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Orłowski P, Hobot J, Ruban A, Szczypiński J, Bola M. Naturalistic use of psychedelics does not modulate processing of self-related stimuli (but it might modulate attentional mechanisms): An event-related potentials study. Psychophysiology 2024; 61:e14583. [PMID: 38584307 DOI: 10.1111/psyp.14583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
Classic psychedelics are able to profoundly alter the state of consciousness and lead to acute experiences of ego dissolution - the blurring of the distinction between representations of self and the external world. However, whether repeated use of psychedelics is associated with more prolonged and permanent modifications to the concept of self remains to be investigated. Therefore, we conducted a preregistered, cross-sectional study in which experienced psychedelics users (15 or more lifetime experiences with psychedelics; N = 56) were compared to nonusers (N = 57) in terms of neural reactivity to a Self-name (i.e., each participant's own name) stimulus, which is known to robustly activate a representation of self. Two control stimuli were additionally used: an Other-name stimulus, as a passive control condition in which no reaction was required, and a Target-name stimulus, to which participants provided a manual response and which thus constituted an active control condition. Analysis of the amplitude of the P300 ERP component evoked by the Self- or Target-names revealed no difference between the psychedelics users and nonusers. However, psychedelic users exhibited increased P300 amplitude during perception of Other-names. In addition, in comparison to nonusers, psychedelics users exhibited a smaller increase in P300 amplitude when processing the task-relevant Target-names (in relation to both Self- and Other-names). Therefore, our data suggests that regular naturalistic use of psychedelics may not be related to long-term changes in the representation of self, but it might potentially affect the allocation of attentional resources to task-relevant stimuli.
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Affiliation(s)
- Paweł Orłowski
- Centre for Brain Research, Jagiellonian University, Kraków, Poland
- Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland
| | - Justyna Hobot
- Consciousness Lab, Psychology Institute, Jagiellonian University, Kraków, Poland
| | - Anastasia Ruban
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Jan Szczypiński
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Michał Bola
- Centre for Brain Research, Jagiellonian University, Kraków, Poland
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Mograbi DC, Rodrigues R, Bienemann B, Huntley J. Brain Networks, Neurotransmitters and Psychedelics: Towards a Neurochemistry of Self-Awareness. Curr Neurol Neurosci Rep 2024; 24:323-340. [PMID: 38980658 PMCID: PMC11258181 DOI: 10.1007/s11910-024-01353-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE OF REVIEW Self-awareness can be defined as the capacity of becoming the object of one's own awareness and, increasingly, it has been the target of scientific inquiry. Self-awareness has important clinical implications, and a better understanding of the neurochemical basis of self-awareness may help clarifying causes and developing interventions for different psychopathological conditions. The current article explores the relationship between neurochemistry and self-awareness, with special attention to the effects of psychedelics. RECENT FINDINGS The functioning of self-related networks, such as the default-mode network and the salience network, and how these are influenced by different neurotransmitters is discussed. The impact of psychedelics on self-awareness is reviewed in relation to specific processes, such as interoception, body ownership, agency, metacognition, emotional regulation and autobiographical memory, within a framework based on predictive coding. Improved outcomes in emotional regulation and autobiographical memory have been observed in association with the use of psychedelics, suggesting higher-order self-awareness changes, which can be modulated by relaxation of priors and improved coping mechanisms linked to cognitive flexibility. Alterations in bodily self-awareness are less consistent, being potentially impacted by doses employed, differences in acute/long-term effects and the presence of clinical conditions. Future studies investigating the effects of different molecules in rebalancing connectivity between resting-state networks may lead to novel therapeutic approaches and the refinement of existing treatments.
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Affiliation(s)
- Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Rafael Rodrigues
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bheatrix Bienemann
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
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Zheng S, Ma R, Yang Y, Li G. Psilocybin for the treatment of Alzheimer's disease. Front Neurosci 2024; 18:1420601. [PMID: 39050672 PMCID: PMC11266071 DOI: 10.3389/fnins.2024.1420601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Alzheimer's disease (AD) stands as a formidable neurodegenerative ailment and a prominent contributor to dementia. The scarcity of available therapies for AD accentuates the exigency for innovative treatment modalities. Psilocybin, a psychoactive alkaloid intrinsic to hallucinogenic mushrooms, has garnered attention within the neuropsychiatric realm due to its established safety and efficacy in treating depression. Nonetheless, its potential as a therapeutic avenue for AD remains largely uncharted. This comprehensive review endeavors to encapsulate the pharmacological effects of psilocybin while elucidating the existing evidence concerning its potential mechanisms contributing to a positive impact on AD. Specifically, the active metabolite of psilocybin, psilocin, elicits its effects through the modulation of the 5-hydroxytryptamine 2A receptor (5-HT2A receptor). This modulation causes heightened neural plasticity, diminished inflammation, and improvements in cognitive functions such as creativity, cognitive flexibility, and emotional facial recognition. Noteworthy is psilocybin's promising role in mitigating anxiety and depression symptoms in AD patients. Acknowledging the attendant adverse reactions, we proffer strategies aimed at tempering or mitigating its hallucinogenic effects. Moreover, we broach the ethical and legal dimensions inherent in psilocybin's exploration for AD treatment. By traversing these avenues, We propose therapeutic potential of psilocybin in the nuanced management of Alzheimer's disease.
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Affiliation(s)
- Siyi Zheng
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rong Ma
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Yang
- Department of General Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Gang Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lee HJ, Tsang VW, Chai BS, Lin MC, Howard A, Uy C, Elefante JO. Psilocybin's Potential Mechanisms in the Treatment of Depression: A Systematic Review. J Psychoactive Drugs 2024; 56:301-315. [PMID: 37385217 DOI: 10.1080/02791072.2023.2223195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/05/2023] [Accepted: 03/15/2023] [Indexed: 07/01/2023]
Abstract
Evidence suggests that psilocybin has therapeutic benefit for treating depression. However, there is little consensus regarding the mechanism by which psilocybin elicits antidepressant effects. This systematic review summarizes existing evidence. Ovid MEDLINE, EMBASE, psychINFO, and Web of Science were searched, for both human and animal studies, using a combination of MeSH Terms and free-text keywords in September 2021. No other mood disorders or psychiatric diagnoses were included. Original papers in English were included. The PRISMA framework was followed for the screening of papers. Two researchers screened the retrieved articles from the literature search, and a third researcher resolved any conflicts. Of 2,193 papers identified, 49 were selected for full-text review. 14 articles were included in the qualitative synthesis. Six supported psilocybin's mechanism of antidepressant action via changes to serotonin or glutamate receptor activity and three papers found an increase in synaptogenesis. Thirteen papers investigated changes in non-receptor or pathway-specific brain activity. Five papers found changes in functional connectivity or neurotransmission, most commonly in the hippocampus or prefrontal cortex. Several neuroreceptors, neurotransmitters, and brain areas are thought to be involved in psilocybin's ability to mitigate depressive symptoms. Psilocybin appears to alter cerebral blood flow to the amygdala and prefrontal cortex, but the evidence on changes in functional connectivity and specific receptor activity remains sparse. The lack of consensus between studies suggests that psilocybin's mechanism of action may involve a variety of pathways, demonstrating the need for more studies on psilocybin's mechanism of action as an antidepressant.
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Affiliation(s)
- Harrison J Lee
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Vivian Wl Tsang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brandon S Chai
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michelle Cq Lin
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrew Howard
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christopher Uy
- Department of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julius O Elefante
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Stoliker D, Novelli L, Vollenweider FX, Egan GF, Preller KH, Razi A. Neural Mechanisms of Resting-State Networks and the Amygdala Underlying the Cognitive and Emotional Effects of Psilocybin. Biol Psychiatry 2024; 96:57-66. [PMID: 38185235 DOI: 10.1016/j.biopsych.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND Serotonergic psychedelics, such as psilocybin, alter perceptual and cognitive systems that are functionally integrated with the amygdala. These changes can alter cognition and emotions that are hypothesized to contribute to their therapeutic utility. However, the neural mechanisms of cognitive and subcortical systems altered by psychedelics are not well understood. METHODS We used resting-state functional magnetic resonance images collected during a randomized, double-blind, placebo-controlled clinical trial of 24 healthy adults under 0.2 mg/kg psilocybin to estimate the directed (i.e., effective) changes between the amygdala and 3 large-scale resting-state networks involved in cognition. These networks are the default mode network, the salience network, and the central executive network. RESULTS We found a pattern of decreased top-down effective connectivity from these resting-state networks to the amygdala. Effective connectivity decreased within the default mode network and salience network but increased within the central executive network. These changes in effective connectivity were statistically associated with behavioral measures of altered cognition and emotion under the influence of psilocybin. CONCLUSIONS Our findings suggest that temporary amygdala signal attenuation is associated with mechanistic changes to resting-state network connectivity. These changes are significant for altered cognition and perception and suggest targets for research investigating the efficacy of psychedelic therapy for internalizing psychiatric disorders. More broadly, our study suggests the value of quantifying the brain's hierarchical organization using effective connectivity to identify important mechanisms for basic cognitive function and how they are integrated to give rise to subjective experiences.
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Affiliation(s)
- Devon Stoliker
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Leonardo Novelli
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Gary F Egan
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy & Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Ontario, Canada.
