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Exploring the case for research on incorporating psychedelics within interventions for borderline personality disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2019.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Effects of MDMA on attention to positive social cues and pleasantness of affective touch. Neuropsychopharmacology 2019; 44:1698-1705. [PMID: 31042696 PMCID: PMC6785008 DOI: 10.1038/s41386-019-0402-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 12/29/2022]
Abstract
The psychostimulant drug ±3,4-methylenedioxymethamphetamine (MDMA) reportedly produces distinctive feelings of empathy and closeness with others. MDMA increases social behavior in animal models and has shown promise in psychiatric disorders, such as autism spectrum disorder (ASD) and post-traumatic stress disorder (PTSD). How it produces these prosocial effects is not known. This behavioral and psychophysiological study examined the effects of MDMA, compared with the prototypical stimulant methamphetamine (MA), on two measures of social behavior in healthy young adults: (i) responses to socially relevant, "affective" touch, and (ii) visual attention to emotional faces. Men and women (N = 36) attended four sessions in which they received MDMA (0.75 or 1.5 mg/kg), MA (20 mg), or a placebo in randomized order under double-blind conditions. Responses to experienced and observed affective touch (i.e., being touched or watching others being touched) were assessed using facial electromyography (EMG), a proxy of affective state. Responses to emotional faces were assessed using electrooculography (EOG) in a measure of attentional bias. Subjective ratings were also included. We hypothesized that MDMA, but not MA, would enhance the ratings of pleasantness and psychophysiological responses to affective touch and increase attentional bias toward positive facial expressions. Consistent with this, we found that MDMA, but not MA, selectively enhanced ratings of pleasantness of experienced affective touch. Neither drug altered the ratings of pleasantness of observed touch. On the EOG measure of attentional bias, MDMA, but not MA, increased attention toward happy faces. These results provide new evidence that MDMA can enhance the experience of positive social interactions; in this case, pleasantness of physical touch and attentional bias toward positive facial expressions. The findings are consistent with evidence that the prosocial effects are unique to MDMA relative to another stimulant. Understanding the behavioral and neurobiological processes underlying the distinctive social effects of MDMA is a key step to developing the drug for psychiatric disorders.
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Abstract
BACKGROUND 3,4-Methylenedioxymethamphetamine (MDMA) is widely known for its positive acute effects on social behaviour, such as increasing empathy, whilst also attenuating the negative impact of social exclusion. However there is a scarcity of research that investigates the long-term impact of recreational MDMA use on these fundamental social processes. METHOD Sixty-seven individuals were split into three groups based on their drug-use history: poly-drug MDMA users ( n = 25), poly-drug users who do not use MDMA ( n = 19), alcohol-only users ( n = 23), and were tested in an independent groups design. Participants completed both a self-report measure of emotional and cognitive empathy, along with the Multifaceted Empathy Task - a computerised assessment of empathy - and the Cyberball Game - a social exclusion paradigm. RESULTS MDMA users had significantly greater subjective emotional empathy, and greater cognitive empathy on the computer task compared with the poly-drug users who do not use MDMA. There were no significant differences in subjective responses to social exclusion between the groups. Indices of MDMA use did not correlate with empathy. CONCLUSIONS Long-term MDMA users in this sample exhibited normal psychosocial functioning in regard to empathy and social pain and had higher subjective emotional empathy. This conflicts with previous suggestions that moderate, long-term MDMA use may cause heightened social distress, and is further evidence of the safety of the drug, which is relevant to considerations of its therapeutic use.
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Affiliation(s)
- Molly Carlyle
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Tobias Stevens
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Leah Fawaz
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Beth Marsh
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK.,2 Clinical Psychopharmacology Unit, University College London, London, UK
| | - Sophia Kosmider
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Celia Ja Morgan
- 1 Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
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Feduccia AA, Jerome L, Yazar-Klosinski B, Emerson A, Mithoefer MC, Doblin R. Breakthrough for Trauma Treatment: Safety and Efficacy of MDMA-Assisted Psychotherapy Compared to Paroxetine and Sertraline. Front Psychiatry 2019; 10:650. [PMID: 31572236 PMCID: PMC6751381 DOI: 10.3389/fpsyt.2019.00650] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 12/15/2022] Open
Abstract
Unsuccessfully treated posttraumatic stress disorder (PTSD) is a serious and life-threatening disorder. Two medications, paroxetine hydrochloride and sertraline hydrochloride, are approved treatments for PTSD by the Food and Drug Administration (FDA). Analyses of pharmacotherapies for PTSD found only small to moderate effects when compared with placebo. The Multidisciplinary Association for Psychedelic Studies (MAPS) obtained Breakthrough Therapy Designation (BTD) from the FDA for 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for treatment of PTSD on the basis of pooled analyses showing a large effect size for this treatment. This review covers data supporting BTD. In this treatment, MDMA is administered with psychotherapy in up to three monthly 8-h sessions. Participants are prepared for these sessions beforehand, and process material arising from the sessions in follow-up integrative psychotherapy sessions. Comparing data used for the approval of paroxetine and sertraline and pooled data from Phase 2 studies, MAPS demonstrated that MDMA-assisted psychotherapy constitutes a substantial improvement over available pharmacotherapies in terms of safety and efficacy. Studies of MDMA-assisted psychotherapy had lower dropout rates compared to sertraline and paroxetine trials. As MDMA is only administered under direct observation during a limited number of sessions, there is little chance of diversion, accidental or intentional overdose, or withdrawal symptoms upon discontinuation. BTD status has expedited the development of MAPS phase 3 trials occurring worldwide, leading up to a planned submission seeking FDA approval in 2021. Clinical Trial Registration: www.ClinicalTrials.gov, identifiers NCT00090064, NCT00353938, NCT01958593, NCT01211405, NCT01689740, NCT01793610.
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Affiliation(s)
- Allison A Feduccia
- Department of Research Development and Regulatory Affairs, MAPS Public Benefit Corporation, Santa Cruz, CA, United States
| | - Lisa Jerome
- Department of Research Development and Regulatory Affairs, MAPS Public Benefit Corporation, Santa Cruz, CA, United States
| | - Berra Yazar-Klosinski
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, United States
| | - Amy Emerson
- MAPS Public Benefit Corporation, Santa Cruz, CA, United States
| | - Michael C Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, United States
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Abstract
The available treatments for disorders affecting large segments of the population are often costly, complex, and only marginally effective, and many have numerous side effects. These disorders include dementias, debilitating neurological disorders, the multiple types of drug addiction, and the spectrum of mental health disorders.Preliminary studies have shown that a variety of psychedelic and similar U.S. Drug Enforcement Administration Schedule I drugs may offer better treatment options than those that currently exist and pose potentially the same or even less risk than do legal psychoactive (alcohol, caffeine, nicotine) and nonpsychoactive (aspirin, acetaminophen, ibuprofen) substances. The pharmaceutical industry and academia, however, have largely avoided this avenue of research.Fairness to the affected populations demands that these drugs be adequately studied and, if they or their congeners are shown to be effective, made available with the proper caveats, instructions, and protections that other potentially abused medications (e.g., narcotics) receive. These substances may prove to relieve patients' struggles with less effective treatments and decrease mortality from nontreatment of some conditions.
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Fonzo GA. Diminished positive affect and traumatic stress: A biobehavioral review and commentary on trauma affective neuroscience. Neurobiol Stress 2018; 9:214-230. [PMID: 30450386 PMCID: PMC6234277 DOI: 10.1016/j.ynstr.2018.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/20/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022] Open
Abstract
Post-traumatic stress manifests in disturbed affect and emotion, including exaggerated severity and frequency of negative valence emotions, e.g., fear, anxiety, anger, shame, and guilt. However, another core feature of common post-trauma psychopathologies, i.e. post-traumatic stress disorder (PTSD) and major depression, is diminished positive affect, or reduced frequency and intensity of positive emotions and affective states such as happiness, joy, love, interest, and desire/capacity for interpersonal affiliation. There remains a stark imbalance in the degree to which the neuroscience of each affective domain has been probed and characterized in PTSD, with our knowledge of post-trauma diminished positive affect remaining comparatively underdeveloped. This remains a prominent barrier to realizing the clinical breakthroughs likely to be afforded by the increasing availability of neuroscience assessment and intervention tools. In this review and commentary, the author summarizes the modest extant neuroimaging literature that has probed diminished positive affect in PTSD using reward processing behavioral paradigms, first briefly reviewing and outlining the neurocircuitry implicated in reward and positive emotion and its interrelationship with negative emotion and negative valence circuitry. Specific research guidelines are then offered to best and most efficiently develop the knowledge base in this area in a way that is clinically translatable and will exert a positive impact on routine clinical care. The author concludes with the prediction that the development of an integrated, bivalent theoretical and predictive model of how trauma impacts affective neurocircuitry to promote post-trauma psychopathology will ultimately lead to breakthroughs in how trauma treatments are conceptualized mechanistically and developed pragmatically.
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Affiliation(s)
- Gregory A. Fonzo
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, 401 Quarry Road, MC 5722, Stanford, CA, 94305, USA.
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Gaddis A, Lake S, Tupper K, Nosova E, Blommaert K, Wood E, DeBeck K. Regular MDMA use is associated with decreased risk of drug injection among street-involved youth who use illicit drugs. Drug Alcohol Depend 2018; 192:112-117. [PMID: 30245459 PMCID: PMC6223257 DOI: 10.1016/j.drugalcdep.2018.07.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Childhood trauma is common among street-involved youth and is associated with injection drug use. Illicit 3,4-Methylenedioxymethamphetamine (MDMA) use is also common among street-involved youth, and data suggest this substance has clinical utility in management of post-traumatic stress disorder (PTSD) and associated harms. Despite this, little is known about co-occurring patterns of MDMA use and injection drug use. METHODS Data were derived from a prospective cohort of street-involved youth using illicit drugs in Vancouver, Canada. Using multivariable generalized estimating equation logistic regression, we examined the association between MDMA use and the use of injection drugs, adjusting for confounders such as polysubstance use and sociodemographic factors. RESULTS 4941 surveys from 1208 participants between September 2005 and May 2015 were included. Of these, 829 (68.6%) were male, 815 (67.5%) reported white ethnicity, and median age was 21.7 years. Overall, 599 (49.6%) participants reported MDMA use, 544 (45.0%) reported injection drug use, and 244 (20.2%) reported concurrent MDMA and injection drug use at least once during the study period. In multivariable analyses, regular MDMA use was significantly negatively associated with injection drug use (Adjusted Odds Ratio [AOR] = 0.57, 95% CI: 0.46-0.69). DISCUSSION After accounting for socio-demographic factors and polysubstance use, periods of reported regular MDMA use were negatively associated with reported injection drug use among this cohort. These findings suggest that, unlike the use of most other non-injection drugs, illicit MDMA use does not appear to promote injection drug use but rather is associated with a reduced likelihood of injection drug use.
