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Vollenweider FX, Smallridge JW. Classic Psychedelic Drugs: Update on Biological
Mechanisms. PHARMACOPSYCHIATRY 2022; 55:121-138. [PMID: 35079988 PMCID: PMC9110100 DOI: 10.1055/a-1721-2914] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Renewed interest in the effects of psychedelics in the treatment of psychiatric
disorders warrants a better understanding of the neurobiological mechanisms
underlying the effects of these substances. During the past two decades,
state-of-the-art studies of animals and humans have yielded new important
insights into the molecular, cellular, and systems-level actions of psychedelic
drugs. These efforts have revealed that psychedelics affect primarily
serotonergic receptor subtypes located in cortico-thalamic and cortico-cortical
feedback circuits of information processing. Psychedelic drugs modulate
excitatory-inhibitory balance in these circuits and can participate in
neuroplasticity within brain structures critical for the integration of
information relevant to sensation, cognition, emotions, and the narrative of
self. Neuroimaging studies showed that characteristic dimensions of the
psychedelic experience obtained through subjective questionnaires as well as
alterations in self-referential processing and emotion regulation obtained
through neuropsychological tasks are associated with distinct changes in brain
activity and connectivity patterns at multiple-system levels. These recent
results suggest that changes in self-experience, emotional processing, and
social cognition may contribute to the potential therapeutic effects of
psychedelics.
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Affiliation(s)
- Franz X. Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry,
Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich,
Zurich, Switzerland
| | - John W. Smallridge
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry,
Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich,
Zurich, Switzerland
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52
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Rieser NM, Herdener M, Preller KH. Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action. Curr Top Behav Neurosci 2022; 56:187-211. [PMID: 34910289 DOI: 10.1007/7854_2021_284] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Substance use disorders (SUD) represent a significant public health issue with a high need for novel and efficacious treatment options. In light of this high unmet need, recent results reporting beneficial outcomes of psychedelic-assisted therapy in SUD are particularly relevant. However, several questions remain with regard to this treatment approach. The clinical mechanisms of action of psychedelic substances in the treatment of SUD are not well understood. Closing this knowledge gap is critical to inform and optimize the psychotherapeutic embedding of the acute substance administration. In this chapter, we discuss potential mechanisms that have implications on psychotherapeutic approaches including induced neuroplasticity, alterations in brain network connectivity, reward and emotion processing, social connectedness, insight, and mystical experiences. Furthermore, we outline considerations and approaches that leverage these mechanisms in order to optimize the therapeutic embedding by maximizing synergy between substance effects and psychotherapy. Understanding the mechanisms of action, developing psychotherapeutic approaches accordingly, and evaluating their synergistic efficacy in scientific studies will be critical to advance the framework of psychedelic-assisted therapy for addiction, create evidence-based approaches, and achieve the best treatment outcome for patients with SUD.
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Affiliation(s)
- Nathalie M Rieser
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric University Hospital Zurich, Zurich, Switzerland
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53
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Petranker R, Anderson T, Maier LJ, Barratt MJ, Ferris JA, Winstock AR. Microdosing psychedelics: Subjective benefits and challenges, substance testing behavior, and the relevance of intention. J Psychopharmacol 2022; 36:85-96. [PMID: 33591231 DOI: 10.1177/0269881120953994] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Microdosing psychedelics is the practice of taking small, sub-hallucinogenic doses of lysergic acid diethylamide or psilocybin-containing mushrooms. Despite its surging popularity, little is known about the specific intentions to start microdosing and the effects of this practice. AIMS First, we aimed to replicate previous findings regarding the subjective benefits and challenges reported for microdosing. Second, we assessed whether people who microdose test their substances before consumption. Third, we examined whether having an approach-intention to microdosing was predictive of more reported benefits. METHODS The Global Drug Survey runs the world's largest online drug survey. Participants who reported last year use of lysergic acid diethylamide or psilocybin in the Global Drug Survey 2019 were offered the opportunity to answer a sub-section on microdosing. RESULTS Data from 6753 people who reported microdosing at least once in the last 12 months were used for analyses. Our results suggest a partial replication of previously reported benefits and challenges among the present sample often reporting enhanced mood, creativity, focus and sociability. Counter to our prediction, the most common challenge participants associated with microdosing was 'None'. As predicted, most participants reported not testing their substances. Counter to our hypothesis, approach-intention - microdosing to approach a desired goal - predicted less rather than more benefits. We discuss alternate frameworks that may better capture the reasons people microdose. CONCLUSION Our results suggest the perceived benefits associated with microdosing greatly outweigh the challenges. Microdosing may have utility for a variety of uses while having minimal side effects. Double-blind, placebo-controlled experiments are required to substantiate these reports.
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Affiliation(s)
- Rotem Petranker
- Clinical Psychology, York University, Toronto, Canada.,Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada
| | - Thomas Anderson
- Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Larissa J Maier
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, United States of America.,Early Postdoc Mobility Grantee (P2ZHP1_17812), Swiss National Science Foundation, Bern, Switzerland
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Adam R Winstock
- University College London, Gower Street, London, United Kingdom.,Global Drug Survey Ltd, London, United Kingdom
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Holze F, Caluori TV, Vizeli P, Liechti ME. Safety pharmacology of acute LSD administration in healthy subjects. Psychopharmacology (Berl) 2022; 239:1893-1905. [PMID: 34515824 PMCID: PMC9166834 DOI: 10.1007/s00213-021-05978-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 11/04/2022]
Abstract
RATIONALE Lysergic acid diethylamide (LSD) is used in psychiatric and psychological research and investigated as a potential treatment for medical and psychiatric disorders, including depression, anxiety, and cluster headache. OBJECTIVES Safety data on clinical safety are available from small studies but not from larger samples. We report safety pharmacology data from a large pooled study sample on acute effects of LSD in healthy subjects. METHODS We conducted a pooled analysis of four double-blind, randomized, placebo-controlled, crossover studies that included a total of 83 healthy subjects and 131 single-dose administrations of LSD. LSD administrations were matched to dose groups according to measured LSD peak plasma concentrations to adjust for uncertainties in the correct LSD dose in some studies. Single doses were 25, 50, 100, and 200 µg of LSD base. We investigated subjective effects (self-rated any drug effect, good drug effect, bad drug effect, and anxiety), blood pressure, heart rate, body temperature, duration of the acute LSD response, acute (12 h) and subacute (24 h) adverse effects, reports of flashbacks, and liver and kidney function before and after the studies. RESULTS LSD dose-dependently increased subjective, physiologic, and adverse effects. The dose-response curves for the proportions of subjects with a certain amount of a subjective effect were steeper and reached a higher maximum for positive acute subjective effects compared with negative acute subjective effects. Maximal ratings of > 50% good drug effects were reached in 37%, 91%, 96%, and 91% of the LSD administrations at 25, 50, 100, and 200 µg. Maximal ratings of > 50% bad drug effects were reached in 0%, 9%, 27%, 31% at 25, 50, 100, and 200 µg, respectively. Mean ratings of Oceanic Boundlessness were 10%, 25%, 41%, and 44%, and mean ratings of Anxious Ego-Dissolution were 3.4%, 13%, 20%, and 22% at 25, 50, 100, and 200 µg, respectively. The physiologic effects of LSD were moderate. None of the subjects had systolic blood pressure > 180 mmHg at any time. Peak heart rate > 100 beats/min was observed in 0%, 6%, 20%, and 25% of the subjects at 25, 50, 100, and 200 µg, respectively. Maximal heart rates of 129 and 121 beats/min were observed in one subject at the 50 and 200 µg doses, respectively. Peak body temperature > 38° was observed in 0%, 11%, 7%, and 34% at 25, 50, 100, and 200 µg, respectively. Mean acute adverse effect scores on the List of Complaints were 5.6, 9.2, 12, and 13 at 25, 50, 100, and 200 µg, respectively. Kidney and liver function parameters were unaltered. Six subjects reported transient flashback phenomena. CONCLUSIONS The single-dose administration of LSD is safe in regard to acute psychological and physical harm in healthy subjects in a controlled research setting.
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Affiliation(s)
- Friederike Holze
- grid.410567.1Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, CH-4056 Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Toya V. Caluori
- grid.410567.1Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, CH-4056 Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- grid.410567.1Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, CH-4056 Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias E. Liechti
- grid.410567.1Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, CH-4056 Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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Marschall J, Fejer G, Lempe P, Prochazkova L, Kuchar M, Hajkova K, van Elk M. Psilocybin microdosing does not affect emotion-related symptoms and processing: A preregistered field and lab-based study. J Psychopharmacol 2022; 36:97-113. [PMID: 34915762 PMCID: PMC8801668 DOI: 10.1177/02698811211050556] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Microdoses of psychedelics (i.e. a sub-hallucinogenic dose taken every third day) can reduce symptoms of depression, anxiety and stress according to anecdotal reports and observational studies. Research with medium to high doses of psilocybin points towards potential underlying mechanisms, including the modulation of emotion and interoceptive processing. AIMS In this preregistered study, we investigated whether psilocybin microdoses alter self-reported interoceptive awareness and whether repeated microdosing over 3 weeks modulates emotion processing and reduces symptoms of anxiety and depression. METHODS We used a double-blind, placebo-controlled, within-subject crossover design. Participants completed the Multidimensional Assessment of Interoceptive Awareness Questionnaire 1½ h after self-administering their second dose (or placebo), and the emotional go/no-go task and the shortened Depression Anxiety Stress Scale 1½ h after self-administering their seventh dose. RESULTS Our confirmatory analyses revealed that psilocybin microdosing did not affect emotion processing or symptoms of anxiety and depression compared with placebo. Our exploratory analyses revealed that psilocybin microdosing did not affect self-reported interoceptive awareness, that symptoms of depression and stress were significantly reduced in the first block compared with baseline, that participants broke blind in the second block and that there was no effect of expectations. Further research in a substance-naïve population with clinical range anxiety and depressive symptoms is needed to substantiate the potential beneficial effects of microdosing.