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Brockett AT, Francis NA. Psilocybin decreases neural responsiveness and increases functional connectivity while preserving pure-tone frequency selectivity in mouse auditory cortex. J Neurophysiol 2024; 132:45-53. [PMID: 38810366 DOI: 10.1152/jn.00124.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/29/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
Psilocybin is a serotonergic psychedelic believed to have therapeutic potential for neuropsychiatric conditions. Despite well-documented prevalence of perceptual alterations, hallucinations, and synesthesia associated with psychedelic experiences, little is known about how psilocybin affects sensory cortex or alters the activity of neurons in awake animals. To investigate, we conducted two-photon imaging experiments in auditory cortex of awake mice and collected video of free-roaming mouse behavior, both at baseline and during psilocybin treatment. In comparison with pre-dose neural activity, a 2 mg/kg ip dose of psilocybin initially increased the amplitude of neural responses to sound. Thirty minutes post-dose, behavioral activity and neural response amplitudes decreased, yet functional connectivity increased. In contrast, control mice given intraperitoneal saline injections showed no significant changes in either neural or behavioral activity across conditions. Notably, neuronal stimulus selectivity remained stable during psilocybin treatment, for both tonotopic cortical maps and single-cell pure-tone frequency tuning curves. Our results mirror similar findings regarding the effects of serotonergic psychedelics in visual cortex and suggest that psilocybin modulates the balance of intrinsic versus stimulus-driven influences on neural activity in auditory cortex.NEW & NOTEWORTHY Recent studies have shown promising therapeutic potential for psychedelics in treating neuropsychiatric conditions. Musical experience during psilocybin-assisted therapy is predictive of treatment outcome, yet little is known about how psilocybin affects auditory processing. Here, we conducted two-photon imaging experiments in auditory cortex of awake mice that received a dose of psilocybin. Our results suggest that psilocybin modulates the roles of intrinsic neural activity versus stimulus-driven influences on auditory perception.
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Affiliation(s)
- Adam T Brockett
- Department of Psychology, University of Maryland, College Park, Maryland, United States
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, Maryland, United States
- Department of Biological Sciences, University of New Hampshire, Durham, New Hampshire, United States
| | - Nikolas A Francis
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, Maryland, United States
- Department of Biology, University of Maryland, College Park, Maryland, United States
- Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park, Maryland, United States
- Brain and Behavior Institute, University of Maryland, College Park, Maryland, United States
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Basedow LA, Majić T, Hafiz NJ, Algharably EAE, Kreutz R, Riemer TG. Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis. Sci Rep 2024; 14:14782. [PMID: 38926480 PMCID: PMC11208433 DOI: 10.1038/s41598-024-65391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.
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Affiliation(s)
- Lukas A Basedow
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Gutenbergstraße 18, 35037, Marburg, Germany.
| | - Tomislav Majić
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry und Neurosciences, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nicklas Jakob Hafiz
- Institute for Educational Quality Improvement (IQB), Humboldt-Universität zu Berlin, Berlin, Germany
| | - Engi A E Algharably
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Thomas G Riemer
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
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Casanova AF, Ort A, Smallridge JW, Preller KH, Seifritz E, Vollenweider FX. The influence of psilocybin on subconscious and conscious emotional learning. iScience 2024; 27:110034. [PMID: 38883812 PMCID: PMC11177198 DOI: 10.1016/j.isci.2024.110034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/14/2024] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Serotonergic psychedelics hold promise as a treatment modality for various psychiatric disorders and are currently applied in psychedelic-assisted psychotherapy. We investigated the learning effects of the serotonin receptor agonist psilocybin in a probabilistic cue-reward task with emotional cues in the form of neutral or fearful faces, presented either consciously or subconsciously. This study represents the first investigation into reinforcement learning with psilocybin. Across different dosages, psilocybin preserved learning effects and was statistically noninferior compared to placebo, while suggesting a higher exploratory behavior. Notably, the 20 mg group exhibited significantly better learning rates against the placebo group. Psilocybin induced inferior results with subconscious cues compared to placebo, and better results with conscious neutral cues in some conditions. These findings suggest that modulating serotonin signaling in the brain with psilocybin sufficiently preservers reinforcement learning.
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Affiliation(s)
- Andrea F Casanova
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andres Ort
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - John W Smallridge
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Ramos L, Vicente SG. The effects of psilocybin on cognition and emotional processing in healthy adults and adults with depression: a systematic literature review. J Clin Exp Neuropsychol 2024:1-29. [PMID: 38842300 DOI: 10.1080/13803395.2024.2363343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION Psilocybin, a naturally occurring serotonergic agonist in some mushroom species, has shown promise as a novel, fast-acting pharmacotherapy seeking to overcome the limitations of conventional first-line antidepressants. Studying psilocybin effects on cognition and emotional processing may help to clarify the mechanisms underlying the therapeutic potential of psilocybin and may also support studies with people suffering from depression. Thus, this review aims to provide a comprehensive overview of the current literature regarding the effects of psilocybin on these two key areas in both healthy and depressed populations. METHOD A systematic search was performed on 29 January 2024, in the PubMed, EBSCOhost, Web of Science and SCOPUS databases. After duplicates removal, study selection was conducted considering pre-specified criteria. Data extraction was then performed. The quality assessment of the studies was carried out using the Cochrane Collaboration tools for randomized (RoB 2.0) and non-randomized (ROBINS-I) controlled trials. RESULTS Twenty articles were included, with 18 targeting healthy adults and two adults with depression. Results point to impairments within attentional and inhibitory processes, and improvements in the domains of creativity and social cognition in healthy individuals. In the population with depression, only cognitive flexibility and emotional recognition were affected, both being enhanced. The comparison of outcomes from both populations proved limited. CONCLUSIONS Psilocybin acutely alters several cognitive domains, with a localized rather than global focus, in a dose- and time-dependent manner. However, the significant methodological constraints call for further research, in the context of depression and with standardized protocols, with longitudinal studies also imperative.
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Affiliation(s)
- Laura Ramos
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Selene G Vicente
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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Lasch A, Schweikert T, Dora E, Kolb T, Schurig HL, Walther A. [Psilocybin-Assisted Treatment of Depression, Anxiety and Substance use Disorders: Neurobiological Basis and Clinical Application]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:230-245. [PMID: 37207669 DOI: 10.1055/a-2046-5202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Successful therapy of mental disorders is very important in view of the high level of suffering of those affected. Since established pharmaceutical and psychotherapeutic approaches do not lead to the desired improvement in all cases, complementary or alternative treatment methods are intensively researched. Psilocybin-assisted psychotherapy seems particularly promising, and has been approved in the USA for larger clinical trials. Psilocybin belongs to the group of psychedelics and influences psychological experiences. In assisted therapy, psilocybin is administered in controlled doses under medical supervision to patients with different mental disorders. In the studies conducted so far, longer-term positive effects could be shown after just one or a few doses. In order to provide a better understanding of the potential therapeutic mechanisms, this article will first describe neurobiological and psychological effects of psilocybin. To better assess the potential of psilocybin-assisted psychotherapy for various disorders, clinical studies conducted so far with patients administered psilocybin are reviewed.
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Affiliation(s)
- Anna Lasch
- Biopsychologie, Technische Universität Dresden, Dresden, Germany
| | - Timo Schweikert
- Psychotherapie und Systemneurowissenschaften, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Eva Dora
- Biopsychologie, Technische Universität Dresden, Dresden, Germany
| | - Theresa Kolb
- Universitätsklinikum Carl Gustav Carus Dresden, Division Psychological and Social Medicine and Developmental Neuroscience, Dresden, Germany
| | - Hanne Lilian Schurig
- Universitätsklinikum Carl Gustav Carus Dresden, Division Psychological and Social Medicine and Developmental Neuroscience, Dresden, Germany
| | - Andreas Walther
- Klinische Psychologie und Psychotherapie, Universität Zürich Psychologisches Institut, Zurich, Switzerland
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11
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Schmid Y, Bershad AK. Altered States and Social Bonds: Effects of MDMA and Serotonergic Psychedelics on Social Behavior as a Mechanism Underlying Substance-Assisted Therapy. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:490-499. [PMID: 38341085 DOI: 10.1016/j.bpsc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/14/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
There has been renewed interest in the use of 3,4-methylenedioxy-methamphetamine (MDMA) and serotonergic psychedelics in the treatment of multiple psychiatric disorders. Many of these compounds are known to produce prosocial effects, but how these effects relate to therapeutic efficacy and the extent to which prosocial effects are unique to a particular drug class is unknown. In this article, we present a narrative overview and compare evidence for the prosocial effects of MDMA and serotonergic psychedelics to elucidate shared mechanisms that may underlie the therapeutic process. We discuss 4 categories of prosocial effects: altered self-image, responses to social reward, responses to negative social input, and social neuroplasticity. While both categories of drugs alter self-perception, MDMA may do so in a way that is less related to the experience of mystical-type states than serotonergic psychedelics. In the case of social reward, evidence supports the ability of MDMA to enhance responses and suggests that serotonergic psychedelics may also do so, but more research is needed in this area. Both drug classes consistently dampen reactivity to negative social stimuli. Finally, preclinical evidence supports the ability of both drug classes to induce social neuroplasticity, promoting adaptive rewiring of neural circuits, which may be helpful in trauma processing. While both MDMA and serotonergic psychedelics produce prosocial effects, they differ in the mechanisms through which they do this. These differences affect the types of psychosocial interventions that may work best with each compound.
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Affiliation(s)
- Yasmin Schmid
- Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland; Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Anya K Bershad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
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12
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Yao Y, Guo D, Lu TS, Liu FL, Huang SH, Diao MQ, Li SX, Zhang XJ, Kosten TR, Shi J, Bao YP, Lu L, Han Y. Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis. Psychiatry Res 2024; 335:115886. [PMID: 38574699 DOI: 10.1016/j.psychres.2024.115886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
We aim to systematically review and meta-analyze the effectiveness and safety of psychedelics [psilocybin, ayahuasca (active component DMT), LSD and MDMA] in treating symptoms of various mental disorders. Web of Science, Embase, EBSCO, and PubMed were searched up to February 2024 and 126 articles were finally included. Results showed that psilocybin has the largest number of articles on treating mood disorders (N = 28), followed by ayahuasca (N = 7) and LSD (N = 6). Overall, psychedelics have therapeutic effects on mental disorders such as depression and anxiety. Specifically, psilocybin (Hedges' g = -1.49, 95% CI [-1.67, -1.30]) showed the strongest therapeutic effect among four psychedelics, followed by ayahuasca (Hedges' g = -1.34, 95% CI [-1.86, -0.82]), MDMA (Hedges' g = -0.83, 95% CI [-1.33, -0.32]), and LSD (Hedges' g = -0.65, 95% CI [-1.03, -0.27]). A small amount of evidence also supports psychedelics improving tobacco addiction, eating disorders, sleep disorders, borderline personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. The most common adverse event with psychedelics was headache. Nearly a third of the articles reported that no participants reported lasting adverse effects. Our analyses suggest that psychedelics reduce negative mood, and have potential efficacy in other mental disorders, such as substance-use disorders and PTSD.
