JAMA network open
June 3, 2024
Amy L McGuire, I Glenn Cohen, Dominic Sisti et al.
41 citations
A consensus statement from a 2023 meeting of 27 experts identifies 20 points of consensus across five ethical issues for integrating psychedelic medicines into mainstream medical practice: reparations and reciprocity, equity, and respect; informed consent; professional boundaries and physical touch; personal experience; and gatekeeping. The meeting included clinicians, researchers, Indigenous groups, industry, philanthropy, veterans, retreat facilitators, training programs, and bioethicists. The statement focuses on government-approved medical use in the US and abroad, emphasizing that policymakers must address challenges ahead while acknowledging the hopeful moment.
JAMA network open
June 3, 2024
Manish Kumar Jha, Samuel T Wilkinson, Kamini Krishnan et al.
29 citations
In people with treatment-resistant depression who do not have psychosis, intravenous ketamine works as well as electroconvulsive therapy (ECT) overall. Among outpatients with moderately severe or severe depression, ketamine produced greater improvement in depressive symptoms than ECT. In contrast, inpatients with very severe depression improved more with ECT early in treatment, though by the end of the three-week course both treatments were similarly effective. Higher premorbid intelligence and a diagnosis of posttraumatic stress disorder were linked to greater improvement with ECT, but not with ketamine. These findings may help patients and clinicians decide between the two treatments.
JAMA network open
January 2, 2024
Asli Korkmaz, Guro Pauck Bernhardsen, Burcu Cirit et al.
24 citations
A yoga breathing and meditation program (Sudarshan Kriya Yoga, SKY) reduced stress, depression, anxiety, and burnout and increased professional fulfillment among physicians compared with stress management education alone. In a randomized trial with 129 physicians from Turkey, Germany, and Dubai, those who practiced SKY for about 30 minutes daily over two months showed significantly lower stress and depression scores at both posttraining and postintervention, and lower anxiety at postintervention, compared with controls. Insomnia also decreased in the SKY group. No effect was found on self-reported medical errors. The findings suggest SKY may be a practical strategy to improve physician wellness and reduce burnout.
JAMA network open
November 4, 2024
Cihan Atila, Isabelle Straumann, Patrick Vizeli et al.
15 citations
A single dose of MDMA (ecstasy) caused acute hyponatremia (low blood sodium) in 31% of 96 healthy participants across four placebo-controlled trials. Hyponatremia occurred in 37% of those with unrestricted fluid intake but in none of the 15 participants whose fluid intake was restricted, suggesting fluid restriction may prevent this complication. The drop in sodium levels correlated with a sharp rise in oxytocin (433% increase) but not with copeptin, a marker of vasopressin. This challenges the long-held belief that MDMA-induced hyponatremia is caused by vasopressin release and instead points to oxytocin mimicking vasopressin's water-retaining effect in the kidneys due to structural similarity.
JAMA network open
February 3, 2025
Li Ren, Ting Zhang, Bingyu Zou et al.
13 citations
A single-site randomized clinical trial at a Chinese hospital found that administering a low dose of esketamine during cesarean delivery significantly reduced the incidence of postpartum depression at six weeks. Among 308 women, 10.4% who received esketamine developed postpartum depression compared with 19.5% who received a placebo saline infusion, a relative risk of 0.53. The authors suggest esketamine shows promise for preventing postpartum depression in this setting but call for further research in broader clinical practice.
JAMA network open
January 2, 2025
Rachel M Radin, Julie Vacarro, Elena Fromer et al.
11 citations
A brief digital mindfulness meditation program, compared to a waiting list, reduced perceived stress and job strain among employees of a large academic medical center. In a randomized clinical trial with 1458 adults (mostly female, average age 35.5 years), those assigned to 10 minutes of daily meditation for 8 weeks showed moderate to large improvements in stress and secondary outcomes like burnout and work engagement at 8 weeks, and these benefits persisted at 4 months. Greater daily use of the app (5 to 9.9 minutes versus less than 5 minutes) was linked to larger stress reductions. The findings suggest that a scalable digital meditation program can effectively lower stress in the workplace.
JAMA network open
April 1, 2025
Xue Zhang, Laura M Hack, Claire Bertrand et al.