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Affiliation(s)
- Andrew Gaddis
- Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA, 24016, USA; British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada
| | - Stephanie Lake
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z9, Vancouver, BC, Canada
| | - Kenneth Tupper
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z9, Vancouver, BC, Canada
| | - Ekaterina Nosova
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada
| | - Katrina Blommaert
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada
| | - Evan Wood
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, 1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, V5A 1S6, Burnaby, BC, Canada; School of Public Policy, Simon Fraser University, 515 W. Hastings St, V6B 5K3, Vancouver, BC, Canada.
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Dunlap LE, Andrews AM, Olson DE. Dark Classics in Chemical Neuroscience: 3,4-Methylenedioxymethamphetamine. ACS Chem Neurosci 2018; 9:2408-2427. [PMID: 30001118 PMCID: PMC6197894 DOI: 10.1021/acschemneuro.8b00155] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Better known as "ecstasy", 3,4-methylenedioxymethamphetamine (MDMA) is a small molecule that has played a prominent role in defining the ethos of today's teenagers and young adults, much like lysergic acid diethylamide (LSD) did in the 1960s. Though MDMA possesses structural similarities to compounds like amphetamine and mescaline, it produces subjective effects that are unlike any of the classical psychostimulants or hallucinogens and is one of the few compounds capable of reliably producing prosocial behavioral states. As a result, MDMA has captured the attention of recreational users, the media, artists, psychiatrists, and neuropharmacologists alike. Here, we detail the synthesis of MDMA as well as its pharmacology, metabolism, adverse effects, and potential use in medicine. Finally, we discuss its history and why it is perhaps the most important compound for the future of psychedelic science-having the potential to either facilitate new psychedelic research initiatives, or to usher in a second Dark Age for the field.
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Affiliation(s)
- Lee E Dunlap
- Department of Chemistry , University of California, Davis , One Shields Avenue , Davis , California 95616 , United States
| | - Anne M Andrews
- Departments of Psychiatry and Chemistry & Biochemistry, Semel Institute for Neuroscience and Human Behavior, and Hatos Center for Neuropharmacology , University of California , Los Angeles , California 90095 , United States
| | - David E Olson
- Department of Chemistry , University of California, Davis , One Shields Avenue , Davis , California 95616 , United States
- Department of Biochemistry & Molecular Medicine, School of Medicine , University of California, Davis , 2700 Stockton Blvd, Suite 2102 , Sacramento , California 95817 , United States
- Center for Neuroscience , University of California, Davis , 1544 Newton Ct , Davis , California 95616 , United States
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Jungaberle H, Thal S, Zeuch A, Rougemont-Bücking A, von Heyden M, Aicher H, Scheidegger M. Positive psychology in the investigation of psychedelics and entactogens: A critical review. Neuropharmacology 2018; 142:179-199. [PMID: 29964094 DOI: 10.1016/j.neuropharm.2018.06.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 01/07/2023]
Abstract
RATIONALE We reviewed the concepts and empirical findings in studies with psychedelics and entactogens related to positive psychology - the study of healthy human functioning, well-being and eudaemonia. It is an unresolved question how beneficial effects of psychedelics and entactogens are related to the potential risks of these substances - particularly in non-clinical settings. METHODS We searched in PubMed, PsychINFO and the Cochrane Library for controlled clinical and epidemiological studies which applied concepts from positive psychology. We included N = 77 eligible studies with 9876 participants published before November 1st, 2017: (1) quantitative studies (N = 54), (2) preliminary or exploratory studies and reviews not including meta-analyses (N = 17), and (3) studies evidencing primarily negative results (N = 6). RESULTS Positive psychology concepts have been applied for measuring effects of clinical trials, recreational and ceremonial use of psychedelics and entactogens. Psychedelics and entactogens were shown to produce acute and long-term effects on mood, well-being, prosocial behaviours, empathy, cognitive flexibility, creativity, personality factors like openness, value orientations, nature-relatedness, spirituality, self-transcendence and mindfulness-related capabilities. CONCLUSIONS There is preliminary evidence for beneficial effects of psychedelics and entactogens on measures of positive psychology in clinical and healthy populations, however their sustainability remains largely unresolved. The reported results must be considered preliminary due to methodological restrictions. Since longitudinal data on both positive and adverse effects of psychedelics are lacking, more rigorous and standardized measures from positive psychology should be applied in less biased populations with prospective longitudinal designs to carefully assess the benefit-risk-ratio. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Henrik Jungaberle
- MIND European Foundation for Psychedelic Science, betahaus, Prinzessinnenstr. 19/20, 10969 Berlin, Germany.
| | - Sascha Thal
- Faculty of Behavioural and Social Sciences, University of Groningen, Netherlands, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands.
| | - Andrea Zeuch
- MIND European Foundation for Psychedelic Science, betahaus, Prinzessinnenstr. 19/20, 10969 Berlin, Germany.
| | - Ansgar Rougemont-Bücking
- Faculty of Science and Medicine, Department of Neurosciences and Movement Science, Laboratory for Psychiatric Neuroscience and Psychotherapy, University of Fribourg, Ch. du Musée 5, Fribourg, Switzerland.
| | - Maximilian von Heyden
- FINDER Institute for Prevention Research, Germany, betahaus, Prinzessinnenstr. 19/20, 10969 Berlin, Germany.
| | - Helena Aicher
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics (DPP), University Hospital of Psychiatry Zurich, Lenggstrasse 31, Postfach 1931, CH-8032 Zurich, Switzerland.
| | - Milan Scheidegger
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics (DPP), University Hospital of Psychiatry Zurich, Lenggstrasse 31, Postfach 1931, CH-8032 Zurich, Switzerland.
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MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? Prog Neuropsychopharmacol Biol Psychiatry 2018. [PMID: 29524515 DOI: 10.1016/j.pnpbp.2018.03.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
MDMA-assisted psychotherapy for treatment of PTSD has recently progressed to Phase 3 clinical trials and received Breakthrough Therapy designation by the FDA. MDMA used as an adjunct during psychotherapy sessions has demonstrated effectiveness and acceptable safety in reducing PTSD symptoms in Phase 2 trials, with durable remission of PTSD diagnosis in 68% of participants. The underlying psychological and neurological mechanisms for the robust effects in mitigating PTSD are being investigated in animal models and in studies of healthy volunteers. This review explores the potential role of memory reconsolidation and fear extinction during MDMA-assisted psychotherapy. MDMA enhances release of monoamines (serotonin, norepinephrine, dopamine), hormones (oxytocin, cortisol), and other downstream signaling molecules (BDNF) to dynamically modulate emotional memory circuits. By reducing activation in brain regions implicated in the expression of fear- and anxiety-related behaviors, namely the amygdala and insula, and increasing connectivity between the amygdala and hippocampus, MDMA may allow for reprocessing of traumatic memories and emotional engagement with therapeutic processes. Based on the pharmacology of MDMA and the available translational literature of memory reconsolidation, fear learning, and PTSD, this review suggests a neurobiological rationale to explain, at least in part, the large effect sizes demonstrated for MDMA in treating PTSD.
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Dolder PC, Strajhar P, Vizeli P, Odermatt A, Liechti ME. Acute effects of lisdexamfetamine and D-amphetamine on social cognition and cognitive performance in a placebo-controlled study in healthy subjects. Psychopharmacology (Berl) 2018; 235:1389-1402. [PMID: 29511807 DOI: 10.1007/s00213-018-4849-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/31/2018] [Indexed: 01/26/2023]
Abstract
RATIONALE Amphetamines are used as medications but are also misused as cognitive enhancers by healthy subjects and may have additional effects on social cognition. METHODS We investigated the acute effects of single, high, equimolar doses of D-amphetamine (40 mg) and lisdexamfetamine (100 mg) on social cognition and cognitive performance using a randomized, placebo-controlled, double-blind, cross-over design in 24 healthy volunteers. Effects on social cognition were assessed using the Facial Emotion Recognition Task (FERT), Multifaceted Empathy Test (MET), and Sexual Arousal Task (SAT). Cognitive performance was measured using the Digit Symbol Substitution Test (DSST), Digit Span (DS), Stop-Signal Task (SST), and Mackworth Clock Test (MCT). RESULTS D-Amphetamine and lisdexamfetamine had small effects on measures of social cognition. There were no effects on emotion recognition on the FERT. D-Amphetamine increased direct empathy on the MET, but only for positive stimuli. Both amphetamines increased ratings of pleasantness and attractiveness on the SAT in response to sexual but also to neutral stimuli. D-Amphetamine and lisdexamfetamine increased cognitive performance (go-accuracy and vigilance on the SST and MCT, respectively). Lisdexamfetamine increased processing speed on the DSST. Neither drug had an effect on the DS. CONCLUSION Single, high, equimolar doses of D-amphetamine and lisdexamfetamine enhanced certain aspects of cognitive performance in healthy non-sleep-deprived subjects. Both amphetamines also slightly altered aspects of social cognition. Whether these small effects also influence social interaction behavior in amphetamine users remains to be investigated. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (NCT02668926).
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Affiliation(s)
- Patrick C Dolder
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland
| | - Petra Strajhar
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland.