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Affiliation(s)
- Josephine Marschall
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - George Fejer
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Pascal Lempe
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Luisa Prochazkova
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Martin Kuchar
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czech Republic,Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Katerina Hajkova
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czech Republic,Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Michiel van Elk
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands,Michiel van Elk, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
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Administration of N,N-dimethyltryptamine (DMT) in psychedelic therapeutics and research and the study of endogenous DMT. Psychopharmacology (Berl) 2022; 239:1749-1763. [PMID: 35064294 PMCID: PMC8782705 DOI: 10.1007/s00213-022-06065-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022]
Abstract
As with all drugs, the route, form, and/or dose of a substance administered or applied can play a defining role in its overall pharmacology and use as a therapeutic. This review will focus on these factors as they relate to the psychedelic N,N-dimethyltryptamine (DMT). It will examine the positive and negative aspects of different formulations and routes of administration of DMT and the observed effects from such administrations in the form of ayahuasca teas; oral "pharmahuasca"; injections by intravenous (IV) and intramuscular (IM) routes; inhalation, insufflation; and other routes; and high-dose, low-dose, and "micro-dose" effects. The review will consider possible oral route of administration alternatives that would not require concomitant use of a monoamine oxidase inhibitor. The review will then address the current research findings for DMT from in vivo and in vitro studies as well as the possibility that these findings may be revealing the role of endogenous DMT in normal brain function.
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57
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van Elk M, Fejer G, Lempe P, Prochazckova L, Kuchar M, Hajkova K, Marschall J. Effects of psilocybin microdosing on awe and aesthetic experiences: a preregistered field and lab-based study. Psychopharmacology (Berl) 2022; 239:1705-1720. [PMID: 33928421 PMCID: PMC9166866 DOI: 10.1007/s00213-021-05857-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
There is an increased societal trend to engage in microdosing, in which small sub-hallucinogenic amounts of psychedelics are consumed on a regular basis. Following subjective reports that microdosing enhances the experience of nature and art, in the present study we set out to study the effects of psilocybin microdosing on feelings of awe and art perception. In this preregistered combined field- and lab-based study, participants took part in a microdosing workshop after which they volunteered to self-administer a psilocybin microdose or a placebo for three consecutive weeks, while the condition was kept blind to the participants and researchers. Following a 2-week break, the condition assignment was reversed. During each block, participants visited the lab twice to measure the effects of psilocybin microdosing vs. placebo. We used standardized measures of awe, in which participants reported their experiences in response to short videos or when viewing abstract artworks from different painters. Our confirmatory analyses showed that participants felt more awe in response to videos representing funny animals and moving objects in the microdosing compared to the placebo condition. However, about two-third of our participants were breaking blind to their experimental condition. Our exploratory findings suggest that expectancy-effects may be a driving factor underlying the subjective benefits of microdosing.
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Affiliation(s)
- Michiel van Elk
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
| | - George Fejer
- grid.7177.60000000084992262Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WT Amsterdam, The Netherlands
| | - Pascal Lempe
- grid.7177.60000000084992262Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WT Amsterdam, The Netherlands
| | - Luisa Prochazckova
- grid.5132.50000 0001 2312 1970Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Martin Kuchar
- grid.448072.d0000 0004 0635 6059Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czech Republic ,grid.447902.cDepartment of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Katerina Hajkova
- grid.448072.d0000 0004 0635 6059Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Prague, Czech Republic ,grid.447902.cDepartment of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Josephine Marschall
- grid.5132.50000 0001 2312 1970Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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van den Berg M, Magaraggia I, Schreiber R, Hillhouse TM, Porter JH. How to account for hallucinations in the interpretation of the antidepressant effects of psychedelics: a translational framework. Psychopharmacology (Berl) 2022; 239:1853-1879. [PMID: 35348806 PMCID: PMC9166823 DOI: 10.1007/s00213-022-06106-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/24/2022] [Indexed: 01/02/2023]
Abstract
RATIONALE Recent trials with psychedelics in major depressive disorder and treatment-resistant depression showed remarkable improvements in depressive symptoms that can last for up to several months after even a single administration. The lack of an appropriate placebo control group-as patients are often able to discriminate the subjective effects of the drug-and an incomplete understanding of the role of the hallucinogenic and mystical experience, hampers the interpretation of these therapeutic effects. OBJECTIVES To control for these factors, we developed a translational framework based on establishing pharmacokinetic/pharmacodynamic (PK/PD) relationships in rodents and humans for hallucinogenic (i.e., discriminative stimulus effects in rodents and humans; head twitch responses in rodents; questionnaires in humans) and therapeutic effects. For the latter, we selected the pattern separation and attentional set-shifting tasks as measures for cognitive flexibility because of their high translational value. We predict that these PK/PD analyses will lead to a more objective evaluation of improvements in patients compared to relying only on the currently used self-reported questionnaires. We hypothesize that-if the role of the hallucinogenic experience is not central in the antidepressant effects of psychedelics-the ED50's for the therapeutic effects will be significantly lower than for the hallucinogenic and mystical effects. CONCLUSION Our framework will help to inform future studies that aim at the elucidation of the mechanism(s) of action of psychedelics in depression, and the role of the acute subjective and/or hallucinogenic experience in their effects.
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Affiliation(s)
- Manon van den Berg
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Igor Magaraggia
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Rudy Schreiber
- Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
| | - Todd M. Hillhouse
- Department of Psychology, University of Wisconsin Green Bay, Green Bay, WI USA
| | - Joseph H. Porter
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
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Garcia-Romeu A, Darcy S, Jackson H, White T, Rosenberg P. Psychedelics as Novel Therapeutics in Alzheimer's Disease: Rationale and Potential Mechanisms. Curr Top Behav Neurosci 2021; 56:287-317. [PMID: 34734390 DOI: 10.1007/7854_2021_267] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Serotonin 2A receptor (5-HT2AR) agonist "classic psychedelics" are drawing increasing interest as potential mental health treatments. Recent work suggests psychedelics can exert persisting anxiolytic and antidepressant effects lasting up to several months after a single administration. Data indicate acute subjective drug effects as important psychological factors involved in observed therapeutic benefits. Additionally, animal models have shown an important role for 5-HT2AR agonists in modulating learning and memory function with relevance for Alzheimer's Disease (AD) and related dementias. A number of biological mechanisms of action are under investigation to elucidate 5-HT2AR agonists' therapeutic potential, including enhanced neuroplasticity, anti-inflammatory effects, and alterations in brain functional connectivity. These diverse lines of research are reviewed here along with a discussion of AD pathophysiology and neuropsychiatric symptoms to highlight classic psychedelics as potential novel pharmacotherapies for patients with AD. Human clinical research suggests a possible role for high-dose psychedelic administration in symptomatic treatment of depressed mood and anxiety in early-stage AD. Preclinical data indicate a potential for low- or high-dose psychedelic treatment regimens to slow or reverse brain atrophy, enhance cognitive function, and slow progression of AD. In conclusion, rationale and potential approaches for preliminary research with psychedelics in patients with AD are presented, and ramifications of this line of investigation for development of novel AD treatments are discussed.
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Affiliation(s)
- Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Sean Darcy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hillary Jackson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Toni White
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Memory and Alzheimer's Treatment Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Memory and Alzheimer's Treatment Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
Classic psychedelics, including psilocybin, lysergic acid diethylamide (LSD), dimethyltryptamine, and mescaline, and entactogens/empathogens, especially 3,4-methylenedioxymethamphetamine, have received renewed attention in psychiatric research and may be developed into medications for such indications as anxiety, depression, cluster headache, and posttraumatic stress disorder, among others. However, identifying proper doses is crucial. Controlled study data on dosing using well-characterized pharmaceutical formulations of the substances are scarce. The dose equivalence of different substances, dose-response effects, and subjective effects of different doses are of great interest and practically important for their clinical use in psychotherapy. Furthermore, the so-called microdosing of psychedelics has recently gained popularity, and the first placebo-controlled studies of LSD have been published. This chapter discusses different aspects of psychedelic dosing, including pharmaceutical aspects, definitions and characteristics of different doses, including microdoses, aspects of personalized dosing, and non-pharmacological factors, that can influence the response to psychedelics.
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Carlyle M, Broomby R, Simpson G, Hannon R, Fawaz L, Mollaahmetoglu OM, Drain J, Mostazir M, Morgan CJA. A randomised, double-blind study investigating the relationship between early childhood trauma and the rewarding effects of morphine. Addict Biol 2021; 26:e13047. [PMID: 34155732 DOI: 10.1111/adb.13047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/12/2021] [Accepted: 04/13/2021] [Indexed: 12/11/2022]
Abstract
Experiences of childhood trauma (abuse and neglect) are disproportionately higher in those with opioid use disorder (OUD). Childhood trauma may affect the reinforcing and rewarding properties of opioid drugs and responses to pain, potentially via developmental changes to the endogenous opioid system. This has been supported by preclinical research, yet this has not been investigated in non-addicted humans. Physically healthy participants with either a history of severe childhood trauma or no previous history of childhood trauma attended two sessions where they received either an intramuscular active dose of morphine (0.15 mg/kg) or a very low dose control (0.01 mg/kg) in a randomised, double-blind crossover design. Sessions were held 1 week apart. Participants' physical pain threshold and tolerance were measured pre- and post-drug administration using the cold water pressor test, alongside acute subjective and behavioural responses over 2.5 h. The trauma group reported liking the effects of morphine, feeling more euphoric and wanting more of the drug over the session, as well as feeling less nauseous, dizzy, and dislike of the effects of morphine compared to the non-trauma comparison group. Morphine increased pain threshold and tolerance, yet this did not differ between the groups. Childhood trauma may therefore sensitise individuals to the pleasurable and motivational effects of opioids and reduce sensitivity to the negative effects, providing compelling evidence for individual differences in opioid reward sensitivity. This may explain the link between childhood trauma and vulnerability to OUD, with consequent implications on interventions for OUD, the prescribing of opioids, and reducing stigmas surrounding OUD.
