1
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Rucker JJ, Roberts C, Seynaeve M, Young AH, Suttle B, Yamamoto T, Ermakova AO, Dunbar F, Wiegand F. Phase 1, placebo-controlled, single ascending dose trial to evaluate the safety, pharmacokinetics and effect on altered states of consciousness of intranasal BPL-003 (5-methoxy- N,N-dimethyltryptamine benzoate) in healthy participants. J Psychopharmacol 2024:2698811241246857. [PMID: 38616411 DOI: 10.1177/02698811241246857] [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] [Indexed: 04/16/2024]
Abstract
AIMS To investigate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of BPL-003, a novel intranasal benzoate salt formulation of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT), in healthy participants. METHODS In all, 44 psychedelic-naïve participants enrolled in the double-blind, placebo-controlled single ascending dose study (1-12 mg BPL-003). Concentrations of 5-MeO-DMT and its pharmacologically active metabolite, bufotenine, were determined in plasma and urine. PD endpoints included subjective drug intensity (SDI) rating, the Mystical Experience Questionnaire (MEQ-30) and the Ego Dissolution Inventory (EDI). RESULTS BPL-003 was well tolerated at doses up to 12 mg. There were no serious adverse events (AEs), and most AEs were mild; the most common being nasal discomfort, nausea, headache and vomiting. 5-MeO-DMT was rapidly absorbed and eliminated; the median time to peak plasma concentration was approximately 8-10 min and the mean terminal elimination half-life was <27 min. 5-MeO-DMT systemic exposure increased approximately dose-proportionally, while plasma bufotenine concentrations and urinary excretion of 5-MeO-DMT and bufotenine were negligible. The intensity of the SDI ratings was associated with plasma 5-MeO-DMT concentrations. MEQ-30 and EDI scores generally increased with the BPL-003 dose; 60% of participants had a 'complete mystical experience' at 10 and 12 mg doses. Profound and highly emotional consciousness-altering effects were observed with BPL-003, with a rapid onset and short-lasting duration. CONCLUSION The novel intranasal formulation of BPL-003 was well tolerated with dose-proportional increases in PK and PD effects. The short duration of action and induction of mystical experiences suggest clinical potential, warranting further trials. CLINICAL TRIAL REGISTRATION NCT05347849.
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Affiliation(s)
- James Jonathan Rucker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- The South London and Maudsley NHS Foundation Trust, Beckenham, Kent, UK
| | | | - Mathieu Seynaeve
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Beckley Psytech Ltd, Oxford, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- The South London and Maudsley NHS Foundation Trust, Beckenham, Kent, UK
| | | | | | - Anna O Ermakova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Beckley Psytech Ltd, Oxford, UK
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Peill J, Marguilho M, Erritzoe D, Barba T, Greenway KT, Rosas F, Timmermann C, Carhart-Harris R. Psychedelics and the 'inner healer': Myth or mechanism? J Psychopharmacol 2024:2698811241239206. [PMID: 38605658 DOI: 10.1177/02698811241239206] [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] [Indexed: 04/13/2024]
Abstract
BACKGROUND Reference to an intrinsic healing mechanism or an 'inner healer' is commonplace amongst psychedelic drug-using cultures. The 'inner healer' refers to the belief that psychedelic compounds, plants or concoctions have an intrinsically regenerative action on the mind and brain, analogous to intrinsic healing mechanisms within the physical body, for example, after sickness or injury. AIMS Here, we sought to test and critique this idea by devising a single subjective rating item pertaining to perceived 'inner healing' effects. METHODS The item was issued to 59 patients after a single high (25 mg, n = 30) or 'placebo' (1 mg, n = 29) dose of psilocybin in a double-blind randomised controlled trial of psilocybin for depression. RESULTS Inner healer scores were higher after the high versus placebo dose of psilocybin (t = 3.88, p < 0.001). Within the high-dose sub-sample only, inner healer scores predicted improved depressive symptomatology at 2 weeks post-dosing. CONCLUSIONS The principle of activating inner healing mechanisms via psychedelics is scientifically nascent; however, this study takes a positivist and pragmatic step forward, asking whether it warrants further examination.