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Considering the context: social factors in responses to drugs in humans. Psychopharmacology (Berl) 2018; 235:935-945. [PMID: 29470605 PMCID: PMC5871591 DOI: 10.1007/s00213-018-4854-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/06/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Drugs are typically used in social settings. Here, we consider two factors that may contribute to this observation: (i) the presence of other people may enhance the positive mood effects of a drug, and conversely, (ii) drugs may enhance the value of social stimuli. METHODS We review evidence from controlled laboratory studies with human volunteers, which investigated either of these interactions between social factors and responses to drugs. We examine the bidirectional effects of social stimuli and single doses of alcohol, stimulants, opioids, and cannabis. RESULTS All four classes of drugs interact with social contexts, but the nature of these interactions varies across drugs, and depends on whether the context is positive or negative. CONCLUSIONS Alcohol and stimulant drugs enhance the attractiveness of social stimuli and the desire to socialize, and social contexts, in turn, enhance these drugs' effects. In contrast, opioids and cannabis have subtler effects on social interactions and their effects are less influenced by the presence of others. Overall, there is stronger evidence that drugs enhance positive social contexts than that they dampen the negativity of unpleasant social settings. Controlled research is needed to understand the interactions between drugs of abuse and social contexts, to model and understand the determinants of drug use outside the laboratory.
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Doss MK, Weafer J, Gallo DA, de Wit H. MDMA Impairs Both the Encoding and Retrieval of Emotional Recollections. Neuropsychopharmacology 2018; 43:791-800. [PMID: 28825422 PMCID: PMC5809786 DOI: 10.1038/npp.2017.171] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/19/2017] [Accepted: 08/06/2017] [Indexed: 12/21/2022]
Abstract
The psychoactive drug ±3,4-methylenedioxymethamphetamine (MDMA) is increasingly used for its perceived emotional effects (eg, prosociality, empathy, psychotherapy), but surprisingly little research has been aimed at identifying the effect of the drug on emotional episodic memory in humans. Here, we report the first double-blind placebo-controlled study to examine the effects of MDMA on emotional memory separately during encoding and retrieval in healthy participants. Participants viewed emotionally negative, neutral, and positive pictures and their labels. Forty-eight hours later, they were given cued recollection and recognition memory tests designed to assess recollection and familiarity for the studied pictures. Participants were randomly assigned to one of three groups who received MDMA (1 mg/kg) either during encoding (Encoding group; N=20), retrieval (Retrieval group; N=20), or neither (Placebo group; N=20). Although MDMA administered at either phase did not affect overall memory accuracy, it did alter the recollection of details associated specifically with emotional memories as estimated using a dual process signal detection analysis of confidence judgments and subjective 'remember' judgments. In the Encoding group, MDMA reduced recollection estimates for negative and positive pictures but had little to no effect on neutral items or familiarity estimates. There was evidence for similar trends in the Retrieval group. These findings indicate that MDMA attenuates the encoding and retrieval of salient details from emotional events, consistent with the idea that its potential therapeutic effects for treating posttraumatic stress disorder are related to altering emotional memory.
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Affiliation(s)
- Manoj K Doss
- Department of Psychology, University of Chicago, Chicago, IL, USA,Department of Psychology, The University of Chicago, 5848 S. University Ave., Beecher 308, Chicago, IL 60637, USA. Tel: +1 773 702 4376, E-mail:
| | - Jessica Weafer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - David A Gallo
- Department of Psychology, University of Chicago, Chicago, IL, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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Progress and promise for the MDMA drug development program. Psychopharmacology (Berl) 2018; 235:561-571. [PMID: 29152674 DOI: 10.1007/s00213-017-4779-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/01/2017] [Indexed: 12/23/2022]
Abstract
Pharmacotherapy is often used to target symptoms of posttraumatic stress disorder (PTSD), but does not provide definitive treatment, and side effects of daily medication are often problematic. Trauma-focused psychotherapies are more likely than drug treatment to achieve PTSD remission, but have high dropout rates and ineffective for a large percentage of patients. Therefore, research into drugs that might increase the effectiveness of psychotherapy is a logical avenue of investigation. The most promising drug studied as a catalyst to psychotherapy for PTSD thus far is 3,4-methylenedioxymethamphetamine (MDMA), commonly known as the recreational drug "Ecstasy." MDMA stimulates the release of hormones and neurochemicals that affect key brain areas for emotion and memory processing. A series of recently completed phase 2 clinical trials of MDMA-assisted psychotherapy for treatment of PTSD show favorable safety outcomes and large effect sizes that warrant expansion into multi-site phase 3 trials, set to commence in 2018. The nonprofit sponsor of the MDMA drug development program, the Multidisciplinary Association for Psychedelic Studies (MAPS), is supporting these trials to explore whether MDMA, administered on only a few occasions, can increase the effectiveness of psychotherapy. Brain imaging techniques and animal models of fear extinction are elucidating neural mechanisms underlying the robust effects of MDMA on psychological processing; however, much remains to be learned about the complexities of MDMA effects as well as the complexities of PTSD itself.
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Thal SB, Lommen MJJ. Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2018; 48:99-108. [PMID: 29720767 PMCID: PMC5917000 DOI: 10.1007/s10879-017-9379-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The present paper discusses the current literature with regard to substance-assisted psychotherapy with Methylenedioxymethamphetamine (MDMA) for posttraumatic stress disorder (PTSD). The aim of the paper is to give a comprehensive overview of the development from MDMA's early application in psychotherapy to its present and future role in the treatment of PTSD. It is further attempted to increase the attention for MDMA's therapeutic potential by providing a thorough depiction of the scientific evidence regarding its theorized mechanism of action and potential harms of its application in the clinical setting (e.g., misattribution of therapeutic gains to medication instead of psychological changes). Empirical support for the use of MDMA-assisted psychotherapy, including the randomized, double-blind, placebo-controlled trails that have been conducted since 2008, is discussed. Thus far, an overall remission rate of 66.2% and low rates of adverse effects have been found in the six phase two trials conducted in clinical settings with 105 blinded subjects with chronic PTSD. The results seem to support MDMA's safe and effective use as an adjunct to psychotherapy. Even though preliminary studies may look promising, more studies of its application in a psychotherapeutic context are needed in order to establish MDMA as a potential adjunct to therapy.
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Affiliation(s)
- Sascha B. Thal
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Miriam J. J. Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
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66
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MDMA-induced indifference to negative sounds is mediated by the 5-HT 2A receptor. Psychopharmacology (Berl) 2018; 235:481-490. [PMID: 28735368 PMCID: PMC5813067 DOI: 10.1007/s00213-017-4699-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/11/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND MDMA has been shown to induce feelings of sociability, a positive emotional bias and enhanced empathy. While previous research has used only visual emotional stimuli, communication entails more than that single dimension and it is known that auditory information is also crucial in this process. In addition, it is, however, unclear what the neurobiological mechanism underlying these MDMA effects on social behaviour is. Previously, studies have shown that MDMA-induced emotional excitability and positive mood are linked to the action on the serotonin (5-HT) 2A receptor. AIM The present study aimed at investigating the effect of MDMA on processing of sounds (Processing of Affective Sounds Task (PAST)) and cognitive biases (Approach-Avoidance Task (AAT)) towards emotional and social stimuli and the role of 5-HT2A receptor in these effects. METHODS Twenty healthy recreational users entered a 2 × 2, placebo-controlled, within-subject study with ketanserin (40 mg) as pre-treatment and MDMA (75 mg) as treatment. Behavioural (PAST, AAT) measures were conducted 90 min after treatment with MDMA, respectively, 120 min after ketanserin. Self-report mood measures and oxytocin concentrations were taken at baseline and before and after behavioural tests. RESULTS Findings showed that MDMA reduced arousal elicited by negative sounds. This effect was counteracted by ketanserin pre-treatment, indicating involvement of the 5-HT2 receptor in this process. MDMA did not seem to induce a bias towards emotional and social stimuli. It increased positive and negative mood ratings and elevated oxytocin plasma concentrations. The reduction in arousal levels when listening to negative sounds was not related to the elevated subjective arousal. CONCLUSION It is suggested that this decrease in arousal to negative stimuli reflects potentially a lowering of defences, a process that might play a role in the therapeutic process.
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67
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Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Psychopharmacology (Berl) 2018; 235:3137-3148. [PMID: 30196397 PMCID: PMC6208958 DOI: 10.1007/s00213-018-5010-9] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
RATIONALE Standard therapeutic approaches to reduce social anxiety in autistic adults have limited effectiveness. Since 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy shows promise as a treatment for other anxiety disorders, a blinded, placebo-controlled pilot study was conducted. OBJECTIVES To explore feasibility and safety of MDMA-assisted psychotherapy for reduction of social fear and avoidance that are common in the autistic population. METHODS Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg, n = 8) or inactive placebo (0 mg, n = 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 non-drug psychotherapy sessions following each. The primary outcome was change in Leibowitz Social Anxiety Scale (LSAS) Total scores from Baseline to one month after the second experimental session. Outcomes were measured again six months after the last experimental session. RESULTS Improvement in LSAS scores from baseline to the primary endpoint was significantly greater for MDMA group compared to the placebo group (P = 0.037), and placebo-subtracted Cohen's d effect size was very large (d = 1.4, CI - 0.074, 2.874). Change in LSAS scores from baseline to 6-month follow-up showed similar positive results (P = 0.036), with a Cohen's d effect size of 1.1 (CI - 0.307, 2.527). Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase. CONCLUSIONS This pilot trial demonstrated rapid and durable improvement in social anxiety symptoms in autistic adults following MDMA-assisted psychotherapy. Initial safety and efficacy outcomes support expansion of research into larger samples to further investigate this novel treatment for social anxiety. TRIAL REGISTRATION clinicaltrials.gov identifier, NCT02008396.
