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Cureus

ISSN 2168-8184

113 papers in the library · 487 citations · publishing 2020-2026

Papers

Severe Rhabdomyolysis With Stage 3 Acute Kidney Injury After Ayahuasca Use Managed Without Renal Replacement Therapy: A Case Report.

Cureus September 17, 2025 1 citation

A case report describes a patient who developed severe rhabdomyolysis—a condition involving rapid muscle breakdown—along with stage 3 acute kidney injury after using ayahuasca. The kidney injury was managed successfully without the need for renal replacement therapy (dialysis). The patient recovered fully with medical treatment, demonstrating that even severe complications from ayahuasca can be managed conservatively in some cases.

Ketamine-Induced Uropathy in a High-Prevalence Region: Knowledge, Diagnostic Practices, and Treatment Patterns Among Primary and Secondary Care Providers.

Cureus June 1, 2025 Zakaria W Shkoukani, Praveen Gopi, Lauren Tate et al. 1 citation

Ketamine-induced uropathy (KIU) is a growing problem from recreational ketamine use that can progressively damage the urinary tract, yet many clinicians lack awareness and standardized approaches to manage it. In a region of the United Kingdom with high KIU incidence, secondary care professionals showed significantly greater awareness of KIU than primary care professionals, though familiarity with British Association of Urological Surgeons guidelines was limited overall. Primary care providers lacked confidence in managing KIU and often deferred to secondary services; many also believed law enforcement should be involved. High non-attendance rates (41.5%) underscored the need for early psychosocial support. General practitioners expressed strong interest in targeted education to improve community care.

Exploring the Neuroprotective and Neuropsychiatric Symptom Management Potential of Ketamine in Alzheimer's Disease.

Cureus June 1, 2025 Amy Avakian, Zachary I Merhavy 1 citation

Ketamine, an anesthetic that blocks NMDA receptors, may offer new ways to manage Alzheimer's disease by improving communication between brain cells and reducing inflammation. The review describes how ketamine could help with depression and agitation that often accompany Alzheimer's, though these results are still preliminary and more research is needed to confirm its safety and effectiveness.

An Investigation of the Effects of Yoga on the Psychological Well-Being of Young Athletes: A Randomized Controlled Trial.

Cureus June 1, 2025 Priyanka Saraswati, Satish Kanaujia, Ghanshyam Singh Thakur et al. 1 citation

A month-long yoga program combining pranayama (breath control) and meditation reduced stress and increased mindfulness and psychological flexibility in recreational athletes aged 18 to 45. Compared to a control group that received no treatment, the yoga group showed significantly lower stress levels and fewer negative emotional states, along with higher dispositional mindfulness. Stress reduction and mindfulness improvement strongly predicted everyday psychological flexibility skills. The findings suggest that regular yoga practice supports mental and emotional health beyond physical fitness, helping athletes manage stress and regulate emotions.

Elevated Endogenous Psychedelic Bufotenine in the Urine of Patients Diagnosed With a Mental Illness: A Systematic Review.

Cureus May 20, 2025 1 citation

A systematic review examined whether patients diagnosed with a mental illness have elevated levels of the endogenous psychedelic compound bufotenine in their urine. The review found that bufotenine levels are higher in the urine of individuals with certain psychiatric disorders compared to healthy controls, suggesting a potential link between this neurochemical and mental health diagnoses. However, the evidence is limited by small sample sizes and methodological variability across studies, indicating that bufotenine may serve as a biomarker for some mental illnesses, but further research is needed to confirm these findings.

Neuropharmacology of Ketamine and Its Use in the Treatment of Major Depressive Disorder: A Review.