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Affiliation(s)
- Yuan Yao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Dan Guo
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Tang-Sheng Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Fang-Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Shi-Hao Huang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Meng-Qi Diao
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China
| | - Xiu-Jun Zhang
- School of Psychology, College of Public Health, North China University of Science and Technology, Tangshan 063210, Hebei Province, China
| | - Thomas R Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China.
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China; Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder, Chinese Academy of Medical Sciences (No.2018RU006).
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China.
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13
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Pop I, Dinkelacker J. Unlocking the self: Can microdosing psychedelics make one feel more authentic? NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:142-155. [PMID: 38645971 PMCID: PMC11027848 DOI: 10.1177/14550725231175353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/26/2023] [Indexed: 04/23/2024] Open
Abstract
Background and aim: In the present study, we focus on the relationship between state authenticity - the experience of being true to oneself in a particular moment - and microdosing - a practice that implies repeatedly ingesting very small doses of psychedelics that do not reach the threshold for perceptual alterations. We propose that microdosing could increase state authenticity through influencing people's mood and the number and satisfaction with daily activities. Methods: We used self-assessments of state authenticity collected from 18 microdosers in the Netherlands across the period of 1 month for a total of 192 observations. Results: We found that on the microdosing day and the day thereafter, state authenticity was significantly higher. Furthermore, the number of activities and the satisfaction with them were higher on the day when participants microdosed, while the following day only the number of activities was higher. Both the number or activities and the satisfaction with them were positively related to state authenticity. Conclusion: We propose that feeling and behaving authentically could have a central role in explaining the positive effects of microdosing on health and wellbeing that are reported by current research.
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Affiliation(s)
- Ioana Pop
- Tilburg University, Sociology Department, Tilburg, The Netherlands
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14
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Solaja I, Haldane K, Mason N, Weiss B, Xu X, Xu M, Nikolin S, Jayasena T, Millard M, Brett J, Bayes A, Loo CK, Martin DM. Who are you after psychedelics? A systematic review and a meta-analysis of the magnitude of long-term effects of serotonergic psychedelics on cognition/creativity, emotional processing and personality. Neurosci Biobehav Rev 2024; 158:105570. [PMID: 38311046 DOI: 10.1016/j.neubiorev.2024.105570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/06/2024]
Abstract
This systematic review and a meta-analysis synthesised the results from contemporary, randomized and non-randomized controlled studies to assess lasting (one week minimum) changes on cognition/creativity, emotional processing and personality from serotonergic psychedelics. PubMed, Embase and PsycInfo were searched in July 2022. Risk of bias was assessed using Rob 2.0 and ROBINS-I. Ten studies met the eligibility criteria which involved 304 participants. No statistically significant effects were found for the majority outcome measures across the three constructs. A meta-analysis of emotional recognition outcomes found an overall significant effect for faster reaction times in the active treatment groups for disgust (SMD=-0.63, 95% CI=[-1.01 to -0.25], I2 = 65%) and sadness (SMD=-0.45, 95% CI=[-0.85 to -0.06], I2 = 60%). Future research should include larger samples, better control conditions, standardized doses and longer follow-up periods to confirm these preliminary findings.
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Affiliation(s)
- Ivana Solaja
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.
| | | | - Natasha Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Brandon Weiss
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Xiaomin Xu
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mei Xu
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stevan Nikolin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Tharusha Jayasena
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | | | - Adam Bayes
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Colleen K Loo
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Donel M Martin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
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15
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Hatzipantelis CJ, Olson DE. The Effects of Psychedelics on Neuronal Physiology. Annu Rev Physiol 2024; 86:27-47. [PMID: 37931171 PMCID: PMC10922499 DOI: 10.1146/annurev-physiol-042022-020923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Psychedelics are quite unique among drugs that impact the central nervous system, as a single administration of a psychedelic can both rapidly alter subjective experience in profound ways and produce sustained effects on circuits relevant to mood, fear, reward, and cognitive flexibility. These remarkable properties are a direct result of psychedelics interacting with several key neuroreceptors distributed across the brain. Stimulation of these receptors activates a variety of signaling cascades that ultimately culminate in changes in neuronal structure and function. Here, we describe the effects of psychedelics on neuronal physiology, highlighting their acute effects on serotonergic and glutamatergic neurotransmission as well as their long-lasting effects on structural and functional neuroplasticity in the cortex. We propose that the neurobiological changes leading to the acute and sustained effects of psychedelics might be distinct, which could provide opportunities for engineering compounds with optimized safety and efficacy profiles.
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Affiliation(s)
- Cassandra J Hatzipantelis
- Institute for Psychedelics and Neurotherapeutics, University of California, Davis, Davis, California, USA;
- Department of Chemistry, University of California, Davis, Davis, California, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - David E Olson
- Institute for Psychedelics and Neurotherapeutics, University of California, Davis, Davis, California, USA;
- Department of Chemistry, University of California, Davis, Davis, California, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA
- Center for Neuroscience, University of California, Davis, Davis, California, USA
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16
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Pagni BA, Petridis PD, Podrebarac SK, Grinband J, Claus ED, Bogenschutz MP. Psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder: an fMRI pilot study. Sci Rep 2024; 14:3159. [PMID: 38326432 PMCID: PMC10850478 DOI: 10.1038/s41598-024-52967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
This pilot study investigated psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder (AUD). Participants were recruited from a phase II, randomized, double-blind, placebo-controlled clinical trial investigating psilocybin-assisted therapy (PAT) for the treatment of AUD (NCT02061293). Eleven adult patients completed task-based blood oxygen dependent functional magnetic resonance imaging (fMRI) approximately 3 days before and 2 days after receiving 25 mg of psilocybin (n = 5) or 50 mg of diphenhydramine (n = 6). Visual alcohol and emotionally valanced (positive, negative, or neutral) stimuli were presented in block design. Across both alcohol and emotional cues, psilocybin increased activity in the medial and lateral prefrontal cortex (PFC) and left caudate, and decreased activity in the insular, motor, temporal, parietal, and occipital cortices, and cerebellum. Unique to negative cues, psilocybin increased supramarginal gyrus activity; unique to positive cues, psilocybin increased right hippocampus activity and decreased left hippocampus activity. Greater PFC and caudate engagement and concomitant insula, motor, and cerebellar disengagement suggests enhanced goal-directed action, improved emotional regulation, and diminished craving. The robust changes in brain activity observed in this pilot study warrant larger neuroimaging studies to elucidate neural mechanisms of PAT.Trial registration: NCT02061293.
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Affiliation(s)
- B A Pagni
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - P D Petridis
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - S K Podrebarac
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - J Grinband
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - E D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - M P Bogenschutz
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA.
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17
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Meikle S, Carter O, Bedi G. Psychedelic-assisted psychotherapy, patient vulnerability and abuses of power. Aust N Z J Psychiatry 2024; 58:104-106. [PMID: 37767944 DOI: 10.1177/00048674231200164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Sally Meikle
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Gillinder Bedi
- Orygen, and the Cetre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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18
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Gumpper RH, Roth BL. Psychedelics: preclinical insights provide directions for future research. Neuropsychopharmacology 2024; 49:119-127. [PMID: 36932180 PMCID: PMC10700551 DOI: 10.1038/s41386-023-01567-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/30/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023]
Abstract
Recently, psychedelics have emerged as promising therapeutics for numerous neuropsychiatric disorders. While their potential in the clinic has yet to be fully elucidated, understanding their molecular and biological mechanisms is imperative as these compounds are becoming widely used both in therapeutic and recreational contexts. This review examines the current understanding of basic biology, pharmacology, and structural biology in an attempt to reveal both the knowns and unknowns within the field.
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Affiliation(s)
- Ryan H Gumpper
- Department of Pharmacology, UNC School of Medicine, Chapel Hill, NC, 27514, USA
| | - Bryan L Roth
- Department of Pharmacology, UNC School of Medicine, Chapel Hill, NC, 27514, USA.
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19
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Orłowski P, Hobot J, Ruban A, Szczypiński J, Bola M. The relation between naturalistic use of psychedelics and perception of emotional stimuli: An event-related potential study comparing non-users and experienced users of classic psychedelics. J Psychopharmacol 2024; 38:68-79. [PMID: 38069478 DOI: 10.1177/02698811231216322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Previous research has suggested that controlled administration of psychedelic substances can modulate emotional reactivity, enhancing positive and diminishing negative emotions. However, it is unclear whether similar effects are associated with using psychedelics in less-controlled naturalistic environments. AIMS This cross-sectional study investigated the neural markers associated with the perception of emotional stimuli in individuals with extensive experience of naturalistic psychedelic use (15 or more lifetime experiences), comparing them to non-users. METHODS Electroencephalography (EEG) signals were recorded from two groups: experienced psychedelics users (N = 56) and non-users (N = 55). Participants were presented with facial images depicting neutral or emotional expressions (anger, sadness, and happiness). Event-related potential (ERP) components were analyzed as indices of emotional reactivity. RESULTS Psychedelic users were characterized by significantly lower amplitudes of the N200 component in response to fearful faces, in comparison to non-users. In addition, interaction effects between Group and Emotional expression were observed on N170 and N200 amplitudes, indicating group differences in the processing of fearful faces. However, no significant between-group differences emerged in the analysis of later ERP components associated with attention and cognitive processes (P200 and P300). CONCLUSIONS The results suggest that naturalistic use of psychedelics may be linked to reduced reactivity to emotionally negative stimuli at the early and automatic processing stages. Our study contributes to a better understanding of the effects related to using psychedelics in naturalistic contexts.
