Australian & New Zealand Journal of Psychiatry
November 15, 2019
Katrina Witt, Jennifer Potts, Anna A.m. Hubers et al.
203 citations
A single infusion of ketamine may reduce suicidal thoughts in people with treatment-resistant depression within four hours, and the effect can last up to 72 hours. The analysis combined 15 randomized controlled trials with 572 participants, mostly with mood disorders. At four hours after infusion, suicidal ideation scores dropped significantly (standardized mean difference -0.51), and the reduction persisted through 72 hours (standardized mean difference -0.57 to -0.63 at different intervals) but not beyond. Results varied widely across studies, and evidence quality was moderate to low. There were almost no data on whether ketamine prevents actual suicide attempts or self-harm. Further trials are needed to confirm these findings and find ways to sustain the anti-suicidal effect.
Australian & New Zealand Journal of Psychiatry
July 25, 2007
Edmund Silins, Jan Copeland, Paul Dillon
76 citations
Combining ecstasy (MDMA) with other serotonergic drugs can cause serotonin syndrome, a potentially life-threatening condition. A review of online databases created a hierarchy of risk: substances that inhibit serotonin re-uptake are less likely to cause dangerous serotonin elevations with ecstasy. High doses or repeated use of stimulants like methamphetamine and cocaine with ecstasy increase risk, as does pharmaceutical amphetamine. Serotonin precursors also influence the syndrome. Monoamine oxidase inhibitors pose the highest risk of serious serotonin increases. Findings underscore the need to screen for ecstasy and other serotonergic substance use when prescribing antidepressants.
Australian & New Zealand Journal of Psychiatry
March 4, 2022
59 citations
The psychedelic renaissance has generated excitement about potential medical uses, but the field faces significant challenges that must be addressed. This viewpoint identifies three categories of challenges: research study design issues including blinding, expectancy, therapy use, and bias; broader research environment problems such as evidence standards, funding, and scheduling that contradicts risk profiles; and implementation hurdles related to social and economic contexts. The authors offer suggestions for improving research protocols to mitigate these challenges.
Australian & New Zealand Journal of Psychiatry
March 21, 2021
Daniel Perkins, Jerome Sarris, Susan L. Rossell et al.
53 citations
Psychedelic substances such as psilocybin, ayahuasca, LSD, and MDMA are gaining renewed medical interest due to the need for new psychiatric treatments and promising study results. This viewpoint reflects on the Royal Australian and New Zealand College of Psychiatrists' Clinical Memorandum on Psychedelics and notes regulatory developments, including applications for down-scheduling and access approvals. The authors argue that rigorous research is needed to assess benefits, safety, and therapeutic mechanisms. They summarize recent findings on mechanisms of action and the psychedelic-assisted psychotherapy model, suggesting medicinal psychedelics could become a new class of psychiatric treatments when used under medical supervision with psychotherapeutic support. However, sufficiently powered trials and safety protocols are required before clinical use, and untrained practitioner access could be harmful.
Australian & New Zealand Journal of Psychiatry
March 12, 2022
Steve Kisely, Mark Connor, Andrew A. Somogyi et al.
36 citations
A systematic review of randomized controlled trials found that MDMA and psilocybin, given with psychological support, may reduce symptoms in highly selected populations under close supervision. The strongest evidence was for MDMA in post-traumatic stress disorder, with a large effect compared to active controls (standardized mean difference = -0.86). Psilocybin showed small benefits for social anxiety in adults with autism and was as effective as escitalopram for long-standing depression on the primary outcome, though most secondary benefits were not significant after correction. Both drugs were well tolerated, but overall certainty of evidence was low or very low.
Australian & New Zealand Journal of Psychiatry
November 17, 2022
30 citations
Psychedelic-assisted psychotherapy is being studied as a treatment for various psychiatric illnesses. Current evidence indicates that the subjective experiences caused by psychedelics are important for therapeutic outcomes. Most knowledge of these experiences comes from psychometric scales like the Mystical Experience Questionnaire. The authors argue that more detailed descriptions of how psychedelics change subjective experience are needed. They propose using qualitative methods from phenomenological psychopathology to systematically investigate these changes. This approach aims to characterize therapeutic psychedelic experiences using concepts from philosophical phenomenology, which should help clarify the mechanisms of psychedelic therapy, the role of integration therapy, and related philosophical debates.
Australian & New Zealand Journal of Psychiatry
May 10, 2023
Steve Kisely
22 citations
No Summary
Australian & New Zealand Journal of Psychiatry
January 25, 2019
Antonio Inserra
22 citations
No Summary
Australian & New Zealand Journal of Psychiatry
November 22, 2019
Sally Meikle, Paul Liknaitzky, Susan L. Rossell et al.
19 citations
Psilocybin, a psychedelic drug, is gaining attention as a potential treatment for depression due to its mechanism of action, benefits in early trials, and relatively low side effect burden. This viewpoint outlines key unresolved issues for its clinical use: identifying which patients are most likely to benefit or experience adverse effects, understanding longer-term outcomes, and clarifying the role of psychotherapeutic support alongside the drug. There are also opportunities to better understand the neurobiology underlying its effects.
Australian & New Zealand Journal of Psychiatry
September 28, 2023
18 citations
No Summary
Australian & New Zealand Journal of Psychiatry
December 13, 2024
Rosana Freitas, Efstathia Stephanie Gotsis, Alexander T. Gallo et al.
