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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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2
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Peled-Avron L, Aday JS, Kalafateli AL, Hamilton HK, Woolley JD. Editorial: Down the rabbit hole - the psychological and neural mechanisms of psychedelic compounds and their use in treating mental health and medical conditions. Front Psychiatry 2024; 15:1431389. [PMID: 38915850 PMCID: PMC11194731 DOI: 10.3389/fpsyt.2024.1431389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 05/20/2024] [Indexed: 06/26/2024] Open
Affiliation(s)
- Leehe Peled-Avron
- Department of Psychology and Gonda Interdisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Jacob S. Aday
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Holly K. Hamilton
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
- Mental Health Service, Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Joshua D. Woolley
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
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3
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Buzzi B, AlSharari SD, Walentiny DM, Damaj MI. Nelotanserin, a selective 5-HT2A receptor inverse agonist, attenuates aspects of nicotine withdrawal but not reward in mice. Behav Brain Res 2024; 467:115019. [PMID: 38677331 PMCID: PMC11250952 DOI: 10.1016/j.bbr.2024.115019] [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: 02/02/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Nicotine smoking contributes to many preventable disabilities, diseases and deaths. Targeting nicotine reward and withdrawal is a basis for the majority of smoking cessation pharmacotherapies. Due to the emergence of interest in 5-HT2A receptor modulators for numerous psychiatric disorders, we investigated the effect of nelotanserin, a 5-HT2A receptor inverse agonist, on nicotine reward and withdrawal in ICR mice. In nicotine-dependent mice, nelotanserin dose-dependently reduced somatic signs of nicotine withdrawal and thermal hyperalgesia as measured in the hot plate test. However, nelotanserin had no effect on anxiety-like behavior and failed to reduce nicotine reward as measured in the conditioned place preference test. Our results suggest that inverse agonism of the 5-HT2A receptor may be a feasible novel mechanism for smoking cessation by reducing both physical withdrawal and thermal hyperalgesia associated with nicotine abstinence but may require complementary pharmacotherapies targeting affective and reward-associated decrements to improve cessation outcomes.
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Affiliation(s)
- Belle Buzzi
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Shakir D AlSharari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - David M Walentiny
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
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Sloshower J, Zeifman RJ, Guss J, Krause R, Safi-Aghdam H, Pathania S, Pittman B, D'Souza DC. Psychological flexibility as a mechanism of change in psilocybin-assisted therapy for major depression: results from an exploratory placebo-controlled trial. Sci Rep 2024; 14:8833. [PMID: 38632313 PMCID: PMC11024097 DOI: 10.1038/s41598-024-58318-x] [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: 09/07/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Several phase II studies have demonstrated that psilocybin-assisted therapy shows therapeutic potential across a spectrum of neuropsychiatric conditions, including major depressive disorder (MDD). However, the mechanisms underlying its often persisting beneficial effects remain unclear. Observational research suggests that improvements in psychological flexibility may mediate therapeutic effects. However, no psychedelic trials to date have substantiated this finding in a clinical sample. In an exploratory placebo-controlled, within-subject, fixed-order study, individuals with moderate to severe MDD were administered placebo (n = 19) followed by psilocybin (0.3 mg/kg) (n = 15) 4 weeks later. Dosing sessions were embedded within a manualized psychotherapy that incorporated principles of Acceptance and Commitment Therapy. Depression severity, psychological flexibility, mindfulness, and values-congruent living were measured over a 16-weeks study period. Psychological flexibility, several facets of mindfulness, and values-congruent living significantly improved following psilocybin and were maintained through week 16. Additionally, improvements in psychological flexibility and experiential acceptance were strongly associated with reductions in depression severity following psilocybin. These findings support the theoretical premise of integrating psilocybin treatment with psychotherapeutic platforms that target psychological flexibility and add to emerging evidence that increasing psychological flexibility may be an important putative mechanism of change in psilocybin-assisted therapy for MDD and potentially, other mental health conditions.
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Affiliation(s)
- Jordan Sloshower
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.
- West Rock Wellness PLLC, New Haven, CT, USA.
| | - Richard J Zeifman
- NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Jeffrey Guss
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Robert Krause
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
- Centered PLLC, New Haven, CT, USA
| | - Hamideh Safi-Aghdam
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Surbhi Pathania
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
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5
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Glynos NG, Aday JS, Kruger D, Boehnke KF, Lake S, Lucas P. Psychedelic substitution: altered substance use patterns following psychedelic use in a global survey. Front Psychiatry 2024; 15:1349565. [PMID: 38455520 PMCID: PMC10917882 DOI: 10.3389/fpsyt.2024.1349565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Recent research suggests that psychedelics may have potential for the treatment of various substance use disorders. However, most studies to date have been limited by small sample sizes and neglecting to include non-North American and European populations. Methods We conducted a global, cross-sectional online survey of adults (n = 5,268, 47.2% women) self-reporting past or current psychedelic use and investigated whether psychedelic use was associated with changes in use of other substances. Results Nearly three-quarters (70.9%; n = 3,737/5,268) reported ceasing or decreasing use of one or more non-psychedelic substances after naturalistic psychedelic use. Among those with previous use, 60.6% (n = 2,634/4,344) decreased alcohol use, 55.7% (n = 1,223/2,197) decreased antidepressant use, and 54.2% (n = 767/1,415) decreased use of cocaine/crack. Over a quarter of the sample indicated that their decrease in substance use persisted for 26 weeks or more following use of a psychedelic. Factors associated with decreased use included a motivation to either decrease one's substance use or self-treat a medical condition. Importantly, 19.8% of respondents also reported increased or initiated use of one or more other substances after psychedelic use, with illicit opioids (14.7%; n = 86/584) and cannabis (13.3%; n = 540/4,064) having the highest proportions. Factors associated with increased substance use included having a higher income and residing in Canada or the US. Discussion Although limited by cross-sectional study design, this large observational study will help inform future studies aiming to investigate the relationship between substance use patterns and psychedelic use.
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Affiliation(s)
- Nicolas G. Glynos
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States
- Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Abor, MI, United States
- Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States
| | - Jacob S. Aday
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States
- Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Abor, MI, United States
- Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States
| | - Daniel Kruger
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Kevin F. Boehnke
- Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States
- Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Abor, MI, United States
- Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States
| | - Stephanie Lake
- University of California Los Angeles (UCLA) Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Villiger D. Giving Consent to the Ineffable. NEUROETHICS-NETH 2024; 17:11. [PMID: 38371714 PMCID: PMC10869409 DOI: 10.1007/s12152-024-09545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment's transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience.
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Affiliation(s)
- Daniel Villiger
- Institute of Philosophy, University of Zurich, Zollikerstrasse 117, 8008 Zurich, Switzerland
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Yaden DB, Berghella AP, Hendricks PS, Yaden ME, Levine M, Rohde JS, Nayak S, Johnson MW, Garcia-Romeu A. IUPHAR-review: The integration of classic psychedelics into current substance use disorder treatment models. Pharmacol Res 2024; 199:106998. [PMID: 38029805 DOI: 10.1016/j.phrs.2023.106998] [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: 07/12/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
Substance use disorders (SUDs) have an enormous impact on public health. With classic psychedelic-assisted therapies showing initial promise in treating multiple SUDs, it is possible that these treatments will become legally available options for patients with SUDs in the future. This article highlights how classic psychedelic-assisted therapies might be integrated into current clinical practice. We first describe contemporary evidence-based treatments for SUDs and highlight how classic psychedelic-assisted therapies might fit within each treatment. We suggest that classic psychedelic-assisted therapies can be integrated into most mainstream evidence-based SUD treatments that are currently used in clinical settings, indicating broad compatibility of classic psychedelics with contemporary SUD treatment paradigms.
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Affiliation(s)
- David B Yaden
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Andrea P Berghella
- Thomas Jefferson University MD/PhD Program, Sidney Kimmel Medical College and Jefferson College of Life Sciences, Philadelphia, USA
| | - Peter S Hendricks
- School of Public Health, The University of Alabama at Birmingham, Birmingham, USA
| | - Mary E Yaden
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Michael Levine
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Julia S Rohde
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sandeep Nayak
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Matthew W Johnson
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Albert Garcia-Romeu
- Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
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8
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Abstract
Cannabis and classic psychedelics are controlled substances with emerging evidence of efficacy in the treatment of a variety of psychiatric illnesses. Cannabis has largely not been regarded as having psychedelic effects in contemporary literature, despite many examples of historical use along with classic psychedelics to attain altered states of consciousness. Research into the "psychedelic" effects of cannabis, and delta-9-tetrahydrocannabinol (THC) in particular, could prove helpful for assessing potential therapeutic indications and elucidating the mechanism of action of both cannabis and classic psychedelics. This review aggregates and evaluates the literature assessing the capacity of cannabis to yield the perceptual changes, aversiveness, and mystical experiences more typically associated with classic psychedelics such as psilocybin. This review also provides a brief contrast of neuroimaging findings associated with the acute effects of cannabis and psychedelics. The available evidence suggests that high-THC cannabis may be able to elicit psychedelic effects, but that these effects may not have been observed in recent controlled research studies due to the doses, set, and settings commonly used. Research is needed to investigate the effects of high doses of THC in the context utilized in therapeutic studies of psychedelics aimed to occasion psychedelic and/or therapeutic experiences. If cannabis can reliably generate psychedelic experiences under these conditions, high-THC dose cannabis treatments should be explored as potential adjunctive treatments for psychiatric disorders and be considered as an active comparator in clinical trials involving traditional psychedelic medications.