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Schmidt A, Müller F, Dolder PC, Schmid Y, Zanchi D, Egloff L, Liechti ME, Borgwardt S. Acute Effects of Methylphenidate, Modafinil, and MDMA on Negative Emotion Processing. Int J Neuropsychopharmacol 2017; 21:345-354. [PMID: 29206921 PMCID: PMC5887414 DOI: 10.1093/ijnp/pyx112] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/22/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Stimulants such as methylphenidate and modafinil are frequently used as cognitive enhancers in healthy people, whereas 3,4-methylenedioxymethamphetamine (ecstasy) is proposed to enhance mood and empathy in healthy subjects. However, comparative data on the effects of methylphenidate and modafinil on negative emotions in healthy subjects have been partially missing. The aim of this study was to compare the acute effects of methylphenidate and modafinil on the neural correlates of fearful face processing using 3,4-methylenedioxymethamphetamine as a positive control. METHODS Using a double-blind, within-subject, placebo-controlled, cross-over design, 60 mg methylphenidate, 600 mg modafinil, and 125 mg 3,4-methylenedioxymethamphetamine were administrated to 22 healthy subjects while performing an event-related fMRI task to assess brain activation in response to fearful faces. Negative mood states were assessed with the State-Trait Anxiety Inventory and subjective ratings. RESULTS Relative to placebo, modafinil, but not methylphenidate or 3,4-methylenedioxymethamphetamine, increased brain activation within a limbic-cortical-striatal-pallidal-thalamic circuit during fearful face processing. Modafinil but not methylphenidate also increased amygdala responses to fearful faces compared with 3,4-methylenedioxymethamphetamine. Furthermore, activation in the middle and inferior frontal gyrus in response to fearful faces correlated positively with subjective feelings of fearfulness and depressiveness after modafinil administration. CONCLUSIONS Despite the cognitive enhancement effects of 600 mg modafinil in healthy people, potential adverse effects on emotion processing should be considered.
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Affiliation(s)
- André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland,Correspondence: André Schmidt, PhD, University of Basel, Department of Psychiatry (UPK), Wilhelm Klein Strasse 27, 4012 Basel, Switzerland ()
| | - Felix Müller
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Patrick C Dolder
- Department of Biomedicine, Division of Clinical Pharmacology and Toxicology, University of Basel, Basel, Switzerland,Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Yasmin Schmid
- Department of Biomedicine, Division of Clinical Pharmacology and Toxicology, University of Basel, Basel, Switzerland,Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Davide Zanchi
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Laura Egloff
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Department of Biomedicine, Division of Clinical Pharmacology and Toxicology, University of Basel, Basel, Switzerland,Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
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Van Hedger K, Bershad AK, de Wit H. Pharmacological challenge studies with acute psychosocial stress. Psychoneuroendocrinology 2017; 85:123-133. [PMID: 28858691 PMCID: PMC5623124 DOI: 10.1016/j.psyneuen.2017.08.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
Abstract
Chronic stress is known to affect many psychiatric disorders, and studies of responses to acute stress may reveal processes that ultimately lead to maladaptive responses to chronic stress. Many studies have used simulated public speaking tasks to induce stress in the laboratory and, of interest to this review, the tasks have been used to assess the effects of both therapeutic and nonmedical drugs on stress reactivity. Here we review 38 studies that examined effects of single doses of drugs on subjective, cardiovascular and hormonal responses to an acute social stressor in healthy volunteers. Most studies have used the Trier Social Stress Test (TSST), or variations on it involving public speaking or mental arithmetic. Pharmacological studies with the TSST (ph-TSST) have been conducted for three main reasons: i) to determine the clinical effectiveness of psychiatric medications to reduce stress responses, ii) to investigate the neurochemical mechanisms involved in the stress response, and iii) to determine whether drugs of abuse relieve, or occasionally worsen, responses to acute stress. The review indicates that standard anxiolytic medications consistently reduce subjective responses to the TSST, whereas single doses of antidepressants produce mixed effects. Mechanistic studies indicate that several neurotransmitter systems are involved in the stress response, including serotonin, norepinephrine, GABA, glutamate, opioids, and endocannabinoids. Among drugs of abuse, alcohol and cannabinoids exert some stress-dampening effects, whereas caffeine, nicotine, and amphetamines tend to increase stress responses. Comparing outcome measures of the responses to stress, subjective ratings of anxiety are among the most sensitive indices of the stress response, with cortisol levels second and cardiovascular responses least sensitive. We conclude that the TSST is a valuable tool to study the clinical effectiveness of medications for stress-related disorders, and that it is important to use standardized procedures to enable comparisons across studies.
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Affiliation(s)
- Kathryne Van Hedger
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL USA
| | - Anya K. Bershad
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL USA,University of Chicago Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
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Abstract
Previous attempts to identify a unified theory of brain serotonin function have largely failed to achieve consensus. In this present synthesis, we integrate previous perspectives with new and older data to create a novel bipartite model centred on the view that serotonin neurotransmission enhances two distinct adaptive responses to adversity, mediated in large part by its two most prevalent and researched brain receptors: the 5-HT1A and 5-HT2A receptors. We propose that passive coping (i.e. tolerating a source of stress) is mediated by postsynaptic 5-HT1AR signalling and characterised by stress moderation. Conversely, we argue that active coping (i.e. actively addressing a source of stress) is mediated by 5-HT2AR signalling and characterised by enhanced plasticity (defined as capacity for change). We propose that 5-HT1AR-mediated stress moderation may be the brain's default response to adversity but that an improved ability to change one's situation and/or relationship to it via 5-HT2AR-mediated plasticity may also be important - and increasingly so as the level of adversity reaches a critical point. We propose that the 5-HT1AR pathway is enhanced by conventional 5-HT reuptake blocking antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), whereas the 5-HT2AR pathway is enhanced by 5-HT2AR-agonist psychedelics. This bipartite model purports to explain how different drugs (SSRIs and psychedelics) that modulate the serotonergic system in different ways, can achieve complementary adaptive and potentially therapeutic outcomes.
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Affiliation(s)
- RL Carhart-Harris
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - DJ Nutt
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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71
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Wagner MT, Mithoefer MC, Mithoefer AT, MacAulay RK, Jerome L, Yazar-Klosinski B, Doblin R. Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy. J Psychopharmacol 2017; 31:967-974. [PMID: 28635375 PMCID: PMC5544120 DOI: 10.1177/0269881117711712] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of "openness" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.
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Affiliation(s)
- Mark T Wagner
- Department of Neurology, Medical University of South Carolina, Charleston, USA
| | | | | | | | - Lisa Jerome
- MAPS Public Benefit Corp (MPBC), Santa Cruz, USA
| | | | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, USA
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72
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Puxty DJ, Ramaekers JG, de la Torre R, Farré M, Pizarro N, Pujadas M, Kuypers KPC. MDMA-Induced Dissociative State not Mediated by the 5-HT 2A Receptor. Front Pharmacol 2017; 8:455. [PMID: 28744219 PMCID: PMC5504523 DOI: 10.3389/fphar.2017.00455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/23/2017] [Indexed: 11/13/2022] Open
Abstract
Previous research has shown that a single dose of MDMA induce a dissociative state, by elevating feelings of depersonalization and derealization. Typically, it is assumed that action on the 5-HT2A receptor is the mechanism underlying these psychedelic experiences. In addition, other studies have shown associations between dissociative states and biological parameters (heart rate, cortisol), which are elevated by MDMA. In order to investigate the role of the 5-HT2 receptor in the MDMA-induced dissociative state and the association with biological parameters, a placebo-controlled within-subject study was conducted including a single oral dose of MDMA (75 mg), combined with placebo or a single oral dose of the 5-HT2 receptor blocker ketanserin (40 mg). Twenty healthy recreational MDMA users filled out a dissociative states scale (CADSS) 90 min after treatments, which was preceded and followed by assessment of a number of biological parameters (cortisol levels, heart rate, MDMA blood concentrations). Findings showed that MDMA induced a dissociative state but this effect was not counteracted by pre-treatment with ketanserin. Heart rate was the only biological parameter that correlated with the MDMA-induced dissociative state, but an absence of correlation between these measures when participants were pretreated with ketanserin suggests an absence of directional effects of heart rate on dissociative state. It is suggested that the 5-HT2 receptor does not mediate the dissociative effects caused by a single dose of MDMA. Further research is needed to determine the exact neurobiology underlying this effect and whether these effects contribute to the therapeutic potential of MDMA.
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Affiliation(s)
- Drew J Puxty
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Rafael de la Torre
- Integrative Pharmacology and Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions MèdiquesBarcelona, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and NutritionSantiago de Compostela, Spain.,Facultat de Ciencies de la Salut i de la Vida, Universitat Pompeu FabraBarcelona, Spain
| | - Magí Farré
- Integrative Pharmacology and Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions MèdiquesBarcelona, Spain.,Department of Pharmacology, Therapeutic and Toxicology, Universitat Autonoma de BarcelonaBarcelona, Spain.,Hospital Universitari Germans Trias i Pujol, Clinical PharmacologyBadalona, Spain
| | - Neus Pizarro
- Integrative Pharmacology and Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions MèdiquesBarcelona, Spain.,Department of Pharmacology, Therapeutic and Toxicology, Universitat Autonoma de BarcelonaBarcelona, Spain
| | - Mitona Pujadas
- Integrative Pharmacology and Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions MèdiquesBarcelona, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and NutritionSantiago de Compostela, Spain
| | - Kim P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
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Bershad AK, Miller MA, de Wit H. MDMA does not alter responses to the Trier Social Stress Test in humans. Psychopharmacology (Berl) 2017; 234:2159-2166. [PMID: 28432376 PMCID: PMC5984654 DOI: 10.1007/s00213-017-4621-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
RATIONALE ±3,4-Methylenedioxymethamphetamine (MDMA, "ecstasy") is a stimulant-psychedelic drug with unique social effects. It may dampen reactivity to negative social stimuli such as social threat and rejection. Perhaps because of these effects, MDMA has shown promise as a treatment for post-traumatic stress disorder (PTSD). However, the effect of single doses of MDMA on responses to an acute psychosocial stressor has not been tested. OBJECTIVES In this study, we sought to test the effects of MDMA on responses to stress in healthy adults using a public speaking task. We hypothesized that the drug would reduce responses to the stressful task. METHODS Volunteers (N = 39) were randomly assigned to receive placebo (N = 13), 0.5 mg/kg MDMA (N = 13), or 1.0 mg/kg MDMA (N = 13) during a stress and a no-stress session. Dependent measures included subjective reports of drug effects and emotional responses to the task, as well as salivary cortisol, heart rate, and blood pressure. RESULTS The stress task produced its expected increase in physiological responses (cortisol, heart rate) and subjective ratings of stress in all three groups, and MDMA produced its expected subjective and physiological effects. MDMA alone increased ratings of subjective stress, heart rate, and saliva cortisol concentrations, but contrary to our hypothesis, it did not moderate responses to the Trier Social Stress Test. CONCLUSIONS Despite its efficacy in PTSD and anxiety, MDMA did not reduce either the subjective or objective responses to stress in this controlled study. The conditions under which MDMA relieves responses to negative events or memories remain to be determined.
