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Dworkin RH, McDermott MP, Nayak SM, Strain EC. Reply to "Capturing Synergy Holistically in Psychedelic Clinical Trials". Clin Pharmacol Ther 2024; 115:401-402. [PMID: 38087954 DOI: 10.1002/cpt.3130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/04/2024]
Affiliation(s)
- Robert H Dworkin
- Departments of Anesthesiology and Perioperative Medicine, Neurology, and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Michael P McDermott
- Departments of Biostatistics and Computational Biology and Neurology, University of Rochester, Rochester, New York, USA
| | - Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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O'Donnell KC, Anderson BT, Barrett FS, Bogenschutz MP, Grob CS, Hendricks PS, Kelmendi B, Nayak SM, Nicholas CR, Paleos CA, Stauffer CS, Gukasyan N. Misinterpretations and Omissions: A Critical Response to Goodwin and Colleagues' Commentary on Psilocybin-Assisted Therapy. Am J Psychiatry 2024; 181:74-75. [PMID: 38161295 DOI: 10.1176/appi.ajp.20230661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Kelley C O'Donnell
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Brian T Anderson
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Frederick S Barrett
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Michael P Bogenschutz
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Charles S Grob
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Peter S Hendricks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Benjamin Kelmendi
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Sandeep M Nayak
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Christopher R Nicholas
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Casey A Paleos
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Christopher S Stauffer
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Natalie Gukasyan
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
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Yaden DB, Gukasyan N, Nayak SM. Psilocybin in Bipolar II Study Provides Preliminary Data on Safety. JAMA Psychiatry 2023:2812445. [PMID: 38055240 DOI: 10.1001/jamapsychiatry.2023.4680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- David B Yaden
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Natalie Gukasyan
- Columbia University Medical Center, New York State Psychiatric Institute, New York
| | - Sandeep M Nayak
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Dworkin RH, McDermott MP, Nayak SM, Strain EC. Psychedelics and Psychotherapy: Is the Whole Greater than the Sum of its Parts? Clin Pharmacol Ther 2023; 114:1166-1169. [PMID: 37795632 DOI: 10.1002/cpt.3050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Affiliation(s)
- Robert H Dworkin
- Departments of Anesthesiology and Perioperative Medicine, Neurology, and Psychiatry, University of Rochester School of Medicine and Dentistry, New York, Rochester, USA
| | - Michael P McDermott
- Departments of Biostatistics and Computational Biology and Neurology, University of Rochester, New York, Rochester, USA
| | - Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Graziosi M, Singh M, Nayak SM, Yaden DB. Acute Subjective Effects of Psychedelics within and Beyond WEIRD Contexts. J Psychoactive Drugs 2023; 55:558-569. [PMID: 37679890 DOI: 10.1080/02791072.2023.2255274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023]
Abstract
Reports of psychedelic experiences may contain similarities and differences across cultural contexts, but most current characterizations and quantifications of psychedelic experiences come from Western medical and naturalistic settings. In this article, we begin with a brief history of the diversity of psychedelic use in non-Western settings. We then compare and contrast accounts of psychedelic experiences within and beyond Western, educated, industrialized, rich, and democratic (WEIRD) contexts. We focus on specific reports of direct testimony of the acute subjective effects of psychedelics experienced across these contexts. We compare themes from each of these various contexts, with special emphasis on psychometric measures such as the mystical experiences questionnaire (MEQ), the five-dimensional altered states of consciousness (5D-ASC) scale, the Survey of God Encounters, and the Survey of Entity Encounters, the Challenging Experiences Questionnaire, and the Inventory of Nonordinary Experiences (INOE). Finally, we offer recommendations for future research to quantify these similarities and differences across cultures to assess them empirically in the future.