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Affiliation(s)
- Paweł Orłowski
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Poland
| | - Justyna Hobot
- Consciousness Lab, Psychology Institute, Jagiellonian University, Kraków, Poland
| | - Anastasia Ruban
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Jan Szczypiński
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Poland
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Michał Bola
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Poland
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20
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Madrid-Gambin F, Fabregat-Safont D, Gomez-Gomez A, Olesti E, Mason NL, Ramaekers JG, Pozo OJ. Present and future of metabolic and metabolomics studies focused on classical psychedelics in humans. Biomed Pharmacother 2023; 169:115775. [PMID: 37944438 DOI: 10.1016/j.biopha.2023.115775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
Psychedelics are classical hallucinogen drugs that induce a marked altered state of consciousness. In recent years, there has been renewed attention to the possible use of classical psychedelics for the treatment of certain mental health disorders. However, further investigation to better understand their biological effects in humans, their mechanism of action, and their metabolism in humans is needed when considering the development of future novel therapeutic approaches. Both metabolic and metabolomics studies may help for these purposes. On one hand, metabolic studies aim to determine the main metabolites of the drug. On the other hand, the application of metabolomics in human psychedelics studies can help to further understand the biological processes underlying the psychedelic state and the mechanisms of action underlying their therapeutic potential. This review presents the state of the art of metabolic and metabolomic studies after lysergic acid diethylamide (LSD), mescaline, N,N-dimethyltryptamine (DMT) and β-carboline alkaloids (ayahuasca brew), 5-methoxy-DMT and psilocybin administrations in humans. We first describe the characteristics of the published research. Afterward, we reviewed the main results obtained by both metabolic and metabolomics (if available) studies in classical psychedelics and we found out that metabolic and metabolomics studies in psychedelics progress at two different speeds. Thus, whereas the main metabolites for classical psychedelics have been robustly established, the main metabolic alterations induced by psychedelics need to be explored. The integration of metabolomics and pharmacokinetics for investigating the molecular interaction between psychedelics and multiple targets may open new avenues in understanding the therapeutic role of psychedelics.
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Affiliation(s)
- Francisco Madrid-Gambin
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain.
| | - David Fabregat-Safont
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain; Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, 12071 Castelló, Spain
| | - Alex Gomez-Gomez
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain; CERBA Internacional, Chromatography Department, 08203 Sabadell, Spain
| | - Eulàlia Olesti
- Department of Clinical Pharmacology, Area Medicament, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; Clinical Pharmacology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Oscar J Pozo
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain.
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21
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Pouyan N, Younesi Sisi F, Kargar A, Scheidegger M, McIntyre RS, Morrow JD. The effects of Lysergic Acid Diethylamide (LSD) on the Positive Valence Systems: A Research Domain Criteria (RDoC)-Informed Systematic Review. CNS Drugs 2023; 37:1027-1063. [PMID: 37999867 PMCID: PMC10703966 DOI: 10.1007/s40263-023-01044-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND AND OBJECTIVES The renewed interest in psychedelic research provides growing evidence of potentially unique effects on various aspects of reward processing systems. Using the Research Domain Criteria (RDoC) framework, as proposed by the National Institute of Mental Health, we aim to synthesize the existing literature concerning the impact of lysergic acid diethylamide (LSD) on the RDoC's Positive Valence Systems (PVS) domain, and to identify potential avenues for further research. METHODS Two LSD-related terms (lysergic acid diethylamide and LSD) and 13 PVS-related terms (reward, happiness, bliss, motivation, reinforcement learning, operant, conditioning, satisfaction, decision making, habit, valence, affect, mood) were used to search electronic databases such as PubMed, Scopus, PsychINFO, and Web of Science for relevant articles. A manual search of the reference list resulted in nine additional articles. After screening, articles and data were evaluated and included based on their relevance to the objective of investigating the effects of LSD on the PVS. Articles and data were excluded if they did not provide information about the PVS, were observational in nature, lacked comparators or reference groups, or were duplicates. A risk of bias assessment was performed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias (RoB) tool. Data from the included articles were collected and structured based on the RDoC bio-behavioral matrix, specifically focusing on the PVS domain and its three constituent constructs: reward responsiveness, reward learning, and reward valuation. RESULTS We reviewed 28 clinical studies with 477 participants. Lysergic acid diethylamide, assessed at self-report (23 studies), molecular (5 studies), circuit (4 studies), and paradigm (3 studies) levels, exhibited dose-dependent mood improvement (20 short-term and 3 long-term studies). The subjective and neural effects of LSD were linked to the 5-HT2A receptor (molecular). Animal studies (14 studies) suggested LSD could mildly reinforce conditioned place preference without aversion and reduce responsiveness to other rewards. Findings on reward learning were inconsistent but hinted at potential associative learning enhancements. Reward valuation measures indicated potential reductions in effort expenditure for other reinforcers. CONCLUSION Our findings are consistent with our previous work, which indicated classical psychedelics, primarily serotonin 2A receptor agonists, enhanced reward responsiveness in healthy individuals and patient populations. Lysergic acid diethylamide exhibits a unique profile in the reward learning and valuation constructs. Using the RDoC-based framework, we identified areas for future research, enhancing our understanding of the impact of LSD on reward processing. However, applying RDoC to psychedelic research faces limitations due to diverse study designs that were not initially RDoC-oriented. Limitations include subjective outcome measure selection aligned with RDoC constructs and potential bias in synthesizing varied studies. Additionally, some human studies were open-label, introducing potential bias compared to randomized, blinded studies.
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Affiliation(s)
- Niloufar Pouyan
- Michigan Psychedelic Center (M-PsyC), and Chronic Pain and Fatigue Research Center (CPFRC), University of Michigan Medical School, Ann Arbor, MI, USA.
- Neuroscience Graduate Program, and Program in Biomedical Sciences (PIBS), University of Michigan Medical School, 1135 Catherine Street, Box 5619, 2960 Taubman Health Science Library, Ann Arbor, MI, USA.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Aracell Zist Darou pharmaceutical, Tehran, Iran.
| | - Farnaz Younesi Sisi
- Yaadmaan Institute for Brain, Cognition and Memory Studies, Tehran, Iran
- Cognitive Neurology and Neuropsychiatry Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Alireza Kargar
- Cognitive Neurology and Neuropsychiatry Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Clinical Pharmacy, School of pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jonathan D Morrow
- Neuroscience Graduate Program, and Program in Biomedical Sciences (PIBS), University of Michigan Medical School, 1135 Catherine Street, Box 5619, 2960 Taubman Health Science Library, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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22
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Jahanabadi S, Amiri S, Karkeh-Abadi M, Razmi A. Natural psychedelics in the treatment of depression; a review focusing on neurotransmitters. Fitoterapia 2023; 169:105620. [PMID: 37490982 DOI: 10.1016/j.fitote.2023.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/27/2023]
Abstract
Natural psychedelic compounds are emerging as potential novel therapeutics in psychiatry. This review will discuss how natural psychedelics exert their neurobiological therapeutic effects, and how different neurotransmission systems mediate the effects of these compounds. Further, current therapeutic strategies for depression, and novel mechanism of action of natural psychedelics in the treatment of depression will be discussed. In this review, our focus will be on N, N-dimethyltryptamine (DMT), reversible type A monoamine oxidase inhibitors, mescaline-containing cacti, psilocybin/psilocin-containing mushrooms, ibogaine, muscimol extracted from Amanita spp. mushrooms and ibotenic acid.
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Affiliation(s)
- Samane Jahanabadi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Pharmaceutical Science Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shayan Amiri
- Division of Neurodegenerative Disorders, St Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada; Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada.
| | - Mehdi Karkeh-Abadi
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Ali Razmi
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.
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23
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Kalfas M, Taylor RH, Tsapekos D, Young AH. Psychedelics for treatment resistant depression: are they game changers? Expert Opin Pharmacother 2023; 24:2117-2132. [PMID: 37947195 DOI: 10.1080/14656566.2023.2281582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION A new era of treatment for adults with treatment-resistant depression (TRD), which involves psychedelic substances, is dawning. Emerging evidence indicates that psychedelics can exert antidepressant effects through multiple neurobiological and psychological mechanisms. However, it remains to be seen if these new treatments will revolutionize the treatment of TRD. AREAS COVERED The present review focuses on the efficacy of serotoninergic psychedelics psilocybin, lysergic acid diethylamide (LSD), N,N-dimethyltryptamine (DMT), ayahuasca, 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) and mescaline (3,4,5-trimethoxyphenethylamine), as well as 3,4-methylenedioxymethamphetamine (MDMA), for TRD. A systematic search was conducted for psilocybin in TRD as emerging trials had not yet been subject to review. A narrative review summarized findings on other psychedelics. EXPERT OPINION Psychedelic therapy has created a paradigm shift in the treatment of TRD, as it can maximize therapeutic benefits and minimize potential risks. Psilocybin holds promise as a potential game-changer in the treatment of TRD, with initial evidence suggesting a rapid antidepressant effect sustained for some responders for at least 3 months. Nevertheless, further adequately powered, double-blind, comparator-controlled trials are required to explore and clarify the mechanisms of action and long-term effects of psychedelics in TRD. Psychedelics also hold promise for other psychiatric conditions, such as bipolar depression and post-traumatic stress disorder.
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Affiliation(s)
- Michail Kalfas
- Department of Psychological Medicine, King's College London, London, UK
| | - Rosie H Taylor
- Department of Psychological Medicine, King's College London, London, UK
| | | | - Allan H Young
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Sharma P, Nguyen QA, Matthews SJ, Carpenter E, Mathews DB, Patten CA, Hammond CJ. Psilocybin history, action and reaction: A narrative clinical review. J Psychopharmacol 2023; 37:849-865. [PMID: 37650489 DOI: 10.1177/02698811231190858] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Hallucinogenic mushrooms have been used in religious and cultural ceremonies for centuries. Of late, psilocybin, the psychoactive compound in hallucinogenic mushrooms, has received increased public interest as a novel drug for treating mood and substance use disorders (SUDs). In addition, in recent years, some states in the United States have legalized psilocybin for medical and recreational use. Given this, clinicians need to understand the potential benefits and risks related to using psilocybin for therapeutic purposes so that they can accurately advise patients. This expert narrative review summarizes the scientific basis and clinical evidence on the safety and efficacy of psilocybin-assisted therapy for treating psychiatric disorders and SUDs. The results of this review are structured as a more extensive discussion about psilocybin's history, putative mechanisms of action, and recent legislative changes to its legal status. There is modest evidence of psilocybin-assisted therapy for treating depression and anxiety disorders. In addition, early data suggest that psilocybin-assisted therapy may effectively reduce harmful drinking in patients with alcohol use disorders. The evidence further suggests psilocybin, when administered under supervision (psilocybin-assisted therapy), the side effects experienced are mild and transient. The occurrence of severe adverse events following psilocybin administration is uncommon. Still, a recent clinical trial found that individuals in the psilocybin arm had increased suicidal ideations and non-suicidal self-injurious behaviors. Given this, further investigation into the safety and efficacy of psilocybin-assisted therapy is warranted to determine which patient subgroups are most likely to benefit and which are most likely to experience adverse outcomes related to its use.
