Clinical Psychopharmacology and Neuroscience
December 26, 2014
Georg Northoff
65 citations
Auditory verbal hallucinations (AVH) may arise from abnormally elevated resting state activity in the auditory cortex, abnormal modulation of the auditory cortex by anterior cortical midline regions of the default-mode network, and neural confusion between resting state changes and stimulus-induced activity. This 'resting state hypothesis' integrates recent findings on intrinsic brain activity and corresponds with subjective-experiential features from phenomenological accounts, leading to a 'neurophenomenal resting state hypothesis' of AVH in schizophrenia.
Clinical Psychopharmacology and Neuroscience
October 16, 2023
Tessa Watford, Naqash Masood
21 citations
Psilocybin, a classical psychedelic used for healing for millennia, shows promise as a treatment for major depressive disorder by acting on 5-HT1a receptors. This systematic review of 6 studies involving 319 participants found that every study significantly favored psilocybin in reducing depressive symptoms, with few side effects. This gives psilocybin an advantage over commonly prescribed SSRIs, which carry more risk and cause more adverse effects. The drug shows promise as a clinical treatment, but future research should develop a standardized paradigm for its use, including timing of sessions and type of psychological support, and more studies are needed to detect publication bias.
Clinical Psychopharmacology and Neuroscience
November 30, 2023
Sunghwan Kim, Won-Seok Choi, Hyun Kook Lim et al.
16 citations
Psilocybin shows promise for treating depression and anxiety, with notable safety profiles. A review of eleven clinical trials—six open-label and five double-blinded randomized trials—found that psilocybin, a 5-HT2A receptor agonist, may reduce depressive symptoms by increasing glutamate transmission, reducing brain inflammation, and decreasing default mode network activity. In treatment-resistant depression, a pilot study reported significant symptom reductions after two sessions, with sustained improvements and high remission rates. Among cancer patients, two trials showed reductions in anxiety and depression lasting over six months. In major depressive disorder, psilocybin produced rapid depression reductions with higher remission rates than escitalopram. A dose-response trial found that 25 mg, but not 10 mg, was superior to 1 mg. Further research should explore optimal dosages and long-term effects.
Clinical Psychopharmacology and Neuroscience
May 21, 2024
S Morris
5 citations
A man with depression, personality disorder traits, and cannabis use developed a psychotic episode with catatonic features and suicidality after several months of heavy psilocybin use. A review of similar published cases shows that psilocybin-induced psychosis typically occurs in people with predisposing risk factors who take high or repeated doses. This pattern warns that psilocybin use carries risks, while reassuring researchers that the much lower doses used in clinical trials for mental illness are safer.
Clinical Psychopharmacology and Neuroscience
July 14, 2026
Alessandro Serretti
Ketamine and esketamine can relieve depression within hours, even in people who have not responded to other treatments. Yet this advance has not solved the problem of treatment-resistant depression; it has shifted the focus from short-term improvement to what happens afterward. The main unanswered questions are how long the benefit lasts, how to prevent relapse, how to structure and eventually stop maintenance treatment, whether symptom relief leads to functional recovery, which patients benefit most, why useful biomarkers remain unknown, and what the long-term safety and abuse risk of repeated use will be. This review argues that durability, functional recovery, patient selection, long-term safety, and real-world implementation should now guide research and clinical decisions.