Frontiers in Psychiatry
March 14, 2023
Jonathan Brett, Elizabeth Knock, Paul Liknaitzky et al.
16 citations
Methamphetamine use disorder is a chronic condition with high relapse rates and limited effective treatments. Contingency management and psychotherapy show modest efficacy, while pharmacological options have little to no benefit. Psilocybin-assisted psychotherapy is emerging as a promising approach for substance use disorders, though no studies have yet examined it for methamphetamine use disorder. This review presents the rationale for using psilocybin-assisted psychotherapy to treat methamphetamine use disorder and describes practical considerations from early experience designing and implementing four clinical trials on this approach.
Frontiers in Psychiatry
February 20, 2023
Chelsea R. Miller, Bradley G. Burk, Rachel E. Fargason et al.
16 citations
Three patients who regularly used only delta-8-tetrahydrocannabinol (Δ8-THC), a federally unregulated cannabis derivative, developed psychotic and paranoid symptoms severe enough to require admission to a university psychiatric hospital. The symptoms exceeded the severity of their previous psychiatric episodes and included new-onset violence and visual hallucinations in two patients, including one with no prior psychiatric history and one on a therapeutic antipsychotic dose. A third patient developed bizarre, fixed delusions of puppies dissolving in the bathtub. The report documents a temporal association between Δ8-THC use and psychosis, though conclusions are limited by reliance on self-reported use and possible confounding factors.
Frontiers in Psychiatry
November 4, 2021
Ricarda Evens, Simon Reiche, Roman M. Marek et al.
16 citations
During the early COVID-19 pandemic, a survey of over 5,000 people across five languages found that among 1,375 who had used psychedelics in 2019 or 2020, 642 (46.6%) continued using them during the pandemic. Usage shifted away from settings outside the home, and motives changed: less curiosity, celebration, or social influence, more boredom. Positively connoted, often pro-social experiences increased, and two thirds of pandemic users said psychedelics helped them cope with the pandemic at least slightly. The changes likely reflect pandemic restrictions and a possible shift toward safer settings and self-selection.
Frontiers in Psychiatry
May 14, 2018
Ben J. A. Palanca, Hannah R. Maybrier, Angela M. Mickle et al.
16 citations
Electroconvulsive therapy (ECT) deliberately induces generalized seizures to treat severe psychiatric illness, offering a chance to study how consciousness, cognition, and brain activity recover after seizures. Fifteen patients with treatment-resistant major depressive disorder will receive right unilateral ECT under etomidate anesthesia. They will then undergo three treatments in randomized order: etomidate plus ECT, ketamine plus ECT, and ketamine plus sham ECT, repeated for six total sessions. Cognitive tests assess sensorimotor speed, working memory, and executive function before and after each treatment. The study will measure time to return of responsiveness, cognitive recovery trajectories, postictal delirium, and EEG changes. It aims to develop biomarkers for tailoring cognitive and emotional recovery in ECT patients.
Frontiers in Psychiatry
January 10, 2023
Jonina Rabinowitz, Raz Gross, Shaul Lev‐ran
15 citations
Past use of peyote or mescaline was associated with 32% lower odds of past-year substance dependence or abuse compared with people who had never used classic psychedelics, after controlling for sociodemographic factors, other illicit drug use, and mental health variables. In contrast, past use of LSD or psilocybin was associated with increased odds of substance use disorder, especially with more recent LSD use. No association was found between any classic psychedelic use and nicotine dependence. The authors suggest the difference may stem from pharmacological distinctions or the ceremonial context in which peyote or mescaline are traditionally taken.
Frontiers in Psychiatry
September 21, 2022
Laurent Elkrief, Olivier Payette, Jean-Nicolas Foucault et al.
15 citations
A patient with bipolar treatment-resistant depression who had not responded to medication, psychotherapy, or either repetitive transcranial magnetic stimulation (rTMS) or intravenous ketamine alone achieved complete and sustained remission when rTMS and ketamine were used together. The authors discuss how the two treatments may have complementary antidepressant mechanisms and call for further research on the combination's feasibility, tolerability, and efficacy.
Frontiers in Psychiatry
October 11, 2021
Sélim Benjamin Guessoum, Laelia Benoit, Sevan Minassian et al.