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Affiliation(s)
- Joseph Peill
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Miriam Marguilho
- Division of Psychiatry, Lisbon Psychiatric Hospital Centre, Lisbon, Portugal
| | - David Erritzoe
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Tommaso Barba
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Kyle T Greenway
- Division of Psychiatry, Lisbon Psychiatric Hospital Centre, Lisbon, Portugal
- Faculty of Medicine, Department of Psychiatry, McGill University, Ludmer Research and Training Building, Montréal, QC, Canada
- Lady Davis Institute, Jewish General Hospital, Montréal, QC, Canada
| | - Fernando Rosas
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
- Department of Informatics, University of Sussex, Brighton, UK
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Christopher Timmermann
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin Carhart-Harris
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Departments of Neurology and Psychiatry, Carhart-Harris Lab, University of California San Francisco, San Francisco, CA, USA
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3
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Norring SA, Spigarelli MG. The Promise of Therapeutic Psilocybin: An Evaluation of the 134 Clinical Trials, 54 Potential Indications, and 0 Marketing Approvals on ClinicalTrials.gov. Drug Des Devel Ther 2024; 18:1143-1151. [PMID: 38618282 PMCID: PMC11016263 DOI: 10.2147/dddt.s443177] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction Psilocybin, a tryptamine psychedelic, has been touted in the media both historically and recently as a potential game-changing mental health therapeutic. ClinicalTrials.gov has over one hundred and thirty psilocybin clinical trials listed covering the last twenty years. The single most important aspect of any therapeutic is to gain approval for marketing and thus enter the real-world phase of development. A typical new chemical entity progresses from inception to US Food and Drug Administration (FDA) approval in approximately 12 years and seeks approval for a single indication. Methods An observational study was conducted with the available information on the ClinicalTrials.gov site to observe the extent of progress made demonstrating the clinical utility of psilocybin. Results The results showed 134 psilocybin trials typically unblinded studies of 10-20 participants, recruited over years at a single site. Additionally, there have been only three advanced trials (1 Phase 2/3 and 2 Phase 3) submitted, and only in the last two years. Discussion The hundreds of psilocybin clinical trials initiated over the past twenty years comprising a myriad of potential indications may actually be slowing this potential game-changing mental health therapeutic agent's approval and is costing excessive amounts of capital. To fully evaluate the actual potential of psilocybin, purposeful clinical trials need to be designed well, executed efficiently, and analyzed utilizing sequential and statistically valid processes for each potential indication. This will require a change from the current exploratory forays to defined, well-funded, sequential pharmaceutical development practices, including adequate and appropriate blinding of studies, statistical design to determine the number of participants and more importantly, professional expertise in conducting multicenter trials. Unfortunately, these results demonstrate little real progress towards FDA approval of psilocybin and a field with no clear direction forward.
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Jones G, Herrmann F, Bear A, Carhart-Harris R, Kettner H. The Relationship Between Changes in Mindfulness and Subsequent Changes in Well-Being Following Psychedelic Use: Prospective Cohort Study. JMIR Form Res 2024; 8:e54632. [PMID: 38437005 PMCID: PMC10949123 DOI: 10.2196/54632] [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] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
This study demonstrates that changes in mindfulness predict subsequent changes in well-being in a data set including individuals who recently engaged in psychedelic use.
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Affiliation(s)
- Grant Jones
- Harvard University, Cambridge, MA, United States
| | | | - Adam Bear
- Harvard University, Cambridge, MA, United States
| | | | - Hannes Kettner
- University of California, San Francisco, San Francisco, CA, United States
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5
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Trout K, Daley PF. The origin of 2,5-dimethoxy-4-methylamphetamine (DOM, STP). Drug Test Anal 2024. [PMID: 38419183 DOI: 10.1002/dta.3667] [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] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
The story of the 1967 appearance of the powerful psychedelic 2,5-dimethoxy-4-methylamphetamine (DOM, STP) commonly omits details and often includes hyperbole and inaccuracies. It is well known how and when the drug was first distributed to the public for free by Owsley Stanley, but the role that Alexander Shulgin played in providing that material is not as well understood. In the interest of transparency and historical accuracy, this article attempts to present an accurate account of this well-known but inadequately detailed event. It follows DOM's development as an experimental substance believed to hold potential promise in psychotherapeutic applications through its appearance as a street drug generating bad press and a lasting bad impression among the public. One of the more interesting questions is why Shulgin would have taken such an immense risk in releasing this material to clandestine operators. While DOM was still legal it was also Dow's intellectual property, so discovery of his involvement could have jeopardized his career. The escape is especially curious as all fingers would logically first point towards Shulgin as the source. Drawing from published and unpublished sources, the authors attempt to suggest answers. DOM rapidly faded into oblivion before human pharmacodynamics and pharmacokinetics could be established. In this account, the reader is informed of the potential value that the compound played in non-clinical molecular neuroscience, elucidating receptor specificity of new drugs, and how mistaken warnings about combining DOM with chlorpromazine led to better non-pharmacological drug crisis response.