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Affiliation(s)
- Marianna Graziosi
- Department of Clinical Psychology, Hofstra University, Hempstead, NY, USA
- Center for Consciousness and Psychedelic Research, Johns Hopkins University, Baltimore, MD, USA
| | | | - Sandeep M Nayak
- Center for Consciousness and Psychedelic Research, Johns Hopkins University, Baltimore, MD, USA
| | - David B Yaden
- Center for Consciousness and Psychedelic Research, Johns Hopkins University, Baltimore, MD, USA
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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7
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Raison CL, Sanacora G, Woolley J, Heinzerling K, Dunlop BW, Brown RT, Kakar R, Hassman M, Trivedi RP, Robison R, Gukasyan N, Nayak SM, Hu X, O’Donnell KC, Kelmendi B, Sloshower J, Penn AD, Bradley E, Kelly DF, Mletzko T, Nicholas CR, Hutson PR, Tarpley G, Utzinger M, Lenoch K, Warchol K, Gapasin T, Davis MC, Nelson-Douthit C, Wilson S, Brown C, Linton W, Ross S, Griffiths RR. Single-Dose Psilocybin Treatment for Major Depressive Disorder: A Randomized Clinical Trial. JAMA 2023; 330:843-853. [PMID: 37651119 PMCID: PMC10472268 DOI: 10.1001/jama.2023.14530] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023]
Abstract
Importance Psilocybin shows promise as a treatment for major depressive disorder (MDD). Objective To evaluate the magnitude, timing, and durability of antidepressant effects and safety of a single dose of psilocybin in patients with MDD. Design, Setting, and Participants In this phase 2 trial conducted between December 2019 and June 2022 at 11 research sites in the US, participants were randomized in a 1:1 ratio to receive a single dose of psilocybin vs niacin placebo administered with psychological support. Participants were adults aged 21 to 65 years with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of MDD of at least 60 days' duration and moderate or greater symptom severity. Exclusion criteria included history of psychosis or mania, active substance use disorder, and active suicidal ideation with intent. Participants taking psychotropic agents who otherwise met inclusion/exclusion criteria were eligible following medication taper. Primary and secondary outcomes and adverse events (AEs) were assessed at baseline (conducted within 7 days before dosing) and at 2, 8, 15, 29, and 43 days after dosing. Interventions Interventions were a 25-mg dose of synthetic psilocybin or a 100-mg dose of niacin in identical-appearing capsules, each administered with psychological support. Main Outcomes and Measures The primary outcome was change in central rater-assessed Montgomery-Asberg Depression Rating Scale (MADRS) score (range, 0-60; higher scores indicate more severe depression) from baseline to day 43. The key secondary outcome measure was change in MADRS score from baseline to day 8. Other secondary outcomes were change in Sheehan Disability Scale score from baseline to day 43 and MADRS-defined sustained response and remission. Participants, study site personnel, study sponsor, outcome assessors (raters), and statisticians were blinded to treatment assignment. Results A total of 104 participants (mean [SD] age, 41.1 [11.3] years; 52 [50%] women) were randomized (51 to the psilocybin group and 53 to the niacin group). Psilocybin treatment was associated with significantly reduced MADRS scores compared with niacin from baseline to day 43 (mean difference,-12.3 [95% CI, -17.5 to -7.2]; P <.001) and from baseline to day 8 (mean difference, -12.0 [95% CI, -16.6 to -7.4]; P < .001). Psilocybin treatment was also associated with significantly reduced Sheehan Disability Scale scores compared with niacin (mean difference, -2.31 [95% CI, 3.50-1.11]; P < .001) from baseline to day 43. More participants receiving psilocybin had sustained response (but not remission) than those receiving niacin. There were no serious treatment-emergent AEs; however, psilocybin treatment was associated with a higher rate of overall AEs and a higher rate of severe AEs. Conclusions and Relevance Psilocybin treatment was associated with a clinically significant sustained reduction in depressive symptoms and functional disability, without serious adverse events. These findings add to increasing evidence that psilocybin-when administered with psychological support-may hold promise as a novel intervention for MDD. Trial Registration ClinicalTrials.gov Identifier: NCT03866174.