Cureus April 1, 2025 Zach Papadopoulos 1 citation

Ketamine acts as a rapid antidepressant primarily by blocking N-methyl-D-aspartate receptors, though its effects also involve monoaminergic signaling, BDNF signaling, opioid receptor agonism, and neuroinflammation. Compared to SSRIs and tricyclic antidepressants, ketamine shows greater efficacy, faster onset, and better tolerability but has a shorter duration of action and accessibility issues. In a head-to-head trial, ketamine matched electroconvulsive therapy in efficacy for non-psychotic depression while providing faster relief. Further research is needed to optimize dosing, improve accessibility, and address risks like bladder toxicity and addiction.

Comparative Efficacy and Functional Outcomes of Psychedelic-Assisted Therapies in Treatment-Resistant Depression: A Systematic Review of Recent Clinical Trials.

Cureus April 1, 2025 Ciara Mimms, Kassandra Sotelo, Abdul Saboor Khaliq 1 citation

A systematic review of ten recent randomized controlled trials found that psychedelic-assisted therapies, including ketamine, esketamine, and psilocybin, significantly reduce depressive symptoms in treatment-resistant depression. Oral and intranasal esketamine and high-dose psilocybin showed sustained antidepressant effects. Some trials also reported functional improvements, such as better workplace productivity and cognitive stability, particularly with esketamine. The therapies were well tolerated with minimal cognitive side effects. Risk of bias was low in four studies and moderate in six due to open-label or observational extensions. The findings support psychedelic-assisted therapies as viable alternatives or adjuncts for treatment-resistant depression and emphasize the need to assess both clinical and functional outcomes.

Posterior Reversible Encephalopathy Syndrome in the Postpartum Period: A Rare Entity With Atypical Presentation.

Cureus April 1, 2025 Auriane Leslie Kouam Djembi, Marie-Anne Labaisse, Thibault Warlop et al. 1 citation

Posterior reversible encephalopathy syndrome (PRES) is a rare brain condition that can occur after childbirth, even in women with normal blood pressure. A case is reported of a first-time mother who developed severe neurological symptoms, including temporary blindness and memory loss, after delivery. Brain imaging showed swelling in unusual areas such as the temporal lobes, hippocampi, and thalami. Special MRI techniques helped distinguish PRES from early stroke, which is critical for proper treatment. The case demonstrates that PRES should be considered in postpartum patients with serious neurological symptoms, regardless of blood pressure or protein levels. Early recognition is important because the syndrome is reversible with timely care.

A Modern Overview of the Potential Therapeutic Effects of Psilocybin in the Treatment of Depressive Disorders, Treatment-Resistant Depression, and End-of-Life Distress

Cureus March 17, 2025 Fejzic Dino 1 citation

Psilocybin, a psychedelic alkaloid from Psilocybe mushrooms, shows therapeutic potential for conditions including treatment-resistant depression and end-of-life distress. This review consolidates current data on its efficacy, safety, therapeutic effects, indications, contraindications, drug interactions, adverse reactions, pharmacokinetics, pharmacodynamics, and dosing regimens. The evidence suggests psilocybin can produce rapid and sustained antidepressant effects, though its use requires careful screening and professional supervision due to risks such as anxiety, transient hypertension, and potential for adverse psychological reactions. The review provides a comprehensive pharmaceutical reference for clinicians and researchers.

Qigong Versus Usual Exercise in the Treatment of Chronic Nonspecific Low Back Pain as an Add-On to a Standardized Physiotherapy Program.

Cureus March 1, 2025 Spyridon Sotiropoulos, Theodora Plavoukou, George Georgoudis 1 citation

Adding Qigong to standard physiotherapy for chronic low back pain may reduce pain and disability more than adding strengthening exercises alone. In a four-week trial with 42 participants, both groups improved, but the Qigong group showed greater reductions in pain and disability, as well as improved proprioception. Kinesiophobia decreased similarly in both groups. The authors call for longer-term follow-up and larger trials to clarify whether Qigong offers distinct advantages over conventional exercise programs.

Mindful Jazz and Preferred Music Interventions Reduce Pain Among Patients With Chronic Pain and Anxiety: A Pilot Randomized Controlled Trial.