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Affiliation(s)
- David Wolinsky
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Frederick Streeter Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychological & Brain Sciences, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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9
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Jerotic K, Vuust P, Kringelbach ML. Psychedelia: The interplay of music and psychedelics. Ann N Y Acad Sci 2024; 1531:12-28. [PMID: 37983198 DOI: 10.1111/nyas.15082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Music and psychedelics have been intertwined throughout the existence of Homo sapiens, from the early shamanic rituals of the Americas and Africa to the modern use of psychedelic-assisted therapy for a variety of mental health conditions. Across such settings, music has been highly prized for its ability to guide the psychedelic experience. Here, we examine the interplay between music and psychedelics, starting by describing their association with the brain's functional hierarchy that is relied upon for music perception and its psychedelic-induced manipulation, as well as an exploration of the limited research on their mechanistic neural overlap. We explore music's role in Western psychedelic therapy and the use of music in indigenous psychedelic rituals, with a specific focus on ayahuasca and the Santo Daime Church. Furthermore, we explore work relating to the evolution and onset of music and psychedelic use. Finally, we consider music's potential to lead to altered states of consciousness in the absence of psychedelics as well as the development of psychedelic music. Here, we provide an overview of several perspectives on the interaction between psychedelic use and music-a topic with growing interest given increasing excitement relating to the therapeutic efficacy of psychedelic interventions.
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Affiliation(s)
- Katarina Jerotic
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Aarhus, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Aarhus, Denmark
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Aarhus, Denmark
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10
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Weiss B, Ginige I, Shannon L, Giribaldi B, Murphy-Beiner A, Murphy R, Baker-Jones M, Martell J, Nutt DJ, Carhart-Harris RL, Erritzoe D. Personality change in a trial of psilocybin therapy v. escitalopram treatment for depression. Psychol Med 2024; 54:178-192. [PMID: 37264814 PMCID: PMC10692311 DOI: 10.1017/s0033291723001514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's therapeutic action. METHODS In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up. RESULTS PT was associated with decreases in neuroticism (B = -0.63), introversion (B = -0.38), disagreeableness (B = -0.47), impulsivity (B = -0.40), and increases in absorption (B = 0.32), conscientiousness (B = 0.30), and openness (B = 0.23) at week 6, with neuroticism (B = -0.47) and disagreeableness (B = -0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism (B = -0.38), disagreeableness (B = -0.26), impulsivity (B = -0.35), and increases in openness (B = 0.28) at week 6, with neuroticism (B = -0.46) remaining decreased at month 6. No significant between-condition differences were observed. CONCLUSIONS Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT (v. ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.
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Affiliation(s)
- Brandon Weiss
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Induni Ginige
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Lu Shannon
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Ashleigh Murphy-Beiner
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Roberta Murphy
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Michelle Baker-Jones
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Jonny Martell
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - David J. Nutt
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
| | - Robin L. Carhart-Harris
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, CA, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, UK
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Villiger D, Trachsel M. With great power comes great vulnerability: an ethical analysis of psychedelics' therapeutic mechanisms proposed by the REBUS hypothesis. JOURNAL OF MEDICAL ETHICS 2023; 49:826-832. [PMID: 37045591 DOI: 10.1136/jme-2022-108816] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
Psychedelics are experiencing a renaissance in mental healthcare. In recent years, more and more early phase trials on psychedelic-assisted therapy have been conducted, with promising results overall. However, ethical analyses of this rediscovered form of treatment remain rare. The present paper contributes to the ethical inquiry of psychedelic-assisted therapy by analysing the ethical implications of its therapeutic mechanisms proposed by the relaxed beliefs under psychedelics (REBUS) hypothesis. In short, the REBUS hypothesis states that psychedelics make rigid beliefs revisable by increasing the influence of bottom-up input. Put differently, patients become highly suggestible and sensitive to context during a psychedelic session, amplifying therapeutic influence and effects. Due to that, patients are more vulnerable in psychedelic-assisted therapy than in other therapeutic interventions; they lose control during a psychedelic session and become dependent on the therapeutic setting (including the therapist). This enhanced vulnerability is ethically relevant and has been exploited by some therapists in the past. Therefore, patients in current research settings and starting mainstream medical settings need to be well informed about psychedelics' mechanisms and their implications to give valid informed consent to treatment. Furthermore, other security measures are warranted to protect patients from the vulnerability coming with psychedelic-assisted therapy.
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Affiliation(s)
- Daniel Villiger
- Department of Philosophy, University of Zurich, Zurich, Switzerland
| | - Manuel Trachsel
- Clinical Ethics Unit of University Hospital Basel and Psychiatric University Clinics, Basel, Switzerland
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12
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Romeo B, Fauvel B, Dejean S, Strika L, Amirouche A, Verroust V, Piolino P, Benyamina A. Impact of a Naturalistic Psychedelic Experience on Smoking: A Retrospective Survey. J Psychoactive Drugs 2023; 55:640-649. [PMID: 37341764 DOI: 10.1080/02791072.2023.2227171] [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: 10/01/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 06/22/2023]
Abstract
Tobacco use disorder is a major public health concern. The aim of this study was to investigate the impact of a psychedelic experience in a natural context on tobacco use. A retrospective online survey was conducted on 173 individuals who reported having had a psychedelic experience while being smokers. Demographic information was collected, and characteristics of the psychedelic experience, tobacco addiction and psychological flexibility were assessed. Mean number of cigarettes smoked per day, and proportion of individuals with high tobacco dependency significantly decreased between the three time points (p < .001). Participants who reduced or quit smoking had more intense mystical experiences during the psychedelic session (p = .01) and lower psychological flexibility before the psychedelic experience (p = .018). The increase in psychological flexibility post psychedelic session, and the personal motives for the psychedelic experience were significant positive predictors of smoking reduction or cessation (p < .001). Our results confirmed that a psychedelic experience in smoker individuals can be associated with smoking and tobacco dependency reduction and that the personal motives for the psychedelic session, the intensity of the mystical experience, and the increase of psychological flexibility following the psychedelic experience, are associated with smoking cessation or reduction.
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Affiliation(s)
- B Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD -Paris Saclay University Île-de-France, Villejuif, France
| | - B Fauvel
- Laboratoire Mémoire, Cerveau Et Cognition (UR 7536), Institut de Psychologie, Université de Paris Cité, Paris, France
| | - S Dejean
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - L Strika
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD -Paris Saclay University Île-de-France, Villejuif, France
| | - A Amirouche
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD -Paris Saclay University Île-de-France, Villejuif, France
| | - V Verroust
- Unité de Recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD -Paris Saclay University Île-de-France, Villejuif, France
- Centre d'histoire des sciences, des sociétés et des conflits, Université Picardie-Jules Vernes, Amiens, France
| | - P Piolino
- Laboratoire Mémoire, Cerveau Et Cognition (UR 7536), Institut de Psychologie, Université de Paris Cité, Paris, France
| | - A Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD -Paris Saclay University Île-de-France, Villejuif, France
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13
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Nayak SM, Jackson H, Sepeda ND, Mathai DS, So S, Yaffe A, Zaki H, Brasher TJ, Lowe MX, Jolly DRP, Barrett FS, Griffiths RR, Strickland JC, Johnson MW, Jackson H, Garcia-Romeu A. Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey. Front Psychiatry 2023; 14:1199642. [PMID: 37795509 PMCID: PMC10545967 DOI: 10.3389/fpsyt.2023.1199642] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction The classic psychedelic psilocybin, found in some mushroom species, has received renewed interest in clinical research, showing potential mental health benefits in preliminary trials. Naturalistic use of psilocybin outside of research settings has increased in recent years, though data on the public health impact of such use remain limited. Methods This prospective, longitudinal study comprised six sequential automated web-based surveys that collected data from adults planning to take psilocybin outside clinical research: at time of consent, 2 weeks before, the day before, 1-3 days after, 2-4 weeks after, and 2-3 months after psilocybin use. Results A sample of 2,833 respondents completed all baseline assessments approximately 2 weeks before psilocybin use, 1,182 completed the 2-4 week post-use survey, and 657 completed the final follow-up survey 2-3 months after psilocybin use. Participants were primarily college-educated White men residing in the United States with a prior history of psychedelic use; mean age = 40 years. Participants primarily used dried psilocybin mushrooms (mean dose = 3.1 grams) for "self-exploration" purposes. Prospective longitudinal data collected before and after a planned psilocybin experience on average showed persisting reductions in anxiety, depression, and alcohol misuse, increased cognitive flexibility, emotion regulation, spiritual wellbeing, and extraversion, and reduced neuroticism and burnout after psilocybin use. However, a minority of participants (11% at 2-4 weeks and 7% at 2-3 months) reported persisting negative effects after psilocybin use (e.g., mood fluctuations, depressive symptoms). Discussion Results from this study, the largest prospective survey of naturalistic psilocybin use to date, support the potential for psilocybin to produce lasting improvements in mental health symptoms and general wellbeing.
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Affiliation(s)
- Sandeep M. Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hillary Jackson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nathan D. Sepeda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic Drug Research and Education, The Ohio State University, Columbus, OH, United States
| | - David S. Mathai
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sara So
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Abigail Yaffe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hadi Zaki
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | | | | | - Frederick S. Barrett
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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14
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Buot A, Pallares C, Oganesyan A, Dauré C, Bonnelle V, Burguière E, Dos Santos JFA, N'Diaye K, Ljuslin M, Smith P, Verroust V, Wyplosz B, Morgiève M, Mallet L. Improvement in OCD symptoms associated with serotoninergic psychedelics: a retrospective online survey. Sci Rep 2023; 13:13378. [PMID: 37591906 PMCID: PMC10435518 DOI: 10.1038/s41598-023-39812-0] [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: 03/13/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
A renewed interest in the use of psychedelics for treating obsessive compulsive disorder (OCD) has emerged in the last 20 years. But pre-clinical and clinical evidence remain scarce, and little is known about the factor determining the magnitude and persistence of the therapeutic effect. We therefore designed a retrospective online survey to explore, in the general population using psychoactive drugs, their impact on OCD symptoms. We also assessed the attitude of the participants towards the substance in term of frequency of intakes. In a sample of 174 participants, classic psychedelics were reported as the only substances effective at reducing OCD symptoms. In classic psychedelics users, symptoms reduction was associated with the intensity of acute effects, itself correlated to the dose. Reports on the persistence of the therapeutic effect varied from weeks to months, but we could not find any predicting factor. Finally, the occurrence and frequency of subsequent intakes, which seemed to be limited in our sample, were predicted by the magnitude and persistence of the therapeutic effect, respectively. Our observations support the hypothesis of classic psychedelics efficacy in reducing OCD symptoms but a careful evaluation of the persistence of this effect is still needed.