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Affiliation(s)
| | - Gerard Sanacora
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
| | - Joshua Woolley
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
- San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Randall T. Brown
- Department of Family Medicine & Community Health, University of Wisconsin School of Medicine & Public Health, Madison
| | - Rishi Kakar
- Center for Psychedelic Research, Segal Trials, Lauderhill, Florida
| | | | | | - Reid Robison
- Numinus Wellness, Draper, Utah
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City
| | - Natalie Gukasyan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sandeep M. Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xiaojue Hu
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
| | - Kelley C. O’Donnell
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
| | - Benjamin Kelmendi
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
| | - Jordan Sloshower
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut
| | - Andrew D. Penn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
- School of Nursing, University of California San Francisco
| | - Ellen Bradley
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
- San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Tanja Mletzko
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Christopher R. Nicholas
- Department of Family Medicine & Community Health, University of Wisconsin School of Medicine & Public Health, Madison
| | - Paul R. Hutson
- Pharmacy Practice & Translational Research Division, School of Pharmacy, University of Wisconsin-Madison
| | | | | | | | | | | | | | | | | | | | | | - Stephen Ross
- NYU Langone Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Gukasyan N, Griffiths RR, Yaden DB, Antoine DG, Nayak SM. Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use. J Psychopharmacol 2023:2698811231179910. [PMID: 37291890 DOI: 10.1177/02698811231179910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Psilocybin is being studied for depression, but little is known about how it interacts with common antidepressants. Limited data suggest that psilocybin's effects may be diminished by serotonergic antidepressants acutely and even after a medication washout period. AIMS To learn the extent to which antidepressants may diminish the effects of psilocybin-containing mushrooms both concurrently and after discontinuation of antidepressants. METHODS Online retrospective survey of individuals with use of psilocybin mushrooms (1) with an antidepressant and/or (2) within 2 years of discontinuing an antidepressant. Participants who took mushrooms with an antidepressant and either took the same dose pre-antidepressant or took the same dose with other people not on antidepressant reported the strength of drug effects relative to their expectation. Participants who took mushrooms following discontinuation of an antidepressant also reported the presence of weakened effects. RESULTS In reports (n = 611) of taking mushrooms with an antidepressant, probabilities [95% CI] of weaker than expected drug effects were 0.47 [0.41-0.54] (selective serotonergic reuptake inhibitors, SSRIs), 0.55 [0.44-0.67] (serotonin norepinephrine reuptake inhibitors, SNRIs) and 0.29 [0.2-0.39] (bupropion). Following SSRI/SNRI discontinuation (n = 1,542 reports), the probability of reduced drug effects was not significantly different from the earliest post-discontinuation timepoint (within 1 week) until 3-6 months, probability = 0.3 [0.20-0.46], p = 0.001. A sensitivity analysis found that removing responses involving fluoxetine, which has an especially long half-life, did not significantly alter this result. CONCLUSIONS SSRI/SNRIs appear to weaken psilocybin drug effects relative to a non-serotonergic antidepressant. This dampening effect may last as long as 3 months following antidepressant discontinuation.
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Affiliation(s)
- Natalie Gukasyan
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - David B Yaden
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Denis G Antoine
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Nayak SM, Bradley MK, Kleykamp BA, Strain EC, Dworkin RH, Johnson MW. Control Conditions in Randomized Trials of Psychedelics: An ACTTION Systematic Review. J Clin Psychiatry 2023; 84. [PMID: 37167563 DOI: 10.4088/jcp.22r14518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Objective: To systematically review control conditions of all available randomized psychedelic trials. Data Sources: We searched PubMed, PsycINFO, and EMBASE for randomized trials of psychedelics in humans from 1940 through May 2020 with no language restrictions. PRISMA guidelines were followed. (PROSPERO registration number: PROSPERO-CRD42020205341.). Study Selection: All randomized trials of psychedelics in humans from 1940 through May 2020 were included. Data Extraction: Two independent reviewers performed extraction. Extracted data included study design, demographics, blinding type, whether and how blind integrity was assessed, psychedelic used and dose, drug control condition and dose, type of non-drug control condition, number of dosing sessions, and recruitment source. Outcome data were not collected. Results: In total, 126 articles were included, encompassing 86 unique studies. Of studies with a drug control condition (80), 49 (61.2%) used an inert placebo control, 16 (20.0%) used active comparators, 12 (15.0%) used both, and 3 (3.8%) used only different active psychedelic doses as a control. Only 3 of 21 therapeutic trials compared the use of psychological support to a minimally supportive condition. The majority (81/86; 94%) of studies were blinded, though only 14 (17.3%) included blind assessment; only 8 of these 14 studies assessed participants' blinding. Blinding success, assessed in highly varied ways, was generally poor. Conclusions: Randomized psychedelic trials underutilize elements that would improve quality or provide important information: blind assessment, active drug controls, and testing psychological support against minimal-support conditions. Several queried categories, including blind integrity assessment and details of non-drug control conditions, were insufficiently reported by many reviewed studies. Recommendations are provided to improve trial methods.