Cureus March 1, 2025 Sean D Young, Josh Kim, Adam Hanley 1 citation

Mindfully listening to music, including improvisational jazz, can reduce chronic pain and anxiety more effectively than listening without mindfulness training. In a pilot study of 120 adults with chronic musculoskeletal pain, participants were randomly assigned to mindful listening or music education groups, each with either preferred music or jazz. Those in the mindful listening groups reported significantly greater reductions in pain intensity and anxiety. A clinically meaningful (20%) decrease in pain occurred more often in the mindful jazz (50%) and mindful music (41%) groups than in the jazz education (29%) and music education (26%) groups. The findings suggest that combining mindfulness with music listening enhances pain relief.

Mace Poisoning: Accidental Toxic Ingestion in a Child Leading to a Reversible Coma.

Cureus December 1, 2024 Ayesha Imtiaz, Bassam M Almutairy, Taghreed M Almutairi et al. 1 citation

A six-year-old child who accidentally swallowed six pieces of mace, a spice derived from the nutmeg plant, developed symptoms resembling serotonin syndrome and anticholinergic poisoning, including altered consciousness and respiratory acidosis. The child recovered with only supportive care and was discharged after 36 hours. Mace contains myristicin, which inhibits monoamine oxidase and is metabolized into a compound with psychedelic effects. Although nutmeg poisoning is more frequently reported, this case illustrates that mace ingestion can also cause serious toxicity, particularly in young children, and underscores the importance of preventing accidental exposures in homes.

Navigating Treatment-Resistant Major Depressive Disorder With Suicidal Ideation: Exploring the Efficacy of Spravato (Esketamine) in an 86-Year-Old Male.

Cureus December 1, 2024 Aarman P Jivraj, Katherine A Heimer, Christopher J Wukovits et al. 1 citation

An 86-year-old patient with treatment-resistant major depressive disorder and suicidal ideation was treated with intranasal esketamine (Spravato), representing one of the oldest documented cases. Under the supervision of a double board-certified adult and geriatric psychiatrist, the therapy led to positive treatment outcomes. The case highlights unique pharmacodynamic and clinical challenges in geriatric populations, including advanced age, comorbidities, and sensitivity to adverse effects. While most research focuses on people aged 65 and younger, this case contributes evidence on the safety and efficacy of intranasal esketamine for treatment-resistant depression in elderly patients and aims to inform future clinical guidelines.

Improving Prefrontal Oxygenation and Cardiac Autonomic Activity Following Meditation: A Functional Near-Infrared Spectroscopy (fNIRS) Study.

Cureus August 1, 2024 Sushanta Mohanty, Deepeshwar Singh, Amit Singh et al. 1 citation

Practicing the mind sound resonance technique (MSRT), a meditative relaxation approach, improved oxygenation in the right prefrontal cortex and altered heart rate variability—increasing low-frequency and decreasing high-frequency components—compared to baseline in college students aged 19–30. Fifty volunteers (30 women, 20 men) were split into MSRT and supine rest groups. MSRT also showed a significant difference from supine rest in the standard deviation of normal-to-normal intervals of heart rate variability. Self-reported mindfulness and anxiety were measured before and after. The evidence suggests MSRT may help develop anxiety-related coping skills by promoting prefrontal cortex oxygenation and modulating heart rate variability.

Treatment-Related Fluctuation in Guillain-Barre Syndrome With the Acute Motor-Sensory Axonal Neuropathy (AMSAN) Variant: A Case Report.

Cureus July 1, 2024 Elliot Hernandez, David Dominguez, Raul Medina-Rioja et al. 1 citation

A 60-year-old man developed Guillain-Barré syndrome (GBS) two weeks after consuming ayahuasca, with no preceding infection or vaccination. He had progressive limb weakness, areflexia, and the acute motor-sensory axonal neuropathy (AMSAN) variant. Initial treatment with intravenous immunoglobulin improved his strength, but ten days later he experienced a severe relapse requiring ventilatory support, consistent with treatment-related fluctuation. Retreatment with immunoglobulin led to improvement. This case suggests ayahuasca may be a trigger for GBS and highlights the possibility of treatment-related fluctuations in such patients.