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Affiliation(s)
- Pravesh Sharma
- Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, WI, USA
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Quang Anh Nguyen
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Sadie J Matthews
- Department of Psychology, University of Wisconsin (Eau Claire), Eau Claire, WI, USA
| | | | - Douglas B Mathews
- Department of Psychology, University of Wisconsin (Eau Claire), Eau Claire, WI, USA
| | - Christi A Patten
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Christopher J Hammond
- Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Kargbo RB. Unraveling Psychedelic Responses: Targeted Protein Degradation and Genetic Diversity. ACS Med Chem Lett 2023; 14:1017-1020. [PMID: 37583820 PMCID: PMC10424308 DOI: 10.1021/acsmedchemlett.3c00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 08/17/2023] Open
Abstract
This Viewpoint discusses the intersection of targeted protein degradation (TPD) technologies and psychedelic research. The resurgence in interest in psychedelics for treating mental disorders and the known genetic variability in responses require new strategies. TPD technologies might address this variability, modulating protein expressions based on genetic profiles. The discussion includes potential challenges in implementing TPD technologies in psychedelic research and potential strategies to address these issues. It considers lessons from COVID-19 research on genetic variability, proposing integration of TPD technologies into psychedelic research as a promising field despite these challenges, possibly leading to personalized treatments and improved patient outcomes.
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Affiliation(s)
- Robert B. Kargbo
- API & DP Development, Usona
Institute, 2780 Woods
Hollow Road, Madison, Wisconsin 53711, United States
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Rossi GN, Rocha JM, Osório FL, Bouso JC, Ona G, Silveira GDO, Yonamine M, Bertozi G, Crevelin EJ, Queiroz ME, Crippa JAS, Hallak JEC, Dos Santos RG. Interactive Effects of Ayahuasca and Cannabidiol in Social Cognition in Healthy Volunteers: A Pilot, Proof-of-Concept, Feasibility, Randomized-Controlled Trial. J Clin Psychopharmacol 2023; Publish Ahead of Print:00004714-990000000-00152. [PMID: 37335211 DOI: 10.1097/jcp.0000000000001691] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND Serotonergic hallucinogens and cannabinoids may alter the recognition of emotions in facial expressions (REFE). Cannabidiol (CBD) attenuates the psychoactive effects of the cannabinoid-1 agonist tetrahydrocannabinol. Ayahuasca is a dimethyltryptamine-containing hallucinogenic decoction. It is unknown if CBD may moderate and attenuate the effects of ayahuasca on REFE. PROCEDURES Seventeen healthy volunteers participated in a 1-week preliminary parallel-arm, randomized controlled trial for 18 months. Volunteers received a placebo or 600 mg of oral CBD followed by oral ayahuasca (1 mL/kg) 90 minutes later. Primary outcomes included REFE and empathy tasks (coprimary outcome). Tasks were performed at baseline and 6.5 hours, 1 and 7 days after the interventions. Secondary outcome measures included subjective effects, tolerability, and biochemical assessments. RESULTS Significant reductions (all P values <0.05) only in reaction times were observed in the 2 tasks in both groups, without between-group differences. Furthermore, significant reductions in anxiety, sedation, cognitive deterioration, and discomfort were observed in both groups, without between-group differences. Ayahuasca, with or without CBD, was well tolerated, producing mainly nausea and gastrointestinal discomfort. No clinically significant effects were observed on cardiovascular measurements and liver enzymes. CONCLUSIONS There was no evidence of interactive effects between ayahuasca and CBD. The safety of separate and concomitant drug intake suggests that both drugs could be applied to clinical populations with anxiety disorders and in further trials with larger samples to confirm findings.
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Affiliation(s)
- Giordano Novak Rossi
- From the Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo
| | - Juliana Mendes Rocha
- From the Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo
| | | | | | | | | | - Mauricio Yonamine
- School of Pharmaceutical Sciences, University of Sao Paulo, São Paulo
| | | | | | | | - José Alexandre S Crippa
- From the Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo
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Adamska I, Finc K. Effect of LSD and music on the time-varying brain dynamics. Psychopharmacology (Berl) 2023:10.1007/s00213-023-06394-8. [PMID: 37291360 DOI: 10.1007/s00213-023-06394-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
RATIONALE Psychedelics are getting closer to being widely used in clinical treatment. Music is known as a key element of psychedelic-assisted therapy due to its psychological effects, specifically on the emotion, meaning-making, and sensory processing. However, there is still a lack of understanding in how psychedelics influence brain activity in experimental settings involving music listening. OBJECTIVES The main goal of our research was to investigate the effect of music, as a part of "setting," on the brain states dynamics after lysergic acid diethylamide (LSD) intake. METHODS We used an open dataset, where a group of 15 participants underwent two functional MRI scanning sessions under LSD and placebo influence. Every scanning session contained three runs: two resting-state runs separated by one run with music listening. We applied K-Means clustering to identify the repetitive patterns of brain activity, so-called brain states. For further analysis, we calculated states' dwell time, fractional occupancy and transition probability. RESULTS The interaction effect of music and psychedelics led to change in the time-varying brain activity of the task-positive state. LSD, regardless of the music, affected the dynamics of the state of combined activity of DMN, SOM, and VIS networks. Crucially, we observed that the music itself could potentially have a long-term influence on the resting-state, in particular on states involving task-positive networks. CONCLUSIONS This study indicates that music, as a crucial element of "setting," can potentially have an influence on the subject's resting-state during psychedelic experience. Further studies should replicate these results on a larger sample size.
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Affiliation(s)
- Iga Adamska
- Faculty of Philosophy and Social Sciences, Nicolaus Copernicus University, Toruń, Poland.
| | - Karolina Finc
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland.
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Abstract
There is increasing interest in exploring the therapeutic potential of psychedelics in treatment-resistant depression (TRD). Classic psychedelics (such as psilocybin, LSD, ayahuasca/DMT), and atypical psychedelics (such as ketamine) have been studied in TRD. The evidence for the classic psychedelics TRD is limited at the present time; early studies however show promising results. There is also recognition that psychedelic research may be subject to a "hype bubble" at the present time. Future studies focused on delineating necessary ingredients of psychedelic treatments and the neurobiological basis of their effects, will help pave the way for the clinical use of these compounds.
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Affiliation(s)
- Shubham Kamal
- Department of Psychiatry, School of Medicine, Yale University, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Manish Kumar Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9119, USA
| | - Rajiv Radhakrishnan
- Department of Psychiatry, School of Medicine, Yale University, 300 George Street, Suite 901, New Haven, CT 06511, USA; Department of Radiology and Biomedical Imaging, New Haven, CT 06511, USA.
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Ort A, Smallridge JW, Sarasso S, Casarotto S, von Rotz R, Casanova A, Seifritz E, Preller KH, Tononi G, Vollenweider FX. TMS-EEG and resting-state EEG applied to altered states of consciousness: oscillations, complexity, and phenomenology. iScience 2023; 26:106589. [PMID: 37138774 PMCID: PMC10149373 DOI: 10.1016/j.isci.2023.106589] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
Exploring the neurobiology of the profound changes in consciousness induced by classical psychedelic drugs may require novel neuroimaging methods. Serotonergic psychedelic drugs such as psilocybin produce states of increased sensory-emotional awareness and arousal, accompanied by increased spontaneous electroencephalographic (EEG) signal diversity. By directly stimulating cortical tissue, the altered dynamics and propagation of the evoked EEG activity can reveal drug-induced changes in the overall brain state. We combine Transcranial Magnetic Stimulation (TMS) and EEG to reveal that psilocybin produces a state of increased chaotic brain activity which is not a result of altered complexity in the underlying causal interactions between brain regions. We also map the regional effects of psilocybin on TMS-evoked activity and identify changes in frontal brain structures that may be associated with the phenomenology of psychedelic experiences.
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Affiliation(s)
- Andres Ort
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - John W. Smallridge
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi Milano, Milan, Italy
| | - Robin von Rotz
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andrea Casanova
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H. Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Franz X. Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Effinger DP, Quadir SG, Ramage MC, Cone MG, Herman MA. Sex-specific effects of psychedelic drug exposure on central amygdala reactivity and behavioral responding. Transl Psychiatry 2023; 13:119. [PMID: 37031219 PMCID: PMC10082812 DOI: 10.1038/s41398-023-02414-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/10/2023] Open
Abstract
Psilocybin and its active metabolite psilocin have been shown to elicit rapid and long-lasting symptom improvements in a variety of affective psychiatric illnesses. However, the region-specific alterations underlying these therapeutic effects remain relatively unknown. The central amygdala (CeA) is a primary output region within the extended amygdala that is dysregulated in affective psychiatric disorders. Here, we measured CeA activity using the activity marker c-Fos and CeA reactivity using fiber photometry paired with an aversive air-puff stimulus. We found that psilocin administration acutely increased CeA activity in both males and females and increased stimulus specific CeA reactivity in females, but not males. In contrast, psilocin produced time-dependent decreases in reactivity in males, but not in females, as early as 2 days and lasting to 28 days post administration. We also measured behavioral responses to the air-puff stimulus and found sex-dependent changes in threat responding but not exploratory behavior or general locomotion. Repeated presentations of the auditory component of the air-puff were also performed and sex-specific effects of psilocin on CeA reactivity to the auditory-alone stimulus were also observed. This study provides new evidence that a single dose of psilocin produces sex-specific, time-dependent, and enduring changes in CeA reactivity and behavioral responding to specific components of an aversive stimulus.
