Journal of the neurological sciences
May 15, 2024
Emmanuelle A D Schindler, R Andrew Sewell, Christopher H Gottschalk et al.
37 citations
In a blinded extension of a prior randomized trial, ten people with cluster headache received a second round of three doses of psilocybin (10 mg/70 kg, five days apart) at least six months after their first round. Attack frequency dropped significantly from a baseline of 18.4 attacks per week to 9.8 attacks per week in the three weeks after the first dose, a reduction of about 50%. This benefit occurred regardless of whether the participant had responded to psilocybin in the first round. No serious or unexpected adverse events occurred. The findings suggest that repeating a pulse of psilocybin can substantially reduce cluster headache attacks and that prior response does not predict the effect of retreatment.
Journal of the neurological sciences
September 15, 2022
Sabrina Correa Da Costa, Tyler Oesterle, Teresa A Rummans et al.
21 citations
Existing psychiatric drugs often work slowly, have limited effectiveness, and cause side effects. Recent human studies with psychedelics such as psilocybin, MDMA, and LSD show rapid and lasting clinical benefits for conditions like alcohol use disorder, anxiety, and depression in terminal illness. These compounds have been used in spiritual ceremonies for millennia, and early research suggested their therapeutic potential. After a research pause following the 1970 Controlled Substance Act, interest revived in the 1990s. Although preliminary findings are encouraging, current evidence is insufficient for routine clinical use; long-term safety and efficacy remain unclear, and ongoing trials aim to clarify these questions. This article provides an overview of the evidence to date.
Journal of the neurological sciences
March 15, 2022
David E Smith
A clinical toxicology trainee living in San Francisco's Haight Ashbury in 1965 studied psychedelics such as LSD, mescaline, and ibogaine in both human and animal models. At that time, these substances were used therapeutically in clinical settings and also researched as potential antipersonnel agents by the U.S. government. Their use became a rite of passage for the countercultural movement. After adverse reactions and negative publicity, states began criminalizing these drugs in 1966, and the federal government later classified them as Schedule 1, which nearly halted all research.
Journal of the neurological sciences
August 15, 2022
Ryan L Henner, Matcheri S Keshavan, Kevin P Hill
Post-traumatic stress disorder (PTSD) is a severe mental illness with few effective treatments and high dropout rates. Psychedelics, often paired with psychotherapy, are being explored as potential treatments. MDMA-assisted psychotherapy is in FDA phase III clinical trials for PTSD; it may work by increasing empathy and reducing amygdala activation during therapy. Classical psychedelics like psilocybin may work through subjective transformative experiences and brain network changes, though they have not been clinically studied for PTSD. In recent human studies, MDMA-assisted therapy significantly improved PTSD symptoms with good safety. Direct clinical evidence for classical psychedelics in PTSD is lacking, but supports such a trial. Studies remain small with well-screened participants.
Journal of the neurological sciences
March 15, 2022
Darin F Quach, Victoria C De Leon, Charles R Conway
About 20-25% of people with major depressive disorder do not respond to standard antidepressants, prompting the search for new treatments. Ketamine, which acts on the NMDA receptor, has drawn substantial research interest. Nitrous oxide, used for over a century as an anesthetic and analgesic, is now being studied for treatment-resistant depression. This review covers nitrous oxide's use as a psychiatric intervention, its current applications in psychiatry, proposed mechanisms of action, and future research directions, including knowledge gaps and other potential psychiatric uses.
Journal of the neurological sciences
May 15, 2020
Molly C Kalmoe, Alvin M Janski, Charles F Zorumski et al.
NMDAR antagonists like ketamine and nitrous oxide are being studied as rapid-acting antidepressants. Intravenous ketamine rapidly reduces depressive and suicidal symptoms in treatment-resistant depression (TRD), as shown by several trials. The FDA has approved intranasal esketamine for TRD, with a REMS program to minimize misuse. Nitrous oxide, a gas used for anesthesia and analgesia, also acts as an NMDAR inhibitor. A recent double-blind, prospective, cross-over study found that nitrous oxide reduced depressive symptoms in severely ill TRD patients, though further research is needed.