10 citations
In a double-blind, placebo-controlled trial, 16 adults with subthreshold PTSD symptoms and early life trauma but no current psychiatric disorders were given 120 mg of MDMA or placebo. Participants were split into two groups based on baseline brain activity in the amygdala in response to nonconscious threat cues: those with high amygdala reactivity (NTNA+) and those with low reactivity (NTNA-). MDMA, compared with placebo, reduced activity in the amygdala and subgenual anterior cingulate cortex (sgACC), increased connectivity between the sgACC and amygdala, and increased liking of threatening facial expressions, but only in the NTNA+ subgroup. These findings suggest that baseline neural circuit profiles can identify who may benefit most from MDMA therapy and point to possible biomarkers for personalized treatment.
JAMA network open
January 2, 2026
Gianluca Andri Florineth, Isabell Klima, Anna Laura Boeker et al.
5 citations
In a systematic review and meta-analysis of 12 controlled clinical trials involving 733 adults with depressive symptoms, psychedelic-assisted therapy (PAT) with psilocybin or LSD produced a large overall reduction in depressive symptoms compared to control conditions. More hours of preparation therapy before the psychedelic session were significantly linked to greater symptom reduction. However, the number of post-dosing integration therapy hours, total therapy sessions, and longer follow-up periods were not associated with better outcomes. Most studies had high risk of bias due to ineffective blinding. The findings suggest that preparation therapy may be a key component in optimizing PAT outcomes, but further research is needed.
JAMA network open
July 1, 2025
Sarah-Catherine Rodan, Sarah Maguire, Noah Meez et al.
5 citations
In a large international survey of over 6,600 adults with eating disorders or disordered eating, cannabis and psychedelics were rated as most helpful for improving eating disorder symptoms, while prescription antidepressants were seen as beneficial for overall mental health but not for eating disorder symptoms, except for fluoxetine in bulimia nervosa and lisdexamfetamine in binge-eating disorder. Alcohol, nicotine, and tobacco were rated as most harmful. The findings suggest that cannabis and psychedelics may alleviate eating disorder symptoms, supporting further research into these substances as potential treatments.
JAMA network open
June 1, 2026
Martin Walter, Christine Zu Eulenburg, Ani Damyanova et al.
1 citation
A novel oral prolonged-release ketamine tablet, KET01, produced minimal dissociative and cardiovascular side effects compared to intranasal esketamine, which caused significant dissociation. In a phase 2 trial for treatment-resistant depression, the primary endpoint at 21 days was not met; the difference in Montgomery-Åsberg Depression Rating Scale (MADRS) score for 240 mg/day KET01 versus placebo was -1.82 points, not statistically significant. However, early reductions in depression scores were observed at 7 hours and at days 4 and 7. The antidepressant properties and tolerability support further development of KET01 for at-home use.
JAMA network open
January 2, 2026
Moshe Berchansky, A Eden Evins, Bryn Evohr et al.
1 citation
A brain-imaging technique called resting-state functional near-infrared spectroscopy (fNIRS) detected THC-induced impairment more accurately and with far fewer false positives than standard behavioral field sobriety tests (FSTs). In a double-blind, randomized crossover trial, 183 regular cannabis users (average age 25, half female) received either a single oral dose of synthetic THC or a placebo. fNIRS scans of the prefrontal cortex, taken at rest and during a working-memory task, were used to train machine-learning models to identify clinically determined intoxication. The fNIRS classifier achieved 90% accuracy and a 5% false-positive rate, compared with 69% accuracy and a 34% false-positive rate for FSTs. The findings suggest that resting-state fNIRS may provide a more reliable, objective method for detecting cannabis-related driving impairment.
JAMA network open
May 1, 2026
C Austin Zamarripa, Spencer Lin, Mckenna Klausner et al.
Combining cannabis edibles with alcohol worsens driving impairment more than either substance alone. In a controlled experiment with 25 healthy adults who reported prior co-use, driving performance was significantly impaired under most active drug conditions, including 25 mg THC with alcohol at 0.05% breath alcohol concentration. The legal alcohol intoxication limit of 0.08% may be too high when cannabis has also been consumed. Standard field sobriety tests often failed to detect impairment that was evident in driving measures. The findings suggest a need for better impairment detection and policies that account for co-use.