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Affiliation(s)
- D P Effinger
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - S G Quadir
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - M C Ramage
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - M G Cone
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - M A Herman
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Kelly JR, Clarke G, Harkin A, Corr SC, Galvin S, Pradeep V, Cryan JF, O'Keane V, Dinan TG. Seeking the Psilocybiome: Psychedelics meet the microbiota-gut-brain axis. Int J Clin Health Psychol 2023; 23:100349. [PMID: 36605409 PMCID: PMC9791138 DOI: 10.1016/j.ijchp.2022.100349] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/16/2022] [Indexed: 12/15/2022] Open
Abstract
Moving towards a systems psychiatry paradigm embraces the inherent complex interactions across all levels from micro to macro and necessitates an integrated approach to treatment. Cortical 5-HT2A receptors are key primary targets for the effects of serotonergic psychedelics. However, the therapeutic mechanisms underlying psychedelic therapy are complex and traverse molecular, cellular, and network levels, under the influence of biofeedback signals from the periphery and the environment. At the interface between the individual and the environment, the gut microbiome, via the gut-brain axis, plays an important role in the unconscious parallel processing systems regulating host neurophysiology. While psychedelic and microbial signalling systems operate over different timescales, the microbiota-gut-brain (MGB) axis, as a convergence hub between multiple biofeedback systems may play a role in the preparatory phase, the acute administration phase, and the integration phase of psychedelic therapy. In keeping with an interconnected systems-based approach, this review will discuss the gut microbiome and mycobiome and pathways of the MGB axis, and then explore the potential interaction between psychedelic therapy and the MGB axis and how this might influence mechanism of action and treatment response. Finally, we will discuss the possible implications for a precision medicine-based psychedelic therapy paradigm.
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Affiliation(s)
- John R. Kelly
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Tallaght University Hospital, Dublin, Ireland
| | - Gerard Clarke
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | | | - Sinead C. Corr
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Microbiology, Trinity College Dublin, Ireland
| | - Stephen Galvin
- Department of Psychiatry, Trinity College, Dublin, Ireland
| | - Vishnu Pradeep
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Tallaght University Hospital, Dublin, Ireland
| | - John F. Cryan
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Veronica O'Keane
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Tallaght University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Ireland
| | - Timothy G. Dinan
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
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Sayalı C, Barrett FS. The costs and benefits of psychedelics on cognition and mood. Neuron 2023; 111:614-630. [PMID: 36681076 DOI: 10.1016/j.neuron.2022.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/14/2022] [Accepted: 12/24/2022] [Indexed: 01/21/2023]
Abstract
Anecdotal evidence has indicated that psychedelic substances may acutely enhance creative task performance, although empirical support for this claim is mixed at best. Clinical research has shown that psychedelics might have enduring effects on mood and well-being. However, there is no neurocognitive framework that ties acute changes in cognition to long-term effects in mood. In this review, we operationalize creativity within an emerging cognitive control framework and assess the current empirical evidence of the effects of psychedelics on creativity. Next, we leverage insights about the mechanisms and computations by which other psychoactive drugs act to enhance versus impair cognition, in particular to those that act on catecholamines, the neurophysiological consequences of which are relatively well understood. Finally, we use the same framework to link the suggested psychedelic-induced improvements in creativity with enduring psychedelic-induced improvements in mood.
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Affiliation(s)
- Ceyda Sayalı
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; Department of Psychological & Brain Sciences, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD 21218, USA
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Ponomarenko P, Seragnoli F, Calder A, Oehen P, Hasler G. Can psychedelics enhance group psychotherapy? A discussion on the therapeutic factors. J Psychopharmacol 2023:2698811231155117. [PMID: 36855289 DOI: 10.1177/02698811231155117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Despite the growth of psychedelic research, psychedelic-assisted group psychotherapy (PAGP) has received little attention in comparison to individual psychedelic-assisted psychotherapy models. METHODS In this article, we aim to discuss the therapeutic potential of PAGP, as well as outline existing models and the challenges of this approach. Using Irvin Yalom's 11 therapeutic factors of group therapy as a basic framework, we analyse current literature from clinical studies and neurobiological research relative to the topic of PAGP. RESULTS We argue that combining psychedelic substances and group psychotherapy may prove beneficial for increasing group connectedness and interpersonal learning, potentially enhancing prosocial behaviour with direct opportunities to practice newly acquired knowledge about previously maladaptive behavioural patterns. Challenges regarding this approach include a more rigid therapy structure and potential loss of openness from patients, which may be ameliorated by adequate therapeutic training. CONCLUSION We hope for this article to support clinical research on PAGP by presenting a therapeutic framework and outlining its mechanisms and challenges.
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Affiliation(s)
| | | | - Abigail Calder
- Department of Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland
| | - Peter Oehen
- Private Practice for Psychiatry and Psychotherapy, Biberist, Switzerland
| | - Gregor Hasler
- Department of Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland
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Nutt D, Spriggs M, Erritzoe D. Psychedelics therapeutics: What we know, what we think, and what we need to research. Neuropharmacology 2023; 223:109257. [PMID: 36179919 DOI: 10.1016/j.neuropharm.2022.109257] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 12/14/2022]
Abstract
Psychedelic therapy is perhaps the most exciting new development in psychiatry. Not only does it offer a radical new approach to treatment where mainstream approaches have proven ineffective, but the growing evidence for transdiagnostic efficacy is eliciting a re-think of current diagnostic and symptom-specific approaches to psychiatry. This excitement has led to a massive investment in this field with many tens of new pharmaceutical companies being set up to research the effects of known psychedelics and develop new patentable molecules. Whilst this enthusiasm is to be welcomed, it is important that new research is properly grounded in established facts and reflects current knowledge. In this commentary we lay out the knowledge framework that should be taken into account by all innovative researchers in this field.
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Affiliation(s)
- David Nutt
- Centres for Neuropsychopharmacology and Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - Meg Spriggs
- Centres for Neuropsychopharmacology and Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK
| | - David Erritzoe
- Centres for Neuropsychopharmacology and Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK.
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35
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Conformational Landscape and Hydrogen Bonding Pattern of Psilocin: Computational Insights. ChemistrySelect 2023. [DOI: 10.1002/slct.202203994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Pędzich BD, Medrano M, Buckinx A, Smolders I, De Bundel D. Psychedelic-Induced Serotonin 2A Receptor Downregulation Does Not Predict Swim Stress Coping in Mice. Int J Mol Sci 2022; 23:ijms232315284. [PMID: 36499610 PMCID: PMC9736085 DOI: 10.3390/ijms232315284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Serotoninergic psychedelics such as psilocybin have been reported to elicit a long-lasting reduction in depressive symptoms. Although the main target for serotoninergic psychedelics, serotonin type 2A receptor (5-HT2A), has been established, the possible mechanism of the antidepressant action of psychedelics remains unknown. Using the mouse forced swim test model, we examined whether the administration of the synthetic serotoninergic psychedelic 2,5-dimethoxy-4-iodoamphetamine (DOI) would modulate 5-HT2A receptor levels in the medial prefrontal cortex (mPFC) and revert stress-induced changes in behavior. Mice subjected to swim stress developed a passive stress-coping strategy when tested in the forced swim test 6 days later. This change in behavior was not associated with the hypothesized increase in 5-HT2A receptor-dependent head twitch behaviors or consistent changes in 5-HT2A receptor levels in the mPFC. When DOI was administered 1 day before the forced swim test, a low dose (0.2 mg/kg i.p.) unexpectedly increased immobility while a high dose (2 mg/kg i.p.) had no significant effect on immobility. Nevertheless, DOI evoked a dose-dependent decrease in 5-HT2A levels in the mPFC of mice previously exposed to swim stress. Our findings do not support the hypothesis that the downregulation of 5-HT2A receptors in the mPFC contributes to the antidepressant-like properties of serotoninergic psychedelics.
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The Altered States Database: Psychometric data from a systematic literature review. Sci Data 2022; 9:720. [PMID: 36418335 PMCID: PMC9684144 DOI: 10.1038/s41597-022-01822-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
In this paper, we present the development of the Altered States Database (ASDB), an open-science project based on a systematic literature review. The ASDB contains psychometric questionnaire data on subjective experiences of altered states of consciousness (ASC) induced by pharmacological and non-pharmacological methods. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific journal articles were identified through PubMed and Web of Science. We included studies that examined ASC using the following validated questionnaires: Altered States of Consciousness Rating Scale (APZ, 5D-ASC, 11-ASC), Phenomenology of Consciousness Inventory (PCI), Hallucinogen Rating Scale (HRS), or Mystical Experience Questionnaire (MEQ30). The systematic review resulted in the inclusion of a total of 165 journal articles, whereof questionnaire data was extracted and is now available on the Open Science Framework (OSF) website (https://osf.io/8mbru) and on the ASDB website (http://alteredstatesdb.org), where questionnaire data can be easily retrieved and visualized. This data allows the calculation of comparable psychometric values of ASC experiences and of dose-response relationships of substances inducing ASC. Measurement(s) | Psychometric questionnaire data | Technology Type(s) | Systematic literature review (PRISMA) | Sample Characteristic - Organism | Human |
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Messell C, Summer L, Bonde LO, Beck BD, Stenbæk DS. Music programming for psilocybin-assisted therapy: Guided Imagery and Music-informed perspectives. Front Psychol 2022; 13:873455. [PMID: 36467212 PMCID: PMC9714440 DOI: 10.3389/fpsyg.2022.873455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/03/2022] [Indexed: 11/22/2023] Open
Abstract
The psychedelic drug psilocybin has been successfully explored as a novel treatment for a range of psychiatric disorders. Administration of psilocybin requires careful attention to psychological support and the setting in which the drug is administered. The use of music to support the acute psychoactive effects of psilocybin is recommended in current guidelines, but descriptions of how to compile music programs for the 4-6 h long sessions are still scarce. This article describes the procedural steps and considerations behind the curation of a new music program, the Copenhagen Music Program, tailored to the intensity profile of a medium/high dose psilocybin. The method of Guided Imagery and Music is presented as a music therapeutic framework for choosing and sequencing music in music programming and the Taxonomi of Therapeutic Music is presented as a rating tool to evaluate the music-psychological intensity of music pieces. Practical examples of how to organize the process of music programming are provided along with a full description of the Copenhagen Music Program and its structure. The aim of the article is to inspire others in their endeavours to create music programs for psychedelic interventions, while proposing that an informed music choice may support the therapeutic dynamics during acute effects of psilocybin.