14 citations
A systematic review of 24 clinical trials on psilocybin-assisted psychotherapy for clinical populations found that physical and psychological adverse events during and after sessions varied in how they were measured and reported. The most common adverse events included elevated blood pressure, headaches, nausea, vomiting, fatigue, and anxiety. Suicidal ideation and behavior occurred infrequently and mainly in participants with a prior history of suicidality. No deaths were attributed to psilocybin. The review calls for standardized definitions and reporting of adverse events in psychedelic trials and emphasizes the importance of screening for suicidality history. Overall, the safety profile is generally supported, but cautious optimism is warranted given the preliminary and heterogeneous data.
Australian & New Zealand Journal of Psychiatry
May 3, 2023
Susan L. Rossell, Sally Meikle, M.l. Williams et al.
14 citations
The text provides no content to summarize.
Australian & New Zealand Journal of Psychiatry
June 1, 1995
K. M. H. Perera, A. Ferraro, M. R. M. Pinto
11 citations
A patient developed psychosis two days after ingesting LSD, followed by catatonia one week later. A single electroconvulsive therapy (ECT) treatment resolved the catatonic syndrome dramatically. This appears to be the first reported case of catatonia following LSD use. The case highlights the need for a diagnostic category of organic catatonia.
Australian & New Zealand Journal of Psychiatry
April 16, 2024
Samuel P Hatfield, Nicollette Lr Thornton, Kayla Greenstien et al.
9 citations
The Australian government's recent rescheduling of psilocybin and MDMA for limited clinical use has raised regulatory challenges for psychedelic-assisted therapy. Through a desktop review, interviews with experts, and framework analysis, researchers developed a taxonomy of regulatory matters across six domains. Three domains—Service Establishment, Practitioner, and Treatment Delivery—contain many matters with uncertainty or conflicting views, such as where services should be located and which professionals qualify as therapists. The remaining domains—Patient Evaluation, Drug Supply, and Service Oversight—are relatively settled, with established regulation or consensus that regulation is unnecessary. The taxonomy offers a roadmap for health services and policymakers.
Australian & New Zealand Journal of Psychiatry
July 15, 2025
Zohaib Nadeem, Stephen Parker, Hugh McGovern et al.
7 citations
Australian mental health clinicians—general practitioners, psychiatrists, and psychologists—generally hold positive attitudes toward psychedelic-assisted therapy, but concerns about safety and efficacy persist, especially among psychiatrists. Psychiatrists were significantly more likely than psychologists to perceive psychedelic use as unsafe under medical supervision and to question the scientific rigor of current research. Many clinicians relied on informal sources like podcasts and internet media for information, indicating gaps in evidence-based education. Clinicians who had personal experience with psychedelics were more likely to agree that these substances improve outcomes when combined with psychotherapy and show promise for treating psychiatric disorders. Targeted educational initiatives from professional bodies are needed to support informed clinical decision-making.
Australian & New Zealand Journal of Psychiatry
December 11, 2025
2 citations
Ketamine is a fast-acting treatment for psychiatric conditions that do not respond to other therapies, but its use is controversial. Evidence shows it can reduce depression, anxiety, and suicidal thoughts, yet it also carries risks such as dissociation, dependence, and unknown long-term effects. Its reputation as a recreational drug adds stigma and regulatory hurdles. The authors argue that ketamine should be accepted as a legitimate psychiatric treatment, but its use must be guided by ethical principles—autonomy, beneficence, non-maleficence, and justice—and supported by careful regulation and research, avoiding both unwarranted rejection and premature hype.
Australian & New Zealand Journal of Psychiatry
September 20, 2025
Emma Scott, Don Thomas Thekkuden, Katelyn Kerr et al.
2 citations
A systematic review found that ketamine or esketamine may improve depression symptoms in people who also have borderline personality disorder. However, the available data are limited. Case reports describe suicidal ideation and self-harm after stopping treatment, and individuals with borderline personality disorder may face a higher risk of acute dissociation. Clinicians should therefore exercise caution when using ketamine for depression in this population. Larger randomized controlled trials are needed to better assess efficacy and side effects.
Australian & New Zealand Journal of Psychiatry
May 26, 2026
1 citation
Novel treatments for treatment-resistant depression, such as ketamine, esketamine, transcranial magnetic stimulation, and psilocybin-assisted therapy, are available in Australia but mostly through commercial clinics that require out-of-pocket payment, leaving many patients without access. The authors identify barriers including difficulty diagnosing treatment-resistant depression, lack of clinician training, and regulatory and economic hurdles. They propose establishing specialist treatment-resistant depression clinics, particularly in the public sector, to improve access and build expertise.
Australian & New Zealand Journal of Psychiatry
December 17, 2025
Megan Dutton, Paul Schwenn, Jules Mitchell et al.
1 citation
Australia reclassified psilocybin as a Schedule 8 substance for treatment-resistant depression, a major policy shift. Implementation faces challenges: limited prescriber access, no Australian Register of Therapeutic Goods-listed products, lack of standardized training, and high costs. Ethical issues include informed consent, cultural safety, and therapeutic fidelity in trauma-informed care. Recommendations include national training accreditation, fidelity monitoring, and research into neurobiologically informed stratification models for treatment. These steps aim to ensure safe, equitable, and evidence-based integration of psilocybin-assisted therapy into Australia's mental health system.