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Affiliation(s)
- Keeper Trout
- Shulgin Archive, Trouts Notes, Boonville, California, USA
| | - Paul F Daley
- Alexander Shulgin Research Institute, Lafayette, California, USA
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6
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White E, Kennedy T, Ruffell S, Perkins D, Sarris J. Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review. Int J Toxicol 2024:10915818241230916. [PMID: 38363085 DOI: 10.1177/10915818241230916] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The objective of this paper is to conduct a systematic thematic review of adverse events, safety, and toxicity of traditional ayahuasca plant preparations and its main psychoactive alkaloids (dimethyltryptamine [DMT], harmine, harmaline, and tetrahydroharmine), including discussing clinical considerations (within clinical trials or approved settings). A systematic literature search of preclinical, clinical, epidemiological, and pharmacovigilance data (as well as pertinent reviews and case studies) was conducted for articles using the electronic databases of PubMed and Web of Science (to 6 July 2023) and PsycINFO, ClinicalTrials.gov, and Embase (to 21 September 2022) and included articles in English in peer-reviewed journals. Additionally, reference lists were searched. Due to the breadth of the area covered, we presented the relevant data in a thematic format. Our searches revealed 78 relevant articles. Data showed that ayahuasca or DMT is generally safe; however, some adverse human events have been reported. Animal models using higher doses of ayahuasca have shown abortifacient and teratogenic effects. Isolated harmala alkaloid studies have also revealed evidence of potential toxicity at higher doses, which may increase with co-administration with certain medications. Harmaline revealed the most issues in preclinical models. Nevertheless, animal models involving higher-dose synthetic isolates may not necessarily be able to be extrapolated to human use of therapeutic doses of plant-based extracts. Serious adverse effects are rarely reported within healthy populations, indicating an acceptable safety profile for the traditional use of ayahuasca and DMT in controlled settings. Further randomized, controlled trials with judicious blinding, larger samples, and longer duration are needed.
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Affiliation(s)
- Eleanor White
- Biomedicine Discovery Institute, Department of Physiology, Monash University, Melbourne, VIC, Australia
| | - Tom Kennedy
- The University of Queensland, Brisbane, QLD, Australia
| | - Simon Ruffell
- Psychae Institue, Melbourne, VIC, Australia
- Onaya Science, Iquitos, Peru
| | - Daniel Perkins
- Psychae Institue, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Jerome Sarris
- Psychae Institue, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
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7
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Funk D, Araujo J, Slassi M, Lanthier J, Atkinson J, Feng D, Lau W, Lê A, Higgins GA. Effect of a single psilocybin treatment on Fos protein expression in male rat brain. Neuroscience 2024; 539:1-11. [PMID: 38184069 DOI: 10.1016/j.neuroscience.2024.01.001] [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: 09/17/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
Psilocybin has received attention as a treatment for depression, stress disorders and drug and alcohol addiction. To help determine the mechanisms underlying its therapeutic effects, here we examined acute effects of a range of behaviourally relevant psilocybin doses (0.1-3 mg/kg SC) on regional expression of Fos, the protein product of the immediate early gene, c-fos in brain areas involved in stress, reward and motivation in male rats. We also determined the cellular phenotypes activated by psilocybin, in a co-labeling analysis with NeuN, a marker of mature neurons, or Olig1, a marker of oligodendrocytes. In adult male Sprague-Dawley rats, psilocybin increased Fos expression dose dependently in several brain regions, including the frontal cortex, nucleus accumbens, central and basolateral amygdala and locus coeruleus. These effects were most marked in the central amygdala. Double labeling experiments showed that Fos was expressed in both neurons and oligodendrocytes. These results extend previous research by determining Fos expression in multiple brain areas at a wider psilocybin dose range, and the cellular phenotypes expressing Fos. The data also highlight the amygdala, especially the central nucleus, a key brain region involved in emotional processing and learning and interconnected with other brain areas involved in stress, reward and addiction, as a potentially important locus for the therapeutic effects of psilocybin. Overall, the present findings suggest that the central amygdala may be an important site through which the initial brain activation induced by psilocybin is translated into neuroplastic changes, locally and in other regions that underlie its extended therapeutic effects.