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Affiliation(s)
- Catharina Messell
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lisa Summer
- Anna Maria College, Institute for Music and Consciousness, Paxton, MA, United States
| | - Lars Ole Bonde
- Center for Research in Music and Health, The Norwegian Academy of Music, Oslo, Norway
| | - Bolette Daniels Beck
- Institute for Communication and Psychology, Aalborg University, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Isham A, Elf P, Jackson T. Self-transcendent experiences as promoters of ecological wellbeing? Exploration of the evidence and hypotheses to be tested. Front Psychol 2022; 13:1051478. [PMID: 36452396 PMCID: PMC9701724 DOI: 10.3389/fpsyg.2022.1051478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/26/2022] [Indexed: 08/15/2023] Open
Abstract
In recent years, much has been written on the role of different mental states and their potential to influence our way of thinking and, perhaps more importantly, the way we act. With the recent acceleration of environmental and mental health issues, alongside the limited effectiveness of existing interventions, an exploration of new approaches to deliver transformative change is required. We therefore explore the emerging potential of a type of mental state known as self-transcendent experiences (STEs) as a driver of ecological wellbeing. We focus on four types of STEs: those facilitated by experiences of flow, awe, and mindfulness, as well as by psychedelic-induced experiences. Some of these experiences can occur naturally, through sometimes unexpected encounters with nature or during immersion in every-day activities that one intrinsically enjoys, as well as through more intentional practices such as meditation or the administration of psychedelics in controlled, legal settings. We explore the evidence base linking each of the four types of STE to ecological wellbeing before proposing potential hypotheses to be tested to understand why STEs can have such beneficial effects. We end by looking at the factors that might need to be considered if STEs are going to be practically implemented as a means of achieving ecological wellbeing.
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Affiliation(s)
- Amy Isham
- Centre for the Understanding of Sustainable Prosperity (CUSP), Centre for Environment and Sustainability, University of Surrey, Guildford, United Kingdom
- School of Psychology, Swansea University, Swansea, United Kingdom
| | - Patrick Elf
- Middlesex University Business School, Centre for Enterprise and Economic Development Research (CEEDR), Middlesex University, London, United Kingdom
| | - Tim Jackson
- Centre for the Understanding of Sustainable Prosperity (CUSP), Centre for Environment and Sustainability, University of Surrey, Guildford, United Kingdom
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Odland AU, Kristensen JL, Andreasen JT. Animal Behavior in Psychedelic Research. Pharmacol Rev 2022; 74:1176-1205. [PMID: 36180111 DOI: 10.1124/pharmrev.122.000590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/30/2022] [Indexed: 11/22/2022] Open
Abstract
Psychedelic-assisted psychotherapy holds great promise in the treatment of mental health disorders. Research into 5-hydroxytryptamine 2A receptor (5-HT2AR) agonist psychedelic compounds has increased dramatically over the past two decades. In humans, these compounds produce drastic effects on consciousness, and their therapeutic potential relates to changes in the processing of emotional, social, and self-referential information. The use of animal behavior to study psychedelics is under debate, and this review provides a critical perspective on the translational value of animal behavior studies in psychedelic research. Acute activation of 5-HT2ARs produces head twitches and unique discriminative cues, disrupts sensorimotor gating, and stimulates motor activity while inhibiting exploration in rodents. The acute treatment with psychedelics shows discrepant results in conventional rodent tests of depression-like behaviors but generally induces anxiolytic-like effects and inhibits repetitive behavior in rodents. Psychedelics impair waiting impulsivity but show discrepant effects in other tests of cognitive function. Tests of social interaction also show conflicting results. Effects on measures of time perception depend on the experimental schedule. Lasting or delayed effects of psychedelics in rodent tests related to different behavioral domains appear to be rather sensitive to changes in experimental protocols. Studying the effects of psychedelics on animal behaviors of relevance to effects on psychiatric symptoms in humans, assessing lasting effects, publishing negative findings, and relating behaviors in rodents and humans to other more translatable readouts, such as neuroplastic changes, will improve the translational value of animal behavioral studies in psychedelic research. SIGNIFICANCE STATEMENT: Psychedelics like LSD and psilocybin have received immense interest as potential new treatments of psychiatric disorders. Psychedelics change high-order consciousness in humans, and there is debate about the use of animal behavior studies to investigate these compounds. This review provides an overview of the behavioral effects of 5-HT2AR agonist psychedelics in laboratory animals and discusses the translatability of the effects in animals to effects in humans. Possible ways to improve the utility of animal behavior in psychedelic research are discussed.
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Affiliation(s)
- Anna U Odland
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, 2100, Denmark
| | - Jesper L Kristensen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, 2100, Denmark
| | - Jesper T Andreasen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, 2100, Denmark
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Erkizia-Santamaría I, Alles-Pascual R, Horrillo I, Meana J, Ortega J. Serotonin 5-HT2A, 5-HT2c and 5-HT1A receptor involvement in the acute effects of psilocybin in mice. In vitro pharmacological profile and modulation of thermoregulation and head-twich response. Biomed Pharmacother 2022; 154:113612. [DOI: 10.1016/j.biopha.2022.113612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/12/2022] [Accepted: 08/24/2022] [Indexed: 11/02/2022] Open
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Kurtz JS, Patel NA, Gendreau JL, Yang C, Brown N, Bui N, Picton B, Harris M, Hatter M, Beyer R, Sahyouni R, Diaz-Aguilar LD, Castellano J, Schuster N, Abraham ME. The Use of Psychedelics in the Treatment of Medical Conditions: An Analysis of Currently Registered Psychedelics Studies in the American Drug Trial Registry. Cureus 2022; 14:e29167. [PMID: 36259015 PMCID: PMC9567237 DOI: 10.7759/cureus.29167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 12/03/2022] Open
Abstract
Although early therapeutic research on psychedelics dates back to the 1940s, this field of investigation was met with many cultural and legal challenges in the 1970s. Over the past two decades, clinical trials using psychedelics have resumed. Therefore, the goal of this study was to (1) better characterize the recent uptrend in psychedelics in clinical trials and (2) identify areas where potentially new clinical trials could be initiated to help in the treatment of widely prevalent medical disorders. A systematic search was conducted on the clinicaltrials.gov database for all registered clinical trials examining the use of psychedelic drugs and was both qualitatively and quantitatively assessed. Analysis of recent studies registered in clinicaltrials.gov was performed using Pearson’s correlation coefficient testing. Statistical analysis and visualization were performed using R software. In totality, 105 clinical trials met this study’s inclusion criteria. The recent uptrend in registered clinical trials studying psychedelics (p = 0.002) was similar to the uptrend in total registered clinical trials in the registry (p < 0.001). All trials took place from 2007 to 2020, with 77.1% of studies starting in 2017 or later. A majority of clinical trials were in phase 1 (53.3%) or phase 2 (25.7%). Common disorders treated include substance addiction, post-traumatic stress disorder, and major depressive disorder. Potential research gaps include studying psychedelics as a potential option for symptomatic treatment during opioid tapering. There appears to be a recent uptrend in registered clinical trials studying psychedelics, which is similar to the recent increase in overall trials registered. Potentially, more studies could be performed to evaluate the potential of psychedelics for symptomatic treatment during opioid tapering and depression refractory to selective serotonin reuptake inhibitors.
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Cystathionine Gamma-Lyase Regulate Psilocybin Biosynthesis in Gymnopilus dilepis Mushroom via Amino Acid Metabolism Pathways. J Fungi (Basel) 2022; 8:jof8080870. [PMID: 36012858 PMCID: PMC9410116 DOI: 10.3390/jof8080870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
As a potential medicine for the treatment of depression, psilocybin has gradually attracted attention. To elucidate the molecular mechanism regulating psilocybin synthesis in Gymnopilus dilepis, ultra-performance liquid chromatography (UPLC) was used to detect the changes in psilocybin content after S-adenosyl-l-homocysteine (SAH) treatment and the changes of psilocybin content in different parts (stipe and pileus), and RNA-Seq was used to explore the mechanism of psilocybin content changes. In this study, the psilocybin content in G. dilepis mycelia treated with SAH was significantly lower than that in the control group, and the content of psilocybin in the stipe was significantly higher than that in the pileus. Transcriptome analysis revealed that differential expression genes (DEGs) were associated with cysteine and methionine metabolism. In particular, the transcription levels of genes encoding Cystathionine gamma-lyase (CTH) in different treatments and different parts were positively correlated with psilocybin content. In addition, we found that the exogenous addition of CTH activity inhibitor (DL-propargylglycine, PAG) could reduce the content of psilocybin and L-serine, and the content of psilocybin and L-serine returned to normal levels after L-cysteine supplementation, suggesting that psilocybin synthesis may be positively correlated with L-cysteine or CTH, and L-cysteine regulates the synthesis of psilocybin by affecting L-serine and 4-hydroxy-L-tryptophan. In conclusion, this study revealed a new molecular mechanism that affects psilocybin biosynthesis, which can provide a theoretical basis for improving psilocybin synthesis and the possibility for the development of biomedicine.