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Affiliation(s)
- Anne Buot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France.
| | - Cecile Pallares
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | | | - Charles Dauré
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | | | - Eric Burguière
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | | | - Karim N'Diaye
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Michael Ljuslin
- Service de Médecine Palliative, Département de Réadaptation Et Gériatrie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Pauline Smith
- Environmental Justice Program, Georgetown University, Washington, D.C, USA
| | - Vincent Verroust
- RESPADD, Paris, France
- UR PSYCOMADD- CHU Paul Brousse, Villejuif, France
- Université de Picardie-Jules Vernes, Amiens, France
| | - Benjamin Wyplosz
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Margot Morgiève
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
- Université Paris Cité, CNRS, Inserm, Cermes3, Paris, France
| | - Luc Mallet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
- Department of Mental Health and Psychiatry, University of Geneva, Geneva, Switzerland
- Univ Paris-Est Créteil, DMU IMPACT, Département Médical-Universitaire de Psychiatrie Et d'Addictologie, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France
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15
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Zafar R, Siegel M, Harding R, Barba T, Agnorelli C, Suseelan S, Roseman L, Wall M, Nutt DJ, Erritzoe D. Psychedelic therapy in the treatment of addiction: the past, present and future. Front Psychiatry 2023; 14:1183740. [PMID: 37377473 PMCID: PMC10291338 DOI: 10.3389/fpsyt.2023.1183740] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023] Open
Abstract
Psychedelic therapy has witnessed a resurgence in interest in the last decade from the scientific and medical communities with evidence now building for its safety and efficacy in treating a range of psychiatric disorders including addiction. In this review we will chart the research investigating the role of these interventions in individuals with addiction beginning with an overview of the current socioeconomic impact of addiction, treatment options, and outcomes. We will start by examining historical studies from the first psychedelic research era of the mid-late 1900s, followed by an overview of the available real-world evidence gathered from naturalistic, observational, and survey-based studies. We will then cover modern-day clinical trials of psychedelic therapies in addiction from first-in-human to phase II clinical trials. Finally, we will provide an overview of the different translational human neuropsychopharmacology techniques, including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), that can be applied to foster a mechanistic understanding of therapeutic mechanisms. A more granular understanding of the treatment effects of psychedelics will facilitate the optimisation of the psychedelic therapy drug development landscape, and ultimately improve patient outcomes.
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Affiliation(s)
- Rayyan Zafar
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Maxim Siegel
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rebecca Harding
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - Tommaso Barba
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Claudio Agnorelli
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Shayam Suseelan
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Matthew Wall
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Invicro, London, United Kingdom
| | - David John Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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16
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Strika-Bruneau L, Fauvel B, Dupuis D, Benyamina A. Articulation de la thérapie d’acceptation et d’engagement à la psychothérapie assistée par psychédéliques en addictologie. L'ÉVOLUTION PSYCHIATRIQUE 2023. [DOI: 10.1016/j.evopsy.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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17
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Ellison-Barnes A, Galiatsatos P. Initiating Pharmacologic Treatment in Tobacco-Dependent Adults. Med Clin North Am 2022; 106:1067-1080. [PMID: 36280333 DOI: 10.1016/j.mcna.2022.07.008] [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] [Indexed: 11/20/2022]
Abstract
There is a strong evidence base for the use of existing pharmacotherapies to support tobacco cessation, alone or in combination, ideally with concurrent behavioral interventions. Future pharmacotherapies under development may assist in the most refractory cases. Incorporating current and future therapies into a longitudinal chronic care model for tobacco dependence will help a diverse range of patients achieve independence from nicotine addiction.
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Affiliation(s)
- Alejandra Ellison-Barnes
- The Tobacco Treatment and Cancer Screening Clinic, The Johns Hopkins Health System, Baltimore, MD, USA; Division of General Internal Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Panagis Galiatsatos
- The Tobacco Treatment and Cancer Screening Clinic, The Johns Hopkins Health System, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
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18
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Søgaard Juul T, Ebbesen Jensen M, Fink-Jensen A. The use of classic psychedelics among adults: a Danish online survey study. Nord J Psychiatry 2022; 77:367-378. [PMID: 36173202 DOI: 10.1080/08039488.2022.2125069] [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: 10/14/2022]
Abstract
BACKGROUND Clinical studies report preliminary therapeutic effects of classic psychedelic drugs in several psychiatric conditions and international drug trends show increased use of these compounds. However, the epidemiology of classic psychedelic drug use in Scandinavian countries remains sparsely investigated. To this end, we investigated the patterns of use and the subjectively perceived acute and persisting effects of lysergic acid diethylamide (LSD), psilocybin, N,N-dimethyltryptamine (DMT), and mescaline, among Danish adults. METHODS An anonymous online survey with 152 items was conducted using the secure survey web application REDCap. Results were presented descriptively and as comparisons between psychedelic drugs. RESULTS Five-hundred participants (30.0% female, mean age 34.5 years) were included. Classic psychedelics were mostly used with therapeutic (28.0%) or spiritual (27.2%) intentions. Sixty-seven per cent used classic psychedelics once a year or less. Most participants (56.4%) preferred using psilocybin. Classic psychedelic use was for some individuals, associated with hazardous use of alcohol (39.4%). Among participants with a psychiatric treatment history, 80.9% reported subjective improvements in symptoms following classic psychedelic use. Participants' most memorable experiences were moderate-to-strong mystical-type experiences (MEQ30 mean ± SD 3.4 ± 1.0; range 1-5) and had positive persisting effects on well-being (mean ± SD 2.1 ± 1.0), social relationships (mean ± SD 1.7 ± 1.2), meaning of life (mean ± SD 1.9 ± 1.1), and mood (mean ± SD 1.8 ± 1.1); range -3 to 3. DMT users experienced significantly greater subjective positive effects. CONCLUSIONS Classic psychedelics were mostly used therapeutically or spiritually and had self-reported positive persisting effects, but were also associated with hazardous use of alcohol, among Danish adults. DMT was associated with significantly greater positive effects compared to LSD and psilocybin.
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Affiliation(s)
- Tobias Søgaard Juul
- Mental Health Services, Psychiatric Centre Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Ebbesen Jensen
- Mental Health Services, Psychiatric Centre Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Fink-Jensen
- Mental Health Services, Psychiatric Centre Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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19
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Poulie CBM, Pottie E, Simon IA, Harpsøe K, D'Andrea L, Komarov IV, Gloriam DE, Jensen AA, Stove CP, Kristensen JL. Discovery of β-Arrestin-Biased 25CN-NBOH-Derived 5-HT 2A Receptor Agonists. J Med Chem 2022; 65:12031-12043. [PMID: 36099411 PMCID: PMC9511481 DOI: 10.1021/acs.jmedchem.2c00702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The serotonin 2A receptor (5-HT2AR) is the mediator of the psychedelic effects of serotonergic psychedelics, which have shown promising results in clinical studies for several neuropsychiatric indications. The 5-HT2AR is able to signal through the Gαq and β-arrestin effector proteins, but it is currently not known how the different signaling pathways contribute to the therapeutic effects mediated by serotonergic psychedelics. In the present work, we have evaluated the subtype-selective 5-HT2AR agonist 25CN-NBOH and a series of close analogues for biased signaling at this receptor. These ligands were designed to evaluate the role of interactions with Ser1593×36. The lack of interaction between this hydroxyl moiety and Ser1593×36 resulted in detrimental effects on potency and efficacy in both βarr2 and miniGαq recruitment assays. Remarkably, Gαq-mediated signaling was considerably more affected. This led to the development of the first efficacious βarr2-biased 5-HT2AR agonists 4a-b and 6e-f, βarr2 preferring, relative to lysergic acid diethylamide (LSD).
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Affiliation(s)
- Christian B M Poulie
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | - Eline Pottie
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Campus Heymans, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Icaro A Simon
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | - Kasper Harpsøe
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | - Laura D'Andrea
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | | | - David E Gloriam
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | - Anders A Jensen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Campus Heymans, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Jesper L Kristensen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK─2100 Copenhagen, Denmark
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20
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Barnett BS, Weleff J. Psychedelics in the Treatment of Substance Use Disorders. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220804-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Moreton SG, Burden-Hill A, Menzies RE. Reduced death anxiety and obsessive beliefs as mediators of the therapeutic effects of psychedelics on obsessive compulsive disorder symptomology. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2086793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sam G. Moreton
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Amber Burden-Hill
- School of Psychology, University of Wollongong, Wollongong, Australia
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22
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Jones G, Lipson J, Nock MK. Associations between classic psychedelics and nicotine dependence in a nationally representative sample. Sci Rep 2022; 12:10578. [PMID: 35732796 PMCID: PMC9216303 DOI: 10.1038/s41598-022-14809-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Tobacco use is the single largest cause of preventable death worldwide, but none of the established treatments aimed at smoking cessation work for a majority of smokers. As such, there is an urgent need for interventions capable of reliably treating nicotine addiction. The use of classic psychedelics has been associated with lower odds of many forms of substance dependence. Here we tested whether lifetime use of classic psychedelics (tryptamine, lysergamide, and phenethylamine) is associated with lower odds of current nicotine dependence. We tested these associations in a sample of 214,505 adult participants in the National Survey on Drug Use and Health (2015–2019) using multivariable logistic regression models. Lifetime psilocybin use was associated with reduced odds of odds of current nicotine dependence (aOR 0.87–0.93). Lifetime use of peyote and mescaline also conferred reduced odds of multiple subdomains of a main nicotine dependence measure (Nicotine Dependence Syndrome Scale [NDSS]) (aOR 0.79–0.91). Conversely, lifetime use of LSD was associated with increased odds of nicotine dependence (aOR 1.17–1.24). Psilocybin, mescaline, and peyote use are associated with lowered odds of nicotine dependence. Experimental studies are needed to establish whether these associations are causal. These results make the case for further research into the efficacy of both tryptamine and phenethylamine psychedelics in promoting smoking cessation.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA.
| | - Joshua Lipson
- Teacher's College, Columbia University, New York, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA
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23
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Frymann T, Whitney S, Yaden DB, Lipson J. The Psychedelic Integration Scales: Tools for Measuring Psychedelic Integration Behaviors and Experiences. Front Psychol 2022; 13:863247. [PMID: 35677137 PMCID: PMC9168432 DOI: 10.3389/fpsyg.2022.863247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
In this study, we describe the development and initial validation of two psychometric scales for measuring psychedelic integration. Psychedelic integration refers to the post-acute period of time following psychedelic drug administration. We created the Integration Engagement Scale (IES) to capture positive behavioral engagement with integration and the Experienced Integration Scale (EIS) to capture internal aspects of feeling integrated. These scales were developed to measure post-acute psychedelic administration dynamics in order to inform the creation of enhanced integration support and to help refine a general conceptual understanding of the construct of psychedelic integration. The scales are brief and face valid instruments designed for practical use in applied and research settings. Scale items were generated and refined using the Iterative Process Model of scale development, with input from psychedelics experts and clinicians. Content validity, internal structure, and reliability were assessed via expert surveys, content validity analysis, cognitive interviewing, convergent validity analysis, exploratory factor analysis, and confirmatory factor analysis. The data indicates the scales are valid and reliable measurements of the behavioral and experiential forms of Psychedelic Integration.