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Affiliation(s)
- Molly Carlyle
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Rupert Broomby
- Anaesthesia & Pain Management Royal Devon and Exeter NHS Foundation Trust Exeter UK
| | - Graham Simpson
- Anaesthesia & Pain Management Royal Devon and Exeter NHS Foundation Trust Exeter UK
| | - Rachel Hannon
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Leah Fawaz
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | | | - Jade Drain
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Mohammod Mostazir
- College of Life and Environmental Sciences University of Exeter Exeter UK
| | - Celia J. A. Morgan
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
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Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM. Psychedelics and Psychedelic-Assisted Psychotherapy. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2021; 19:95-115. [PMID: 34483775 DOI: 10.1176/appi.focus.19104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 08/10/2019] [Accepted: 11/12/2019] [Indexed: 11/30/2022]
Abstract
(Reprinted with permission from The American Journal of Psychiatry 2020; 177:391-410).
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Affiliation(s)
- Collin M Reiff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Elon E Richman
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Charles B Nemeroff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Linda L Carpenter
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Alik S Widge
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Carolyn I Rodriguez
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Ned H Kalin
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - William M McDonald
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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Psiuk D, Nowak E, Cholewa K, Łopuszańska U, Samardakiewicz M. The Potential Role of Serotonergic Hallucinogens in Depression Treatment. Life (Basel) 2021; 11:life11080765. [PMID: 34440508 PMCID: PMC8400004 DOI: 10.3390/life11080765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/11/2022] Open
Abstract
Due to an increasing number of depression diagnoses and limited effective treatments, researchers continue to explore novel therapeutic strategies for this disorder. Recently, interest has revolved around the use of serotonergic psychedelics to reduce the symptoms of depression. In this systematic review, we summarize the currently available knowledge on the safety and efficacy of psychedelic substances for the treatment of depression. A literature search of the PubMed/MEDLINE database identified 14 clinical trials from the last 10 years that examined the use of psilocybin, MDMA, DMT, or LSD for the treatment of depression symptoms. Some psychedelics, especially psilocybin, demonstrated an ability to reduce depressive symptoms as measured by several psychological scales, which was often sustained for months after the last psychedelic session. Moreover, one study revealed that psilocybin has comparable efficacy to escitalopram in the treatment of depression. None of the studies reported any serious adverse events associated with psychedelic administration. The reviewed studies suggest that psychedelics have great potential in depression therapy and, after addressing and overcoming the current study limitations, may be used as a novel method of treating depression in the future.
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Psychedelic perceptions: mental health service user attitudes to psilocybin therapy. Ir J Med Sci 2021; 191:1385-1397. [PMID: 34131812 PMCID: PMC8205319 DOI: 10.1007/s11845-021-02668-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/26/2021] [Indexed: 12/18/2022]
Abstract
Introduction Despite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes. Objectives To explore mental health service user attitudes to psychedelics and psilocybin therapy. Methods A questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users. Results Ninety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued. Conclusions The majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy. Supplementary information The online version contains supplementary material available at 10.1007/s11845-021-02668-2.
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Dressler HM, Bright SJ, Polito V. Exploring the relationship between microdosing, personality and emotional insight: A prospective study. JOURNAL OF PSYCHEDELIC STUDIES 2021. [DOI: 10.1556/2054.2021.00157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AbstractBackround and aimsHaving entered the recent public and research zeitgeist, microdosing involves consuming sub-perceptual doses of psychedelic drugs, allegedly to enhance performance, creativity, and wellbeing. The results of research to date have been mixed. Whereas most studies have reported positive impacts of microdosing, some microdosers have also reported adverse effects. In addition, research to date has revealed inconsistent patterns of change in personality traits. This prospective study explored the relationship between microdosing, personality change, and emotional awareness.MethodsMeasures of personality and alexithymia were collected at two time points. 76 microdosers participated at baseline. Invitations to a follow-up survey were sent out after 31 days, and 24 participants were retained.ResultsConscientiousness increased, while neuroticism decreased across these time points (n = 24). At baseline (N = 76), neuroticism was associated with alexithymia. In addition, neuroticism correlated negatively with duration of prior microdosing experience, and extraversion correlated positively with both duration of prior microdosing experience and lifetime number of microdoses.ConclusionThese results suggest that microdosing might have an impact on otherwise stable personality traits.
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Affiliation(s)
- Hannah M. Dressler
- 1Georg Elias Mueller Institute of Psychology, University of Göttingen, Goßlerstraße 14, 37073 Göttingen, Germany
| | - Stephen J. Bright
- 2School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Vince Polito
- 3Department of Cognitive Science, Macquarie University, NSW, 2109, Australia
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Effects of Ayahuasca on the Recognition of Facial Expressions of Emotions in Naive Healthy Volunteers: A Pilot, Proof-of-Concept, Randomized Controlled Trial. J Clin Psychopharmacol 2021; 41:267-274. [PMID: 33843820 DOI: 10.1097/jcp.0000000000001396] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The recognition of emotions in facial expressions (REFE) is a core aspect of social cognition. Previous studies with the serotonergic hallucinogens lysergic acid diethylamide and psilocybin showed that these drugs reduced the recognition of negative (fear) faces in healthy volunteers. This trial assessed the acute and prolonged effects of a single dose of ayahuasca on the REFE. METHODS Twenty-two healthy volunteers participated in a pilot, proof-of-concept, randomized trial. Study variables included a REFE task performed before and 4 hours after drug intake, subjective effects (self-reports/observer impressions), tolerability measures (cardiovascular measures, self-reports), and brain-derived neurotrophic factor plasma levels. The REFE task was applied again 1, 7, 14, and 21 days and 3 months after drug intake. Stability of ayahuasca alkaloids during the study was also assessed (room temperature, 18 months). FINDINGS Compared with placebo, ayahuasca did not modify the REFE. No significant effects were observed on cardiovascular measures and brain-derived neurotrophic factor levels. Volunteers reported visual effects, tranquility/relaxation, and well-being, with few reports of transient anxiety/confusion. Ayahuasca was well tolerated, producing mainly nausea, gastrointestinal discomfort, and vomiting. A significant time-dependent deterioration of alkaloids was observed, especially for dimethyltryptamine. CONCLUSIONS Absence of significant effects on the REFE task could be due to lack of effects of ayahuasca (at the doses used), alkaloid degradation, learning effects, and the high educational level of the sample. Further trials with different samples are needed to better understand the effects of ayahuasca and other serotonergic hallucinogens on the REFE. Future trials should improve methods to guarantee the stability of ayahuasca alkaloids.
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Murphy RJ, Sumner RL, Evans W, Menkes D, Lambrecht I, Ponton R, Sundram F, Hoeh N, Ram S, Reynolds L, Muthukumaraswamy S. MDLSD: study protocol for a randomised, double-masked, placebo-controlled trial of repeated microdoses of LSD in healthy volunteers. Trials 2021; 22:302. [PMID: 33892777 PMCID: PMC8062934 DOI: 10.1186/s13063-021-05243-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 03/31/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Regular ingestion of sub-hallucinogenic doses of psychedelics, referred to as "microdosing", has gained increasing popularity and attention in the press and in online forums, with reported benefits across multiple cognitive and emotional domains. Rigorously controlled studies to date, however, have been limited in scope and have failed to produce results comparable to those reported in the grey literature. METHODS Eighty healthy male participants will receive 14 doses of placebo or 10 μg lysergic acid diethylamide orally every 3rd day over a 6-week treatment protocol. A battery of personality, creativity, mood, cognition, and EEG plasticity measures, as well as resting-state fMRI imaging, will be administered at baseline and at the end of the protocol. Creativity, mood, and plasticity measures will additionally be assessed in the acute phase of the first dose. Daily functioning will be monitored with questionnaires and a wearable sleep and activity tracker. DISCUSSION This study will rigorously examine the claims presented in the microdosing grey literature by pairing a comparable dosing protocol with objective measures. Potential therapeutic implications include future clinical trials to investigate microdosed psychedelics as a standalone treatment or as an augmentation of psychotherapy in the treatment of depression, addiction, eating disorders, obsessive-compulsive disorders, and palliative care. TRIAL REGISTRATION ACTRN12621000436875 . Registered on 19 February 2021.
