CNS Drugs
August 17, 2020
Joost J Breeksema, Alistair R Niemeijer, Erwin Krediet et al.
217 citations
This review argues that qualitative research on psychedelic treatments can reveal unique features of different substances and uncover implications for treating specific psychiatric disorders that quantitative methods might miss. By examining subjective experiences, such studies can help tailor therapies to particular conditions and substances, offering insights into how psilocybin, LSD, or other compounds produce distinct psychological effects. The authors suggest that incorporating qualitative findings into clinical practice could enhance treatment precision and patient outcomes, highlighting the value of exploring personal narratives and emotional processes in psychedelic therapy.
CNS Drugs
February 14, 2022
Jennifer Swainson, L. Klassen, Stefan Brennan et al.
42 citations
Intravenous ketamine and intranasal esketamine are used for depression but face cost and access barriers. Non-parenteral racemic ketamine (oral, sublingual, intranasal) might improve access, though evidence is limited. Concerns about ketamine's addictive potential have not been examined against available evidence. The authors argue that ketamine misuse risks are similar to those of stimulants or benzodiazepines, and prescribing should balance patient access with misuse concerns. A consortium of mood disorder specialists considers non-parenteral ketamine a reasonable option for select treatment-resistant depression cases and provides practical prescribing recommendations.
CNS Drugs
July 20, 2021
Vera Miriam Ludwig, Cathrin Sauer, Allan H. Young et al.
23 citations
Combining esketamine with the monoamine oxidase inhibitor tranylcypromine in patients with treatment-resistant depression does not cause clinically dangerous blood pressure spikes, despite earlier safety concerns. In a retrospective analysis of 509 esketamine administrations in 43 hospitalized patients, those who also received tranylcypromine showed statistically greater changes in systolic and diastolic blood pressure during the first hour after esketamine administration, but these changes were small (mean systolic increase of 2.96 mmHg versus a decrease of 8.84 mmHg in the non-tranylcypromine group) and not clinically significant. Heart rate was unaffected. A dose-response relationship was observed, with higher tranylcypromine doses linked to larger blood pressure increases, suggesting caution with high doses. The findings indicate that the combination is safe at standard doses.
CNS Drugs
November 28, 2025
D J Hirsch, Jace Reed, Aasim Naqvi et al.
2 citations
Eating disorders are complex psychiatric conditions with limited pharmacological treatment options. A review of clinical drug trials from 2010 to 2025 found 43 eligible phase I-IV trials for anorexia nervosa, binge eating disorder, bulimia nervosa, and rumination disorder. Among 24 distinct compounds studied, only lisdexamfetamine dimesylate received FDA approval for an eating disorder during this period. Few agents have shown positive results in late-stage trials, though solriamfetol and psilocybin show promise. There remains a significant lack of evidence-based pharmacological interventions for anorexia nervosa and little progress for bulimia nervosa, highlighting an urgent need for more rigorous clinical trials.
CNS Drugs
October 16, 2025
Gisèle Pickering, Véronique Morel, Marion Voute
2 citations
Ketamine, an anesthetic and sedative drug, is used off-label for chronic refractory pain and can provide significant short-term pain relief, especially for neuropathic pain, and is fairly well-tolerated in patients with severe refractory pain. However, long-term data on efficacy, cognitive impact, addiction risk, and optimal dosing are severely lacking. The intravenous route is the most studied, while alternatives remain underexplored. Ketamine is not a first-line treatment and must be prescribed by trained specialists within a structured standard of care. Future use depends on collaborative research to define optimal administration routes, patient phenotyping, and long-term studies assessing mood, quality of life, and cognitive function.
CNS Drugs
July 1, 2026
Omer A. Syed, Valentyn Sobolenko, Sean M. Nestor et al.
Most demographic and clinical variables do not reliably predict who will benefit from ketamine or esketamine for treatment-resistant depression, though a few promising factors—such as early response to treatment and a family history of substance use disorders—warrant further study. This systematic review synthesized 122 studies involving 12,674 participants, finding that the majority of 77 examined predictor variables showed no association with antidepressant outcomes. The review included both unipolar and bipolar treatment-resistant depression, with most studies using intravenous ketamine at a fixed 0.5 mg/kg dose.
CNS Drugs
June 15, 2026
Edward P. Hackett, Aditi Chaudhri -, Linda Hasman et al.
Dextromethorphan (DXM), a common over-the-counter cough suppressant, produces psychedelic effects at high doses that may be useful for treating psychiatric disorders resistant to standard therapies. A systematic review of eight studies with 104 total participants found that psychedelic effects begin at 100 mg, with hallucinatory and mystical experiences intensifying at 300 and 400 mg. Adverse effects such as nausea, vomiting, motor impairment, and cognitive slowing become more prominent above 200 mg. The evidence is too limited to establish true dose-response relationships, and the certainty of evidence is low for most outcomes, highlighting the need for larger, well-designed studies.
CNS Drugs
March 24, 2026
Mathieu Seynaeve, Fiona Dunbar, Chandni Hindocha et al.
A proof-of-concept trial tested intranasal 5-MeO-DMT combined with an SSRI in people with treatment-resistant depression. The treatment was generally well tolerated and showed preliminary signals of antidepressant effects, though the small, uncontrolled design limits conclusions.