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Affiliation(s)
- Anya K. Bershad
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| | - Melissa A. Miller
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL, 60637, USA.
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74
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Sessa B. MDMA and PTSD treatment. Neurosci Lett 2017; 649:176-180. [DOI: 10.1016/j.neulet.2016.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/02/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
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75
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Acute effects of LSD on amygdala activity during processing of fearful stimuli in healthy subjects. Transl Psychiatry 2017; 7:e1084. [PMID: 28375205 PMCID: PMC5416695 DOI: 10.1038/tp.2017.54] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/30/2017] [Accepted: 02/14/2017] [Indexed: 12/20/2022] Open
Abstract
Lysergic acid diethylamide (LSD) induces profound changes in various mental domains, including perception, self-awareness and emotions. We used functional magnetic resonance imaging (fMRI) to investigate the acute effects of LSD on the neural substrate of emotional processing in humans. Using a double-blind, randomised, cross-over study design, placebo or 100 μg LSD were orally administered to 20 healthy subjects before the fMRI scan, taking into account the subjective and pharmacological peak effects of LSD. The plasma levels of LSD were determined immediately before and after the scan. The study (including the a priori-defined study end point) was registered at ClinicalTrials.gov before study start (NCT02308969). The administration of LSD reduced reactivity of the left amygdala and the right medial prefrontal cortex relative to placebo during the presentation of fearful faces (P<0.05, family-wise error). Notably, there was a significant negative correlation between LSD-induced amygdala response to fearful stimuli and the LSD-induced subjective drug effects (P<0.05). These data suggest that acute administration of LSD modulates the engagement of brain regions that mediate emotional processing.
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76
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Varas-Díaz G, Brunetti EP, Rivera-Lillo G, Maldonado PE. Patients with Chronic Spinal Cord Injury Exhibit Reduced Autonomic Modulation during an Emotion Recognition Task. Front Hum Neurosci 2017; 11:59. [PMID: 28228721 PMCID: PMC5296323 DOI: 10.3389/fnhum.2017.00059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/30/2017] [Indexed: 11/22/2022] Open
Abstract
Spinal cord injury (SCI) is a devastating event for individuals, who frequently develop motor and sensory impairment as well as autonomic dysfunction. Previous studies reported that autonomic activity plays a major role in social cognition and that difficulties in the ability to interpret social information are commonly observed in a variety of mental disorders, which in turn correlate with a poor autonomic nervous system (ANS) regulation. It is well established that subjects with SCI have an alteration in ANS regulation mechanisms. We hypothesized that subjects diagnosed with SCI, who are experiencing a period of adaptation and socio-labor insertion suffer alterations in an emotion recognition task, a component of social cognition, which correlate with poor ANS regulation. We evaluated ANS function by measuring the heart rate variability (HRV) in 18 healthy subjects and 10 subjects with SCI. A 5-min baseline HRV was compared to a task period while performing The reading the mind in the eyes test (RMET). We found that while both groups have similar general performance in the test, healthy subjects responded with greater certainty during the RMET. This level of certainty during the RMET was positively correlated with baseline HRV measures in this group. Also, the group of healthy subjects exhibited higher HRV at baseline than participants with SCI. Finally, the changes in HRV between baseline and task condition were significantly higher in healthy individuals than in SCI participants. Our results show that patients with SCI have low levels of autonomic regulation mechanisms which may promote social cognition problems during their reinsertion to daily life.
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Affiliation(s)
- Gonzalo Varas-Díaz
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de ChileSantiago, Chile; Centro de Estudios Integrados en Neurorehabilitación, Clinica Los CoihuesSantiago, Chile
| | - Enzo P Brunetti
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile Santiago, Chile
| | - Gonzalo Rivera-Lillo
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de ChileSantiago, Chile; Centro de Estudios Integrados en Neurorehabilitación, Clinica Los CoihuesSantiago, Chile; Departamento de Kinesiología, Facultad de Medicina, Universidad de ChileSantiago, Chile
| | - Pedro E Maldonado
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de ChileSantiago, Chile; Biomedical Neuroscience Institute (BNI), Universidad de ChileSantiago, Chile
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77
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White TL. Beyond Sensation Seeking: A Conceptual Framework for Individual Differences in Psychostimulant Drug Effects in Healthy Humans. Curr Opin Behav Sci 2017; 13:63-70. [PMID: 28111627 DOI: 10.1016/j.cobeha.2016.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Psychostimulant addiction is an important, relapsing condition for which there is no effective pharmacological treatment. Countering this problem requires an understanding of the specific risk factors that predispose individuals to initial misuse of these drugs. Healthy individuals display marked individual differences in emotional, behavioral and brain responses to low and moderate doses of stimulant drugs. These between-person differences have been most often studied using personality measures of sensation seeking. However, a growing body of work in healthy adults indicates potentially unique sources of variance in these responses that are related to four dissociable personality domains: extraversion, fearlessness, impulsivity and absorption. These four domains are empirically dissociable and can serve as endophenotypic markers of dopamine, norepinephrine and serotonin function in healthy individuals. The relationship between normal variation in these traits and the pharmacological effects of these drugs is here proposed as a framework for better understanding the specific sources of between-person variation in stimulant drug effects on mood, behavior and brain responses in healthy humans.
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Affiliation(s)
- Tara L White
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, and Institute for Brain Science, Brown University, Providence, RI. USA
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78
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Neurochemical substrates of the rewarding effects of MDMA: implications for the development of pharmacotherapies to MDMA dependence. Behav Pharmacol 2016; 27:116-32. [PMID: 26650254 DOI: 10.1097/fbp.0000000000000210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, studies with animal models of reward, such as the intracranial self-stimulation, self-administration, and conditioned place preference paradigms, have increased our knowledge on the neurochemical substrates of the rewarding effects of 3,4-methylenedioxymetamphetamine (MDMA) in rodents. However, pharmacological and neuroimaging studies with human participants are scarce. Serotonin [5-hydroxytryptamine (5-HT)], dopamine (DA), endocannabinoids, and endogenous opiates are the main neurotransmitter systems involved in the rewarding effects of MDMA in rodents, but other neurotransmitters such as glutamate, acetylcholine, adenosine, and neurotensin are also involved. The most important finding of recent research is the demonstration of differential involvement of specific neurotransmitter receptor subtypes (5-HT2, 5-HT3, DA D1, DA D2, CB1, μ and δ opioid, etc.) and extracellular proteins (DA and 5-HT transporters) in the acquisition, expression, extinction, and reinstatement of MDMA self-administration and conditioned place preference. It is important to extend the research on the effects of different compounds acting on these receptors/transporters in animal models of reward, especially in priming-induced, cue-induced, and stress-induced reinstatement. Increase in knowledge of the neurochemical substrates of the rewarding effects of MDMA may contribute to the design of new pharmacological treatments for individuals who develop MDMA dependence.
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79
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Francis SM, Kirkpatrick MG, de Wit H, Jacob S. Urinary and plasma oxytocin changes in response to MDMA or intranasal oxytocin administration. Psychoneuroendocrinology 2016; 74:92-100. [PMID: 27592327 DOI: 10.1016/j.psyneuen.2016.08.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/13/2016] [Accepted: 08/13/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The neuropeptide oxytocin (OT) has received increased experimental attention for its putative role in both normal social functioning and several psychiatric disorders that are partially characterized by social dysfunction (e.g., autism spectrum disorders: ASD). Many human experimental studies measure circulating plasma levels of OT in order to examine the relationship between the hormone and behavior. Urinary OT (uOT) assays offer a simple, easy, and non-invasive method to measure peripheral hormone levels, but the correspondence between uOT and plasma OT (pOT) levels is unclear. Here, we conducted two within-subjects, double-blind studies exploring changes in uOT and pOT levels following administration of two drugs: MDMA, an oxytocin-releasing drug (Study 1), and intranasal oxytocin (INOT: Study 1 and 2). METHODS In Study 1, 14 adult participants (2 females) were each administered either oral 1.5mg/kg MDMA or 40IU INOT across two different study sessions. In Study 2, 10 male participants (adolescents and young adults) diagnosed with ASD received either 40IU INOT or placebo across two different sessions. In both studies, blood and urine samples were collected before and after drug administration at each study session. For Study 1, 10 participants provided valid plasma and urine samples for the MDMA session, and 8 provided valid samples for the INOT session. For Study 2, all 10 participants provided valid samples for both INOT and placebo sessions. Pre- and post-administration levels of pOT and uOT were compared. Additionally, correlations between percent change from baseline uOT and pOT levels were examined. RESULTS Study 1: Plasma OT and uOT levels significantly increased after administration of MDMA and INOT. Furthermore, uOT levels were positively correlated with pOT levels following administration of MDMA (r=0.57, p=0.042) but not INOT (r=0.51, p=0.097). Study 2: There was a significant increase in uOT levels after administration of INOT, but not after administration of placebo. Under both conditions, INOT and placebo, significant increases in pOT levels were not observed. Additionally, change from baseline uOT and pOT levels were positively correlated (r=0.57, p=0.021). There was no significant correlation between uOT and pOT levels following placebo administration. CONCLUSION Our results show a measurable and significant increase in pOT and uOT levels after the administration of MDMA (Study 1) and INOT (Study 1 and Study 2). Additionally, a positive correlation between uOT and pOT levels was observed in both samples (healthy adults and ASD patients) in at least one condition. However, uOT and pOT levels were not correlated under all conditions, suggesting that uOT levels do not fully correspond to pOT levels in the time windows we measured. Future studies should further examine the relationship between levels of pOT and uOT in healthy and clinical populations on measures of social behavior because uOT may serve as an additional non-invasive method to measure peripheral OT changes.
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Affiliation(s)
- Sunday M Francis
- Institute of Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Matthew G Kirkpatrick
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, A27 South Maryland Avenue, Chicago, IL 60637, USA.