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Affiliation(s)
- Robin J Murphy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
| | - Rachael L Sumner
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - William Evans
- Mana Health, 7 Ruskin St, Parnell, Auckland, 1052, New Zealand
| | - David Menkes
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, Waikato Clinical Campus, Peter Rothwell Academic Centre, University of Auckland, Pembroke Street, Hamilton, 3240, New Zealand
| | - Ingo Lambrecht
- Regional Cancer & Blood Service, Auckland District Health Board, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Rhys Ponton
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Nicholas Hoeh
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Sanya Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Lisa Reynolds
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand
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Inserra A, De Gregorio D, Rezai T, Lopez-Canul MG, Comai S, Gobbi G. Lysergic acid diethylamide differentially modulates the reticular thalamus, mediodorsal thalamus, and infralimbic prefrontal cortex: An in vivo electrophysiology study in male mice. J Psychopharmacol 2021; 35:469-482. [PMID: 33645311 PMCID: PMC8058830 DOI: 10.1177/0269881121991569] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The reticular thalamus gates thalamocortical information flow via finely tuned inhibition of thalamocortical cells in the mediodorsal thalamus. Brain imaging studies in humans show that the psychedelic lysergic acid diethylamide (LSD) modulates activity and connectivity within the cortico-striato-thalamo-cortical (CSTC) circuit, altering consciousness. However, the electrophysiological effects of LSD on the neurons in these brain areas remain elusive. METHODS We employed in vivo extracellular single-unit recordings in anesthetized adult male mice to investigate the dose-response effects of cumulative LSD doses (5-160 µg/kg, intraperitoneal) upon reticular thalamus GABAergic neurons, thalamocortical relay neurons of the mediodorsal thalamus, and pyramidal neurons of the infralimbic prefrontal cortex. RESULTS LSD decreased spontaneous firing and burst-firing activity in 50% of the recorded reticular thalamus neurons in a dose-response fashion starting at 10 µg/kg. Another population of neurons (50%) increased firing and burst-firing activity starting at 40 µg/kg. This modulation was accompanied by an increase in firing and burst-firing activity of thalamocortical neurons in the mediodorsal thalamus. On the contrary, LSD excited infralimbic prefrontal cortex pyramidal neurons only at the highest dose tested (160 µg/kg). The dopamine D2 receptor (D2) antagonist haloperidol administered after LSD increased burst-firing activity in the reticular thalamus neurons inhibited by LSD, decreased firing and burst-firing activity in the mediodorsal thalamus, and showed a trend towards further increasing the firing activity of neurons of the infralimbic prefrontal cortex. CONCLUSION LSD modulates firing and burst-firing activity of reticular thalamus neurons and disinhibits mediodorsal thalamus relay neurons at least partially in a D2-mediated fashion. These effects of LSD on thalamocortical gating could explain its consciousness-altering effects in humans.
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Affiliation(s)
- Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Canada
| | - Danilo De Gregorio
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Canada
| | - Tamim Rezai
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Stefano Comai
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Canada
- IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milano, Italy
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Canada
- McGill University Health Center, Montreal, Qc, Canada
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Ramaekers JG, Hutten N, Mason NL, Dolder P, Theunissen EL, Holze F, Liechti ME, Feilding A, Kuypers KPC. A low dose of lysergic acid diethylamide decreases pain perception in healthy volunteers. J Psychopharmacol 2021; 35:398-405. [PMID: 32842825 PMCID: PMC8054163 DOI: 10.1177/0269881120940937] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lysergic acid diethylamide (LSD) is an ergot alkaloid derivative with psychedelic properties that has been implicated in the management of persistent pain. Clinical studies in the 1960s and 1970s have demonstrated profound analgesic effects of full doses of LSD in terminally ill patients, but this line of research evaporated after LSD was scheduled worldwide. AIM The present clinical study is the first to revisit the potential of LSD as an analgesic, and at dose levels which are not expected to produce profound mind-altering effects. METHODS Twenty-four healthy volunteers received single doses of 5, 10 and 20 µg LSD as well as placebo on separate occasions. A Cold Pressor Test was administered at 1.5 and 5 h after treatment administration to assess pain tolerance to experimentally evoked pain. Ratings of dissociation and psychiatric symptoms as well as assessments of vital signs were included to monitor mental status as well as safety during treatments. RESULTS LSD 20 µg significantly increased the time that participants were able to tolerate exposure to cold (3°C) water and decreased their subjective levels of experienced pain and unpleasantness. LSD elevated mean blood pressure within the normal range and slightly increased ratings of dissociation, anxiety and somatization. CONCLUSION The present study provides evidence of a protracted analgesic effect of LSD at a dose that is low enough to avoid a psychedelic experience. The present data warrant further research into the analgesic effects of low doses of LSD in patient populations.
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Affiliation(s)
- Johannes G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Nadia Hutten
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Natasha L Mason
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Patrick Dolder
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Friederike Holze
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Kim PC Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
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Abstract
A citizen science approach to research has shown that the improvements in mood and cognition associated with psychedelic microdosing are likely due to a placebo effect.
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Affiliation(s)
- Lindsay P Cameron
- Graduate Program in Neuroscience, University of California, Davis, Davis, United States
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Szigeti B, Kartner L, Blemings A, Rosas F, Feilding A, Nutt DJ, Carhart-Harris RL, Erritzoe D. Self-blinding citizen science to explore psychedelic microdosing. eLife 2021; 10:e62878. [PMID: 33648632 PMCID: PMC7925122 DOI: 10.7554/elife.62878] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022] Open
Abstract
Microdosing is the practice of regularly using low doses of psychedelic drugs. Anecdotal reports suggest that microdosing enhances well-being and cognition; however, such accounts are potentially biased by the placebo effect. This study used a 'self-blinding' citizen science initiative, where participants were given online instructions on how to incorporate placebo control into their microdosing routine without clinical supervision. The study was completed by 191 participants, making it the largest placebo-controlled trial on psychedelics to-date. All psychological outcomes improved significantly from baseline to after the 4 weeks long dose period for the microdose group; however, the placebo group also improved and no significant between-groups differences were observed. Acute (emotional state, drug intensity, mood, energy, and creativity) and post-acute (anxiety) scales showed small, but significant microdose vs. placebo differences; however, these results can be explained by participants breaking blind. The findings suggest that anecdotal benefits of microdosing can be explained by the placebo effect.
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Affiliation(s)
- Balázs Szigeti
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Laura Kartner
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Allan Blemings
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
| | - Fernando Rosas
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Data Science Institute, Imperial College LondonLondonUnited Kingdom
- Center for Complexity Science, Imperial College LondonLondonUnited Kingdom
| | | | - David J Nutt
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Centre for Psychiatry, Imperial College LondonLondonUnited Kingdom
| | | | - David Erritzoe
- Centre for Psychedelic Research, Imperial College LondonLondonUnited Kingdom
- Centre for Psychiatry, Imperial College LondonLondonUnited Kingdom
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Bright S, Gringart E, Blatchford E, Bettinson S. A quantitative exploration of the relationships between regular yoga practice, microdosing psychedelics, wellbeing and personality variables. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1882266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Stephen Bright
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Eyal Gringart
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | - Emily Blatchford
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Healy CJ. The acute effects of classic psychedelics on memory in humans. Psychopharmacology (Berl) 2021; 238:639-653. [PMID: 33420592 DOI: 10.1007/s00213-020-05756-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/28/2020] [Indexed: 12/14/2022]
Abstract
RATIONALE Memory plays a central role in the psychedelic experience. The spontaneous recall and immersive reliving of autobiographical memories has frequently been noted by researchers and clinicians as a salient phenomenon in the profile of subjective effects of classic psychedelic drugs such as psilocybin, LSD, and ayahuasca. The ability for psychedelics to provoke vivid memories has been considered important to their clinical efficacy. OBJECTIVE This review aims to examine and aggregate the findings from experimental, observational, and qualitative studies on the acute modulation of memory by classic psychedelics in humans. METHOD A literature search was conducted using PubMed and PsycInfo as well as manual review of references from eligible studies. Publications reporting quantitative and/or qualitative findings were included; animal studies and case reports were excluded. RESULTS Classic psychedelics produce dose-dependently increasing impairments in memory task performance, such that low doses produce no impairment and higher doses produce increasing levels of impairment. This pattern has been observed in tasks assessing spatial and verbal working memory, semantic memory, and non-autobiographical episodic memory. Such impairments may be less pronounced among experienced psychedelic users. Classic psychedelics also increase the vividness of autobiographical memories and frequently stimulate the recall and/or re-experiencing of autobiographical memories, often memories that are affectively intense (positively or negatively valenced) and that had been avoided and/or forgotten prior to the experience. CONCLUSIONS Classic psychedelics dose-dependently impair memory task performance but may enhance autobiographical memory. These findings are relevant to the understanding of psychological mechanisms of action of psychedelic-assisted psychotherapy.
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Affiliation(s)
- C J Healy
- Department of Psychology, The New School for Social Research, 80 5th Ave, 6th Floor, New York, NY, USA.
