Frontiers in Psychiatry
June 27, 2023
Irene Li, Rodney Fong, Molly M. Hagen et al.
25 citations
Medical students in Nevada hold generally positive attitudes toward psychedelics and psychedelic-assisted therapies but lack knowledge about them. In a survey of 132 students (22.7% response rate), 78.6% agreed that psychedelics have therapeutic potential, and 95.2% agreed they deserve further research. Students expressed uncertainty about neurocognitive risks. Demographic factors such as age, sex, and level of training did not significantly affect attitudes. The authors suggest that as psychedelic therapies may soon gain federal approval for psychiatric conditions, medical training should include early education on these agents to prepare future clinicians.
Frontiers in Psychiatry
September 28, 2022
K. Hassan, W. Struthers, Aditya Sankarabhotla et al.
25 citations
Sublingual rapid-dissolve ketamine tablets, self-administered at home, safely reduce symptoms of depression and anxiety in people with treatment-resistant depression. After three doses, nearly half of patients showed meaningful improvement on standard depression and anxiety questionnaires. Improvement rates were higher among those who completed a full course of six doses. This delivery method offers a practical alternative to intravenous ketamine.
Frontiers in Psychiatry
May 22, 2018
Laura Orsolini, Michela Ciccarese, Duccio Papanti et al.
25 citations
A new 'psychedelic trend' has emerged, driven by psychonauts who consume a variety of novel psychoactive substances (NPS) from animals. This review identifies several species—including ants, amphibians, and fish—that possess psychoactive properties and are abused recreationally. Routes of administration vary by animal, substance, metabolism, toxicity, and cultural context. Online access to these animals is facilitated through tourism-related search terms such as 'frog trip' and 'religious trip.' The review combines online psychonaut reports with literature searches from PubMed/Medline and Google Scholar to provide an overview of commonly abused 'psychedelic animals.'
Frontiers in Psychiatry
November 3, 2022
Lauren Okano, Bri Deyo, Alida Brandenburg et al.
24 citations
Research on psychedelic-assisted therapies is growing, but few studies examine extra-pharmacological factors that may influence treatment efficacy. One critical factor is the therapeutic setting—the physical and socio-cultural environment where the drug session occurs. Despite consensus that setting matters, recommendations for reporting key setting variables remain sparse. This paper reviews what is known about setting's influence, focusing on MDMA-assisted therapy, and proposes reporting guidelines for clinical trials based on MDMA-for-PTSD research. The authors suggest expanding these to include the subject's mood, expectations, and psychological condition once that area matures. The guidelines aim to increase data for future empirical study while preserving practitioner and patient autonomy.
Frontiers in Psychiatry
July 7, 2022
Maggie Kiraga, Kim P. C. Kuypers, Malin V. Uthaug et al.
24 citations
A single dose of psilocybin-containing truffles, taken in a supportive group setting, produced rapid and lasting reductions in both state and trait anxiety among self-reported healthy volunteers. Medium reductions in anxiety were observed the morning after the ceremony and persisted for at least one week. At one week, participants also showed increased non-judging mindfulness and decreased neuroticism. The acute experience of ego dissolution and changes in neuroticism were the strongest predictors of anxiety reduction. Average psilocin consumption was 27.1 mg. Results suggest potential anxiolytic effects for sub-clinical anxiety and support further research in clinical populations.
Frontiers in Psychiatry
November 5, 2021
Enzo Tagliazucchi, Federico Zamberlán, Federico Cavanna et al.
23 citations
Inhaled DMT, a classic psychedelic, produces short but profound shifts in consciousness. In 35 healthy volunteers, electroencephalography recorded before and during the drug's acute effects in a natural setting showed marked reductions in alpha and beta brain oscillations and increases in delta, theta, and gamma power, particularly in posterior regions. The power of fronto-temporal theta oscillations inversely correlated with feelings of unity and transcendence—core features of mystical-type experiences. These findings suggest that baseline brain activity prior to psychedelic use may help predict the likelihood of such experiences, which are linked to lasting well-being and improved therapeutic outcomes.
Frontiers in Psychiatry
November 4, 2021
M.l. Williams, Diana Korevaar, Renee Harvey et al.