15 citations
Clinical lycanthropy is a rare syndrome in which a patient believes they are turning into a wolf. A systematic review of 43 cases found it is associated with schizophrenia, psychotic depression, bipolar disorder, and other psychotic disorders. Antipsychotic medication may be an effective treatment, with antidepressants or mood regulators used when depression or mania is present. Neuroscientific hypotheses include viewing it as a cenesthopathy, a delusional misidentification of the self, or involving impairments in sensory integration, belief evaluation, or right hemisphere anomalies. The syndrome overlaps with other delusional misidentification syndromes and may be a culture-bound syndrome influenced by Western myths and media. A cultural, narrative, and patient-centered approach is recommended for assessment and care.
Frontiers in Psychiatry
February 5, 2024
Rotem Petranker, Thomas Anderson, Youval Aberman et al.
14 citations
Microdosing, the practice of taking small, sub-hallucinogenic doses of psychedelics, has become popular, with users reporting benefits like improved mood and creativity. A review of 15 papers published before March 2022 critically analyzed the research practices in this field. The review concludes that it is premature to draw any conclusions about the efficacy or safety of microdosing because the quality of the research is not confirmatory. The authors propose potential causes for this state of the literature and offer suggestions for improvement.
Frontiers in Psychiatry
December 19, 2023
Jonathan David, José Carlos Bouso, Maja Kohek et al.
14 citations
More than half of people who participate in ayahuasca ceremonies report having a subjective sense of death during the experience, termed Ayahuasca-induced Personal Death (APD). These experiences are typically strong and transformative, associated with an increased sense of transcending death and greater certainty that consciousness continues after death. APDs are not linked to demographics, personality, or psychopathology, but are associated with greater environmental concern, improved ability to cope with life problems, and a heightened sense of life fulfillment. The findings suggest these death experiences may be a mechanism for psychedelics' long-term positive effects.
Frontiers in Psychiatry
July 15, 2023
M. Kati Lear, Sarah M. Smith, Brian Pilecki et al.
14 citations
An open-label pilot study will test MDMA-assisted therapy for social anxiety disorder. Twenty participants with moderate-to-severe generalized social anxiety will be randomly assigned to immediate or delayed treatment. The immediate group receives three preparation sessions, two MDMA medicine sessions, and six integration sessions over about 16 weeks. The primary outcome is symptom reduction measured by the Liebowitz Social Anxiety Scale at post-treatment and 6-month follow-up. Secondary outcomes include changes in functional impairment, safety, and processes like shame, belongingness, self-concealment, and self-compassion. Results will inform the design of larger randomized controlled trials.
Frontiers in Psychiatry
February 9, 2023
Orli Dahan
14 citations
The subjective experience of childbirth strongly influences a mother's long-term mental health, yet many modern births are negative. This paper applies the psychedelic theory of 'set and setting'—where mindset and environment shape an altered state of consciousness—to childbirth. Recent evidence indicates that women enter a natural altered state ('birthing consciousness') during physiological labor. The author argues that deliberately framing birth preparation and the delivery environment using set and setting principles can improve both the psychological and physiological aspects of birth, promoting positive experiences and physiological births, a key but unmet goal in modern obstetrics and public health.
Frontiers in Psychiatry
December 5, 2022
Geovan Menezes de Sousa, Vagner Deuel de Oliveira Tavares, Ana Cecília de Menezes Galvão et al.
14 citations
In a double-blind, placebo-controlled trial with 72 participants, ayahuasca's effects on depression-related biomarkers were examined two days after dosing. Larger reductions in depressive symptoms during the session were linked to higher serum cortisol levels in patients with treatment-resistant depression. Smaller changes in salivary cortisol during ayahuasca use were associated with higher brain-derived neurotrophic factor (BDNF) levels in patients who showed greater clinical improvement in depressive symptoms. No moderating effects were found for the cortisol awakening response, interleukin-6, or C-reactive protein in patients, nor for any biomarker in healthy controls or the placebo group. The findings suggest that acute emotional and physiological responses during ayahuasca sessions may influence key biomarkers of depression.
Frontiers in Psychiatry
September 27, 2022
William Barone, Michiko Mitsunaga-Whitten, Lia Osunfunláyò Blaustein et al.