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Affiliation(s)
- Tomas Frymann
- Psychology and Spirituality Lab, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Sophie Whitney
- Depth and Clinical Psychology, Pacifica Graduate University, Carpinteria, CA, United States
| | - David B Yaden
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Joshua Lipson
- Psychology and Spirituality Lab, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
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24
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Rodrigues LS, Rossi GN, Rocha JM, L Osório F, Bouso JC, Hallak JEC, Dos Santos RG. Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies. Eur Arch Psychiatry Clin Neurosci 2022; 272:541-556. [PMID: 33914164 DOI: 10.1007/s00406-021-01267-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022]
Abstract
Ayahuasca is a hallucinogenic/psychedelic traditionally used for ritual and therapeutic purposes. One such therapeutic use is related to Substance Use Disorders (SUDs). A previous systematic review of preclinical and human studies published until 2016 suggested that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. To conduct an update of this previous review. A systematic review of quantitative studies which analyzed the effects of ayahuasca and its alkaloids on drug use (primary outcome) and other measures (secondary outcomes) related to SUDs was conducted, including articles from 2016 to 2020. Nine studies (four preclinical, five observational) were included in the review. Preclinical studies in rodents reported reductions in amphetamine self-administration and anxiety, and in alcohol- and methylphenidate-induced conditioned place preference. Observational studies among healthy ritual ayahuasca users and patients with SUDs reported reductions in drug use, anxiety, and depression, and increases in quality of life and well-being. We replicated the findings of the previous review suggesting that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. However, translation of preclinical data to humans is limited, observational studies do not allow us to infer causality, and there is a lack of standardization on ayahuasca doses. Although promising, randomized, controlled trials are needed to better elucidate these results. The PROSPERO ID for this study is CRD42020192046.
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Affiliation(s)
- Lucas Silva Rodrigues
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana Mendes Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Flávia L Osório
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - José Carlos Bouso
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain
- Medical Anthopology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Jaime E Cecílio Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil.
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain.
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25
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Daldegan-Bueno D, Maia LO, Massarentti CM, Tófoli LF. Ayahuasca and tobacco smoking cessation: results from an online survey in Brazil. Psychopharmacology (Berl) 2022; 239:1767-1782. [PMID: 35179623 DOI: 10.1007/s00213-022-06063-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022]
Abstract
RATIONALE Smoking-related disease is a major problem globally. Effective smoking cessation treatments are however limited. Increasing evidence suggests that psychedelics have potential as treatments for substance use disorders and may therefore prove an option in aiding smoking cessation. OBJECTIVES To establish which factors predict smoking cessation in people who reported quitting or reducing smoking following ayahuasca consumption. METHODS A retrospective cross-sectional mixed-method study (quantitative and qualitative design) was undertaken using data from an online survey evaluating peoples' experiences before and after drinking ayahuasca. Multivariate logistic regression was performed with smoking condition (cessation or reduction/relapse) as a dependent variable and demographics, smoking, ayahuasca-related variables and the mystical experience (MEQ30) as predicting factors. RESULTS A total of 441 responses were grouped according to self-reported smoking status: cessation (n = 305) or reduction/relapse (n = 136) smoking. Logistic regression showed that mystical experience (OR: 1.03; 95% CI [1.00-1.05]) and frequency of ayahuasca intake (OR: 2.16[1.00-4.70]) were protective factors, while positive mood (measured by the MEQ30) during the ayahuasca experience was a risk factor (OR: 0.91[0.85-0.97]). Qualitative thematic analysis identified eight themes (e.g. acquired awareness, spiritual experience, increased motivation) related to the ayahuasca experience and the process of smoking cessation/reduction. CONCLUSIONS Our results suggest that ayahuasca could be used as a potential tool for smoking cessation, and that effects may be mediated by mystical experience. Given the current burden of smoking-related disease and the limited treatment options, studies are needed to investigate the efficacy of psychedelics in smoking cessation.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Carolina Marcolino Massarentti
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil.
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26
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Wizła M, Kraus SW, Lewczuk K. Perspective: Can psychedelic-assisted therapy be a promising aid in compulsive sexual behavior disorder treatment? Compr Psychiatry 2022; 115:152303. [PMID: 35334305 DOI: 10.1016/j.comppsych.2022.152303] [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] [Received: 10/14/2021] [Revised: 11/24/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022] Open
Abstract
Recently, there has been an increase in studies yielding evidence for psychedelics' anxiolytic and anti-depressive qualities. Preliminary evidence for treatment in substance addiction is also available. In our manuscript, we present a perspective on the possible effectiveness and mechanisms of action of psychedelics' introduction in the treatment of Compulsive Sexual Behavior Disorder (CSBD) and other p roblematic sexual behaviors, which are considered representative of the so-called "behavioral addiction" category. Evidence for the efficacy of Mindfulness Based Interventions in CSBD treatment is promising. Psychedelics- and mindfulness-induced states share common characteristics on both a subjective and objective level. One of the proposed mechanisms regards reduction of experiential avoidance through the promotion of exposure and acceptance. On the neurophysiological level, a shift from higher- to lower-level association regions and an impact on 5- HT2A receptors is observed. Elaborated mechanisms explain the possible enhancement of therapeutic processes by psychedelics. Psychedelics' relative safety and low addictive potential support their introduction into traditional forms of therapy for CSBD and other out of control behaviors.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
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27
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Fauvel B, Samuli K, Lana SB, Bruno R, Pascale P. Validation of a French Version of the Mystical Experience Questionnaire with Retrospective Reports of the Most Significant Psychedelic Experience among French Users. J Psychoactive Drugs 2022; 55:170-179. [PMID: 35384730 DOI: 10.1080/02791072.2022.2059796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mystical experiences triggered by psychedelic drugs predict symptom reduction in various psychiatric disorders, and increased well-being in healthy individuals. This work aimed at validating a French version of a tool used to measure mystical experiences: the Revised Mystical Experience Questionnaire-30 items (MEQ30). Construct validity, internal consistencies, concurrent, discriminant, and predictive validities of the French MEQ30 were examined using data about the most significant psychedelic experience of 320 French individuals. Results showed that the original four-factor (i.e., mystical, positive mood, transcendence, and ineffability) structure fit the data best, with good to excellent statistical indices. Total French MEQ30 score was strongly associated with subjective ratings of the mystical (i.e., mystical, spiritual, or religious, and personally significant) and drug intensity-related qualities of the experience, but not with non-mystical (i.e., fun, inebriating, and easy) qualities. Moreover, French MEQ30 score was a significant predictor of subjective positive changes in psychological well-being, relations with self and others, feeling of proximity or connection with nature, and creativity, whereas drug intensity-related and non-mystical qualities of the experience were not, or were only weakly associated with such changes. This French version of the MEQ30 seems to be an appropriate tool for measuring mystical experiences among French speaking individuals.
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Affiliation(s)
- Baptiste Fauvel
- Laboratoire Mémoire, Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Paris, France
| | - Kangaslampi Samuli
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Strika-Bruneau Lana
- Aphp, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France, Unité de Recherche 4872 Psychiatrie-Comorbidités-Addictions - Psycomadd - Paris Sud University - Ap-hp - Paris Saclay University, Faculté de Médecine, Le Kremlin-Bicêtre, Île-de-France, France
| | - Roméo Bruno
- Aphp, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France, Unité de Recherche 4872 Psychiatrie-Comorbidités-Addictions - Psycomadd - Paris Sud University - Ap-hp - Paris Saclay University, Faculté de Médecine, Le Kremlin-Bicêtre, Île-de-France, France
| | - Piolino Pascale
- Laboratoire Mémoire, Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Paris, France
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28
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Shaw L, Rea K, Lachowsky NJ, Roth EA. Magic Mushroom Use: A Qualitative Interview Study of Post-Trip Impacts and Strategies for Optimizing Experiences. J Psychoactive Drugs 2022; 55:151-158. [PMID: 35315749 DOI: 10.1080/02791072.2022.2054746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The field of psychedelic research is undergoing a revival, yet research focused on non-clinical psychedelic use remains relatively limited. The current qualitative study sheds light on how people use magic mushrooms, what they perceive the effects of such use to be, and the meanings that users attach to their magic mushroom experiences. To be eligible to participate in the study, participants were required to be young adults who had used magic mushrooms within the past three months and residents of Victoria, Canada. Semi-structured, one-on-one in-person interviews regarding magic mushroom use habits, culture, knowledge and other factors were conducted with each participant and subsequently analyzed thematically. Participants associated magic mushroom use with lasting impacts on their lives including transformation and learning experiences. Additionally, participants described strategies to optimize their magic mushroom experiences, including engaging in research regarding magic mushrooms as well as making use of peer supports. Furthermore, aspects of magic mushroom experiences conceptualized as harmful in previous studies were described by participants as associated with learning experiences and few harms. Participants' perceived positive outcomes and relatively low risk profile warrants further research to inform how magic mushroom users can maximize potential positive outcomes and also minimize harms.