23 citations
After a 40-year research hiatus due to sociopolitical issues, psychedelic-assisted therapies are being reinvestigated for mental illness. Clinicians and researchers in Australia identified five categories of challenge to moving these therapies from clinical trials to community practice: inherent risks, poor clinical practice, inadequate infrastructure, problematic perceptions, and divisive relationships. They propose strategies including public-sector support for research and training to establish best practices, funding for equitable access, and a multidisciplinary advisory body to guide policy. While framed in Australia, the challenges and strategies may apply elsewhere.
Frontiers in Psychiatry
August 31, 2020
Giovanni Martinotti, Attilio Negri, Stefania Schiavone et al.
22 citations
Recreational drug use among holidaymakers in Ibiza often involves multiple substances, both traditional and novel, leading to acute psychiatric emergencies. The pattern of poly-substance use is linked to a range of psychopathological consequences. Better understanding of the specific effects of individual drugs, clearer diagnostic signs and symptoms, and long-term follow-up studies are needed.
Frontiers in Psychiatry
September 23, 2024
Zhan-Ming Shi, Yu-Ping Ning, Xin-Hu Yang et al.
21 citations
A systematic review of five randomized controlled trials involving 472 adults with major depressive disorder found that psilocybin improved depressive symptoms in three of the five studies and reduced anxiety symptoms in four of the five studies compared to controls. Suicidal ideation improved in only one trial. Discontinuation rates were similar between psilocybin (2–13%) and control groups (4–21%). The most common adverse drug reaction in both groups was headache. The authors conclude that psilocybin is effective for depressive and anxiety symptoms but note that long-term efficacy and safety require further investigation in larger trials.
Frontiers in Psychiatry
February 15, 2024
Shuping Fang, Xin Yang, Wei Zhang
21 citations
Psilocybin, a classic psychedelic, shows both short-term and long-term antidepressant effects for major depressive disorder and depression related to life-threatening diagnoses. A systematic review and meta-analysis of 10 clinical trials, including 524 adult patients, found a large effect size favoring psilocybin over control conditions. Therapeutic effects increase with higher doses. Adverse events are generally temporary and reversible, though serious events can occur. Psilocybin holds promise as a complementary or alternative therapy for depression.
Frontiers in Psychiatry
November 13, 2023
Tor-Morten Kvam, Malin V Uthaug, Kristoffer A A Andersen et al.
21 citations
In a survey of 770 Norwegian adults who had a memorable experience with a classic psychedelic substance like psilocybin or LSD, most used the substance for recreational (46.1%) or therapeutic (42.3%) reasons. Psilocybin was the most common substance for the memorable experience. Many participants reported self-perceived symptoms of mental disorders and substance use disorders, and most said their condition improved after the experience. Adverse reactions were usually mild and short-lived, but 4.2% lasted a year or more, and 2.9% had persisting flashbacks for a year or more. The findings highlight both benefits and long-term risks in a self-selecting sample.
Frontiers in Psychiatry
September 18, 2023
Karina Sergi, Micah Linton, Rhianna Rich et al.
21 citations
A nature-themed video intervention called Visual Healing, designed to optimize the environment during psilocybin-assisted therapy for alcohol use disorder, was tested in a pilot trial. Nineteen of 20 participants completed the study, and the video intervention was feasible, safe, and well-tolerated, with no video-related adverse events. During the first psilocybin session, participants viewed an average of 37.9 minutes of the 42-minute video. Peak increases in blood pressure after psilocybin were significantly smaller for those assigned to Visual Healing compared to standard procedures. Alcohol use decreased in both groups, and psychedelic effects, stress, and anxiety were similar. The intervention may reduce cardiovascular risks without interfering with treatment outcomes.
Frontiers in Psychiatry
September 30, 2021
James B. Close, Julia Bornemann, Maria Piggin et al.
21 citations
A co-designed guide for patient and public involvement (PPI) in psychedelic research addresses the lack of field-specific frameworks. Core values—trust, learning, purpose, and inclusivity—emerged from a workshop with public collaborators. The guidance aims to help researchers plan, evaluate, and improve PPI so that research is done with and by the public rather than on them, strengthening accountability and relevance as the field grows.