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Affiliation(s)
- Douglas Funk
- Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto M5S 2S1, Canada.
| | - Joseph Araujo
- Transpharmation Ltd., Fergus N1M 2W8, Canada; Mindset Pharma, Toronto M5V 0R2, Canada
| | | | | | | | - Daniel Feng
- Transpharmation Ltd., Fergus N1M 2W8, Canada
| | - Winnie Lau
- Transpharmation Ltd., Fergus N1M 2W8, Canada
| | - Anh Lê
- Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto M5S 2S1, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto M5S 1A8, Canada
| | - Guy A Higgins
- Transpharmation Ltd., Fergus N1M 2W8, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto M5S 1A8, Canada
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8
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Ching THW, Amoroso L, Bohner C, D'Amico E, Eilbott J, Entezar T, Fitzpatrick M, Fram G, Grazioplene R, Hokanson J, Jankovsky A, Kichuk SA, Martins B, Patel P, Schaer H, Shnayder S, Witherow C, Pittenger C, Kelmendi B. Corrigendum: Safety, feasibility, tolerability, and clinical effects of repeated psilocybin dosing combined with non-directive support in the treatment of obsessive-compulsive disorder: protocol for a randomized, waitlist-controlled trial with blinded ratings. Front Psychiatry 2024; 15:1372373. [PMID: 38435972 PMCID: PMC10905264 DOI: 10.3389/fpsyt.2024.1372373] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2023.1278823.].
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Affiliation(s)
- Terence H W Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D'Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Tara Entezar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Madison Fitzpatrick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Geena Fram
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Bradford Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah Shnayder
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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9
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Hatzipantelis CJ, Olson DE. The Effects of Psychedelics on Neuronal Physiology. Annu Rev Physiol 2024; 86:27-47. [PMID: 37931171 PMCID: PMC10922499 DOI: 10.1146/annurev-physiol-042022-020923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Psychedelics are quite unique among drugs that impact the central nervous system, as a single administration of a psychedelic can both rapidly alter subjective experience in profound ways and produce sustained effects on circuits relevant to mood, fear, reward, and cognitive flexibility. These remarkable properties are a direct result of psychedelics interacting with several key neuroreceptors distributed across the brain. Stimulation of these receptors activates a variety of signaling cascades that ultimately culminate in changes in neuronal structure and function. Here, we describe the effects of psychedelics on neuronal physiology, highlighting their acute effects on serotonergic and glutamatergic neurotransmission as well as their long-lasting effects on structural and functional neuroplasticity in the cortex. We propose that the neurobiological changes leading to the acute and sustained effects of psychedelics might be distinct, which could provide opportunities for engineering compounds with optimized safety and efficacy profiles.
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Affiliation(s)
- Cassandra J Hatzipantelis
- Institute for Psychedelics and Neurotherapeutics, University of California, Davis, Davis, California, USA;
- Department of Chemistry, University of California, Davis, Davis, California, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - David E Olson
- Institute for Psychedelics and Neurotherapeutics, University of California, Davis, Davis, California, USA;
- Department of Chemistry, University of California, Davis, Davis, California, USA
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA
- Center for Neuroscience, University of California, Davis, Davis, California, USA
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10
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Flanagan T, Foster TP, Galbato TE, Lum PY, Louie B, Song G, Halberstadt AL, Billac GB, Nichols CD. Serotonin-2 Receptor Agonists Produce Anti-inflammatory Effects through Functionally Selective Mechanisms That Involve the Suppression of Disease-Induced Arginase 1 Expression. ACS Pharmacol Transl Sci 2024; 7:478-492. [PMID: 38357283 PMCID: PMC10863441 DOI: 10.1021/acsptsci.3c00297] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
Functional selectivity in the context of serotonin 2A (5-HT2A) receptor agonists is often described as differences psychedelic compounds have in the activation of Gq vs β-arrestin signaling in the brain and how that may relate to inducing psychoactive and hallucinatory properties with respect to each other. However, the presence of 5-HT2A receptors throughout the body in several cell types, including endothelial, endocrine, and immune-related tissues, suggests that functional selectivity may exist in the periphery as well. Here, we examine functional selectivity between two 5-HT2A receptor agonists of the phenylalkylamine class: (R)-2,5-dimethoxy-4-iodoamphetamine [(R)-DOI] and (R)-2,5-dimethoxy-4-trifluoromethylamphetamine [(R)-DOTFM]. Despite comparable in vitro activity at the 5-HT2A receptor as well as similar behavioral potency, (R)-DOTFM does not exhibit an ability to prevent inflammation or elevated airway hyperresponsiveness (AHR) in an acute murine ovalbumin-induced asthma model as does (R)-DOI. Furthermore, there are distinct differences between protein expression and inflammatory-related gene expression in pulmonary tissues between the two compounds. Using (R)-DOI and (R)-DOTFM as tools, we further elucidated the anti-inflammatory mechanisms underlying the powerful anti-inflammatory effects of certain psychedelics and identified key mechanistic components of the anti-inflammatory effects of psychedelics, including suppression of arginase 1 expression.