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, A27 South Maryland Avenue, Chicago, IL 60637, USA.
| | - Suma Jacob
- Institute of Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
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80
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Bershad AK, Miller MA, Baggott MJ, de Wit H. The effects of MDMA on socio-emotional processing: Does MDMA differ from other stimulants? J Psychopharmacol 2016; 30:1248-1258. [PMID: 27562198 PMCID: PMC8753974 DOI: 10.1177/0269881116663120] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
±3,4-Methylenedioxymethamphetamine (MDMA) is a popular recreational drug that enhances sociability and feelings of closeness with others. These "prosocial" effects appear to motivate the recreational use of MDMA and may also form the basis of its potential as an adjunct to psychotherapy. However, the extent to which MDMA differs from prototypic stimulant drugs, such as dextroamphetamine, methamphetamine, and methylphenidate, in either its behavioral effects or mechanisms of action, is not fully known. The purpose of this review is to evaluate human laboratory findings of the social effects of MDMA compared to other stimulants, ranging from simple subjective ratings of sociability to more complex elements of social processing and behavior. We also review the neurochemical mechanisms by which these drugs may impact sociability. Together, the findings reviewed here lay the groundwork for better understanding the socially enhancing effects of MDMA that distinguish it from other stimulant drugs, especially as these effects relate to the reinforcing and potentially therapeutic effects of the drug.
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Affiliation(s)
- Anya K Bershad
- Department of Psychiatry and Behavioral Neuroscience,Interdisciplinary Scientist Training Program; University of Chicago, Chicago, IL, USA
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81
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Laursen HR, Henningsson S, Macoveanu J, Jernigan TL, Siebner HR, Holst KK, Skimminge A, Knudsen GM, Ramsoy TZ, Erritzoe D. Serotonergic neurotransmission in emotional processing: New evidence from long-term recreational poly-drug ecstasy use. J Psychopharmacol 2016; 30:1296-1304. [PMID: 27599522 DOI: 10.1177/0269881116662633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The brain's serotonergic system plays a crucial role in the processing of emotional stimuli, and several studies have shown that a reduced serotonergic neurotransmission is associated with an increase in amygdala activity during emotional face processing. Prolonged recreational use of ecstasy (3,4-methylene-dioxymethamphetamine [MDMA]) induces alterations in serotonergic neurotransmission that are comparable to those observed in a depleted state. In this functional magnetic resonance imaging (fMRI) study, we investigated the responsiveness of the amygdala to emotional face stimuli in recreational ecstasy users as a model of long-term serotonin depletion. Fourteen ecstasy users and 12 non-using controls underwent fMRI to measure the regional neural activity elicited in the amygdala by male or female faces expressing anger, disgust, fear, sadness, or no emotion. During fMRI, participants made a sex judgement on each face stimulus. Positron emission tomography with 11C-DASB was additionally performed to assess serotonin transporter (SERT) binding in the brain. In the ecstasy users, SERT binding correlated negatively with amygdala activity, and accumulated lifetime intake of ecstasy tablets was associated with an increase in amygdala activity during angry face processing. Conversely, time since the last ecstasy intake was associated with a trend toward a decrease in amygdala activity during angry and sad face processing. These results indicate that the effects of long-term serotonin depletion resulting from ecstasy use are dose-dependent, affecting the functional neural basis of emotional face processing.
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Affiliation(s)
- Helle Ruff Laursen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Susanne Henningsson
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark
| | - Julian Macoveanu
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Terry L Jernigan
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Klaus K Holst
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Arnold Skimminge
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thomas Z Ramsoy
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Decision Neuroscience, Copenhagen Business School, Copenhagen, Denmark.,Singularity University, Moffett Field, CA, USA.,Neurons, Inc., Holbæk, Denmark
| | - David Erritzoe
- Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark .,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Centre for Neuropsychopharmacology, Imperial College London, London, UK
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82
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Caputi FF, Palmisano M, Carboni L, Candeletti S, Romualdi P. Opioid gene expression changes and post-translational histone modifications at promoter regions in the rat nucleus accumbens after acute and repeated 3,4-methylenedioxy-methamphetamine (MDMA) exposure. Pharmacol Res 2016; 114:209-218. [PMID: 27989838 DOI: 10.1016/j.phrs.2016.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/29/2016] [Accepted: 10/28/2016] [Indexed: 01/06/2023]
Abstract
The recreational drug of abuse 3,4-methylenedioxymethamphetamine (MDMA) has been shown to produce neurotoxic damage and long-lasting changes in several brain areas. In addition to the involvement of serotoninergic and dopaminergic systems, little information exists about the contribution of nociceptin/orphaninFQ (N/OFQ)-NOP and dynorphin (DYN)-KOP systems in neuronal adaptations evoked by MDMA. Here we investigated the behavioral and molecular effects induced by acute (8mg/kg) or repeated (8mg/kg twice daily for seven days) MDMA exposure. MDMA exposure affected body weight gain and induced hyperlocomotion; this latter effect progressively decreased after repeated administration. Gene expression analysis indicated a down-regulation of the N/OFQ system and an up-regulation of the DYN system in the nucleus accumbens (NAc), highlighting an opposite systems regulation in response to MDMA exposure. Since histone modifications have been strongly associated to the addiction-related maladaptive changes, we examined two permissive (acH3K9 and me3H3K4) and two repressive transcription marks (me3H3K27 and me2H3K9) at the pertinent opioid gene promoter regions. Chromatin immunoprecipitation assays revealed that acute MDMA increased me3H3K4 at the pN/OFQ, pDYN and NOP promoters. Following acute and repeated treatment a significant decrease of acH3K9 at the pN/OFQ promoter was observed, which correlated with gene expression results. Acute treatment caused an acH3K9 increase and a me2H3K9 decrease at the pDYN promoter which matched its mRNA up-regulation. Our data indicate that the activation of the DYNergic stress system together with the inactivation of the N/OFQergic anti-stress system contribute to the neuroadaptive actions of MDMA and offer novel epigenetic information associated with MDMA abuse.
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Affiliation(s)
- Francesca Felicia Caputi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Irnerio 48, 40126 Bologna, Italy
| | - Martina Palmisano
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Irnerio 48, 40126 Bologna, Italy
| | - Lucia Carboni
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Irnerio 48, 40126 Bologna, Italy
| | - Sanzio Candeletti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Irnerio 48, 40126 Bologna, Italy
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Irnerio 48, 40126 Bologna, Italy.
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83
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Betzler F, Viohl L, Romanczuk-Seiferth N. Decision-making in chronic ecstasy users: a systematic review. Eur J Neurosci 2016; 45:34-44. [PMID: 27859780 DOI: 10.1111/ejn.13480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022]
Abstract
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design.
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Affiliation(s)
- Felix Betzler
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Leonard Viohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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84
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Ritanserin-sensitive receptors modulate the prosocial and the anxiolytic effect of MDMA derivatives, DOB and PMA, in zebrafish. Behav Brain Res 2016; 314:181-9. [DOI: 10.1016/j.bbr.2016.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 07/30/2016] [Accepted: 08/04/2016] [Indexed: 12/19/2022]
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85
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Abstract
Hallucinogens fall into several different classes, as broadly defined by pharmacological mechanism of action, and chemical structure. These include psychedelics, entactogens, dissociatives, and other atypical hallucinogens. Although these classes do not share a common primary mechanism of action, they do exhibit important similarities in their ability to occasion temporary but profound alterations of consciousness, involving acute changes in somatic, perceptual, cognitive, and affective processes. Such effects likely contribute to their recreational use. However, a growing body of evidence indicates that these drugs may have therapeutic applications beyond their potential for abuse. This review will present data on several classes of hallucinogens with a particular focus on psychedelics, entactogens, and dissociatives, for which clinical utility has been most extensively documented. Information on each class is presented in turn, tracing relevant historical insights, highlighting similarities and differences between the classes from the molecular to the behavioral level, and presenting the most up-to-date information on clinically oriented research with these substances, with important ramifications for their potential therapeutic value. (PsycINFO Database Record
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Affiliation(s)
- Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brennan Kersgaard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Peter H. Addy
- Department of Medical Informatics, Department of Veterans Affairs, West Haven, CT
- Department of Medical Informatics, Yale University School of Medicine, New Haven, CT
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86
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Trotter PD, McGlone F, McKie S, McFarquhar M, Elliott R, Walker SC, Deakin JFW. Effects of acute tryptophan depletion on central processing of CT-targeted and discriminatory touch in humans. Eur J Neurosci 2016; 44:2072-83. [DOI: 10.1111/ejn.13298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/18/2016] [Accepted: 06/13/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Paula Diane Trotter
- Research Centre in Brain and Behaviour; School of Natural Sciences & Psychology; Liverpool John Moores University; Byrom Street Liverpool L3 3AF UK
| | - Francis McGlone
- Research Centre in Brain and Behaviour; School of Natural Sciences & Psychology; Liverpool John Moores University; Byrom Street Liverpool L3 3AF UK
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - Shane McKie
- Neuroscience and Psychiatry Unit; The University of Manchester; Manchester UK
| | - Martyn McFarquhar
- Neuroscience and Psychiatry Unit; The University of Manchester; Manchester UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit; The University of Manchester; Manchester UK
| | - Susannah Claire Walker
- Research Centre in Brain and Behaviour; School of Natural Sciences & Psychology; Liverpool John Moores University; Byrom Street Liverpool L3 3AF UK
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87
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Abstract
Psychostimulant drugs alter the salience of stimuli in both laboratory animals and humans. In animals, stimulants increase rates of responding to conditioned incentive stimuli, and in humans, amphetamine increases positive ratings of emotional images. However, the effects of stimulants on real-life emotional events have not been studied in humans. In this study, we examined the effect of d-amphetamine on responses to acute psychosocial stress using a public speaking task. Healthy volunteers (N=56) participated in two experimental sessions, one with a psychosocial stressor (the Trier Social Stress Test) and one with a non-stressful control task. They were randomly assigned to receive d-amphetamine (5 mg n=18, 10 mg n=20) or placebo (n=18) on both sessions under double blind conditions. Salivary cortisol, subjective mood, and vital signs were measured at regular intervals during the session. Subjects also provided cognitive appraisals of the tasks before and after their performances. Amphetamine produced its expected mood and physiological effects, and the Trier Social Stress Test produced its expected effects on cortisol and mood. Although neither dose of amphetamine altered cardiovascular or hormonal responses to stress, amphetamine (10 mg) increased participants' pre-task appraisals of how challenging the task would be, and it increased post-task ratings of self-efficacy. Paradoxically, it also increased ratings of how stressful the task was, and prolonged aversive emotional responses. These findings suggest that amphetamine differentially affects stress response components: it may increase participants' appraisals of self-efficacy without dampening the direct emotional or physiological responses to the stress.