Frontiers in Psychiatry
August 20, 2020
Jeremy J. Watts, Ranjini Garani Ramesh, Tânia Maria Sarmento Silva et al.
21 citations
Long-term cannabis users (26 participants) and non-using controls (47 participants) underwent brain scans measuring chemicals in the anterior cingulate cortex. Markers of glial function and glutamate metabolism did not differ between groups overall. However, lower myo-inositol, a glial marker, was linked to more problematic drug use and greater cannabis dependence severity. Past-year cannabis exposure affected glutamate metabolites differently by sex: greater exposure was associated with higher glutamate levels in male users but not in female users. These findings suggest that cannabis use may alter brain chemistry in ways related to problematic use and that sex differences exist in these effects.
Frontiers in Psychiatry
April 24, 2018
Rachel R. Horsley, Eva Lhotková, Kateřina Hájková et al.
20 citations
MDPV, a potent synthetic cathinone, is rapidly absorbed after subcutaneous injection in male Wistar rats, reaching peak concentrations in serum, brain, and lungs within 30 minutes. It readily crosses the blood-brain barrier, with a brain-to-serum ratio of about 2 lasting for roughly 120 minutes. The drug is primarily excreted as metabolites, with demethylenyl-MDPV and demethylenyl-methyl-MDPV levels three to four times higher than the parent drug in urine. MDPV acts as a typical stimulant, producing locomotor activation, disrupted spatial behavior, moderate hyperthermia (exacerbated in group-housed animals), and transient disruption of prepulse inhibition at 4 mg/kg, consistent with a dopaminergic mechanism. No specific signs of acute toxicity were observed at the doses used.
Frontiers in Psychiatry
November 23, 2023
Florian Buchmayer, Siegfried Kasper
19 citations
Intranasal esketamine, approved in 2019 and 2020 for treatment-resistant depression, helps more than half of non-responders after 2–4 failed antidepressant attempts. Guidelines recommend starting it as an add-on therapy in a medical setting for dose selection, monitoring, and managing adverse events. Long-term treatment is safe, with very rare severe side effects. This review critically evaluates published articles on preparation, management, and observation of the treatment, noting that psychiatrists face new but manageable procedures compared to standard prescribing.
Frontiers in Psychiatry
May 18, 2022
Joyce Huang, Michelle Pham, William J. Panenka et al.
19 citations
In a rat model of obesity, psilocybin—a prodrug for the serotonin receptor agonist psilocin—produced modest but significant reductions in weight gain compared to controls. Rats given a low (0.1 mg/kg) or high (5 mg/kg) dose of psilocybin gained less weight over 27 weekdays; the high dose also decreased consumption of a high-calorie diet and reduced central adiposity. Metformin (300 mg/kg) produced a greater decrease in weight gain than either psilocybin dose. A medium-dose psilocybin group was terminated early. Fasting glucose and glucose tolerance were also assessed. The authors recommend further study of psilocybin as a potential anti-obesity agent.
Frontiers in Psychiatry
January 24, 2022
Tigran Makunts, Lisa Jerome, Ruben Abagyan et al.
19 citations
MDMA, also known as ecstasy, is being studied as a treatment for PTSD and anxiety, with approval expected soon. Although MDMA affects serotonin and could theoretically cause serotonin syndrome—a potentially dangerous condition—no cases have occurred in clinical trials. A review of FDA adverse event reports found 20 cases of serotonin syndrome in people who took MDMA, but all had also used other serotonergic drugs such as amphetamines, stimulants, or opioids. No cases were linked to MDMA alone. These findings suggest that serotonin syndrome from MDMA alone is rare or absent in the available data.
Frontiers in Psychiatry
May 11, 2021
Ridge G. Weston, Paul J. Fitzgerald, Brendon O. Watson
19 citations
The anesthetic drug ketamine has been repurposed as a rapid-acting antidepressant for major depressive disorder (MDD), including treatment-resistant cases, unlike slower monoaminergic antidepressants. Its fast onset suggests a unique mechanism studied in reverse translational rodent models. Most research examines single ketamine doses, but MDD often requires ongoing treatment. This review of rodent studies using repeated ketamine dosing in the forced swim test (FST) found that repeated dosing can paradoxically increase immobility at high doses (50 or 100 mg/kg). However, several studies show repeated dosing more effectively decreases immobility than a single dose, with longer-lasting behavioral effects. The findings indicate repeated ketamine has prominent depression-related effects in rodents, which may help optimize human MDD treatment.