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Affiliation(s)
- Thomas
W. Flanagan
- Department
of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew Orleans, Louisiana70112, United States
| | - Timothy P. Foster
- Department
of Microbiology, Immunology, and ParasitologyLouisiana State University Health Sciences CenterNew Orleans, Louisiana70112, United States
| | - Thomas E. Galbato
- Department
of Microbiology, Immunology, and ParasitologyLouisiana State University Health Sciences CenterNew Orleans, Louisiana70112, United States
| | - Pek Yee Lum
- Auransa
Inc.Palo Alto, California94301, United States
| | - Brent Louie
- Auransa
Inc.Palo Alto, California94301, United States
| | - Gavin Song
- Auransa
Inc.Palo Alto, California94301, United States
| | - Adam L. Halberstadt
- Department
of PsychiatryUniversity of San Diego, California, San Diego, California92093, United States
| | - Gerald B. Billac
- Department
of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew Orleans, Louisiana70112, United States
| | - Charles D. Nichols
- Department
of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew Orleans, Louisiana70112, United States
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11
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Jayakodiarachchi N, Maurer MA, Schultz DC, Dodd CJ, Thompson Gray A, Cho HP, Boutaud O, Jones CK, Lindsley CW, Bender AM. Evaluation of the Indazole Analogs of 5-MeO-DMT and Related Tryptamines as Serotonin Receptor 2 Agonists. ACS Med Chem Lett 2024; 15:302-309. [PMID: 38352850 PMCID: PMC10860182 DOI: 10.1021/acsmedchemlett.3c00566] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Herein, we report the synthesis and characterization of a novel set of substituted indazole-ethanamines and indazole-tetrahydropyridines as potent serotonin receptor subtype 2 (5-HT2) agonists. Specifically, we examine the 5-HT2 pharmacology of the direct indazole analogs of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) and related serotonergic tryptamines, and highlight the need for rigorous characterization of 5-HT2 subtype selectivity for these analogs, particularly for the 5-HT2B receptor subtype. Within this series, the potent analog VU6067416 (19d) was optimized to have suitable preclinical pharmacokinetic properties for in vivo dosing, although potent 5-HT2B agonist activity precluded further characterization for this series. Additionally, in silico docking studies suggest that the high potency of 19d may be a consequence of a halogen-bonding interaction with Phe2345.38 in the 5-HT2A orthosteric pocket.