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Holze F, Vizeli P, Ley L, Müller F, Dolder P, Stocker M, Duthaler U, Varghese N, Eckert A, Borgwardt S, Liechti ME. Acute dose-dependent effects of lysergic acid diethylamide in a double-blind placebo-controlled study in healthy subjects. Neuropsychopharmacology 2021; 46:537-544. [PMID: 33059356 PMCID: PMC8027607 DOI: 10.1038/s41386-020-00883-6] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/18/2020] [Accepted: 09/26/2020] [Indexed: 12/11/2022]
Abstract
Growing interest has been seen in using lysergic acid diethylamide (LSD) in psychiatric research and therapy. However, no modern studies have evaluated subjective and autonomic effects of different and pharmaceutically well-defined doses of LSD. We used a double-blind, randomized, placebo-controlled, crossover design in 16 healthy subjects (eight women, eight men) who underwent six 25 h sessions and received placebo, LSD (25, 50, 100, and 200 µg), and 200 µg LSD 1 h after administration of the serotonin 5-hydroxytryptamine-2A (5-HT2A) receptor antagonist ketanserin (40 mg). Test days were separated by at least 10 days. Outcome measures included self-rating scales that evaluated subjective effects, autonomic effects, adverse effects, plasma brain-derived neurotrophic factor levels, and pharmacokinetics up to 24 h. The pharmacokinetic-subjective response relationship was evaluated. LSD showed dose-proportional pharmacokinetics and first-order elimination and dose-dependently induced subjective responses starting at the 25 µg dose. A ceiling effect was observed for good drug effects at 100 µg. The 200 µg dose of LSD induced greater ego dissolution than the 100 µg dose and induced significant anxiety. The average duration of subjective effects increased from 6.7 to 11 h with increasing doses of 25-200 µg. LSD moderately increased blood pressure and heart rate. Ketanserin effectively prevented the response to 200 µg LSD. The LSD dose-response curve showed a ceiling effect for subjective good effects, and ego dissolution and anxiety increased further at a dose above 100 µg. These results may assist with dose finding for future LSD research. The full psychedelic effects of LSD are primarily mediated by serotonin 5-HT2A receptor activation.
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Affiliation(s)
- Friederike Holze
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Laura Ley
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Felix Müller
- grid.6612.30000 0004 1937 0642Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Patrick Dolder
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Melanie Stocker
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Urs Duthaler
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Nimmy Varghese
- grid.6612.30000 0004 1937 0642Psychiatric University Hospital, University of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Anne Eckert
- grid.6612.30000 0004 1937 0642Psychiatric University Hospital, University of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- grid.6612.30000 0004 1937 0642Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Matthias E. Liechti
- grid.410567.1Department of Biomedicine and Department of Clinical Research, Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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Galvão-Coelho NL, Marx W, Gonzalez M, Sinclair J, de Manincor M, Perkins D, Sarris J. Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants. Psychopharmacology (Berl) 2021; 238:341-354. [PMID: 33427944 PMCID: PMC7826317 DOI: 10.1007/s00213-020-05719-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE Major depressive disorder is one of the leading global causes of disability, for which the classic serotonergic psychedelics have recently reemerged as a potential therapeutic treatment option. OBJECTIVE We present the first meta-analytic review evaluating the clinical effects of classic serotonergic psychedelics vs placebo for mood state and symptoms of depression in both healthy and clinical populations (separately). RESULTS Our search revealed 12 eligible studies (n = 257; 124 healthy participants, and 133 patients with mood disorders), with data from randomized controlled trials involving psilocybin (n = 8), lysergic acid diethylamide ([LSD]; n = 3), and ayahuasca (n = 1). The meta-analyses of acute mood outcomes (3 h to 1 day after treatment) for healthy volunteers and patients revealed improvements with moderate significant effect sizes in favor of psychedelics, as well as for the longer-term (16 to 60 days after treatments) mood state of patients. For patients with mood disorder, significant effect sizes were detected on the acute, medium (2-7 days after treatment), and longer-term outcomes favoring psychedelics on the reduction of depressive symptoms. CONCLUSION Despite the concerns over unblinding and expectancy, the strength of the effect sizes, fast onset, and enduring therapeutic effects of these psychotherapeutic agents encourage further double-blind, placebo-controlled clinical trials assessing them for management of negative mood and depressive symptoms.
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Affiliation(s)
- Nicole L Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
- Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil.
- NICM Health Research Institute, Western Sydney University, Westmead, Australia.
- Departamento de Fisiologia e Comportamento, Universidade Federal do Rio Grande do Norte, Caixa Postal, 1511, CEP: 59078-970, Natal, RN, Brasil.
| | - Wolfgang Marx
- IMPACT Research Institute, School of Medicine, Deakin University, Geelong, Australia
| | - Maria Gonzalez
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Michael de Manincor
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Daniel Perkins
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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76
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Kaertner LS, Steinborn MB, Kettner H, Spriggs MJ, Roseman L, Buchborn T, Balaet M, Timmermann C, Erritzoe D, Carhart-Harris RL. Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing. Sci Rep 2021; 11:1941. [PMID: 33479342 PMCID: PMC7820236 DOI: 10.1038/s41598-021-81446-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022] Open
Abstract
Psychedelic microdosing describes the ingestion of near-threshold perceptible doses of classic psychedelic substances. Anecdotal reports and observational studies suggest that microdosing may promote positive mood and well-being, but recent placebo-controlled studies failed to find compelling evidence for this. The present study collected web-based mental health and related data using a prospective (before, during and after) design. Individuals planning a weekly microdosing regimen completed surveys at strategic timepoints, spanning a core four-week test period. Eighty-one participants completed the primary study endpoint. Results revealed increased self-reported psychological well-being, emotional stability and reductions in state anxiety and depressive symptoms at the four-week primary endpoint, plus increases in psychological resilience, social connectedness, agreeableness, nature relatedness and aspects of psychological flexibility. However, positive expectancy scores at baseline predicted subsequent improvements in well-being, suggestive of a significant placebo response. This study highlights a role for positive expectancy in predicting positive outcomes following psychedelic microdosing and cautions against zealous inferences on its putative therapeutic value.
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Affiliation(s)
- L S Kaertner
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK.
| | - M B Steinborn
- Departmant of Psychology, Julius-Maximilans-University Würzburg, Würzburg, Germany
| | - H Kettner
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - M J Spriggs
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - L Roseman
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - T Buchborn
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - M Balaet
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, London, UK
| | - C Timmermann
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - D Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
| | - R L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Imperial College London, London, UK
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Mertens LJ, Preller KH. Classical Psychedelics as Therapeutics in Psychiatry - Current Clinical Evidence and Potential Therapeutic Mechanisms in Substance Use and Mood Disorders. PHARMACOPSYCHIATRY 2021; 54:176-190. [PMID: 33472250 DOI: 10.1055/a-1341-1907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Classical psychedelics, primarily psilocybin and lysergic acid diethylamide (LSD), have been used and extensively studied in Western medicine as part of substance-assisted psychotherapy in the 1950s and 1960s. Modern clinical research is currently gaining momentum and provides new evidence for the safety and efficacy of classical psychedelics (primarily psilocybin, but also LSD and ayahuasca) in the treatment of different psychiatric conditions, including substance use and mood disorders.In this review article, we outline common pathological mechanisms of substance use disorders (SUD) and unipolar depression. Next, the current literature on the effects of psychedelics is summarized in order to generate hypotheses regarding their potential therapeutic mechanisms of action in treating these psychiatric conditions. Finally, we review and discuss clinical trials published since 2011 investigating the effects of psychedelics in SUD and depression.While results from those modern clinical trials are promising, most of them do not meet the methodological requirements to allow firm conclusions on the clinical efficacy of psychedelics. Larger, blinded, randomized controlled trials (RCT) with clearly defined patient groups and well-defined primary endpoints are needed. Additionally, the therapeutic mechanisms of classical psychedelics are currently unknown. This review presents hypotheses derived from preclinical and human studies that need to be tested in future trials to better understand the clinical potential of psychedelic substances in modern psychiatry.
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Affiliation(s)
- Lea J Mertens
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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78
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Biosynthesis, total synthesis, and biological profiles of Ergot alkaloids. THE ALKALOIDS: CHEMISTRY AND BIOLOGY 2021; 85:1-112. [DOI: 10.1016/bs.alkal.2020.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Inserra A, De Gregorio D, Gobbi G. Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms. Pharmacol Rev 2020; 73:202-277. [PMID: 33328244 DOI: 10.1124/pharmrev.120.000056] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mounting evidence suggests safety and efficacy of psychedelic compounds as potential novel therapeutics in psychiatry. Ketamine has been approved by the Food and Drug Administration in a new class of antidepressants, and 3,4-methylenedioxymethamphetamine (MDMA) is undergoing phase III clinical trials for post-traumatic stress disorder. Psilocybin and lysergic acid diethylamide (LSD) are being investigated in several phase II and phase I clinical trials. Hence, the concept of psychedelics as therapeutics may be incorporated into modern society. Here, we discuss the main known neurobiological therapeutic mechanisms of psychedelics, which are thought to be mediated by the effects of these compounds on the serotonergic (via 5-HT2A and 5-HT1A receptors) and glutamatergic [via N-methyl-d-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors] systems. We focus on 1) neuroplasticity mediated by the modulation of mammalian target of rapamycin-, brain-derived neurotrophic factor-, and early growth response-related pathways; 2) immunomodulation via effects on the hypothalamic-pituitary-adrenal axis, nuclear factor ĸB, and cytokines such as tumor necrosis factor-α and interleukin 1, 6, and 10 production and release; and 3) modulation of serotonergic, dopaminergic, glutamatergic, GABAergic, and norepinephrinergic receptors, transporters, and turnover systems. We discuss arising concerns and ways to assess potential neurobiological changes, dependence, and immunosuppression. Although larger cohorts are required to corroborate preliminary findings, the results obtained so far are promising and represent a critical opportunity for improvement of pharmacotherapies in psychiatry, an area that has seen limited therapeutic advancement in the last 20 years. Studies are underway that are trying to decouple the psychedelic effects from the therapeutic effects of these compounds. SIGNIFICANCE STATEMENT: Psychedelic compounds are emerging as potential novel therapeutics in psychiatry. However, understanding of molecular mechanisms mediating improvement remains limited. This paper reviews the available evidence concerning the effects of psychedelic compounds on pathways that modulate neuroplasticity, immunity, and neurotransmitter systems. This work aims to be a reference for psychiatrists who may soon be faced with the possibility of prescribing psychedelic compounds as medications, helping them assess which compound(s) and regimen could be most useful for decreasing specific psychiatric symptoms.