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Affiliation(s)
- Emma Childs
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Anya K Bershad
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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88
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Bedi G, Shiffrin L, Vadhan NP, Nunes EV, Foltin RW, Bisaga A. Effects of levodopa-carbidopa-entacapone and smoked cocaine on facial affect recognition in cocaine smokers. J Psychopharmacol 2016; 30:370-7. [PMID: 26921145 PMCID: PMC4794345 DOI: 10.1177/0269881115626308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In addition to difficulties in daily social functioning, regular cocaine users have decrements in social processing (the cognitive and affective processes underlying social behavior) relative to non-users. Little is known, however, about the effects of clinically-relevant pharmacological agents, such as cocaine and potential treatment medications, on social processing in cocaine users. Such drug effects could potentially alleviate or compound baseline social processing decrements in cocaine abusers. Here, we assessed the individual and combined effects of smoked cocaine and a potential treatment medication, levodopa-carbidopa-entacapone (LCE), on facial emotion recognition in cocaine smokers. Healthy non-treatment-seeking cocaine smokers (N = 14; two female) completed this 11-day inpatient within-subjects study. Participants received LCE (titrated to 400mg/100mg/200mg b.i.d.) for five days with the remaining time on placebo. The order of medication administration was counterbalanced. Facial emotion recognition was measured twice during target LCE dosing and twice on placebo: once without cocaine and once after repeated cocaine doses. LCE increased the response threshold for identification of facial fear, biasing responses away from fear identification. Cocaine had no effect on facial emotion recognition. Results highlight the possibility for candidate pharmacotherapies to have unintended impacts on social processing in cocaine users, potentially exacerbating already existing difficulties in this population.
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Affiliation(s)
- Gillinder Bedi
- Division on Substance Abuse, New York State Psychiatric Institute, and Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Laura Shiffrin
- Division on Substance Abuse, New York State Psychiatric Institute, and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Nehal P. Vadhan
- Department of Psychiatry, Stony Brook University School of Medicine
| | - Edward V. Nunes
- Division on Substance Abuse, New York State Psychiatric Institute, and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Richard W. Foltin
- Division on Substance Abuse, New York State Psychiatric Institute, and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Adam Bisaga
- Division on Substance Abuse, New York State Psychiatric Institute, and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
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89
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Baggott MJ, Coyle JR, Siegrist JD, Garrison KJ, Galloway GP, Mendelson JE. Effects of 3,4-methylenedioxymethamphetamine on socioemotional feelings, authenticity, and autobiographical disclosure in healthy volunteers in a controlled setting. J Psychopharmacol 2016; 30:378-87. [PMID: 26880224 DOI: 10.1177/0269881115626348] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The drug 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy", "molly") is a widely used illicit drug and experimental adjunct to psychotherapy. MDMA has unusual, poorly understood socioemotional effects, including feelings of interpersonal closeness and sociability. To better understand these effects, we conducted a small (n=12) within-subjects double-blind placebo controlled study of the effects of 1.5 mg/kg oral MDMA on social emotions and autobiographical disclosure in a controlled setting. MDMA displayed both sedative- and stimulant-like effects, including increased self-report anxiety. At the same time, MDMA positively altered evaluation of the self (i.e. increasing feelings of authenticity) while decreasing concerns about negative evaluation by others (i.e. decreasing social anxiety). Consistent with these feelings, MDMA increased how comfortable participants felt describing emotional memories. Overall, MDMA produced a prosocial syndrome that seemed to facilitate emotional disclosure and that appears consistent with the suggestion that it represents a novel pharmacological class.
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Affiliation(s)
| | - Jeremy R Coyle
- Division of Biostatistics, University of California, Berkeley, CA, USA
| | - Jennifer D Siegrist
- Baggott.Net, Redwood City, CA, USA Addiction and Pharmacology Research Laboratory, Friends Research Institute, Baltimore, MD, USA
| | - Kathleen J Garrison
- Addiction and Pharmacology Research Laboratory, Friends Research Institute, Baltimore, MD, USA
| | - Gantt P Galloway
- Addiction and Pharmacology Research Laboratory, Friends Research Institute, Baltimore, MD, USA
| | - John E Mendelson
- Addiction and Pharmacology Research Laboratory, Friends Research Institute, Baltimore, MD, USA
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90
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Bershad AK, Weafer JJ, Kirkpatrick MG, Wardle MC, Miller MA, de Wit H. Oxytocin receptor gene variation predicts subjective responses to MDMA. Soc Neurosci 2016; 11:592-9. [DOI: 10.1080/17470919.2016.1143026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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91
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Danforth AL, Struble CM, Yazar-Klosinski B, Grob CS. MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:237-49. [PMID: 25818246 DOI: 10.1016/j.pnpbp.2015.03.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 12/19/2022]
Abstract
The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol.
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Affiliation(s)
- Alicia L Danforth
- Los Angeles Biomedical Research Institute, Torrance, CA, United States.
| | | | - Berra Yazar-Klosinski
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, United States.
| | - Charles S Grob
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute, Torrance, CA, United States.
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92
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Amoroso T. The Psychopharmacology of ±3,4 Methylenedioxymethamphetamine and its Role in the Treatment of Posttraumatic Stress Disorder. J Psychoactive Drugs 2015; 47:337-44. [DOI: 10.1080/02791072.2015.1094156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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93
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Carhart-Harris RL, Murphy K, Leech R, Erritzoe D, Wall MB, Ferguson B, Williams LTJ, Roseman L, Brugger S, De Meer I, Tanner M, Tyacke R, Wolff K, Sethi A, Bloomfield MAP, Williams TM, Bolstridge M, Stewart L, Morgan C, Newbould RD, Feilding A, Curran HV, Nutt DJ. The Effects of Acutely Administered 3,4-Methylenedioxymethamphetamine on Spontaneous Brain Function in Healthy Volunteers Measured with Arterial Spin Labeling and Blood Oxygen Level-Dependent Resting State Functional Connectivity. Biol Psychiatry 2015; 78:554-62. [PMID: 24495461 PMCID: PMC4578244 DOI: 10.1016/j.biopsych.2013.12.015] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/05/2013] [Accepted: 12/16/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND The compound 3,4-methylenedioxymethamphetamine (MDMA) is a potent monoamine releaser that produces an acute euphoria in most individuals. METHODS In a double-blind, placebo-controlled, balanced-order study, MDMA was orally administered to 25 physically and mentally healthy individuals. Arterial spin labeling and seed-based resting state functional connectivity (RSFC) were used to produce spatial maps displaying changes in cerebral blood flow (CBF) and RSFC after MDMA administration. Participants underwent two arterial spin labeling and two blood oxygen level-dependent scans in a 90-minute scan session; MDMA and placebo study days were separated by 1 week. RESULTS Marked increases in positive mood were produced by MDMA. Decreased CBF only was observed after MDMA, and this was localized to the right medial temporal lobe (MTL), thalamus, inferior visual cortex, and the somatosensory cortex. Decreased CBF in the right amygdala and hippocampus correlated with ratings of the intensity of global subjective effects of MDMA. The RSFC results complemented the CBF results, with decreases in RSFC between midline cortical regions, the medial prefrontal cortex, and MTL regions, and increases between the amygdala and hippocampus. There were trend-level correlations between these effects and ratings of intense and positive subjective effects. CONCLUSIONS The MTLs appear to be specifically implicated in the mechanism of action of MDMA, but further work is required to elucidate how the drug's characteristic subjective effects arise from its modulation of spontaneous brain activity.
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Affiliation(s)
- Robin L Carhart-Harris
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London.
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre (KM), School of Psychology, Cardiff University, Cardiff, London, United Kingdom
| | | | - David Erritzoe
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Matthew B Wall
- Institute of Neurology (MBW),; Imanova (MBW, IDM, MT, RDN), Centre for Imaging Sciences, London
| | - Bart Ferguson
- Clinical Psychopharmacology Unit (BF, LS, CM, HVC), University College London, London; University College London, London
| | - Luke T J Williams
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Leor Roseman
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Stefan Brugger
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Ineke De Meer
- Imanova (MBW, IDM, MT, RDN), Centre for Imaging Sciences, London
| | - Mark Tanner
- Imanova (MBW, IDM, MT, RDN), Centre for Imaging Sciences, London
| | - Robin Tyacke
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Kim Wolff
- School of Biomedical Sciences (KW), Kings College London, London, United Kingdom
| | - Ajun Sethi
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Michael A P Bloomfield
- Psychiatric Imaging Group (MAPB), MRC Clinical Sciences Centre, Institute of Clinical Science, Imperial College London, London
| | - Tim M Williams
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Mark Bolstridge
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
| | - Lorna Stewart
- Clinical Psychopharmacology Unit (BF, LS, CM, HVC), University College London, London; University College London, London
| | - Celia Morgan
- Clinical Psychopharmacology Unit (BF, LS, CM, HVC), University College London, London; University College London, London
| | | | | | - H Val Curran
- Clinical Psychopharmacology Unit (BF, LS, CM, HVC), University College London, London; University College London, London
| | - David J Nutt
- Centre for Neuropsychopharmacology (RLC-H, DE, LTJW, LR, SB, RT, AS, TMW, MB, DJN) and C3NL (RL), Division of Brain Sciences, Faculty of Medicine, London, London
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94
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Acute Effects of the Novel Psychoactive Drug 2C-B on Emotions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:643878. [PMID: 26543863 PMCID: PMC4620274 DOI: 10.1155/2015/643878] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/27/2015] [Indexed: 12/22/2022]
Abstract
Background. 2C-B (Nexus) is one of the most widespread novel psychoactive substances. There is limited information about its pharmacological properties, and few studies in humans concern its acute and chronic effects. 2C-B has been classified as a stimulant, hallucinogen, entactogen, and/or empathogen. Objectives. To evaluate the emotional, subjective, and cardiovascular effects of 2C-B. Methods. Twenty healthy recreational 2C-B users (12 women) self-administered a 20 mg dose of 2C-B. Evaluations included emotional (IAPS, FERT, and speech), subjective (visual analog scales, ARCI, VESSPA, HRS, and POMS questionnaires), and cardiovascular effects (blood pressure and heart rate). Results. Positive subjective effects predominated with a reduction of anger under the influence of 2C-B. It did, however, increase reactivity to negative emotional stimuli and decrease the ability to recognize expressions of happiness. Augmented emotionality in speech could be appreciated by others. 2C-B induced euphoria and well-being, changes in perceptions, and slight hallucinogenic states. Mild sympathetic actions were observed. Conclusions. The specific profile that 2C-B exerts on emotions suggests its classification as an entactogen with psychedelic properties.