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Affiliation(s)
- Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Corresponding author: Sandeep M. Nayak, MD, Behavioral Pharmacology Research Unit, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224
| | - Melissa K Bradley
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert H Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Nayak SM, Bari BA, Yaden DB, Spriggs MJ, Rosas FE, Peill JM, Giribaldi B, Erritzoe D, Nutt DJ, Carhart-Harris R. A Bayesian Reanalysis of a Trial of Psilocybin versus Escitalopram for Depression. Psychedelic Med (New Rochelle) 2023; 1:18-26. [PMID: 37337526 PMCID: PMC10278160 DOI: 10.1089/psymed.2022.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Objectives To perform a Bayesian reanalysis of a recent trial of psilocybin (COMP360) versus escitalopram for Major Depressive Disorder (MDD) in order to provide a more informative interpretation of the indeterminate outcome of a previous frequentist analysis. Design Reanalysis of a two-arm double-blind placebo controlled trial. Participants Fifty-nine patients with MDD. Interventions Two doses of psilocybin 25mg and daily oral placebo versus daily escitalopram and 2 doses of psilocybin 1mg, with psychological support for both groups. Outcome measures Quick Inventory of Depressive Symptomatology-Self-Report (QIDS SR-16), and three other depression scales as secondary outcomes: HAMD-17, MADRS, and BDI-1A. Results Using Bayes factors and 'skeptical priors' which bias estimates towards zero, for the hypothesis that psilocybin is superior by any margin, we found indeterminate evidence for QIDS SR-16, strong evidence for BDI-1A and MADRS, and extremely strong evidence for HAMD-17. For the stronger hypothesis that psilocybin is superior by a 'clinically meaningful amount' (using literature defined values of the minimally clinically important difference), we found moderate evidence against it for QIDS SR-16, indeterminate evidence for BDI-1A and MADRS, and moderate evidence supporting it for HAMD-17. Furthermore, across the board we found extremely strong evidence for psilocybin's non-inferiority versus escitalopram. These findings were robust to prior sensitivity analysis. Conclusions This Bayesian reanalysis supports the following inferences: 1) that psilocybin did indeed outperform escitalopram in this trial, but not to an extent that was clinically meaningful--and 2) that psilocybin is almost certainly non-inferior to escitalopram. The present results provide a more precise and nuanced interpretation to previously reported results from this trial, and support the need for further research into the relative efficacy of psilocybin therapy for depression with respect to current leading treatments. Trial registration number NCT03429075.
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Affiliation(s)
- Sandeep M. Nayak
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bilal A. Bari
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - David B. Yaden
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meg J. Spriggs
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - Fernando E. Rosas
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - Joseph M. Peill
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - David J. Nutt
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - Robin Carhart-Harris
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, CA, USA
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Abstract
BACKGROUND Psychedelic use is anecdotally associated with belief changes, although few studies have tested these claims. AIM Characterize a broad range of psychedelic occasioned belief changes. SURVEY A survey was conducted in 2374 respondents who endorsed having had a belief changing psychedelic experience. Participants rated their agreement with belief statements Before and After the psychedelic experience as well as at the time of survey administration. RESULTS Factor analysis of 45 belief statements revealed five factors: "Dualism," "Paranormal/Spirituality," "Non-mammal consciousness," "Mammal consciousness," and "Superstition." Medium to large effect sizes from Before to After the experience were observed for increases in beliefs in "Dualism" (β = 0.72), "Paranormal/Spirituality" (β = 0.90), "Non-mammal consciousness" (β = 0.72), and "Mammal consciousness" (β = 0.74). In contrast, negligible changes were observed for "Superstition" (β = -0.18).). At the individual item level, increases in non-physicalist beliefs included belief in reincarnation, communication with the dead, existence of consciousness after death, telepathy, and consciousness of inanimate natural objects (e.g., rocks). The percentage of participants who identified as a "Believer (e.g., in Ultimate Reality, Higher Power, and/or God, etc.)" increased from 29% Before to 59% After." At both the factor and individual item level, higher ratings of mystical experience were associated with greater changes in beliefs. Belief changes assessed after the experience (an average 8.4 years) remained largely unchanged at the time of survey. CONCLUSIONS A single psychedelic experience increased a range of non-physicalist beliefs as well as beliefs about consciousness, meaning, and purpose. Further, the magnitude of belief change is associated with qualitative features of the experience.