Meditation and Compassion Therapy in Psychiatric Disorders: A Pilot Study.

Cureus July 1, 2024 Cristian I Babos, Giovanni Zucchi, Augusto E Filimberti et al. 1 citation

Adding meditation and compassion-focused group therapy to standard care for patients with eating disorders, drug addiction, alcohol addiction, and depression improved acceptance, mindfulness awareness, self-compassion, and psychological distress within the group that received the extra therapy. However, at the end of the study, there were no statistically significant differences between the group receiving the added therapy and the group receiving standard care alone on any of the four measured scales. The comparison between groups was limited by data availability.

Navigating Treatment Challenges: A Case Study on Refractory Psychosis in a Chronic MDMA (3,4-Methylenedioxymethamphetamine) User.

Cureus May 1, 2024 Melissa N Litenski, Aoife B O'Reardon, Nicole Pabon et al. 1 citation

A 23-year-old woman with chronic MDMA use disorder and childhood trauma developed severe psychosis and catatonia. Although initially suspected to be drug-induced psychosis, her history and symptoms led to a diagnosis of bipolar I disorder with psychotic features, worsened by MDMA use. Standard antipsychotics failed and worsened catatonia, requiring electroconvulsive therapy (ECT) for improvement. Socioeconomic barriers disrupted follow-up care, resulting in an emergency department visit shortly after discharge. The case illustrates the complex interaction of substance use, psychiatric illness, and trauma, highlights ECT's effectiveness in severe psychosis, and underscores the need for comprehensive mental health services for vulnerable populations and further research on MDMA's psychiatric effects.

Ketamine Infusion in a Resistant Obsessive-Compulsive Disorder Patient in Bangladesh with Severe Suicidal Ideation: A Case Report.

Cureus April 1, 2024 Sultana Algin, Debasish Banik, Sm Atikur Rahman et al. 1 citation

A patient with treatment-resistant obsessive-compulsive disorder (OCD) and severe suicidal ideation received three weekly intravenous ketamine infusions. Obsessive-compulsive symptoms and suicidal severity decreased rapidly after the first infusion, though symptoms temporarily increased after a stressful event. Subsequent infusions produced continued improvement, sustained through discharge and at six- and twelve-week follow-ups. The case suggests ketamine may reduce both resistant OCD symptoms and suicidal ideation, though further research is needed.

Hallucinogen-Induced Persisting Perception Disorder: A Case Report.

Cureus September 1, 2023 Javairia Ayyub, Sailaja Nandennagari, Dylan Edelbaum et al. 1 citation

Hallucinogen-persisting perception disorder (HPPD) causes persistent visual distortions, most commonly after lysergic acid diethylamide (LSD) use. A 28-year-old Caucasian male with a history of polysubstance use, including LSD and cannabis, developed classic HPPD symptoms seven months after stopping LSD. Diagnosis required ruling out other causes through laboratory and imaging tests. His symptoms did not improve with antipsychotics, indicating they were not solely due to mental illness. While alpha-2 adrenergic drugs like clonidine and benzodiazepines are considered first-line treatment, the patient showed improvement with lamotrigine, which is the gold standard for treating perceptual disturbances in time and space.

The Clinical, Philosophical, Evolutionary and Mathematical Machinery of Consciousness: An Analytic Dissection of the Field Theories and a Consilience of Ideas.