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Affiliation(s)
- Lindsay Shaw
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kerri Rea
- School of Social Work, University of Victoria, Victoria, BC, Canada
| | - Nathan J Lachowsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Eric Abella Roth
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.,Department of Anthropology, University of Victoria, Victoria, BC, Canada
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29
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Abstract
BACKGROUND 5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring, short-acting psychedelic tryptamine, produced by a variety of plant and animal species. Plants containing 5-MeO-DMT have been used throughout history for ritual and spiritual purposes. The aim of this article is to review the available literature about 5-MeO-DMT and inform subsequent clinical development. METHODS We searched PubMed database for articles about 5-MeO-DMT. Search results were cross-checked against earlier reviews and reference lists were hand searched. Findings were synthesised using a narrative synthesis approach. This review covers the pharmacology, chemistry and metabolism of 5-MeO-DMT, as well epidemiological studies, and reported adverse and beneficial effects. RESULTS 5-MeO-DMT is serotonergic agonist, with highest affinity for 5-HT1A receptors. It was studied in a variety of animal models, but clinical studies with humans are lacking. Epidemiological studies indicate that, like other psychedelics, 5-MeO-DMT induces profound alterations in consciousness (including mystical experiences), with potential beneficial long-term effects on mental health and well-being. CONCLUSION 5-MeO-DMT is a potentially useful addition to the psychedelic pharmacopoeia because of its short duration of action, relative lack of visual effects and putatively higher rates of ego-dissolution and mystical experiences. We conclude that further clinical exploration is warranted, using similar precautions as with other classic psychedelics.
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Affiliation(s)
- Anna O Ermakova
- Beckley Psytech, Beckley, UK
- Psychedelic Trials Group, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - James Rucker
- Psychedelic Trials Group, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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30
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Rabinowitz J, Lev-Ran S, Gross R. The association between naturalistic use of psychedelics and co-occurring substance use disorders. Front Psychiatry 2022; 13:1066369. [PMID: 36704738 PMCID: PMC9871568 DOI: 10.3389/fpsyt.2022.1066369] [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] [Received: 10/10/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Classic psychedelics (LSD, psilocybin, and peyote/mescaline) have been used to support addiction treatment in a variety of contexts ranging from ceremonial use to clinical trials. The aim of this study was to test the hypothesis that past naturalistic use of classic psychedelics would be associated with decreased prevalence of substance use disorder, when controlling for known confounders. METHODS This cross-sectional study used 2017 NSDUH survey data to evaluate the association between past use of the classic psychedelics LSD, psilocybin and peyote/mescaline and past year substance dependence or abuse. We calculated adjusted odds ratios by multivariate logistic regression, controlling for a range of sociodemographic variables, use of non-psychedelic illicit drugs and mental health related variables. RESULTS A total of 56,276 participants were included in this study. Past use of LSD and psilocybin were associated with increased odds of substance dependence or abuse compared to those who had never used psychedelics before, and this was more likely for those who had used LSD more recently. However, prior use of peyote or mescaline was associated with lower odds of past year substance dependence or abuse compared to people who had never used psychedelics before (aOR = 0.68, p < 0.001). Past use of classic psychedelics was not associated with nicotine dependence. CONCLUSION Past use of peyote/mescaline was associated with decreased odds of substance use disorder compared to people who had never used psychedelics before, while past use of LSD or psilocybin was not. It remains unclear whether this difference is due to pharmacological differences between these compounds or simply due to the context in which peyote/mescaline are traditionally taken. Future research should investigate why naturalistic use of different psychedelics is associated with different substance use disorder effects.
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Affiliation(s)
- Jonina Rabinowitz
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Shaul Lev-Ran
- Lev Hasharon Medical Center, Netanya, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.,Israel Center on Addictions, Netanya, Israel
| | - Raz Gross
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.,Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
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31
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Simonsson O, Hendricks PS, Chambers R, Osika W, Goldberg SB. Classic psychedelics, health behavior, and physical health. Ther Adv Psychopharmacol 2022; 12:20451253221135363. [PMID: 36465958 PMCID: PMC9716448 DOI: 10.1177/20451253221135363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/26/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Preliminary evidence suggests that classic psychedelics may be effective in the treatment of some psychiatric disorders, yet little remains known about their effects on health behavior and physical health. OBJECTIVES The purpose of this study was to investigate associations of lifetime classic psychedelic use and psychological insight during one's most insightful classic psychedelic experience with health behavior and physical health. METHODS Using data representative of the US population with regard to sex, age, and ethnicity (N = 2822), this study examined associations of lifetime classic psychedelic use and psychological insight with health behavior and physical health. RESULTS Lifetime classic psychedelic use was associated with more healthy tobacco-related and diet-related behavior (β = 0.05 and 0.09, respectively). Among lifetime classic psychedelic users (n = 613), greater Psychological Insight Questionnaire (PIQ) total scale, PIQ Avoidance and Maladaptive Patterns (AMP) subscale, and PIQ Goals and Adaptive Patterns (GAP) subscale scores were each associated with higher odds of more healthy exercise-related behavior [adjusted odds ratios (aOR) (95% confidence interval, CI = 1.38 (1.13-1.68), 1.38 (1.13-1.68), and 1.32 (1.10-1.60), respectively] and higher odds of having a healthy body mass index (BMI) [aOR (95% CI) = 1.32 (1.07-1.63), 1.36 (1.10-1.69), and 1.23 (1.01-1.50), respectively], and greater GAP subscale scores were associated with more healthy diet-related behavior (β = 0.10). All PIQ scales were positively associated with some health behavior improvements (overall, diet, exercise) attributed to respondents' most insightful classic psychedelic experience (β = 0.42, 0.18, and 0.17; β = 0.40, 0.19, and 0.17; and β = 0.40, 0.15, and 0.15, respectively), but only PIQ total scale and AMP subscale scores were positively associated with alcohol-related health behavior improvements (β = 0.13 and 0.16, respectively). CONCLUSION Although these results cannot demonstrate causality, they suggest that psychological insight during a classic psychedelic experience may lead to positive health behavior change and better physical health in some domains, in particular in those related to weight management.
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Affiliation(s)
| | - Peter S. Hendricks
- Department of Health Behavior, School of Public
Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard Chambers
- Monash Centre for Consciousness &
Contemplative Studies, Monash University, Melbourne, VIC, Australia
| | - Walter Osika
- Center for Psychiatry Research, Department of
Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Simon B. Goldberg
- Department of Counseling Psychology, University
of Wisconsin–Madison, Madison, WI, USA
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32
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Raison CL, Jain R, Penn AD, Cole SP, Jain S. Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Front Psychiatry 2022; 13:831092. [PMID: 35370864 PMCID: PMC8965278 DOI: 10.3389/fpsyt.2022.831092] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/01/2022] [Indexed: 01/28/2023] Open
Abstract
Survey-based studies suggest naturalistic psychedelic use provides mental health benefits similar to those observed in clinical trials. The current study sought to confirm these findings in a large group of psychedelic users and to conduct a novel examination of associations between amount of psychedelic use and behavioral outcomes, as well as frequency of harms ascribed to psychedelic use. A cross-sectional, online survey was completed by 2,510 adults reporting at least one lifetime psychedelic experience. Participants retrospectively completed a battery of instruments assessing depression, anxiety, and emotional well-being prior to and following psychedelic exposure. Participants also reported preferred psychedelic agent, number of uses, and harms attributed to psychedelic use. Psychedelic use was associated with significant improvements in depressive and anxious symptoms and with increased emotional well-being. These improvements increased in magnitude with increasing psychedelic exposure, with a ceiling effect. However, improvements were noted following a single lifetime use. Strong evidence for benefit of one preferred psychedelic agent over another was not observed, but enduring increases in factors related to mystical-experience and prosocial perspective taking associated with enhanced mental health. Thirteen percent of the survey sample (n = 330) endorsed at least one harm from psychedelic use, and these participants reported less mental health benefit. Results from the current study add to a growing database indicating that psychedelic use-even outside the context of clinical trials-may provide a wide range of mental health benefits, while also posing some risk for harm in a minority of individuals.
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Affiliation(s)
- Charles L Raison
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States
| | - Rakesh Jain
- Department of Psychiatry, Texas Tech University Health Sciences Center Medical School, Lubbock, TX, United States
| | - Andrew D Penn
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Steven P Cole
- Research Design Associates, Yorktown Heights, NY, United States
| | - Saundra Jain
- School of Nursing, University of Texas at Austin, Austin, TX, United States
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33
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Johnson MW. Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation. Curr Top Behav Neurosci 2022; 56:213-227. [PMID: 35704271 DOI: 10.1007/7854_2022_327] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This manuscript reviews research suggesting that classic psychedelics (5-HT2A receptor agonists) are effective in treating addictions including tobacco use disorder. I review historical research from the 1950s to 1970s suggesting that classic psychedelics are associated with addiction recovery across pharmacologically distinct drugs of addiction. I then review anthropological reports about ceremonial use of classic psychedelics and epidemiological studies that are consistent with anti-addiction efficacy. I review modern research using psilocybin in the treatment of alcohol use disorder and tobacco use disorder. Both lines of research show high success rates in preliminary studies. General anti-addiction efficacy across a variety of classes of addictive drugs is consistent with the notion that the persisting positive behavior change prompted by psychedelic therapy is due to amplification of psychotherapeutic processes. Future research should examine classic psychedelic treatment of additional substance use disorders including for opioids, cocaine, methamphetamine, and cannabis, and other disorders broadly characterized as addictions (e.g., obesity, problem gambling, hypersexual disorder). Future research should also explore addiction treatments with other classic psychedelics including LSD, mescaline, DMT, 5-MeO-DMT, and yet-to-be-discovered compounds. Experimental research is also needed to test different protocols for the delivery of classic psychedelic therapy for addictions. Given the staggering society costs of substance use disorders, including the mortality caused by tobacco smoking, it is critical that public funding be made available for scientists to follow up on promising early findings of classic psychedelics in addiction treatment. The costs and risks of not conducting such research are too great.