14 citations
Anxiety related to life-threatening illness is a common problem that current treatments only partially address. In a pilot clinical trial of MDMA-assisted therapy for this condition, participants described key therapeutic experiences: processing trauma and grief, having mystical and existential experiences, engaging more fully with the present moment with less physiological arousal, and facing fears about illness and death. Outcomes included better ability to cope with their illness, reduced psychological symptoms, improved vitality and quality of life, and greater emotional resilience even after medical relapse. The findings suggest that MDMA-assisted therapy may help people reconnect to life and build emotional resources for dealing with existential distress.
Frontiers in Psychiatry
March 14, 2022
Edmund C. Neuhaus, George M. Slavich
14 citations
Psychedelics are being explored for treating mental health conditions like anxiety, depression, PTSD, and addiction, but there is no standard approach for combining them with psychotherapy or measuring their effectiveness. The authors propose the concept of behavioral psychedelics, defined as the study of using psychedelics to intentionally change habits and behaviors to improve health and resilience. They argue that psychedelics might reduce chronic disease risk linked to mental and behavioral rigidity, but the field needs to develop best practices and guidelines for inducing lasting behavioral changes.
Frontiers in Psychiatry
September 22, 2023
Haniya J Halim, Bradley G Burk, Rachel E Fargason et al.
13 citations
A 21-year-old male with a recent diagnosis of bipolar II disorder developed a manic episode after ingesting psilocybin in hallucinogenic mushrooms. Psilocybin is being studied as a treatment for depression and other conditions, but patients at risk for mania are typically excluded from research due to concerns about inducing mania. This case highlights the need for further investigation into the risks of psilocybin and other psychedelics in people with bipolar disorder, who may have high rates of depression, impulsivity, and substance use.
Frontiers in Psychiatry
May 25, 2022
Kevin Mintz, Brinn Gammer, Amanda Khan et al.
13 citations
Clinical trials for psychedelic therapies have increased but often exclude individuals with physical and sensory disabilities, risking structural ableism. Drawing on disability studies and medical ethics, the authors recommend prioritizing inclusion, providing accommodations, training facilitators in disability awareness, and practicing cultural humility. These steps aim to address mental health burdens faced by disability communities and spur further debate on accessibility.
Frontiers in Psychiatry
June 11, 2024
Sandra Szafoni, Piotr Gręblowski, Klaudia Grabowska et al.
12 citations
Psilocybin, a psychedelic substance, is being tested in clinical trials as an adjunct to psychotherapy for patients with major depressive disorder, obsessive-compulsive disorder, and substance use disorders (alcohol and nicotine dependence) that are resistant to traditional treatments. This article reviews current understanding of psilocybin, including data from clinical trials, its mechanism of action, safety profile, and associated risks.
Frontiers in Psychiatry
June 26, 2023
Simon Zhornitsky, Henrique Nunes Pereira Oliva, Laura A. Jayne et al.
12 citations
Ketamine and psychedelics can alter markers of synaptic density, which may relate to their abuse liability and potential therapeutic effects in substance use disorders. A scoping review of 84 studies found mixed results for ketamine: single or repeated doses under basal conditions produced inconsistent synaptic changes in the hippocampus and prefrontal cortex, but a single dose counteracted stress-related reductions in these markers, and repeated dosing also reversed stress effects. Psychedelics generally increased synaptic markers, though results varied by agent. The heterogeneity likely stems from differences in methods, drugs, sex, and marker types.
Frontiers in Psychiatry
May 26, 2022
Igor J. Pietkiewicz, Urszula Kłosińska, Radosław Tomalski
12 citations
A Caucasian Roman-Catholic woman who had undergone exorcisms for affect regulation problems, uncontrolled sexual impulses, and somatoform symptoms with altered consciousness received a diagnosis of Possession Trance Disorder. Using interpretative phenomenological analysis, the case study explores how she attributed meaning to "possession" as both a folk category and a medical diagnosis, and how this shaped her help-seeking. The diagnosis reinforced her belief in supernatural causation and discouraged professional treatment. The study also discusses dilemmas and uncertainties about the diagnostic criteria and validity of the disorder.
