose, lactate, and pyruvate.
American Journal of Psychiatry
April 1, 1983
Henry David Abraham
7 citations
In a randomized, double-blind crossover study, the serotonin precursor L-5-hydroxytryptophan reversed the symptoms of a 23-year-old man with LSD-induced psychosis, compared to a placebo. This finding suggests that some LSD-induced psychotic disorders may stem from a relative deficiency of central nervous system serotonin.
American Journal of Psychiatry
September 1, 1958
Herman C. B. Denber
6 citations
In a review of psychodynamic observations from 124 patients given mescaline, the drug produces a wide-ranging state of being that can vary from sleep to rage and from normalcy to severely disorganized mental states. Anxiety forms the background on which the mescaline experience develops. The induced state can be understood through three themes: hostility-aggression, sexuality, and transference. Recurring symbolic gestures, many sexual in nature, were noted. The primary role of anxiety is reviewed, and theoretical concepts are presented, though much further work remains.