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Affiliation(s)
- Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manvir Singh
- Institute for Advanced Study in Toulouse, University of Toulouse 1 Capitole, Toulouse, Occitanie, France
| | - David B Yaden
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
Psychedelic-assisted treatment is at first glance markedly different in structure and approach from mainstream forms of psychotherapy in the West. A major criticism of clinical psychedelic research rests on the difficulty of executing placebo-controlled studies and distinguishing drug effects from those of the psychotherapeutic container in which psychedelics are typically presented. Detractors also tend to find fault in spiritual or mystical themes that often arise in the context of psychedelic use. Common factors theory of psychotherapy is a useful and extensively studied framework that can help make sense of these issues, and has much to contribute to our understanding of contextual effects that are often discussed in psychedelic literature as "set and setting." In this article, we examine four major contextual "common factors" shared by various healing traditions: 1) the therapeutic relationship; 2) the healing setting; 3) the rationale, conceptual scheme, or myth; and 4) the ritual. We explain how these factors show up in psychedelic-assisted treatment and how they may contribute to therapeutic effects. Lastly, we discuss the implications of these factors for the concept of placebo, and for future research.
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Affiliation(s)
| | - Sandeep M Nayak
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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13
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Zeifman RJ, Yu D, Singhal N, Wang G, Nayak SM, Weissman CR. Corrigendum to "Decreases in Suicidality Following Psychedelic Therapy: A Meta-Analysis of Individual Patient Data Across Clinical Trials". J Clin Psychiatry 2022; 83. [PMID: 35551500 DOI: 10.4088/jcp.22l14505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Richard J Zeifman
- Department of Medicine, Imperial College London, London, United Kingdom.,Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Dengdeng Yu
- Department of Mathematics, University of Texas at Arlington, Arlington, Texas
| | - Nikhita Singhal
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Guan Wang
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cory R Weissman
- Department of Psychiatry, University of California San Diego, La Jolla, California.,Corresponding author: Cory R. Weissman, MD, Department of Psychiatry, University of California San Diego, 16918 Dove Canyon Rd, Ste 100, Mail Code 8322, San Diego, CA 92127
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14
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Nayak SM, Griffiths RR. A Single Belief-Changing Psychedelic Experience Is Associated With Increased Attribution of Consciousness to Living and Non-living Entities. Front Psychol 2022; 13:852248. [PMID: 35418909 PMCID: PMC8995647 DOI: 10.3389/fpsyg.2022.852248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 02/03/2023] Open
Abstract
Introduction Although the topic of consciousness is both mysterious and controversial, psychedelic drugs are popularly believed to provide unique insights into the nature of consciousness despite a lack of empirical evidence. Methods This study addresses the question of whether psychedelics change the attribution of consciousness to a range of living and non-living entities. A survey was conducted in 1,606 respondents who endorsed a belief changing psychedelic experience. Results Participants rated their attributions of consciousness to a range of living and non-living entities before and after their psychedelic experience. Superstitious beliefs and belief in freewill were also assessed. From before the experience to after, there were large increases in attribution of consciousness to various entities including non-human primates (63-83%), quadrupeds (59-79%), insects (33-57%), fungi (21-56%), plants (26-61%), inanimate natural objects (8-26%), and inanimate manmade objects (3-15%). Higher ratings of mystical experience were associated with greater increases in the attribution of consciousness. Moreover, the increased attributions of consciousness did not decrease in those who completed the survey years after the psychedelic experience. In contrast to attributions of consciousness, beliefs in freewill and superstitions did not change. Notably, all findings were similar when restricted to individuals reporting on their first psychedelic experience. Discussion This study demonstrates that, among people who reported belief-changing psychedelic experiences, attribution of consciousness to various entities increases. Future prospective psychedelic drug administration studies that control for expectancies are needed.
