Dialogues in Clinical Neuroscience
June 30, 2019
David Nutt
131 citations
Classical psychedelic drugs like psilocybin and LSD, plus MDMA (ecstasy), were used extensively in psychiatric research before being prohibited. The ban stopped research and clinical treatments that had shown promise, though recreational use continued. In the past decade, groups have re-evaluated these substances in medicine. Preliminary data show promise for psilocybin in anxiety, depression, smoking, and alcoholism, and for MDMA in post-traumatic stress disorder and alcoholism. The European Medicines Agency approved psilocybin for a phase 3 study in treatment-resistant depression, and the FDA approved MDMA for PTSD. Results are expected in 2020; positive outcomes could lead to clinical approval soon after.
Dialogues in Clinical Neuroscience
December 31, 2001
Franz X. Vollenweider
127 citations
A review of brain imaging and behavioral studies finds that classic hallucinogens like psilocybin and dissociative anesthetics like ketamine produce overlapping psychotic syndromes marked by increased activity in the prefrontal cortex and changes in temporoparietal, striatal, and thalamic regions, suggesting a common final pathway. Both drug classes disrupt sensory gating in rats by acting on serotonin 5-HT(2) receptors in cortico-striato-thalamic circuitry, indicating that disruption of cortico-subcortical processing leading to sensory overload of the cortex is a shared feature of these psychoses. In contrast, the entactogen MDMA produces positive mood and activates prefrontolimbic and paralimbic structures while deactivating the amygdala and thalamus.
Dialogues in Clinical Neuroscience
September 30, 2009
Euphrosyne Gouzoulis‐mayfrank, Jörg Daumann
115 citations
High doses of MDMA (ecstasy) and stimulant amphetamines like methamphetamine (speed) are clearly neurotoxic in laboratory animals. MDMA selectively damages central serotonergic nerve terminals, while amphetamines harm both serotonergic and dopaminergic systems. In human drug users, evidence suggests residual alterations of serotonergic transmission from MDMA, with possible partial recovery after long-term abstinence, though functional impairments may persist. Subtle cognitive impairments, especially memory deficits, are the most consistent findings. For methamphetamine, preliminary evidence indicates dopaminergic system alterations may persist after years of abstinence, linked to motor and cognitive performance deficits.
Dialogues in Clinical Neuroscience
September 2, 2024
Shiven Chaudhry, Anne Weisman, Molly M. Hagen et al.
A two-hour team-based learning curriculum improved medical students' knowledge, comprehension, and ethical understanding of psychedelic therapies. Pre- and post-surveys from 63 and 50 students, respectively, showed significant gains in perceived knowledge and attitudes, while 48 matched pre/post-knowledge tests demonstrated enhanced comprehension. Qualitative feedback indicated greater comfort discussing psychedelics clinically, though some students expressed reservations about psychedelic-assisted therapy. The curriculum addresses an educational gap as psychedelic medicine becomes more relevant.