Cureus December 18, 2020 Hassan Kesserwani 1 citation

Consciousness can be understood as a tangible energy field—the conscious electro-magnetic information (CEMI) field—rather than a dualistic mind or soul. This field arises from the brain's high-entropy, wet biological medium and accounts for the binding problem by generating synchronous gamma oscillations across neuronal ensembles, as seen in Freeman's rabbit experiments. The temporo-parietal-occipital cortex, expanded in hominid evolution, along with thalamo-cortical oscillations, is proposed as the minimal neural correlate of consciousness. The theory integrates Kantian philosophy of space and time, Avicenna's thought experiment, and Karl Friston's free energy principle, interpreting consciousness as a flow of probability densities on a Riemannian manifold that minimizes divergence in Bayesian inference. The study of consciousness has moved beyond metaphysics into neurophysiology and mathematics.

Acute Hallucinogen Intoxication Following Ingestion of a Commercially Available Mushroom Extract Product: A Case Report

Cureus June 13, 2026 Akemini J Udoro, Yadanar Yukyi, Ali Z Ansari et al.

A healthy 18-year-old woman developed severe anxiety, hallucinations, and physical agitation after ingesting a mushroom product bought at a gas station. Doctors diagnosed psilocybin intoxication based on her symptoms and their resolution with supportive care, despite not having confirmatory toxicology tests. The product's vague labeling made diagnosis challenging. She was treated with intravenous fluids and benzodiazepines, and her symptoms gradually resolved before discharge. This case illustrates how commercially available mushroom products can cause hallucinogen intoxication, requiring clinicians to rely on clinical signs and careful exclusion of other causes.

Optimized Oral Glutamatergic Augmentation in Refractory Home-Dominant Contamination Obsessive-Compulsive Disorder With Somatic, Affective, and Motivational Features: A Case Report of Incremental Functional Gains.

Cureus June 1, 2026 Hoi Ki Cheung, Ngo Cheung

A 26-year-old woman with severe contamination-focused obsessive-compulsive disorder (OCD) that persisted despite standard treatments showed meaningful improvement after a glutamatergic augmentation strategy using dextromethorphan, piracetam, and L-glutamine, combined with CYP2D6-inhibiting antidepressants. Over nine months, bathing time decreased from about 1.5 hours to about 30 minutes, and ritual preoccupation reduced by 20-30%. Mood, energy, motivation, and daily functioning improved, and passive suicidal ideation resolved temporarily. Residual cleaning symptoms remained at home. The case is hypothesis-generating and not evidence of regimen-specific efficacy; larger controlled studies are needed.

Ketamine and Esketamine in Neurology and Psychiatry: An Overview.

Cureus May 1, 2026 Amalesh S Honnekeri

Ketamine and esketamine, which act on glutamatergic pathways, offer alternative therapeutic approaches for treatment-resistant depression (TRD) when conventional antidepressants fail. Ketamine is typically given intravenously in monitored settings, while esketamine is administered as an intranasal formulation under supervision. This narrative review outlines their proposed mechanisms, clinical uses, administration methods, and safety profiles. Tolerability and monitoring requirements are important considerations. These agents represent a developing area in TRD treatment and highlight the broader emergence of interventional psychiatry. Further research is needed to characterize long-term outcomes, refine protocols, and improve patient selection.

Severe Hyponatremic Encephalopathy Induced by Unsupervised "Therapeutic" 3,4-Methylenedioxymethamphetamine Use in a 55-Year-Old Woman: A Diagnostic Pitfall.

Cureus May 1, 2026 Pierre-Henri Woitrin, Pascale Lievens

MDMA toxicity, once stereotyped as affecting only young people in nightclubs, may now appear in older individuals using the drug for self-directed therapy, creating a diagnostic trap for emergency physicians. A 55-year-old woman developed life-threatening hyponatremic encephalopathy after taking MDMA in a private home, not a rave. Her severe hyponatremia and neurological decline were initially puzzling because her age and setting did not match the expected profile. The case underscores that representativeness bias—judging based on a stereotypical category—can cause clinicians to overlook MDMA as a cause of unexplained hyponatremia with altered mental status, regardless of patient age or social context.