The British journal of psychiatry : the journal of mental science
February 1, 2006
Ursula Werneke, Trevor Turner, Stefan Priebe
98 citations
Complementary medicines are commonly used by people with mental health problems, but their effectiveness is often unproven and they may not be as harmless as assumed. A review of the literature found potentially useful substances: ginkgo and hydergine as cognitive enhancers, passion flower and valerian as sedatives, St John's wort and s-adenosylmethionine as antidepressants, and selenium and folate to complement antidepressants. Evidence is less conclusive for omega-3 fatty acids in schizophrenia, melatonin for tardive dyskinesia, and an ibogaine derivative for addiction. Systematic clinical trials are needed, and users should seek appropriate advice.
The British journal of psychiatry : the journal of mental science
February 1, 1978
L Corbett, S T Christian, R D Morin et al.
49 citations
Levels of dimethyltryptamine and O-methylbufotenine in cerebrospinal fluid were measured in people with acute schizophrenia and in surgical and neurological control groups. Some patients with schizophrenia showed higher levels of both amines than controls, but the differences in distribution were not statistically significant in the sample studied. The gas-chromatographic method used can detect these substances at the low picogram level.
The British journal of psychiatry : the journal of mental science
January 1, 2015
Ben Sessa, David Nutt
36 citations
MDMA has been recognized for its therapeutic potential since its first use, but research halted when it became a recreational drug. Over the past decade, studies have slowly resumed, and there is now enough evidence to reclassify MDMA from Schedule 1 ('no medical use') to Schedule 2, alongside other misused but medically useful drugs like heroin and amphetamine. This regulatory change would allow its use as a medicine for patients with severe mental illnesses, such as treatment-resistant post-traumatic stress disorder.
The British journal of psychiatry : the journal of mental science
September 1, 2024
Friederike Holze, Peter Gasser, Felix Müller et al.
32 citations
A long-term follow-up of a double-blind, placebo-controlled crossover trial found that LSD-assisted therapy produced sustained reductions in anxiety and depression for up to 94 weeks after the last treatment. Participants who received LSD first showed a decrease of 21.6 points on the State-Trait Anxiety Inventory, and those who received LSD second showed a decrease of 16.5 points, both statistically significant. Comorbid depression also improved, with Beck Depression Inventory scores dropping by 8.1 and 8.9 points in the two groups. Personality traits shifted toward lower neuroticism and higher extraversion. Patients attributed lasting positive effects to the psychedelic experience.
The British journal of psychiatry : the journal of mental science
August 1, 2019
Álvaro López-díaz, Manuel Murillo-Izquierdo, Elisa Moreno-Mellado
21 citations
In European public health systems, ketamine therapy for treatment-resistant depression should only be considered after all guideline-recommended antidepressant strategies have been tried. The paper describes the ethical, regulatory, and procedural rules governing the off-label use of ketamine in such settings.
The British journal of psychiatry : the journal of mental science
November 3, 2025
Alaina V Burns, Kyle Nelson, Haley Wang et al.
7 citations
Delusions among people with psychosis increasingly incorporate the internet and new technologies. A review of medical records for 228 adults with psychosis treated between 2016 and 2024 found that over half (51.7%) described technology-related delusions. The odds of having such delusions rose about 15% each year, a statistically significant trend. Most subjects (88.2%) reported some delusional thought content. The findings suggest that clinicians should be aware of technology themes when assessing patients and training others.
The British journal of psychiatry : the journal of mental science
February 1, 2025
Allan H Young, Pierre-Michel Llorca, Andrea Fagiolini et al.
7 citations
In people with treatment-resistant depression, esketamine nasal spray outperformed quetiapine extended release across multiple measures. Sensitivity analyses using different definitions of remission and relapse consistently favored esketamine, with relative risks for the primary endpoint ranging from 1.462 to 1.737 and for the key secondary endpoint from 1.417 to 1.838. Esketamine also shortened time to first remission by 71% and confirmed remission by 66%. The robustness of the original ESCAPE-TRD trial findings was confirmed.
The British journal of psychiatry : the journal of mental science
July 11, 2025
Tor-Morten Kvam, Ivar W Goksøyr, Justyna Rog et al.
6 citations
In an open-label study of twelve adults with moderate to severe major depressive disorder, two sessions of MDMA-assisted therapy one month apart, combined with psychotherapy, led to a substantial average reduction of 19.3 points on the Montgomery-Asberg Depression Rating Scale and an average decrease of 11.7 points on the Sheehan Disability Scale, indicating improved daily functioning. No serious or unexpected adverse events occurred. The results suggest the approach is safe and feasible, with strong indications of efficacy, though randomized controlled trials are needed to confirm.