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Affiliation(s)
- Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Danilo De Gregorio
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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80
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Goldberg SB, Shechet B, Nicholas C, Ng CW, Deole G, Chen Z, Raison C. Post-acute psychological effects of classical serotonergic psychedelics: a systematic review and meta-analysis. Psychol Med 2020; 50:2655-2666. [PMID: 33143790 PMCID: PMC7855004 DOI: 10.1017/s003329172000389x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Scientific interest in the therapeutic effects of classical psychedelics has increased in the past two decades. The psychological effects of these substances outside the period of acute intoxication have not been fully characterized. This study aimed to: (1) quantify the effects of psilocybin, ayahuasca, and lysergic acid diethylamide (LSD) on psychological outcomes in the post-acute period; (2) test moderators of these effects; and (3) evaluate adverse effects and risk of bias. METHODS We conducted a systematic review and meta-analysis of experimental studies (single-group pre-post or randomized controlled trials) that involved administration of psilocybin, ayahuasca, or LSD to clinical or non-clinical samples and assessed psychological outcomes ⩾24 h post-administration. Effects were summarized by study design, timepoint, and outcome domain. RESULTS A total of 34 studies (24 unique samples, n = 549, mean longest follow-up = 55.34 weeks) were included. Classical psychedelics showed significant within-group pre-post and between-group placebo-controlled effects on a range of outcomes including targeted symptoms within psychiatric samples, negative and positive affect-related measures, social outcomes, and existential/spiritual outcomes, with large between-group effect in these domains (Hedges' gs = 0.84 to 1.08). Moderator tests suggest some effects may be larger in clinical samples. Evidence of effects on big five personality traits and mindfulness was weak. There was no evidence of post-acute adverse effects. CONCLUSIONS High risk of bias in several domains, heterogeneity across studies, and indications of publication bias for some models highlight the need for careful, large-scale, placebo-controlled randomized trials.
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Affiliation(s)
- Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin – Madison, Madison, WI, USA
| | - Benjamin Shechet
- Department of Counseling Psychology, University of Wisconsin – Madison, Madison, WI, USA
| | - Christopher Nicholas
- Department of Family Medicine and Community Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Chi Wing Ng
- Department of Counseling Psychology, University of Wisconsin – Madison, Madison, WI, USA
| | - Geetanjali Deole
- Department of Counseling Psychology, University of Wisconsin – Madison, Madison, WI, USA
| | - Zhuofan Chen
- Department of Counseling Psychology, University of Wisconsin – Madison, Madison, WI, USA
| | - Charles Raison
- School of Human Ecology, University of Wisconsin – Madison, Madison, WI, USA
- Usona Institute, Fitchberg, WI, USA
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Hutten NRPW, Mason NL, Dolder PC, Theunissen EL, Holze F, Liechti ME, Feilding A, Ramaekers JG, Kuypers KPC. Mood and cognition after administration of low LSD doses in healthy volunteers: A placebo controlled dose-effect finding study. Eur Neuropsychopharmacol 2020; 41:81-91. [PMID: 33082016 DOI: 10.1016/j.euroneuro.2020.10.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/28/2020] [Accepted: 10/03/2020] [Indexed: 01/10/2023]
Abstract
There is a popular interest in microdosing with psychedelics such as LSD. This practice of using one-tenth of a full psychedelic dose according to a specific dosing schedule, anecdotally enhances mood and performance. Nonetheless, controlled research on the efficacy of microdosing is scarce. The main objective of the present dose-finding study was to determine the minimal dose of LSD needed to affect mood and cognition. A placebo-controlled within-subject study including 24 healthy participants, was conducted to assess the acute effects of three LSD doses (5, 10, and 20 mcg) on measures of cognition, mood, and subjective experience, up until 6 h after administration. Cognition and subjective experience were assessed using the Psychomotor Vigilance Task, Digit Symbol Substitution Test, Cognitive Control Task, Profile of Mood States, and 5-Dimensional Altered States of Consciousness rating scale. LSD showed positive effects in the majority of observations by increasing positive mood (20 mcg), friendliness (5, 20 mcg), arousal (5 mcg), and decreasing attentional lapses (5, 20 mcg). Negative effects manifested as an increase in confusion (20 mcg) and anxiety (5, 20 mcg). Psychedelic-induced changes in waking consciousness were also present (10, 20 mcg). Overall, the present study demonstrated selective, beneficial effects of low doses of LSD on mood and cognition in the majority of observations. The minimal LSD dose at which subjective and performance effects are notable is 5 mcg and the most apparent effects were visible after 20 mcg.
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Affiliation(s)
- Nadia R P W Hutten
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Natasha L Mason
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Patrick C Dolder
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Friederike Holze
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Johannes G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kim P C Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands
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Holze F, Liechti ME, Hutten NRPW, Mason NL, Dolder PC, Theunissen EL, Duthaler U, Feilding A, Ramaekers JG, Kuypers KPC. Pharmacokinetics and Pharmacodynamics of Lysergic Acid Diethylamide Microdoses in Healthy Participants. Clin Pharmacol Ther 2020; 109:658-666. [PMID: 32975835 PMCID: PMC7984326 DOI: 10.1002/cpt.2057] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/12/2020] [Indexed: 12/29/2022]
Abstract
“Microdoses” of lysergic acid diethylamide (LSD) are used recreationally to enhance mood and cognition. Increasing interest has also been seen in developing LSD into a medication. Therefore, we performed a pharmacokinetic‐pharmacodynamic study using very low doses of LSD. Single doses of LSD base (5, 10, and 20 µg) and placebo were administered in a double‐blind, randomized, placebo‐controlled crossover study in 23 healthy participants. Test days were separated by at least 5 days. Plasma levels of LSD and subjective effects were assessed up to 6 hours after administration. Pharmacokinetic parameters were determined using compartmental modeling. Concentration‐subjective effect relationships were described using pharmacokinetic‐pharmacodynamic modeling. Mean (95% confidence interval) maximal LSD concentrations were 151 pg/mL (127–181), 279 pg/mL (243–320), and 500 pg/mL (413–607) after 5, 10, and 20 µg LSD administration, respectively. Maximal concentrations were reached after 1.1 hours. The mean elimination half‐life was 2.7 hours (1.5–6.2). The 5 µg dose of LSD elicited no significant acute subjective effects. The 10 µg dose of LSD significantly increased ratings of “under the influence” and “good drug effect” compared with placebo. These effects began an average of 1.1 hours after 10 µg LSD administration, peaked at 2.5 hours, and ended at 5.1 hours. The 20 µg dose of LSD significantly increased ratings of “under the influence,” “good drug effects,” and “bad drug effects.” LSD concentrations dose‐proportionally increased at doses as low as 5–20 µg and decreased with a half‐life of 3 hours. The threshold dose of LSD base for psychotropic effects was 10 µg.
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Affiliation(s)
- Friederike Holze
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Nadia R P W Hutten
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Natasha L Mason
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Patrick C Dolder
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Urs Duthaler
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Johannes G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kim P C Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands
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Potential safety, benefits, and influence of the placebo effect in microdosing psychedelic drugs: A systematic review. Neurosci Biobehav Rev 2020; 119:194-203. [PMID: 33031815 DOI: 10.1016/j.neubiorev.2020.09.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/24/2020] [Accepted: 09/25/2020] [Indexed: 02/08/2023]
Abstract
Microdosing psychedelic drugs-that is, taking sub-behavioral doses of lysergic acid diethylamide (LSD) or psilocybin-is a growing practice in Western societies. Taken mainly for creative or mood-enhancing purposes, thousands of users are increasingly being exposed to (micro)doses of psychedelic drugs. In this systematic review, we searched the available evidence from human studies, focusing our results in terms of three main axes: efficacy, safety, and the influence of the placebo effect in microdosing practices. While the available evidence has some strengths (e.g. large sample sizes, robust methodologies) there are also remarkable limitations (e.g. gender bias, heterogeneity of dosing schedules and drugs used). Highly contradictory results have been found, showing both the benefits and detriments of microdosing in terms of mood, creative processes, and energy, among other regards. This review provides a general overview of the methods and approaches used, which could be useful for improving future studies.
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84
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Kuypers KP. The therapeutic potential of microdosing psychedelics in depression. Ther Adv Psychopharmacol 2020; 10:2045125320950567. [PMID: 32922736 PMCID: PMC7457631 DOI: 10.1177/2045125320950567] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/21/2020] [Indexed: 12/21/2022] Open
Abstract
Microdosing psychedelics is the repeated use of small doses of, for example, lysergic acid diethylamide (LSD) and psilocybin, typically for a few weeks. Despite the popular and scientific attention in recent years, and claims by users that it has therapeutic value in affective disorders like depression, little scientific knowledge is available to back this. The purpose of this review was to investigate whether there are scientific grounds to state that this practice could be helpful in the treatment of affective disorders, and safe to use repeatedly. To that end, the literature (PubMed, MedLine) was searched, looking for (controlled) experimental studies with low doses of LSD and/or psilocybin, in healthy volunteers and patient samples. After a selection process and the addition of relevant articles, 14 experimental studies entered this review. Findings show that both LSD (10-20 mcg) and psilocybin (<1-3 mg) have subtle (positive) effects on cognitive processes (time perception, convergent and divergent thinking) and brain regions involved in affective processes. Besides the pleasant experience, increased anxiety and a cycling pattern of depressive and euphoric mood were also found. With regard to safety, it was demonstrated that low doses are well tolerated (in healthy volunteers) and have no-to-minimal effects on physiological measures. While it is yet unclear whether psychedelic microdosing is of therapeutic value for depression, the aforementioned effects on selective processes suggest that low doses of psychedelics could play a role in depression by inducing some kind of cognitive flexibility, which might lead to decreased rumination. While previous studies were conducted mostly in small samples of healthy volunteers, future placebo-controlled clinical trials in depressed patients are required to understand the therapeutic value of microdosing psychedelics, how this differs from therapy using full psychedelic doses, and whether different psychedelics have different effect patterns. The proposed research will give new insights into the potential of future alternative psychiatric treatment forms that are fiercely needed.