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Affiliation(s)
- Navoda Jayakodiarachchi
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Mallory A. Maurer
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Daniel C. Schultz
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Cayden J. Dodd
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Analisa Thompson Gray
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Hyekyung P. Cho
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Olivier Boutaud
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Carrie K. Jones
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Craig W. Lindsley
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Aaron M. Bender
- Warren Center for Neuroscience Drug
Discovery and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
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12
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Aday JS, Bloesch EK, Davis AK, Domoff SE, Scherr K, Woolley JD, Davoli CC. Effects of Ayahuasca on Gratitude and Relationships with Nature: A Prospective, Naturalistic Study. J Psychoactive Drugs 2024:1-10. [PMID: 38310541 DOI: 10.1080/02791072.2024.2312980] [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] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024]
Abstract
Qualitative studies and anecdotal reports suggest that experiences with ayahuasca, a psychedelic brew found in Central and South America, may be followed by individuals enduringly feeling more grateful and connected to nature. Yet, to date, these changes have been understudied. Here, participants (N = 54) completed validated surveys related to gratitude, nature relatedness, and nature appreciation one-week before, one-week after, and one-month after attending an ayahuasca retreat center. Compared to baseline, there was a significant increase in gratitude, nature relatedness, and nature appreciation at the one-week and one-month follow-ups. Ratings of mystical-type experiences and awe, but not ego dissolution, during participants' ayahuasca sessions were weakly-to-moderately correlated with these increases. The number of ayahuasca ceremonies attended at the retreat was not related to change in outcomes, underscoring the importance of the quality rather than the quantity of the experiences in post-acute change. Lastly, participant age was negatively related to the occurrence of mystical-type experiences and awe, supporting literature indicating blunted psychedelic effects with increased age. In the context of study limitations, the results suggest that mystical-type experiences and awe occasioned by ayahuasca may be linked to prosocial changes in gratitude and relationships with nature that may be beneficial to mental health.
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Affiliation(s)
- Jacob S Aday
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
- Translational Psychedelic Research (TrPR) Program, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Michigan Psychedelic Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Emily K Bloesch
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, US
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah E Domoff
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Kyle Scherr
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Josh D Woolley
- Translational Psychedelic Research (TrPR) Program, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
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13
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Plourde L, Chang SL, Farzin H, Gagnon P, Hébert J, Foxman R, Deschamps P, Provost F, Masse-Grenier M, Stephan JF, Cheung K, Joly Y, Fallu JS, Dorval M. Social acceptability of psilocybin-assisted therapy for existential distress at the end of life: A population-based survey. Palliat Med 2024; 38:272-278. [PMID: 38253521 PMCID: PMC10865753 DOI: 10.1177/02692163231222430] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Internationally, there is a growing interest in the potential benefits of psilocybin-assisted therapy to treat existential distress at the end of life. However, the social acceptability of this therapy is not yet well known. AIM This study assesses the social acceptability of the medical use of psilocybin to treat existential distress at the end of life. DESIGN An online survey was conducted in Canada between November 23 and December 4, 2022. The questionnaire included items pertaining to perceptions, attitudes and concerns towards psilocybin-assisted therapy to treat existential distress at the end of life. PARTICIPANTS The sample (n = 2800) was stratified by province, age and sex. Participants were adults from four provinces of Canada: Québec, Ontario, Alberta and British Columbia. RESULTS Overall, 79.3% considered psilocybin-assisted therapy a reasonable medical choice for a patient suffering from existential distress at the end of life, 84.8% agreed that the public health system should cover the costs of the intervention and 63.3% would welcome the legalisation of psilocybin for medical purposes. Previous psilocybin use (p < 0.0001, for all dependent variables), exposure to palliative care (p < 0.05, for all dependent variables) and a progressive political orientation (p < 0.05, for all dependent variables) were associated with more favourable attitudes towards psilocybin-assisted therapy at the end of life. CONCLUSION The social acceptability of psilocybin-assisted therapy for existential distress at the end of life is rather high in Canada. These findings may contribute to efforts to mobilise resources and improve access to this emerging therapy in palliative and end of life care settings.