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Affiliation(s)
- Sandeep M. Nayak
- Johns Hopkins Center for Psychedelic and Consciousness Research, Baltimore, MD, United States
| | - Roland R. Griffiths
- Johns Hopkins Center for Psychedelic and Consciousness Research, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Zeifman RJ, Yu D, Singhal N, Wang G, Nayak SM, Weissman CR. Decreases in Suicidality Following Psychedelic Therapy: A Meta-Analysis of Individual Patient Data Across Clinical Trials. J Clin Psychiatry 2022; 83. [PMID: 35044730 DOI: 10.4088/jcp.21r14057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: Suicide is a global health concern, and innovative interventions that target suicidality are needed. While psychedelic therapy shows promise for a range of mental health concerns, including suicidality, not all psychedelic therapy trials have published their suicidality results and no meta-analysis has been published on the topic. Therefore, we completed the first meta-analysis of patient-level data on the effects of psychedelics on suicidality. Data Sources: We conducted a systematic search of MEDLINE, PsycINFO, and PubMed for all psychedelic therapy clinical trials (last search: November 5, 2020). Study Selection: We identified all psychedelic therapy trials that included a measure or measure-item that assesses suicidality. Data Extraction: Suicidality data were requested from study authors and extracted using a data extraction form developed for this study. Results: We identified 8, and successfully collected data from 7, relevant trials. Analysis of standardized mean differences (SMDs) indicated that, relative to baseline, psychedelic therapy was associated with large effect sizes for acute (80-240 min) and sustained (1 day, 1-8 weeks, and 3-4 months) decreases in suicidality (SMD range = -1.48 to -2.36; 95% CI range, -4.30 to 0.23). At 6 months, the effect size was medium (SMD = -0.65; 95% CI, -1.14 to -0.16). Reductions in suicidality were significant at all time points except for 7-8 weeks. Acute and post-acute elevations in suicidality were rare (6.5% and 3.0%, respectively). Conclusions: Limitations include heterogeneous samples and interventions, as well as limited sample size and number of studies. Results provide preliminary support for the safety of psychedelic therapy and its positive effect on suicidality. Controlled trials that specifically evaluate the effect of psychedelic therapy on suicidality may be warranted.
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Affiliation(s)
- Richard J Zeifman
- Department of Medicine, Imperial College London, London, United Kingdom.,Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Dengdeng Yu
- Department of Mathematics, University of Texas at Arlington, Arlington, Texas
| | - Nikhita Singhal
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Guan Wang
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cory R Weissman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dr Weissman is now at the Department of Psychiatry, University of California San Diego, La Jolla, California.,Corresponding author: Cory R. Weissman, MD, Department of Psychiatry, University of California San Diego, 16918 Dove Canyon Road, Suite 100, Mail Code 8322, San Diego, CA 92127
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Nayak SM, Gukasyan N, Barrett FS, Erowid E, Erowid F, Griffiths RR. Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports. Pharmacopsychiatry 2021; 54:240-245. [PMID: 34348413 DOI: 10.1055/a-1524-2794] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Psychedelics show promise in treating unipolar depression, though patients with bipolar disorder have been excluded from recent psychedelic trials. There is limited information on the use of classic psychedelics (e. g., LSD or psilocybin) in individuals using mood stabilizers to treat bipolar disorder. This is important to know, as individuals with bipolar depression may attempt to treat themselves with psychedelics while on a mood stabilizer, particularly given enthusiastic media reports of the efficacy of psilocybin for depression. METHODS This study analyzed reports of classic psychedelics administered with mood stabilizers from 3 websites (Erowid.org, Shroomery.org, and Reddit.com). RESULTS Strikingly, 47% of 62 lithium plus psychedelic reports involved seizures, and an additional 18% resulted in bad trips while none of 34 lamotrigine reports did. Further, 39% of lithium reports involved medical attention. Most of the lamotrigine reports (65%) but few (8%) of the lithium reports were judged to not affect the psychedelic experience. DISCUSSION Although further research is needed, we provisionally conclude that psychedelic use may pose a significant seizure risk for patients on lithium.