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Affiliation(s)
- Kim P.C. Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, PB 616, 6200 MD, the Netherlands
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85
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Vann Jones SA, O’Kelly A. Psychedelics as a Treatment for Alzheimer's Disease Dementia. Front Synaptic Neurosci 2020; 12:34. [PMID: 32973482 PMCID: PMC7472664 DOI: 10.3389/fnsyn.2020.00034] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022] Open
Abstract
Currently, there are no disease-modifying treatments for Alzheimer's disease (AD) or any other dementia subtype. The renaissance in psychedelic research in recent years, in particular studies involving psilocybin and lysergic acid diethylamide (LSD), coupled with anecdotal reports of cognitive benefits from micro-dosing, suggests that they may have a therapeutic role in a range of psychiatric and neurological conditions due to their potential to stimulate neurogenesis, provoke neuroplastic changes and reduce neuroinflammation. This inevitably makes them interesting candidates for therapeutics in dementia. This mini-review will look at the basic science and current clinical evidence for the role of psychedelics in treating dementia, especially early AD, with a particular focus on micro-dosing of the classical psychedelics LSD and psilocybin.
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Carbonaro TM, Johnson MW, Griffiths RR. Subjective features of the psilocybin experience that may account for its self-administration by humans: a double-blind comparison of psilocybin and dextromethorphan. Psychopharmacology (Berl) 2020; 237:2293-2304. [PMID: 32500212 PMCID: PMC10013695 DOI: 10.1007/s00213-020-05533-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
RATIONALE Although both psilocybin and dextromethorphan (DXM) produce psychedelic-like subjective effects, rates of non-medical use of psilocybin are consistently greater than DXM. OBJECTIVE New data are presented from a study of psilocybin and DXM relevant to understanding the features of psilocybin subjective effects that may account for its higher rates of non-medical use. METHODS Single, acute oral doses of psilocybin (10, 20, 30 mg/70 kg), DXM (400 mg/70 kg), and placebo were administered under double-blind conditions to 20 healthy participants with histories of hallucinogen use. RESULTS High doses of both drugs produced similar time courses and increases in participant ratings of peak overall drug effect strength. Nine subjective effect domains are proposed to be related to the reinforcing effects of psilocybin: liking, visual effects, positive mood, insight, positive social effects, increased awareness of beauty (both visual and music), awe/amazement, meaningfulness, and mystical experience. For most ratings, (1) psilocybin and DXM both produced effects significantly greater than placebo; (2) psilocybin showed dose-related increases; 3, DXM was never significantly higher than psilocybin; (4) the two highest psilocybin doses were significantly greater than DXM. These differences were consistent with two measures of desire to take the drug condition again. CONCLUSIONS This analysis provides new information about domains of psilocybin subjective effects proposed to be related to its reinforcing effects (alternatively described as the "motivation" to use). Observed differences on these domains between psilocybin and DXM are consistent with the relative rates of non-medical use of psilocybin and DXM.
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Affiliation(s)
- Theresa M Carbonaro
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224-6823, USA
| | - Matthew W Johnson
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224-6823, USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224-6823, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224-6823, USA.
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87
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Rosenbaum D, Weissman C, Anderson T, Petranker R, Dinh-Williams LA, Hui K, Hapke E. Microdosing psychedelics: Demographics, practices, and psychiatric comorbidities. J Psychopharmacol 2020; 34:612-622. [PMID: 32108529 DOI: 10.1177/0269881120908004] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
RATIONALE Microdosing psychedelics - the practice of consuming small, sub-hallucinogenic doses of substances such as LSD or psilocybin - is gaining attention in popular media but remains poorly characterized. Contemporary studies of psychedelic microdosing have yet to report the basic psychiatric descriptors of psychedelic microdosers. OBJECTIVES To examine the practices and demographics of a population of psychedelic microdosers - including their psychiatric diagnoses, prescription medications, and recreational substance use patterns - to develop a foundation on which to conduct future clinical research. METHODS Participants (n = 909; Mage = 26.9, SD = 8.6; male = 83.2%; White/European = 79.1%) recruited primarily from the online forum Reddit completed an anonymous online survey. Respondents who reported using LSD, psilocybin, or both for microdosing were grouped and compared with non-microdosing respondents using exploratory odds ratio testing on demographic variables, rates of psychiatric diagnoses, and past-year recreational substance use. RESULTS Of microdosers, most reported using LSD (59.3%; Mdose = 13 mcg, or 11.3% of one tab) or psilocybin (25.9%; Mdose = 0.3 g of dried psilocybin mushrooms) on a one-day-on, two-days-off schedule. Compared with non-microdosers, microdosers were significantly less likely to report a history of substance use disorders (SUDs; OR = 0.17 (95% CI: 0.05-0.56)) or anxiety disorders (OR = 0.61 (95% CI: 0.41-0.91)). Microdosers were also more likely to report recent recreational substance use compared with non-microdosers (OR = 5.2 (95% CI: 2.7-10.8)). CONCLUSIONS Well-designed randomized controlled trials are needed to evaluate the safety and tolerability of this practice in clinical populations and to test claims about potential benefits.
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Affiliation(s)
- Daniel Rosenbaum
- Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada
| | - Cory Weissman
- Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada
| | | | | | | | - Katrina Hui
- Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada
| | - Emma Hapke
- Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada
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88
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Bornemann J. The Viability of Microdosing Psychedelics as a Strategy to Enhance Cognition and Well-being - An Early Review. J Psychoactive Drugs 2020; 52:300-308. [PMID: 32362269 DOI: 10.1080/02791072.2020.1761573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Psychedelic substances are currently experiencing a renaissance in interest for both therapeutic as well as recreational applications. It has been proposed that microdosing, i.e., ingesting sub-perceptual doses of a psychedelic, could confer some of the benefits of these substances to users while minimizing the risks associated with full-dose use. This review aimed to summarize and examine the extant literature on psychedelic microdosing. Exploratory evidence published to date indicates a variety of benefits reported by microdosers including improvements in mood, focus, and creativity, with some null reports, and a minority of people reporting selective negative consequences such as increased anxiety and physiological discomfort. Methodological limitations of current evidence, however, make definitive conclusions hard to draw. Recommendations for future research are given.
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Affiliation(s)
- Joel Bornemann
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam , Rotterdam, The Netherlands
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89
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Olson JA, Suissa-Rocheleau L, Lifshitz M, Raz A, Veissière SPL. Tripping on nothing: placebo psychedelics and contextual factors. Psychopharmacology (Berl) 2020; 237:1371-1382. [PMID: 32144438 DOI: 10.1007/s00213-020-05464-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/16/2020] [Indexed: 01/11/2023]
Abstract
RATIONALE Is it possible to have a psychedelic experience from a placebo alone? Most psychedelic studies find few effects in the placebo control group, yet these effects may have been obscured by the study design, setting, or analysis decisions. OBJECTIVE We examined individual variation in placebo effects in a naturalistic environment resembling a typical psychedelic party. METHODS Thirty-three students completed a single-arm study ostensibly examining how a psychedelic drug affects creativity. The 4-h study took place in a group setting with music, paintings, coloured lights, and visual projections. Participants consumed a placebo that we described as a drug resembling psilocybin, which is found in psychedelic mushrooms. To boost expectations, confederates subtly acted out the stated effects of the drug and participants were led to believe that there was no placebo control group. The participants later completed the 5-Dimensional Altered States of Consciousness Rating Scale, which measures changes in conscious experience. RESULTS There was considerable individual variation in the placebo effects; many participants reported no changes while others showed effects with magnitudes typically associated with moderate or high doses of psilocybin. In addition, the majority (61%) of participants verbally reported some effect of the drug. Several stated that they saw the paintings on the walls "move" or "reshape" themselves, others felt "heavy… as if gravity [had] a stronger hold", and one had a "come down" before another "wave" hit her. CONCLUSION Understanding how context and expectations promote psychedelic-like effects, even without the drug, will help researchers to isolate drug effects and clinicians to maximise their therapeutic potential.