The British journal of psychiatry : the journal of mental science
April 1, 2025
Jesus Montero-Marin, Verena Hinze, Shannon Maloney et al.
4 citations
Mindfulness skills mediate the effect of mindfulness-based cognitive therapy (MBCT) on depressive symptoms over 24 months, and this mediation is stronger for people with more severe depression. Among 424 adults with recurrent depression, those with higher severity showed an expected 10-point reduction on the Beck Depression Inventory-II, compared to a 3.5-point reduction for those with lower severity. The findings suggest MBCT with antidepressant tapering support works through a unique mechanism—mindfulness skills—that differs from maintenance medication alone, supporting personalized treatment for recurrent depression.
The British journal of psychiatry : the journal of mental science
May 13, 2025
Shabnam Hossein, Manivel Rengasamy, Aiyedun Uzamere et al.
3 citations
Ketamine infusion most strongly alleviates sadness both immediately and during the first week after treatment, whereas improvements in suicidal thoughts emerge only after three to four weeks. In a secondary analysis of 152 adults with treatment-resistant depression (38.8% with suicidal ideation at baseline), those randomized to a single 40-minute intravenous infusion of ketamine (0.5 mg/kg) showed greater early improvement in sadness-related symptoms compared with saline. Network analyses revealed that ketamine increased connectivity among depressive symptoms, strengthening interrelationships between residual symptoms. The findings suggest that different depressive symptoms respond to ketamine with distinct time courses and possibly different mechanisms.
The British journal of psychiatry : the journal of mental science
January 7, 2025
Natalie T Mills, Stevan Nikolin, Nick Glozier et al.
3 citations
Anxiety disorders and treatment-resistant major depressive disorder (TRD) often occur together. In a randomized controlled trial comparing subcutaneous ketamine to midazolam in 174 people with TRD, ketamine reduced anxiety only when given at flexible, response-guided doses (0.5-0.9 mg/kg). At a fixed low dose (0.5 mg/kg), the reduction in anxiety was not statistically significant. The anxiety-reducing effect was linked to overall depression improvement and was not sustained four weeks after treatment ended. The findings suggest that adequate dosing is necessary for ketamine's anxiolytic effect in this population.
The British journal of psychiatry : the journal of mental science
April 2, 2025
Wei-Chen Lin, Li-Kai Cheng, Tung-Ping Su et al.
2 citations
Dysfunction in the default mode, salience, and frontoparietal networks—the triple network model—may underlie treatment-resistant depression. Analyzing resting-state functional connectivity MRI data from two clinical trials, researchers found that a single low-dose ketamine infusion altered network properties. In one trial, ketamine changed degree centrality and cluster coefficient in the right posterior cingulate cortex (default mode network) and cluster coefficient in the right supramarginal gyrus (salience network), compared to saline. In another trial, ketamine altered characteristic path length in the left posterior cingulate cortex (default mode network) compared to midazolam. A time effect on cluster coefficient in the right dorsolateral prefrontal cortex (frontoparietal network) appeared for both ketamine and saline. These findings suggest the triple-network model helps explain ketamine's antidepressant effects.
The British journal of psychiatry : the journal of mental science
February 26, 2025
Ziad Saade, Alex S Keuroghlian
2 citations
MDMA-assisted therapy may improve exposure and response prevention for obsessive-compulsive disorder by enhancing fear extinction, psychological flexibility, and empathy, potentially boosting treatment adherence and effectiveness. The article discusses these mechanisms and emphasizes safety considerations for future research.
The British journal of psychiatry : the journal of mental science
October 25, 2024
Kabir Nigam, Franklin King, Fernando Espi Forcen
2 citations
Ketamine appears highly effective for refractory depression, with fewer side effects and better tolerability than many other augmentation strategies. Evidence on mediators of psychiatric treatment outcomes suggests that using ketamine earlier in the course of treatment could improve patient outcomes.
The British journal of psychiatry : the journal of mental science
March 21, 2025
Emmert Roberts
1 citation
Recent interest and investment in psychedelic compounds for addiction disorders is growing. Evidence from randomized trials suggests therapeutic potential, though more research is needed. The editorial outlines future research directions and discusses implications for patients, healthcare professionals, and the broader addiction treatment system.
The British journal of psychiatry : the journal of mental science
November 1, 2024
Gero Joks, Steve Su, Jarrad King
A commentary on the KADS study raises concerns about the interpretation of its findings on repeated subcutaneous ketamine injections for treatment-resistant depression. The authors of the commentary aim to clarify points to ensure accurate and balanced information is presented to healthcare professionals, questioning the researchers' discussion of efficacy and safety results from the 4-week randomized double-blind active-controlled trial.