Psychiatry’s next top model: cause for a re-think on drug models of psychosis and other psychiatric disorders
Rl Carhart-Harris, Stefan Brugger, Dj Nutt, James Stone
Journal of Psychopharmacology June 19, 2013 DOI: 10.1177/0269881113494107 via OpenAlex
Summary
AI-generated from the abstractFive drugs—cannabis, psilocybin, amphetamine, ketamine, and alcohol—were compared for how well they model psychiatric symptoms. Mental health professionals rated how specific certain experiences were to symptom clusters like depression or psychosis. People with personal drug experience then reported how reliably each drug produced those experiences. No experiences were specific to negative or cognitive psychotic symptoms over depression. Psilocybin best modeled positive psychotic symptoms, while acute alcohol and amphetamine best modeled mania. These findings challenge current assumptions about drug models and point to an understudied area needing more research.
Study at a glance
| Characteristics | Subjective analysis Peer reviewed |
|---|---|
| Population | Mental health professionals and individuals with personal experience with the drugs |
| Topics | Cannabis Psilocybin |
| Keywords | Psychiatry Mania Psychosis |
| Citations | 43 |
| Key finding | No experiences were specific for negative or cognitive psychotic symptoms over depression; psilocybin best modeled positive symptoms, and acute alcohol and amphetamine best modeled mania. |
Abstract
Despite the widespread application of drug modelling in psychiatric research, the relative value of different models has never been formally compared in the same analysis. Here we compared the effects of five drugs (cannabis, psilocybin, amphetamine, ketamine and alcohol) in relation to psychiatric symptoms in a two-part subjective analysis. In the first part, mental health professionals associated statements referring to specific experiences, for example ‘I don’t bother to get out of bed’, to one or more psychiatric symptom clusters, for example depression and negative psychotic symptoms. This measured the specificity of an experience for a particular disorder. In the second part, individuals with personal experience with each of the above-listed drugs were asked how reliably each drug produced the experiences listed in part 1, both acutely and sub-acutely. Part 1 failed to find any experiences that were specific for negative or cognitive psychotic symptoms over depression. The best model of positive symptoms was psilocybin and the best models overall were the acute alcohol and amphetamine models of mania. These results challenge current assumptions about drug models and motivate further research on this understudied area.