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Affiliation(s)
- Jay A Olson
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
| | - Léah Suissa-Rocheleau
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montreal, QC, H3A 1G1, Canada
| | - Michael Lifshitz
- Department of Anthropology, Stanford University, Main Quad, Building 50, 450 Serra Mall, Stanford, CA, 94305, USA
| | - Amir Raz
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.,Institute for Interdisciplinary Behavioral and Brain Sciences, Chapman University, 9401 Jeronimo Road, Irvine, CA, 92618, USA
| | - Samuel P L Veissière
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.,Culture, Mind, and Brain Lab, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
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Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, Kalin NH, McDonald WM. Psychedelics and Psychedelic-Assisted Psychotherapy. Am J Psychiatry 2020; 177:391-410. [PMID: 32098487 DOI: 10.1176/appi.ajp.2019.19010035] [Citation(s) in RCA: 257] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors provide an evidenced-based summary of the literature on the clinical application of psychedelic drugs in psychiatric disorders. METHODS Searches of PubMed and PsycINFO via Ovid were conducted for articles in English, in peer-reviewed journals, reporting on "psilocybin," "lysergic acid diethylamide," "LSD," "ayahuasca," "3,4-methylenedioxymethamphetamine," and "MDMA," in human subjects, published between 2007 and July 1, 2019. A total of 1,603 articles were identified and screened. Articles that did not contain the terms "clinical trial," "therapy," or "imaging" in the title or abstract were filtered out. The 161 remaining articles were reviewed by two or more authors. The authors identified 14 articles reporting on well-designed clinical trials investigating the efficacy of lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA), psilocybin, and ayahuasca for the treatment of mood and anxiety disorders, trauma and stress-related disorders, and substance-related and addictive disorders as well as in end-of-life care. RESULTS The most significant database exists for MDMA and psilocybin, which have been designated by the U.S. Food and Drug Administration (FDA) as "breakthrough therapies" for posttraumatic stress disorder (PTSD) and treatment-resistant depression, respectively. The research on LSD and ayahuasca is observational, but available evidence suggests that these agents may have therapeutic effects in specific psychiatric disorders. CONCLUSIONS Randomized clinical trials support the efficacy of MDMA in the treatment of PTSD and psilocybin in the treatment of depression and cancer-related anxiety. The research to support the use of LSD and ayahuasca in the treatment of psychiatric disorders is preliminary, although promising. Overall, the database is insufficient for FDA approval of any psychedelic compound for routine clinical use in psychiatric disorders at this time, but continued research on the efficacy of psychedelics for the treatment of psychiatric disorders is warranted.
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Affiliation(s)
- Collin M Reiff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Elon E Richman
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Charles B Nemeroff
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Linda L Carpenter
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Alik S Widge
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Carolyn I Rodriguez
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - Ned H Kalin
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
| | - William M McDonald
- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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- Department of Psychiatry, New York University School of Medicine, New York (Reiff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (Richman, McDonald); Department of Psychiatry, Dell Medical School and the Institute for Early Life Adversity Research, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin)
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Lea T, Amada N, Jungaberle H, Schecke H, Scherbaum N, Klein M. Perceived outcomes of psychedelic microdosing as self-managed therapies for mental and substance use disorders. Psychopharmacology (Berl) 2020; 237:1521-1532. [PMID: 32043165 DOI: 10.1007/s00213-020-05477-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/05/2020] [Indexed: 12/13/2022]
Abstract
RATIONALE The regular consumption of very small doses of psychedelic drugs (known as microdosing) has been a source of growing media and community attention in recent years. However, there is currently limited clinical and social research evidence on the potential role of microdosing as therapies for mental and substance use disorders. OBJECTIVES This paper examined subjective experiences of microdosing psychedelics to improve mental health or to cease or reduce substance use, and examined sociodemographic and other covariates of perceived improvements in mental health that individuals attributed to microdosing. METHODS An international online survey was conducted in 2018 and examined people's experiences of using psychedelics for self-reported therapeutic or enhancement purposes. This paper focuses on 1102 respondents who reported current or past experience of psychedelic microdosing. RESULTS Twenty-one percent of respondents reported primarily microdosing as a therapy for depression, 7% for anxiety, 9% for other mental disorders and 2% for substance use cessation or reduction. Forty-four percent of respondents perceived that their mental health was "much better" as a consequence of microdosing. In a multivariate analysis, perceived improvements in mental health from microdosing were associated with a range of variables including gender, education, microdosing duration and motivations, and recent use of larger psychedelic doses. CONCLUSIONS Given the promising findings of clinical trials of standard psychedelic doses as mental health therapies, clinical microdosing research is needed to determine its potential role in psychiatric treatment, and ongoing social research to better understand the use of microdosing as self-managed mental health and substance use therapies.
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Affiliation(s)
- Toby Lea
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Cologne, Germany.
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia.
| | | | | | - Henrike Schecke
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Michael Klein
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Cologne, Germany
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Bershad AK, Preller KH, Lee R, Keedy S, Wren-Jarvis J, Bremmer MP, de Wit H. Preliminary Report on the Effects of a Low Dose of LSD on Resting-State Amygdala Functional Connectivity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:461-467. [PMID: 32033922 PMCID: PMC7150630 DOI: 10.1016/j.bpsc.2019.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND The practice of "microdosing," or the use of repeated, very low doses of lysergic acid diethylamide (LSD) to improve mood or cognition, has received considerable public attention, but empirical studies are lacking. Controlled studies are needed to investigate both the therapeutic potential and the neurobiological underpinnings of this pharmacologic treatment. METHODS The present study was designed to examine the effects of a single low dose of LSD (13 μg) versus placebo on resting-state functional connectivity and cerebral blood flow in healthy young adults. Twenty men and women, 18 to 35 years old, participated in 2 functional magnetic resonance imaging scanning sessions in which they received placebo or LSD under double-blind conditions. During each session, the participants completed drug effect and mood questionnaires, and physiological measures were recorded. During expected peak drug effect, they underwent resting-state blood oxygen level-dependent and arterial spin labeling scans. Cerebral blood flow as well as amygdala and thalamic connectivity were analyzed. RESULTS LSD increased amygdala seed-based connectivity with the right angular gyrus, right middle frontal gyrus, and the cerebellum, and decreased amygdala connectivity with the left and right postcentral gyrus and the superior temporal gyrus. This low dose of LSD had weak and variable effects on mood, but its effects on positive mood were positively correlated with the increase in amygdala-middle frontal gyrus connectivity strength. CONCLUSIONS These preliminary findings show that a very low dose of LSD, which produces negligible subjective changes, alters brain connectivity in limbic circuits. Additional studies, especially with repeated dosing, will reveal whether these neural changes are related to the drug's purported antidepressant effect.
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Affiliation(s)
- Anya K Bershad
- Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Sarah Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Jamie Wren-Jarvis
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Michael P Bremmer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois.
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93
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Lea T, Amada N, Jungaberle H, Schecke H, Klein M. Microdosing psychedelics: Motivations, subjective effects and harm reduction. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 75:102600. [PMID: 31778967 DOI: 10.1016/j.drugpo.2019.11.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/11/2019] [Accepted: 11/10/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND In recent years there has been growing media attention on microdosing psychedelics (e.g., LSD, psilocybin). This refers to people routinely taking small doses of psychedelic substances to improve mental health and wellbeing, or to enhance cognitive performance. Research evidence is currently limited. This paper examines microdosing motivations, dosing practices, perceived short-term benefits, unwanted effects, and harm reduction practices. METHODS An international online survey was conducted in 2018 examining people's experiences of using psychedelics. Eligible participants were aged 16 years or older, had used psychedelics and could comprehend written English. This paper focuses on 525 participants who were microdosing psychedelics at the time of the survey. RESULTS Participants were primarily motivated to microdose to improve mental health (40%), for personal development (31%) and cognitive enhancement (18%). Most were microdosing with psilocybin (55%) or LSD/1P-LSD (48%). Principal components analysis generated three factors examining perceived short-term benefits of microdosing: improved mood and anxiety, enhanced connection to others and environment, and cognitive enhancement; and three factors examining negative and potentially unwanted effects: stronger-than-expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported at least one harm reduction practice they routinely performed while microdosing. CONCLUSION Our findings suggest that people microdosing are commonly doing so as a self-managed therapy for mental health, either as an alternative or adjunct to conventional treatments. This is despite psychedelics remaining prohibited substances in most jurisdictions. Recent findings from clinical trials with standard psychedelic doses for depression and anxiety suggest that a neurobiological effect beyond placebo is not unreasonable. Randomised controlled trials are needed, complemented by mixed methods social science research and the development of novel resources on microdosing harm reduction.
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Affiliation(s)
- Toby Lea
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Wörthstr. 10, 50668 Cologne, Germany; Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia.
| | - Nicole Amada
- The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA
| | - Henrik Jungaberle
- MIND Foundation, Betahaus Berlin, Rudi-Dutschke-Straße 23, 10969 Berlin, Germany
| | - Henrike Schecke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, LVR-Klinikum Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Michael Klein
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Wörthstr. 10, 50668 Cologne, Germany
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Preller KH. The Effects of Low Doses of Lysergic Acid Diethylamide in Healthy Humans: Demystifying the Microdosing of Psychedelics. Biol Psychiatry 2019; 86:736-737. [PMID: 31648681 DOI: 10.1016/j.biopsych.2019.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
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Preller KH, Vollenweider FX. Modulation of Social Cognition via Hallucinogens and "Entactogens". Front Psychiatry 2019; 10:881. [PMID: 31849730 PMCID: PMC6902301 DOI: 10.3389/fpsyt.2019.00881] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/07/2019] [Indexed: 01/30/2023] Open
Abstract
Social cognition is a fundamental ability in human everyday lives. Deficits in social functioning also represent a core aspect of many psychiatric disorders. Yet, despite its significance, deficits in social cognition skills are insufficiently targeted by current treatments. Hallucinogens and entactogens have been shown to have the potential to modulate social processing. This article reviews the literature on the influence of hallucinogens and entactogens on social processing in controlled experimental studies in humans and elucidates the underlying neurobiological and neuropharmacological mechanisms. Furthermore, it identifies current knowledge gaps and derives implications for hallucinogen-assisted treatment approaches as well as the development of novel medication for trans-diagnostic impairments in social cognition.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
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