Frontiers in Psychiatry
May 23, 2022
Raquel Bennett, Christian Yavorsky, Gary Bravo
12 citations
Bipolar disorder type 1 is a serious chronic psychiatric condition often featuring refractory depressive episodes. Racemic ketamine, a glutamate modulator with dissociative and psychedelic properties, has demonstrated rapid antidepressant and anti-obsessional effects that may help treat bipolar depression. Existing research has mostly examined sub-psychedelic doses given by infusion without psychotherapy. This article expands on that work by describing three paradigms for ketamine treatment: biochemical, psychotherapeutic, and psychedelic. The authors use composite clinical vignettes to illustrate different ways of using ketamine for bipolar depression and discuss clinical considerations including route, dose, frequency, chemical mitigators, and adverse events. The paradigms have broad applicability beyond bipolar treatment.
Frontiers in Psychiatry
September 6, 2021
Elena Argento, Devon Christie, Lindsay Mackay et al.
12 citations
The COVID-19 pandemic is expected to have lasting effects on mental health, adding to the pre-existing global burden where 1 billion people suffer from mental health disorders, with depression and anxiety costing US$1 trillion per year. Among hospitalized COVID-19 patients in China, about 96% experienced post-traumatic stress symptoms, and studies of ICU patients with previous coronaviruses show 30-40% rates of PTSD, depression, and anxiety persisting months after discharge. Indirect exposure through media or worry also triggers PTSD. Pandemic conditions—uncertainty, grief, isolation, economic instability, and reduced service access—exacerbate mental health problems and substance use, with fatal overdose spikes in North America disproportionately affecting racialized groups. The authors argue for considering psychedelic-assisted psychotherapy as a novel approach with potential antidepressant, anxiolytic, and anti-addictive effects that may foster connectedness.
Frontiers in Psychiatry
June 4, 2024
Julia Bornemann, James B Close, Kirran Ahmad et al.
11 citations
Psilocybin-assisted therapy may help treat fibromyalgia, a chronic widespread pain condition with limited treatment options. A protocol describes a mechanistic study with 20 participants who will attend 8 visits over 8 weeks, including two dosing sessions where psilocybin is given at least once, with doses up to 25 mg. The primary focus is on brain mechanisms, measured via electroencephalography during the acute psychedelic state and magnetic resonance imaging before and after treatment. Primary outcomes are Lempel-Ziv complexity from EEG and experiential avoidance via questionnaire. Secondary measures include pain, physical and mental function, and additional neuroimaging. Results aim to clarify how psilocybin-therapy works in the brain and inform a future randomized controlled trial.
Frontiers in Psychiatry
January 10, 2023
Jennifer Warner‐Schmidt, Christopher Pittenger, Martin Stogniew et al.
11 citations
Methylone, a rapid-acting entactogen, produced a stronger and more durable antidepressant-like effect in rats than the standard SSRI fluoxetine. A single dose of methylone reduced immobility in the Forced Swim Test by nearly 95% compared to controls, with effects lasting at least 72 hours, whereas three doses of fluoxetine caused a 50% reduction lasting less than 24 hours. Methylone also showed anxiolytic effects, increasing time spent in the center of an open field. Fluoxetine pretreatment did not alter methylone's effects, suggesting possible co-administration. These results indicate methylone may have potential for treating depression and anxiety.
Frontiers in Psychiatry
October 26, 2022
Tor-Morten Kvam, Ivar W Goksøyr, Lowan H. Stewart et al.
11 citations
A proof-of-principle, open-label clinical trial will test MDMA-assisted therapy for major depressive disorder. Twelve participants with a DSM-5 diagnosis of MDD will receive a flexible dose of MDMA during two dosing sessions over four weeks, each followed by three integration sessions. The primary outcome is change in depression severity measured by the MADRS scale from baseline to eight weeks after the second session. Secondary outcomes include functional impairment and safety measures such as adverse events and suicidality. The trial aims to inform larger studies and optimize the treatment protocol.
Frontiers in Psychiatry
September 27, 2021
Jason Luoma, M. Kati Lear
11 citations
Social anxiety disorder (SAD) often persists despite treatment, prompting interest in MDMA-assisted therapy (MDMA-AT) as an adjunct. A small randomized placebo-controlled trial in autistic adults showed encouraging results, but more research is needed. This review proposes how MDMA-AT may alter four disrupted systems in SAD: social anhedonia and reduced reward sensitivity, heightened threat perception, shame regulation, and dysfunctional interpersonal behaviors. The authors suggest MDMA-AT could enhance social motivation, increase feelings of safety and affiliation, reduce shame through self-transcendent emotions, and improve social skills, potentially boosting extinction learning and relationship quality.