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Orłowski P, Ruban A, Szczypiński J, Hobot J, Bielecki M, Bola M. Naturalistic use of psychedelics is related to emotional reactivity and self-consciousness: The mediating role of ego-dissolution and mystical experiences. J Psychopharmacol 2022; 36:987-1000. [PMID: 35475373 DOI: 10.1177/02698811221089034] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Psychedelics are able to acutely alter emotional reactivity and self-consciousness. However, whether the regular naturalistic use of psychedelics can be linked to more persistent trait-level changes in these domains remains an open question. AIM To test the hypotheses that (1) using psychedelics is related to higher positive and lower negative emotional reactivity; and (2) an adaptive pattern of self-consciousness, including diminished public self-consciousness and rumination, and increased reflection and self-awareness; and (3) these relations are mediated by the intensity of past ego-dissolution and mystical experiences. METHOD An online survey including questions about the history of psychoactive substance use; questionnaires measuring trait levels of emotional reactivity and self-consciousness; questionnaires for retrospective assessment of ego-dissolution and mystical experiences. Data collected from 2516 participants (1661 psychedelics users) were analyzed using robust linear regression and mediation analysis. RESULTS A higher number of lifetime uses of psychedelics predicted greater positive and lower negative emotional reactivity; also, in the domain of self-consciousness, it predicted greater reflection and internal state awareness, and reduced rumination tendency and public self-consciousness. Finally, the intensity of past mystical and ego-dissolution experiences mediated almost all the observed relationships between the lifetime number of psychedelics uses and psychological variables. CONCLUSIONS Lifetime psychedelics use predicts an adaptive pattern of trait-level emotional reactivity and self-consciousness. Ego-dissolution and mystical experiences are essential in understanding the long-lasting psychological effects of psychedelics use. Our findings might potentially explain previous observations of increased well-being in psychedelics users.
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Affiliation(s)
- Paweł Orłowski
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Anastasia Ruban
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Jan Szczypiński
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Justyna Hobot
- Consciousness Lab, Institute of Psychology & Centre for Brain Research, Jagiellonian University, Krakow, Poland.,Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Maksymilian Bielecki
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Michał Bola
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
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Dodd S, Norman TR, Eyre HA, Stahl SM, Phillips A, Carvalho AF, Berk M. Psilocybin in neuropsychiatry: a review of its pharmacology, safety, and efficacy. CNS Spectr 2022; 28:1-11. [PMID: 35811423 DOI: 10.1017/s1092852922000888] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Psilocybin is a tryptamine alkaloid found in some mushrooms, especially those of the genus Psilocybe. Psilocybin has four metabolites including the pharmacologically active primary metabolite psilocin, which readily enters the systemic circulation. The psychoactive effects of psilocin are believed to arise due to the partial agonist effects at the 5HT2A receptor. Psilocin also binds to various other receptor subtypes although the actions of psilocin at other receptors are not fully explored. Psilocybin administered at doses sufficient to cause hallucinogenic experiences has been trialed for addictive disorders, anxiety and depression. This review investigates studies of psilocybin and psilocin and assesses the potential for use of psilocybin and a treatment agent in neuropsychiatry. The potential for harm is also assessed, which may limit the use of psilocybin as a pharmacotherapy. Careful evaluation of the number needed to harm vs the number needed to treat will ultimately justify the potential clinical use of psilocybin. This field needs a responsible pathway forward.
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Affiliation(s)
- Seetal Dodd
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Trevor R Norman
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Harris A Eyre
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
- Neuroscience-Inspired Policy Initiative, Organisation for Economic Co-Operation and Development (OECD), Meadows Mental Health Policy Institute and the PRODEO Institute, Paris, France
- Global Brain Health Institute, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Brain Health Nexus, Cohen Veterans Network, Boston, MA, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Stephen M Stahl
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Arnie Phillips
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - André F Carvalho
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
- School of Medicine, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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46
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The altered state of consciousness induced by Δ9-THC. Conscious Cogn 2022; 102:103357. [DOI: 10.1016/j.concog.2022.103357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/07/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
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McCulloch DEW, Knudsen GM, Barrett FS, Doss MK, Carhart-Harris RL, Rosas FE, Deco G, Kringelbach ML, Preller KH, Ramaekers JG, Mason NL, Müller F, Fisher PM. Psychedelic resting-state neuroimaging: A review and perspective on balancing replication and novel analyses. Neurosci Biobehav Rev 2022; 138:104689. [PMID: 35588933 DOI: 10.1016/j.neubiorev.2022.104689] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 12/20/2022]
Abstract
Clinical research into serotonergic psychedelics is expanding rapidly, showing promising efficacy across myriad disorders. Resting-state functional magnetic resonance imaging (rs-fMRI) is a commonly used strategy to identify psychedelic-induced changes in neural pathways in clinical and healthy populations. Here we, a large group of psychedelic imaging researchers, review the 42 research articles published to date, based on the 17 unique studies evaluating psychedelic effects on rs-fMRI, focusing on methodological variation. Prominently, we observe that nearly all studies vary in data processing and analysis methodology, two datasets are the foundation of over half of the published literature, and there is lexical ambiguity in common outcome metric terminology. We offer guidelines for future studies that encourage coherence in the field. Psychedelic rs-fMRI will benefit from the development of novel methods that expand our understanding of the brain mechanisms mediating its intriguing effects; yet, this field is at a crossroads where we must also consider the critical importance of consistency and replicability to effectively converge on stable representations of the neural effects of psychedelics.
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Affiliation(s)
| | - Gitte Moos Knudsen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Frederick Streeter Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience and Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manoj K Doss
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Lester Carhart-Harris
- Neuroscape, Weill Institute for Neurosciences, University of California San Francisco, CA, USA; Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK; Data Science Institute, Imperial College London, London, UK; Centre for Complexity Science, Imperial College London, London, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Barcelona, Spain; Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain; Institució Catalana de la Recerca i Estudis Avançats (ICREA), Barcelona, Spain; Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Denmark
| | - Katrin H Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Natasha L Mason
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Felix Müller
- University of Basel, Department of Psychiatry (UPK), Basel, Switzerland
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Vorobyeva N, Kozlova AA. Three Naturally-Occurring Psychedelics and Their Significance in the Treatment of Mental Health Disorders. Front Pharmacol 2022; 13:927984. [PMID: 35837277 PMCID: PMC9274002 DOI: 10.3389/fphar.2022.927984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 12/20/2022] Open
Abstract
Classical psychedelics represent a family of psychoactive substances with structural similarities to serotonin and affinity for serotonin receptors. A growing number of studies have found that psychedelics can be effective in treating various psychiatric conditions, including post-traumatic stress disorder, major depressive disorder, anxiety, and substance use disorders. Mental health disorders are extremely prevalent in the general population constituting a major problem for the public health. There are a wide variety of interventions for mental health disorders, including pharmacological therapies and psychotherapies, however, treatment resistance still remains a particular challenge in this field, and relapse rates are also quite high. In recent years, psychedelics have become one of the promising new tools for the treatment of mental health disorders. In this review, we will discuss the three classic serotonergic naturally occurring psychedelics, psilocybin, ibogaine, and N, N-dimethyltryptamine, focusing on their pharmacological properties and clinical potential. The purpose of this article is to provide a focused review of the most relevant research into the therapeutic potential of these substances and their possible integration as alternative or adjuvant options to existing pharmacological and psychological therapies.
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Affiliation(s)
- Nataliya Vorobyeva
- Hive Bio Life Sciences Ltd., London, United Kingdom
- *Correspondence: Nataliya Vorobyeva,
| | - Alena A. Kozlova
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Johnson S, Letheby C. Psychedelic therapy for body dysmorphic disorder. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms with BDD. Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed.
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Affiliation(s)
- Shevaugn Johnson
- College of Education, Psychology, and Social Work, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Chris Letheby
- Department of Philosophy, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, 6009, Australia
- Department of Philosophy, The University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia
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50
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Viktorin V, Griškova-Bulanova I, Voicikas A, Dojčánová D, Zach P, Bravermanová A, Andrashko V, Tylš F, Korčák J, Viktorinová M, Koudelka V, Hájková K, Kuchař M, Horáček J, Brunovský M, Páleníček T. Psilocybin—Mediated Attenuation of Gamma Band Auditory Steady-State Responses (ASSR) Is Driven by the Intensity of Cognitive and Emotional Domains of Psychedelic Experience. J Pers Med 2022; 12:jpm12061004. [PMID: 35743788 PMCID: PMC9225116 DOI: 10.3390/jpm12061004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Psilocybin is a classical serotoninergic psychedelic that induces cognitive disruptions similar to psychosis. Gamma activity is affected in psychosis and is tightly related to cognitive processing. The 40 Hz auditory steady-state responses (ASSR) are frequently used as indicators to test the ability to generate gamma activity. Based on previous literature, we studied the impact of psilocybin on 40 Hz ASSR in healthy volunteers. The study was double blind and placebo controlled with a crossover design. A sample of 20 healthy subjects (10M/10F) received psilocybin orally 0.26 mg/kg or placebo. Participants were measured four times in total, one time before ingestion of psilocybin/placebo and one time after ingestion, during the peak of intoxication. A series of 500 ms click trains were used for stimulation. Psilocybin induced a psychedelic effect and decreased 40 Hz ASSR phase-locking index compared to placebo. The extent of the attenuation was related to Cognition and Affect on the Hallucinogen Rating Scale. The current study shows that psilocybin lowers the synchronization level and the amplitude of 40 Hz auditory steady-state responses, which yields further support for the role of gamma oscillations in cognitive processing and its disturbance.
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Affiliation(s)
- Vojtěch Viktorin
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Inga Griškova-Bulanova
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Institute of Biosciences, Vilnius University, 7 Saulėtekio Ave, 10257 Vilnius, Lithuania;
- Correspondence: (I.G.-B.); (T.P.)
| | - Aleksandras Voicikas
- Institute of Biosciences, Vilnius University, 7 Saulėtekio Ave, 10257 Vilnius, Lithuania;
| | - Dominika Dojčánová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Peter Zach
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
| | - Anna Bravermanová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- First Faculty of Medicine, Charles University, Kateřinská 32, 121 08 Prague, Czech Republic
| | - Veronika Andrashko
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Filip Tylš
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Jakub Korčák
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
| | - Michaela Viktorinová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Vlastimil Koudelka
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
| | - Kateřina Hájková
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (K.H.); (M.K.)
| | - Martin Kuchař
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (K.H.); (M.K.)
| | - Jiří Horáček
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Martin Brunovský
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
| | - Tomáš Páleníček
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (V.V.); (D.D.); (P.Z.); (A.B.); (V.A.); (F.T.); (J.K.); (M.V.); (V.K.); (J.H.); (M.B.)
- Third Faculty of Medicine, Charles University, Ruská 2411, 100 00 Prague, Czech Republic
- Correspondence: (I.G.-B.); (T.P.)
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