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Affiliation(s)
- Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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34
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Teixeira PJ, Johnson MW, Timmermann C, Watts R, Erritzoe D, Douglass H, Kettner H, Carhart-Harris RL. Psychedelics and health behaviour change. J Psychopharmacol 2022; 36:12-19. [PMID: 34053342 PMCID: PMC8801670 DOI: 10.1177/02698811211008554] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Healthful behaviours such as maintaining a balanced diet, being physically active and refraining from smoking have major impacts on the risk of developing cancer, diabetes, cardiovascular diseases and other serious conditions. The burden of the so-called 'lifestyle diseases'-in personal suffering, premature mortality and public health costs-is considerable. Consequently, interventions designed to promote healthy behaviours are increasingly being studied, e.g., using psychobiological models of behavioural regulation and change. In this article, we explore the notion that psychedelic substances such as psilocybin could be used to assist in promoting positive lifestyle change conducive to good overall health. Psilocybin has a low toxicity, is non-addictive and has been shown to predict favourable changes in patients with depression, anxiety and other conditions marked by rigid behavioural patterns, including substance (mis)use. While it is still early days for modern psychedelic science, research is advancing fast and results are promising. Here we describe psychedelics' proposed mechanisms of action and research findings pertinent to health behaviour change science, hoping to generate discussion and new research hypotheses linking the two areas. Therapeutic models including psychedelic experiences and common behaviour change methods (e.g., Cognitive Behaviour Therapy, Motivational Interviewing) are already being tested for addiction and eating disorders. We believe this research may soon be extended to help promote improved diet, exercise, nature exposure and also mindfulness or stress reduction practices, all of which can contribute to physical and psychological health and well-being.
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Affiliation(s)
- Pedro J Teixeira
- CIPER - Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal,The Synthesis Institute B.V, Amsterdam, The Netherlands,Pedro J Teixeira, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada 1499-002, Portugal.
| | - Matthew W Johnson
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, USA
| | | | | | - David Erritzoe
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannah Douglass
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannes Kettner
- Imperial College London Psychedelic Research Group, London, UK
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35
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Koslowski M, Johnson MW, Gründer G, Betzler F. Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00401-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Purpose of Review
The use of psychedelics in a therapeutical setting has been reported for the treatment of various diagnoses in recent years. However, as psychedelic substances are still commonly known for their (illicit) recreational use, it may seem counterintuitive to use psychedelic therapy to treat substance use disorders. This review aims to discuss how psychedelics can promote and intensify psychotherapeutic key processes, in different approaches like psychodynamic and cognitive behavioral therapy, with a spotlight on the treatment of substance use disorders (SUD).
Recent Findings
There is promising evidence of feasibility, safety, and efficacy of psychedelic therapy in SUD. In the whole process of former and current psychedelic therapy regimes that have shown to be safe and efficacious, various psychotherapeutic elements, both psychodynamic and behavioral as well as other approaches, can be identified, while a substantial part of the assumed mechanism of action, the individual psychedelic experience, cannot be distinctly classified to just one approach.
Summary
Psychedelic therapy consists of a complex interaction of pharmacological and psychological processes. When administered in well-defined conditions, psychedelics can serve as augmentation of different psychotherapy interventions in the treatment of SUD and other mental disorders, regardless of their theoretical origin.
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36
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Yaden DB, Berghella AP, Regier PS, Garcia-Romeu A, Johnson MW, Hendricks PS. Classic psychedelics in the treatment of substance use disorder: Potential synergies with twelve-step programs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103380. [PMID: 34329952 DOI: 10.1016/j.drugpo.2021.103380] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/20/2022]
Abstract
Several pilot studies have provided evidence supporting the potential of classic psychedelics like psilocybin in the treatment of substance use disorders (SUDs). If larger trials confirm efficacy, classic psychedelic-assisted psychotherapy may eventually be integrated into existing addiction treatments such as cognitive behavioral therapy, contingency management, and medication-assisted therapies. Many individuals seeking treatment for SUDs also join twelve-step facilitation (TSF) programs like Alcoholics Anonymous (AA), which are among the most widely available and accessed treatments for alcohol use disorder worldwide. For such individuals, engaging in classic psychedelic-assisted psychotherapy could be seen as controversial, as members of AA/TSF programs have historically rejected medication-assisted treatments in favor of a pharmacotherapy-free approach. We argue that classic psychedelics and the subjective experiences they elicit may represent a special, more compatible case than conventional medications. In support of this claim, we describe Bill Wilson's (the founder of AA) little known experiences with psychedelics and on this basis, we argue that aspects of classic psychedelic treatments could complement AA/TSF programs. We provide a review of clinical trials evaluating psychedelics in the context of SUDs and discuss their potential large-scale impact should they be ultimately integrated into AA/TSF.
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Affiliation(s)
- David B Yaden
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences.
| | - Andrea P Berghella
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences; Thomas Jefferson University MD/PhD Program, Sidney Kimmel Medical College and Jefferson College of Life Sciences
| | - Paul S Regier
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Albert Garcia-Romeu
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Matthew W Johnson
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Peter S Hendricks
- University of Alabama at Birmingham, Ryals School of Public Health, Department of Health Behavior
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Cox DJ, Garcia-Romeu A, Johnson MW. Predicting changes in substance use following psychedelic experiences: natural language processing of psychedelic session narratives. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:444-454. [PMID: 34096403 DOI: 10.1080/00952990.2021.1910830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Experiences with psychedelic drugs, such as psilocybin or lysergic acid diethylamide (LSD), are sometimes followed by changes in patterns of tobacco, opioid, and alcohol consumption. But, the specific characteristics of psychedelic experiences that lead to changes in drug consumption are unknown.Objective: Determine whether quantitative descriptions of psychedelic experiences derived using Natural Language Processing (NLP) would allow us to predict who would quit or reduce using drugs following a psychedelic experience.Methods: We recruited 1141 individuals (247 female, 894 male) from online social media platforms who reported quitting or reducing using alcohol, cannabis, opioids, or stimulants following a psychedelic experience to provide a verbal narrative of the psychedelic experience they attributed as leading to their reduction in drug use. We used NLP to derive topic models that quantitatively described each participant's psychedelic experience narrative. We then used the vector descriptions of each participant's psychedelic experience narrative as input into three different supervised machine learning algorithms to predict long-term drug reduction outcomes.Results: We found that the topic models derived through NLP led to quantitative descriptions of participant narratives that differed across participants when grouped by the drug class quit as well as the long-term quit/reduction outcomes. Additionally, all three machine learning algorithms led to similar prediction accuracy (~65%, CI = ±0.21%) for long-term quit/reduction outcomes.Conclusions: Using machine learning to analyze written reports of psychedelic experiences may allow for accurate prediction of quit outcomes and what drug is quit or reduced within psychedelic therapy.
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Affiliation(s)
- David J Cox
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Data & Analytics, Behavioral Health Center of Excellence, Los Angeles, California, USA
| | - Albert Garcia-Romeu
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Rush B, Marcus O, García S, Loizaga-Velder A, Loewinger G, Spitalier A, Mendive F. Protocol for Outcome Evaluation of Ayahuasca-Assisted Addiction Treatment: The Case of Takiwasi Center. Front Pharmacol 2021; 12:659644. [PMID: 34093190 PMCID: PMC8170098 DOI: 10.3389/fphar.2021.659644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023] Open
Abstract
The present study describes the protocol for the Ayahuasca Treatment Outcome Project (ATOP) with a special focus on the evaluation of addiction treatment services provided through Takiwasi Center, the first ATOP study site. The goal of the project is to assess treatment outcomes and understand the therapeutic mechanisms of an Ayahuasca-assisted, integrative treatment model for addiction rehabilitation in the Peruvian Amazon. The proposed intervention protocol highlights the significance of treatment setting in the design, delivery, and efficacy of an addiction rehabilitation program that involves the potent psychedelic tea known as Ayahuasca. After describing the context of the study, we put forth details about our mixed-methods approach to data collection and analysis, with which we seek to gain an understanding of why, how, and for whom this specific ayahuasca-assisted treatment program is effective across a range of outcomes. The ATOP protocol employs qualitative research methods as a means to determine which aspects of the setting are meaningful to clients and practitioners, and how this may correlate with outcome measures. This paper delineates the core principles, methods, and measures of the overall ATOP umbrella, then discusses the role of ATOP in the context of the literature on long-term residential programs. To conclude, we discuss the strengths and limitations of the protocol and the intended future of the project.
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Affiliation(s)
- Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Olivia Marcus
- Department of Anthropology, University of Connecticut, Storrs, CT, United States
| | - Sara García
- Takiwasi Center for Rehabilitation of Drug Addicts and Research on Traditional Medicine, Tarapoto, Peru
| | - Anja Loizaga-Velder
- Nierika Institute, National Autonomous University of Mexico, Mexico City, Mexico
| | - Gabriel Loewinger
- School of Public Health, Harvard University, Boston, MA, United States
| | | | - Fernando Mendive
- Takiwasi Center for Rehabilitation of Drug Addicts and Research on Traditional Medicine, Tarapoto, Peru
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39
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The Therapeutic Potential of Psilocybin. Molecules 2021; 26:molecules26102948. [PMID: 34063505 PMCID: PMC8156539 DOI: 10.3390/molecules26102948] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/11/2022] Open
Abstract
The psychedelic effects of some plants and fungi have been known and deliberately exploited by humans for thousands of years. Fungi, particularly mushrooms, are the principal source of naturally occurring psychedelics. The mushroom extract, psilocybin has historically been used as a psychedelic agent for religious and spiritual ceremonies, as well as a therapeutic option for neuropsychiatric conditions. Psychedelic use was largely associated with the "hippie" counterculture movement, which, in turn, resulted in a growing, and still lingering, negative stigmatization for psychedelics. As a result, in 1970, the U.S. government rescheduled psychedelics as Schedule 1 drugs, ultimately ending scientific research on psychedelics. This prohibition on psychedelic drug research significantly delayed advances in medical knowledge on the therapeutic uses of agents such as psilocybin. A 2004 pilot study from the University of California, Los Angeles, exploring the potential of psilocybin treatment in patients with advanced-stage cancer managed to reignite interest and significantly renewed efforts in psilocybin research, heralding a new age in exploration for psychedelic therapy. Since then, significant advances have been made in characterizing the chemical properties of psilocybin as well as its therapeutic uses. This review will explore the potential of psilocybin in the treatment of neuropsychiatry-related conditions, examining recent advances as well as current research. This is not a systematic review.