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95
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Kamilar-Britt P, Bedi G. The prosocial effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled studies in humans and laboratory animals. Neurosci Biobehav Rev 2015; 57:433-46. [PMID: 26408071 DOI: 10.1016/j.neubiorev.2015.08.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 02/03/2023]
Abstract
Users of ±3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') report prosocial effects such as sociability and empathy. Supporting these apparently unique social effects, data from controlled laboratory studies indicate that MDMA alters social feelings, information processing, and behavior in humans, and social behavior in rodents. Here, we review this growing body of evidence. In rodents, MDMA increases passive prosocial behavior (adjacent lying) and social reward while decreasing aggression, effects that may involve serotonin 1A receptor mediated oxytocin release interacting with vasopressin receptor 1A. In humans, MDMA increases plasma oxytocin and produces feelings of social affiliation. It decreases identification of negative facial expressions (cognitive empathy) and blunts responses to social rejection, while enhancing responses to others' positive emotions (emotional empathy) and increasing social approach. Thus, consistent with drug folklore, laboratory administration of MDMA robustly alters social processing in humans and increases social approach in humans and animals. Effects are consistent with increased sociability, with mixed evidence about enhanced empathy. These neurobiologically-complex prosocial effects likely motivate recreational ecstasy use.
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Affiliation(s)
- Philip Kamilar-Britt
- Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, MC 120, New York, NY 10032, United States.
| | - Gillinder Bedi
- Division on Substance Abuse, New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, MC 120, New York, NY 10032, United States.
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96
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Petrican R, Rosenbaum RS, Grady C. Expressive suppression and neural responsiveness to nonverbal affective cues. Neuropsychologia 2015; 77:321-30. [PMID: 26365712 DOI: 10.1016/j.neuropsychologia.2015.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 07/20/2015] [Accepted: 09/08/2015] [Indexed: 01/10/2023]
Abstract
Optimal social functioning occasionally requires concealment of one's emotions in order to meet one's immediate goals and environmental demands. However, because emotions serve an important communicative function, their habitual suppression disrupts the flow of social exchanges and, thus, incurs significant interpersonal costs. Evidence is accruing that the disruption in social interactions, linked to habitual expressive suppression use, stems not only from intrapersonal, but also from interpersonal causes, since the suppressors' restricted affective displays reportedly inhibit their interlocutors' emotionally expressive behaviors. However, expressive suppression use is not known to lead to clinically significant social impairments. One explanation may be that over the lifespan, individuals who habitually suppress their emotions come to compensate for their interlocutors' restrained expressive behaviors by developing an increased sensitivity to nonverbal affective cues. To probe this issue, the present study used functional magnetic resonance imaging (fMRI) to scan healthy older women while they viewed silent videos of a male social target displaying nonverbal emotional behavior, together with a brief verbal description of the accompanying context, and then judged the target's affect. As predicted, perceivers who reported greater habitual use of expressive suppression showed increased neural processing of nonverbal affective cues. This effect appeared to be coordinated in a top-down manner via cognitive control. Greater neural processing of nonverbal cues among perceivers who habitually suppress their emotions was linked to increased ventral striatum activity, suggestive of increased reward value/personal relevance ascribed to emotionally expressive nonverbal behaviors. These findings thus provide neural evidence broadly consistent with the hypothesized link between habitual use of expressive suppression and compensatory development of increased responsiveness to nonverbal affective cues, while also suggesting one explanation for the suppressors' poorer cognitive performance in social situations. Moreover, our results point to a potential neural mechanism supporting the development and perpetuation of expressive suppression as an emotion regulation strategy.
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Affiliation(s)
- Raluca Petrican
- Rotman Research Institute, 3560 Bathurst Street, Toronto, Ontario, Canada M6A 2E1.
| | - R Shayna Rosenbaum
- Rotman Research Institute, 3560 Bathurst Street, Toronto, Ontario, Canada M6A 2E1; Department of Psychology, York University, Canada.
| | - Cheryl Grady
- Rotman Research Institute, 3560 Bathurst Street, Toronto, Ontario, Canada M6A 2E1; Department of Psychology and Psychiatry, University of Toronto, Canada.
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97
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Blanco-Gandía MC, Mateos-García A, García-Pardo MP, Montagud-Romero S, Rodríguez-Arias M, Miñarro J, Aguilar MA. Effect of drugs of abuse on social behaviour. Behav Pharmacol 2015. [DOI: 10.1097/fbp.0000000000000162] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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98
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Kamboj SK, Kilford EJ, Minchin S, Moss A, Lawn W, Das RK, Falconer CJ, Gilbert P, Curran HV, Freeman TP. Recreational 3,4-methylenedioxy-N-methylamphetamine (MDMA) or 'ecstasy' and self-focused compassion: Preliminary steps in the development of a therapeutic psychopharmacology of contemplative practices. J Psychopharmacol 2015; 29:961-70. [PMID: 25990558 DOI: 10.1177/0269881115587143] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
3,4-methylenedioxy-N-methylamphetamine (MDMA) produces diverse pro-social effects. Cognitive training methods rooted in Eastern contemplative practices also produce these effects through the development of a compassionate mindset. Given this similarity, we propose that one potential mechanism of action of MDMA in psychotherapy is through enhancing effects on intrapersonal attitudes (i.e. pro-social attitudes towards the self). We provide a preliminary test of this idea. Recreational MDMA (ecstasy) users were tested on two occasions, having consumed or not consumed ecstasy. Self-critical and self-compassionate responses to self-threatening scenarios were assessed before (T1) and after (T2) ecstasy use (or non-use), and then after compassionate imagery (T3). Moderating roles of dispositional self-criticism and avoidant attachment were examined. Separately, compassionate imagery and ecstasy produced similar sociotropic effects, as well as increases in self-compassion and reductions in self-criticism. Higher attachment-related avoidance was associated with additive effects of compassionate imagery and ecstasy on self-compassion. Findings were in line with MDMA's neuropharmacological profile, its phenomenological effects and its proposed adjunctive use in psychotherapy. However, although conditions were balanced, the experiment was non-blind and MDMA dose/purity was not determined. Controlled studies with pharmaceutically pure MDMA are still needed to test these effects rigorously.
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Affiliation(s)
- Sunjeev K Kamboj
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Emma J Kilford
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephanie Minchin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Abigail Moss
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Will Lawn
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ravi K Das
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Caroline J Falconer
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Paul Gilbert
- Mental Health Research Unit, University of Derby, Derby, UK
| | - H Valerie Curran
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tom P Freeman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Carpenter KM, Bedi G, Vadhan NP. Understanding and shifting drug-related decisions: contributions of automatic decision-making processes. Curr Psychiatry Rep 2015; 17:607. [PMID: 26084667 PMCID: PMC4684598 DOI: 10.1007/s11920-015-0607-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.
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Affiliation(s)
- Kenneth M. Carpenter
- Department of Psychiatry, Columbia University Medical Center, Center for Motivation and Change, Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, MC 120, NY, NY, 10032, ph: 646-774-8176
| | - Gillinder Bedi
- Division on Substance Abuse, New York State Psychiatric Institute, Department of Psychiatry, Columbia University, 1051 Riverside Drive, MC 120, NY, NY, 10032, ph: 646 774 6133
| | - Nehal P. Vadhan
- Department of Psychiatry, Stony Brook University School of Medicine, Health Sciences Tower 10-040K, Stony Brook, NY 11794-8101, ph: 631-638-1543
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100
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Oxytocin and MDMA ('Ecstasy') enhance social reward in rats. Psychopharmacology (Berl) 2015; 232:2631-41. [PMID: 25772337 DOI: 10.1007/s00213-015-3899-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/16/2015] [Indexed: 01/05/2023]
Abstract
RATIONALE Oxytocin (OT), vasopressin (AVP) and 3,4 methylenedioxymethamphetamine (MDMA, 'Ecstasy') all increase social interaction in rats, perhaps by enhancing the rewarding value of social encounters. OBJECTIVES Here, we used the conditioned place preference (CPP) paradigm to assess the intrinsic rewarding effects of OT, AVP and MDMA, and whether these effects are enhanced by the presence of a conspecific, or a dynamic, tactile object (a tennis ball). METHODS Adult male rats received conditioning sessions in a CPP apparatus twice a day (vehicle at 10 a.m., drug at 3 p.m.). Experiment 1 involved conditioning with OT (0.5 mg/kg, intraperitoneal (i.p.)), AVP (0.005 mg/kg, i.p.) or MDMA (5 mg/kg, i.p.). Experiments 2 and 3 involved conditioning with the same treatments but in the presence of a conspecific receiving the same treatment (social-CPP) or in the presence of a tennis ball (object-CPP), respectively. Conditioned place preference was assessed 24 h, 2 weeks and 4 weeks later. RESULTS OT, AVP and MDMA did not produce a conventional CPP. However, when the conditioning environment also contained a conspecific both OT and MDMA induced a significant CPP lasting for at least 4 weeks. Rats given OT and MDMA also developed a more modest yet significant CPP for the environment where they encountered a tennis ball. CONCLUSIONS These results indicate that OT and MDMA can augment the rewarding effects of social interaction, but also interaction with a dynamic and tactile non-social object. AVP does not condition social- or object-CPPs and may promote social proximity by inducing generalized anxiety and defensive aggregation.
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