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Affiliation(s)
- Sandeep M Nayak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natalie Gukasyan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick S Barrett
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins University School of Medicine, USA
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Nayak SM, Huhn AS, Bergeria CL, Strain EC, Dunn KE. Familial perceptions of appropriate treatment types and goals for a family member who has opioid use disorder. Drug Alcohol Depend 2021; 221:108649. [PMID: 33640679 DOI: 10.1016/j.drugalcdep.2021.108649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite effective, evidence-based medications for opioid use disorder (MOUD), these treatments remain underutilized. This may be due to multiple reasons. Family members may impact patient decision-making when choosing an opioid use disorder (OUD) treatment. While there has been work on patient preferences and attitudes towards opioid use disorder (OUD) treatment, to date, there has been minimal work assessing the attitudes of family member towards OUD treatment and recovery. METHODS Participants were ≥ 18 years of age and endorsed having a first-degree family member with past-year treatment for OUD. Participants were recruited via online crowdsourcing and were asked a number of questions regarding their desired outcomes for OUD treatment, and their familiarity, approval, and perceived effectiveness of various OUD treatment options. RESULTS The most commonly reported desired treatment outcome (50 %) was for family members to never use any kind of opioid, including maintenance therapies or opioid analgesics. Mean familiarity ratings for MOUD (rated 0-100) were relatively low, with naltrexone being the least familiar (32.3). Among those who endorsed a familiarity rating of at least 30 for a given treatment, mean approval and effectiveness ratings were relatively low-buprenorphine (approve 55.1; effective 54.1), methadone (approve 51.9; effective 49.3), naltrexone (approve 61.6; effective 55.9). These were lower than approval and effectiveness ratings for all non-MOUD treatments queried. CONCLUSIONS These findings highlight a need for clinicians and researchers to engage with family members' regarding their preferences and understanding of treatment, and to better understand how this might impact patient engagement with treatment.
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Affiliation(s)
- Sandeep M Nayak
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Andrew S Huhn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cecilia L Bergeria
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eric C Strain
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly E Dunn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Zaller ND, Yokell MA, Nayak SM, Fu JJ, Bazazi AR, Rich JD. Syringe acquisition experiences and attitudes among injection drug users undergoing short-term opioid detoxification in Massachusetts and Rhode Island. J Urban Health 2012; 89:659-70. [PMID: 22427232 PMCID: PMC3535136 DOI: 10.1007/s11524-012-9669-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Access to sterile syringes for injection drug users (IDUs) is a critical part of a comprehensive strategy to combat the transmission of HIV, hepatitis C virus, and other bloodborne pathogens. Understanding IDUs' experiences and attitudes about syringe acquisition is crucial to ensuring adequate syringe supply and access for this population. This study sought to assess and compare IDUs' syringe acquisition experiences and attitudes and HIV risk behavior in two neighboring states, Massachusetts (MA) and Rhode Island (RI). From March 2008 to May 2009, we surveyed 150 opioid IDUs at detoxification facilities in MA and RI, stratified the sample based on where respondents spent most of their time, and generated descriptive statistics to compare responses among the two groups. A large proportion of our participants (83%) reported pharmacies as a source of syringe in the last 6 months, while only 13% reported syringe exchange programs (SEPs) as a syringe source. Although 91% of our sample reported being able to obtain all of the syringes they needed in the past 6 months, 49% had used syringes or injection equipment previously used by someone else in that same time period. In comparison to syringe acquisition behaviors reported by patients of the same detoxification centers in 2001-2003 (data reported in previous publication), we found notable changes among MA participants. Our results reveal that some IDUs in our sample are still practicing high-risk injection behaviors, indicating a need for expanded and renewed efforts to promote safer injection behavior among IDUs. Our findings also indicate that pharmacies have become an important syringe source for IDUs and may represent a new and important setting in which IDUs can be engaged in a wide array of health services. Efforts should be made to involve pharmacists in providing harm reduction and HIV prevention services to IDUs. Finally, despite limited SEP access (especially in MA), SEPs are still used by approximately one of the three IDUs in our overall sample.
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Affiliation(s)
- Nickolas D Zaller
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI, USA.
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