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40
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Romeo B, Hermand M, Pétillion A, Karila L, Benyamina A. Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review. J Psychiatr Res 2021; 137:273-282. [PMID: 33730602 DOI: 10.1016/j.jpsychires.2021.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The use of psychedelic treatments has shown very promising results in some psychiatric and addictive disorders, but not all patients achieved a response. AIM The aim of this review is to explore the clinical and biological factors which could predict the response to psychedelics in psychiatric and addictive disorders. METHODS A systematic research was performed on MEDLINE, PsycInfo, Web of science, and Scopus databases from January 1990 to May 2020. All studies investigating the predictive factors of response to psychedelics regardless of psychiatric or addictive disorders, were included. RESULTS Twenty studies investigating addictive disorder, treatment-resistant depression, obsessive-compulsive disorder and depressive and anxiety symptoms in patients with life-threatening cancer were included in this review. We found that, in all indications, the main predictive factor of response to psychedelics is the intensity of the acute psychedelic experience. Indeed, we found this factor for alcohol and tobacco use disorders, treatment-resistant depression, and anxiety and depressive symptoms in patients with life-threatening cancer, but not for obsessive-compulsive disorder. CONCLUSION The intensity of the acute psychedelic experience was the main predicting factor of response. The action mechanism of this experience was not clear, but some hypotheses could be made, such as a modulation of serotoninergic system by 5-HT2A receptors agonism, a modulation of the default mode network (DMN) with an acute modular disintegration of the DMN followed by a re-integration of this network with a normal functioning, or an anti-inflammatory effect of this treatment.
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Affiliation(s)
- Bruno Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France.
| | - Marianne Hermand
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Amélie Pétillion
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Laurent Karila
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Amine Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
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Berkovitch L, Roméo B, Karila L, Gaillard R, Benyamina A. [Efficacy of psychedelics in psychiatry, a systematic review of the literature]. Encephale 2021; 47:376-387. [PMID: 33888297 DOI: 10.1016/j.encep.2020.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Psychedelics are powerful psychoactive substances. Natural psychedelics have been used for millennia by human civilizations, in particular in Latin America, while synthetic psychedelics were discovered in the 50s, giving rise to a lot of research before they were prohibited. More recently, their therapeutic properties have been studied especially to help patients with psychiatric conditions, psychological distress or substance use disorders. This article is a systematic review of the literature which aims to provide an overview of all studies that assessed the efficacy of psychedelics, i.e. psilocybin, ayahuasca and lysergic acid diethylamide (LSD), on psychiatric diseases and addictions. METHODS We conducted this literature review following the PRISMA recommendations. MEDLINE, PsycInfo, Web of Science and Scopus were searched from January 1990 to May 2020 with the following keywords "(ayahuasca OR psilocybin OR lysergic acid diethylamide) AND (depression OR anxiety OR major depressive disorder OR bipolar disorder OR anxiety disorder OR substance use disorder OR dependence)". RESULTS Twenty-five articles met the inclusion criteria. Five articles studied psychedelic efficacy in the treatment of life-threatening diseases related to anxiety and depression: four were randomized controlled crossover trials (three with psilocybin for a total of 92 patients, and one with LSD, n=12), and one was a long-term follow-up study. Eleven articles explored the efficacy of psychedelics in the treatment of major depressive episodes: two were open-labeled trials (one with ayahuasca, n=17, one with psilocybin, n=20), one was a randomized controlled trial using ayahuasca against placebo (n=29), and the others were long-term follow-up studies or assessed more precise dimensions of the depressive disorder, such as suicidality, emotion processing or personality traits. Eight articles studied the efficacy of psychedelics in the treatment of addictions: two were open-labeled studies using psilocybin (one in alcohol use disorder, n=10, and one in tobacco use disorder, n=15), and the others were long-term follow-up studies or retrospective observational descriptive studies on alcohol, tobacco, opioids, cannabis, and psychostimulants. One study explored the efficacy of psilocybin in obsessional-compulsive disorder (n=9). Overall, these studies found a quick and important response after psychedelic administration that lasted for several months, even after a single dose. However most of these studies were descriptive or open-label studies conducted on small size samples. No severe adverse events occurred. CONCLUSIONS Psychedelics are promising treatments for anxiety, depression and addiction, their efficacy is quick and sustainable, and they are well tolerated. These effects need to be confirmed in larger studies and compared to standard care.
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Affiliation(s)
- L Berkovitch
- Université de Paris, 75006 Paris, France; Département de psychiatrie, service Hospitalo-Universitaire, GHU Paris psychiatrie & neurosciences, 75014 Paris, France.
| | - B Roméo
- Département de psychiatrie et d'addictologie AP-HP, hôpital Paul Brousse, Villejuif, France; Unité psychiatrie-comorbidités-addictions-unité de recherche PSYCOMADD 4872, Université Paris Saclay, France
| | - L Karila
- Département de psychiatrie et d'addictologie AP-HP, hôpital Paul Brousse, Villejuif, France; Unité psychiatrie-comorbidités-addictions-unité de recherche PSYCOMADD 4872, Université Paris Saclay, France
| | - R Gaillard
- Université de Paris, 75006 Paris, France; Département de psychiatrie, service Hospitalo-Universitaire, GHU Paris psychiatrie & neurosciences, 75014 Paris, France; Unité de neuropathologie expérimentale, département santé globale, institut Pasteur, 75015 Paris, France
| | - A Benyamina
- Département de psychiatrie et d'addictologie AP-HP, hôpital Paul Brousse, Villejuif, France; Unité psychiatrie-comorbidités-addictions-unité de recherche PSYCOMADD 4872, Université Paris Saclay, France
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Agin-Liebes G, Haas TF, Lancelotta R, Uthaug MV, Ramaekers JG, Davis AK. Naturalistic Use of Mescaline Is Associated with Self-Reported Psychiatric Improvements and Enduring Positive Life Changes. ACS Pharmacol Transl Sci 2021; 4:543-552. [PMID: 33860184 PMCID: PMC8033766 DOI: 10.1021/acsptsci.1c00018] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Indexed: 12/20/2022]
Abstract
Mescaline is a naturally occurring psychoactive alkaloid that has been used as a sacrament by Indigenous populations in spiritual ritual and healing ceremonies for millennia. Despite promising early preliminary research and favorable anecdotal reports, there is limited research investigating mescaline's psychotherapeutic potential. We administered an anonymous online questionnaire to adults (N = 452) reporting use of mescaline in naturalistic settings about mental health benefits attributed to mescaline. We assessed respondents' self-reported improvements in depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol and drug use disorders (AUD and DUD). Of the respondents reporting histories of these clinical conditions, most (68-86%) reported subjective improvement following their most memorable mescaline experience. Respondents who reported an improvement in their psychiatric conditions reported significantly higher ratings of acute psychological factors including mystical-type, psychological insight, and ego dissolution effects compared to those who did not report improvements (Cohen's d range 0.7 - 1.5). Many respondents (35-50%) rated the mescaline experience as the single or top five most spiritually significant or meaningful experience(s) of their lives. Acute experiences of psychological insight during their mescaline experience were associated with increased odds of reporting improvement in depression, anxiety, AUD and DUD. Additional research is needed to corroborate these preliminary findings and to rigorously examine the efficacy of mescaline for psychiatric treatment in controlled, longitudinal clinical trials.
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Affiliation(s)
- Gabrielle Agin-Liebes
- Department
of Psychiatry, University of California,
San Francisco, 1001 Potrero
Ave., San Francisco, California 94110, United States,Zuckerberg
San Francisco General Hospital, 1001 Potrero Ave., Bldg. 80, San Francisco, California 94110, United States,Tel.: 646-641-2000.
| | - Trevor F. Haas
- University
of California, Davis, School of Medicine, 4610 X Street, Sacramento, California 95817, United States,Department
of Psychiatry and Behavioral Sciences, University
of Southern California, 3620 McClintock Ave., Los Angeles, California 90089-0001, United States
| | - Rafael Lancelotta
- Habituating
to Wholeness, LLC, 6500 W 13th Ave, Lakewood, Colorado 80214, United States
| | - Malin V. Uthaug
- Department
of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Limburg 6200
MD, The Netherlands
| | - Johannes G. Ramaekers
- Department
of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Limburg 6200
MD, The Netherlands
| | - Alan K. Davis
- College
of Social Work, The Ohio State University, 1947 College Road, Columbus, Ohio 43210, United States,Center
for Psychedelic and Consciousness Research, Johns Hopkins University, 5510 Nathan Shock Drive, Baltimore, Maryland 21224, United
States,Tel.: 614-292-5251.
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Higgins GA, Sellers EM. 5-HT 2A and 5-HT 2C receptors as potential targets for the treatment of nicotine use and dependence. PROGRESS IN BRAIN RESEARCH 2021; 259:229-263. [PMID: 33541678 DOI: 10.1016/bs.pbr.2021.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nicotine use and dependence, typically achieved through cigarette smoking, but increasingly through vape products, is the leading cause of preventable death today. Despite a recognition that many current smokers would like to quit, the success rate at doing so is low and indicative of the persistent nature of nicotine dependence and the high urge to relapse. There are currently three main forms of pharmacotherapy approved as aids to treat nicotine dependence: a variety of nicotine replacement products (NRT's), the mixed NA/DA reuptake inhibitor bupropion (Zyban®), and the preferential nicotinic α4β2 receptor agonist drug, varenicline (Chantix®); the latter being generally recognized to be the most effective. However, each of these approaches afford only limited efficacy, and various other pharmacological approaches are being explored. This chapter focusses on approaches targeted to the serotonin (5-HT) system, namely, selective serotonin reuptake inhibitors (SSRI's) which served a pioneer role in the investigation of serotoninergic modulators in human smoking cessation trials; and secondly drugs selectively interacting with the 5-HT2A and 5-HT2C receptor systems. From an efficacy perspective, measured as smoking abstinence, the 5-HT2A agonist psychedelics, namely psilocybin, seem to show the most promise; although as the article highlights, these findings are both preliminary and there are significant challenges to the route to approval, and therapeutic use of this class should they reach approval status. Additional avenues include 5-HT2C receptor agonists, which until recently was pioneered by lorcaserin, and 5-HT2A receptor antagonists represented by pimavanserin. Each of these approaches has distinct profiles across preclinical tests of nicotine dependence, and may have therapeutic potential. It is anticipated as diagnostic and predictive biomarkers emerge, they may provide opportunities for subject stratification and opportunities for personalizing smoking cessation treatment. The clinical assessment of SSRI, 5-HT2A and/or 5-HT2C receptor-based treatments may be best served by this process.