Frontiers in Psychiatry
December 10, 2020
Ove Heradstveit, Jens Christoffer Skogen, Marit Edland-Gryt et al.
19 citations
From 2014 to 2018, the proportion of Norwegian university and college students who had ever tried illicit drugs increased, from 30.8% to 36.7% among males and from 17.5% to 24.0% among females. Cannabis was the most commonly used drug in the past year (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use rose with age, peaking between ages 23 and 28, and was higher among males than females. Use also varied by geographic region, with the highest rates in the Oslo area. The findings point to a need for addressing illicit drug use in this population.
Frontiers in Psychiatry
June 16, 2023
Sean Matthew Viña, Amanda Layne Stephens
18 citations
Classic psychedelic use is associated with lower psychological distress among employed, volunteer, retired, or permanently disabled individuals, but with higher distress among unemployed people, full-time students, and homemakers. Data from 484,732 participants in the 2008–2019 National Survey of Drug Use and Health indicate that psychedelic users work longer hours per week before stress increases. Lifetime classic psychedelic use and employment are independently linked to better health, and psychedelics are unlikely to negatively affect employment outcomes.
Frontiers in Psychiatry
July 3, 2018
Joseph M. Barnby, Mitul A. Mehta
18 citations
The therapeutic potential of psilocybin, a psychedelic compound, is increasingly recognized in psychiatry, but its effects depend heavily on the context of use, known as 'set and setting.' This opinion article argues that the psychotherapeutic framework—including the relationship with therapists and the preparation and integration process—is as important as the drug itself for achieving positive outcomes. The authors suggest that neglecting the therapeutic context risks reducing psilocybin to a mere biological intervention, undermining its full potential for psychological healing and personal insight. The piece calls for careful integration of psychotherapeutic principles into psychedelic treatment models.
Frontiers in Psychiatry
February 1, 2024
Phil Wolfson, Gita Vaid
17 citations
Ketamine, the only legally prescribed psychedelic medicine in psychiatry, produces a spectrum of altered states at subanesthetic doses—from psychoactive to deep ego-dissolving experiences—that are intrinsic to its therapeutic effects. When these experiences occur within a therapeutic relationship that amplifies subjective consciousness, personal growth, inner healing, clarity, and better relationships may follow. Although the dissociative effects of ketamine have historically been labeled as side effects, in a conducive set and setting they can be positively used in psychiatry and psychotherapy, providing a time-out from usual states of mind to reshape self-experience and relieve symptoms. Ketamine-assisted psychotherapy (KAP) emphasizes recognizing experience, individuality, and imagination, with close attention to subjective experience, expression, and integration as essential for successful outcomes.
Frontiers in Psychiatry
November 23, 2023
Anya Ragnhildstveit, Ryan Khan, Paul Seli et al.
17 citations
A single dose of vaporized bufotoxin from the Sonoran Desert Toad, containing an estimated 10-15 mg of 5-MeO-DMT, produced clinically significant improvements in chronic, treatment-resistant PTSD in a 23-year-old female. Next-day effects included marked reductions in hopelessness and suicide risk, with improvements sustained at 1-, 3-, 6-, and 12-month follow-ups. The subject reported a complete mystical experience, which may underlie the therapeutic activity. No serious adverse events occurred, but acute nausea, overwhelming subjective effects, and late-onset night terrors were reported. Results suggest 5-MeO-DMT is generally tolerable and effective for PTSD, though the findings are non-generalizable and rely on methods not clinically accepted.
Frontiers in Psychiatry
March 8, 2022
Daniel Villiger
17 citations
Psychedelics are experiencing a renaissance in clinical research, with promising results for psychedelic-assisted treatment. This paper provides the first account of how pharmacological and psychological effects interact in such therapy. Building on the REBUS hypothesis and the contextual model, it argues that psychedelics amplify common factors of psychotherapy, particularly by attenuating the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy provides a safe environment and remedial expectations, which become incorporated during prediction revision—a process reinforced and accelerated by psychedelics, ultimately leading to symptom relief.