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Affiliation(s)
- Guy A Higgins
- Intervivo Solutions Inc, Fergus, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada.
| | - Edward M Sellers
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Department of Medicine and Psychiatry, University of Toronto, Toronto, ON, Canada; DL Global Partners Inc., Toronto, ON, Canada
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Davis AK, Xin Y, Sepeda ND, Garcia-Romeu A, Williams MT. Increases in Psychological Flexibility Mediate Relationship Between Acute Psychedelic Effects and Decreases in Racial Trauma Symptoms Among People of Color. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:24705470211035607. [PMID: 34377878 PMCID: PMC8342866 DOI: 10.1177/24705470211035607] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous research showed acute psychedelic effects were associated with decreases in racial trauma (RT) symptoms among black, indigenous, and people of color (BIPOC). Among samples comprised primarily of white participants, positive outcomes of psychedelic experiences have been mediated by increases in psychological flexibility. Therefore, we examined whether changes in psychological flexibility from before to after a psychedelic experience mediated the relationship between acute psychedelic effects and changes in RT symptoms among BIPOC. METHODS This cross-sectional online survey study included 313 BIPOC (mean age = 33.1; SD = 11.2; female = 57%). A multiple linear regression analysis was used to examine the association between acute psychedelic effects and decreases in RT symptoms in a nonclinical setting; a path analysis was used to explore whether changes in psychological flexibility mediated this relationship. RESULTS Acute insight and challenging effects were significantly (p < .001) associated with decreases in RT symptoms following a psychedelic experience. Increases in psychological flexibility partially mediated relationships between greater intensity of psychological insight and less intensity of challenging experiences and decreases in RT symptoms (ps<.001). CONCLUSION This research suggests psychedelics confer potential benefits in decreasing RT symptoms among BIPOC and psychological flexibility may be an important mediator of these effects. Future research should test this hypothesis in a longitudinal clinical trial among BIPOC.
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Affiliation(s)
- Alan K. Davis
- The Ohio State University, Columbus, OH, USA
- Johns Hopkins School of
Medicine, Baltimore, MD, USA
| | - Yitong Xin
- The Ohio State University, Columbus, OH, USA
| | | | | | - Monnica T. Williams
- University of Ottawa, Ottawa, Ontario, Canada
- University of Connecticut, Storrs, Connecticut, USA
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O'Shaughnessy DM, Berlowitz I, Rodd R, Sarnyai Z, Quirk F. Within-treatment changes in a novel addiction treatment program using traditional Amazonian medicine. Ther Adv Psychopharmacol 2021; 11:2045125320986634. [PMID: 33717431 PMCID: PMC7841703 DOI: 10.1177/2045125320986634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/24/2020] [Indexed: 12/28/2022] Open
Abstract
AIMS The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods. METHODS The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment. RESULTS Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning. CONCLUSION These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.
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Affiliation(s)
- David M O'Shaughnessy
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Ilana Berlowitz
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Robin Rodd
- Division of Social Sciences, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Zoltán Sarnyai
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Discovery, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Frances Quirk
- New England Institute of Healthcare Research, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Healy CJ, Lee KA, D’Andrea W. Using Psychedelics With Therapeutic Intent Is Associated With Lower Shame and Complex Trauma Symptoms in Adults With Histories of Child Maltreatment. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:24705470211029881. [PMID: 34291179 PMCID: PMC8278461 DOI: 10.1177/24705470211029881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Child maltreatment negatively affects the formation of internal schemata of self and other during development, leading to negative adaptations in self-concept and social cognition. Clinical reports suggest the efficacy of psychedelics in treating the psychopathological sequelae of child maltreatment. Altering maladaptive schemata of self and other implicated in negative self-concept and impaired social cognition may be a central mechanism for reducing posttraumatic stress symptoms. AIMS This study aims to assess whether psychedelic use moderates the relationships between child maltreatment and self-concept, social cognition, and posttraumatic stress symptoms. METHOD An online survey was completed by 166 participants and included measures of maltreatment exposure and severity, history of intentional therapeutic psychedelic use, posttraumatic stress symptoms, internalized shame, and facial emotion recognition. RESULTS Child maltreatment significantly correlated with posttraumatic stress symptoms (r = .26 and r = .20, p < .01) and internalized shame (r = .18, p < .05). Of all maltreatment subtypes, emotional abuse and neglect most strongly correlated with complex trauma symptoms (r = .32, p < .001) and internalized shame (r = .31, p < .001). Participants with a history of intentional therapeutic psychedelic use reported significantly lower complex trauma symptoms (d = 0.33, p < .05) and internalized shame (d = 0.35, p < .05) despite similar histories of maltreatment. Differences in complex trauma symptoms (d = 0.66, p < .01) and internalized shame (d = 0.80, p < .001) were largest for participants with a history of more than 5 occasions of intentional therapeutic psychedelic use. A history of more than 5 occasions of intentional therapeutic psychedelic use significantly moderated the relationship between emotional abuse and neglect and complex trauma symptoms (p < .01). No associations were found between maltreatment or psychedelic use and facial emotion recognition. CONCLUSION These findings demonstrate that using psychedelic drugs with therapeutic intent is associated with lower levels of complex trauma symptoms and internalized shame in individuals with histories of child maltreatment. Psychedelic use may have therapeutic benefit in treating the posttraumatic sequelae of child maltreatment.
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Affiliation(s)
- C. J. Healy
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Kellie Ann Lee
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D’Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
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Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review. Mol Biol Rep 2020; 47:9791-9799. [PMID: 33231817 DOI: 10.1007/s11033-020-06009-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022]
Abstract
Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic and mystical-type experiences that result. After a substantial period of restrictions limiting investigations into the therapeutic potential of psychedelics, a relatively recent recommencement of interest has sparked the burgeoning possibility for these drugs to play a part in the treatment of a wide array of psychopathologies. One of the most promising is in the study of addiction. Evidence has emerged that psychedelic agents may provide a novel avenue for the clinical treatment of patients dealing with substance use disorders (SUD). These serotonergic hallucinogens have displayed remarkable and enduring positive outcomes in this area, even when administered as one or two doses. The neural targets for these psychedelics are varied and underlie a complex mechanism of action-modulating multiple neural networks. It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation.
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O'Callaghan C, Hubik DJ, Dwyer J, Williams M, Ross M. Experience of Music Used With Psychedelic Therapy: A Rapid Review and Implications. J Music Ther 2020; 57:282-314. [PMID: 32227084 DOI: 10.1093/jmt/thaa006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bonny Method of Guided Imagery and Music emerged following discontinuation of psychedelic therapy research in the early 1970s, but psychedelic therapy research has since revived. Music remains a vital component. This study examined participants' experiences of music in psychedelic therapy research. A rapid review of qualitative and quantitative journal articles in four major databases was conducted in February to April, 2019, using the terms hallucinogens, psychedelic, "lysergic acid diethylamide," psilocybin, ayahuasca, music, and/or "music therapy." Of 406 articles retrieved, 10 were included (n = 180; 18-69 years old). Participants had varied backgrounds. Music was widely considered integral for meaningful emotional and imagery experiences and self-exploration during psychedelic therapy. Music transformed through its elicitation of anthropomorphic, transportive, synesthetic, and material sensations. Music could convey love, carry listeners to other realms, be something to "hold," inspire, and elicit a deep sense of embodied transformation. Therapeutic influence was especially evident in music's dichotomous elicitations: Music could simultaneously anchor and propel. Participant openness to music and provision of participant-centered music were associated with optimal immediate and longer-term outcomes. Many studies reported scarce details about the music used and incidental findings of music experienced. Further understanding of participants' idiosyncratic and shared responses to music during drug therapy phases will inform optimal development of flexible music protocols which enhance psychedelic therapy. Music therapists could be involved in the psychedelic therapy research renaissance through assisting with research to optimize music-based protocols used. If psychedelics become approved medicines, music therapists may be involved in offering psychedelic therapy as part of therapeutic teams.
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Affiliation(s)
- Clare O'Callaghan
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, AustraliaDepartment of Medicine, St Vincent's Hospital, and Melbourne Conservatorium of Music, The University of Melbourne, Melbourne, Australia
| | - Daniel J Hubik
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Justin Dwyer
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Martin Williams
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, AustraliaPRISM Inc., Melbourne, Australia
| | - Margaret Ross
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
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Smith WR, Sisti D. Ethics and ego dissolution: the case of psilocybin. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106070. [PMID: 32461241 PMCID: PMC9202314 DOI: 10.1136/medethics-2020-106070] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 04/06/2020] [Indexed: 05/20/2023]
Abstract
Despite the fact that psychedelics were proscribed from medical research half a century ago, recent, early-phase trials on psychedelics have suggested that they bring novel benefits to patients in the treatment of several mental and substance use disorders. When beneficial, the psychedelic experience is characterized by features unlike those of other psychiatric and medical treatments. These include senses of losing self-importance, ineffable knowledge, feelings of unity and connection with others and encountering 'deep' reality or God. In addition to symptom relief, psychedelic experiences often lead to significant changes in a patient's personality and worldview. Focusing on the case of psilocybin, we argue that the peculiar features of psychedelics pose certain novel risks, which warrant an enhanced informed consent process-one that is more comprehensive than what may be typical for other psychiatric medications. We highlight key issues that should be focused on during the consent process and suggest discussion prompts for enhanced consent in psychedelic psychiatry. Finally, we respond to potential objections before concluding with a discussion of ethical considerations that will arise as psychedelics proceed from highly controlled research environments into mainstream clinical psychiatry.
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Affiliation(s)
- William R Smith
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Dominic Sisti
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Psychedelics and psychological flexibility – Results of a prospective web-survey using the Acceptance and Action Questionnaire II. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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