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Affiliation(s)
- Louis Plourde
- Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
| | - Sue-Ling Chang
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
| | - Houman Farzin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Pierre Gagnon
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
- Faculty of Medicine, Université Laval, Québec City, QC, Canada
| | - Johanne Hébert
- Department of Health Sciences, UQAR, Lévis, Rimouski, QC, Canada
- CISSS of Chaudière-Appalaches Research Center, Lévis, QC, Canada
| | | | | | - François Provost
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
- School of Psychology, Université Laval, QC, Canada
| | - Marianne Masse-Grenier
- Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
| | | | | | - Yann Joly
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre of Genomics and Policy, McGill University, Montréal, QC, Canada
| | - Jean-Sébastien Fallu
- School of Psychoeducation, Université de Montréal, Montréal, QC, Canada
- Center for Public Health Research (CReSP), Montréal, QC, Canada
- Institut universitaire sur les dépendances (IUD), Montréal, QC, Canada
| | - Michel Dorval
- Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
- CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada
- CISSS of Chaudière-Appalaches Research Center, Lévis, QC, Canada
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14
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Szigeti B, Weiss B, Rosas FE, Erritzoe D, Nutt D, Carhart-Harris R. Assessing expectancy and suggestibility in a trial of escitalopram v. psilocybin for depression. Psychol Med 2024:1-8. [PMID: 38247730 DOI: 10.1017/s0033291723003653] [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: 01/23/2024]
Abstract
BACKGROUND To investigate the association between pre-trial expectancy, suggestibility, and response to treatment in a trial of escitalopram and investigational drug, COMP360, psilocybin, in the treatment of major depressive disorder (ClinicalTrials.gov registration: NCT03429075). METHODS We used data (n = 55) from our recent double-blind, parallel-group, randomized head-to-head comparison trial of escitalopram and investigational drug, COMP360, psilocybin. Mixed linear models were used to investigate the association between pre-treatment efficacy-related expectations, as well as baseline trait suggestibility and absorption, and therapeutic response to both escitalopram and COMP360 psilocybin. RESULTS Patients had significantly higher expectancy for psilocybin relative to escitalopram; however, expectancy for escitalopram was associated with improved therapeutic outcomes to escitalopram, expectancy for psilocybin was not predictive of response to psilocybin. Separately, we found that pre-treatment trait suggestibility was associated with therapeutic response in the psilocybin arm, but not in the escitalopram arm. CONCLUSIONS Overall, our results suggest that psychedelic therapy may be less vulnerable to expectancy biases than previously suspected. The relationship between baseline trait suggestibility and response to psilocybin therapy implies that highly suggestible individuals may be primed for response to this treatment.
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Affiliation(s)
- Balázs Szigeti
- Centre for Psychedelic Research, Imperial College London, UK
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, USA
| | - Brandon Weiss
- Centre for Psychedelic Research, Imperial College London, UK
| | - Fernando E Rosas
- Centre for Psychedelic Research, Imperial College London, UK
- Centre for Complexity Science, Imperial College London, UK
- Department of Informatics, University of Sussex, Brighton, UK
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Imperial College London, UK
| | - David Nutt
- Centre for Psychedelic Research, Imperial College London, UK
| | - Robin Carhart-Harris
- Depts. of Neurology, Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, USA
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15
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Kervadec E, Fauvel B, Strika-Bruneau L, Amirouche A, Verroust V, Piolino P, Romeo B, Benyamina A. Reduction of alcohol use and increase in psychological flexibility after a naturalistic psychedelic experience: a retrospective survey. Alcohol Alcohol 2024; 59:agad078. [PMID: 37981297 DOI: 10.1093/alcalc/agad078] [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: 04/06/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/21/2023] Open
Abstract
INTRODUCTION Alcohol use can be significantly associated with negative social, professional, and health outcomes. Even more so, alcohol use disorder (AUD) is a critical public health issue and major avoidable risk factor. This study aimed to examine the effect of a naturalistic psychedelic experience on alcohol use and related measures. METHODS A retrospective online survey was conducted on 160 individuals who reported a psychedelic experience and a concomitant drinking habit but did not necessarily have an AUD. Demographic data, characteristics of the psychedelic experience, and changes in alcohol consumption and psychological flexibility were surveyed. Results: The mean number of drinking days per week and AUDIT scores significantly decreased after the psychedelic experience (P < .001). Subjects who quit or reduced drinking had a more severe AUD (P < .01) and lower psychological flexibility (P = .003) before the psychedelic session. Alcohol use reduction was significantly associated with the intensity of the mystical experience (P = .03). Psychological flexibility increased more in participants who reduced their alcohol use (P < .001), and the change in psychological flexibility was one of the predictors of alcohol use improvement (P = .003). Conclusion: Our findings suggest that a naturalistic psychedelic experience could be associated with a reduction in alcohol use and dependency. Such positive health outcomes can be associated with the intensity of the mystical experience as well as an increase in psychological flexibility.
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Affiliation(s)
- Ewen Kervadec
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif F-94800, France
| | - Baptiste Fauvel
- Laboratoire Mémoire, Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Site Boulogne-Centre Henri Pié ron71, avenue Edouard Vaillant 92774 Boulogne-Billancourt, Paris, France
| | - Lana Strika-Bruneau
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif F-94800, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions-PSYCOMADD-Paris Saclay University Île-de-France, Hôpital Paul Brousse AP-HP12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Ammar Amirouche
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif F-94800, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions-PSYCOMADD-Paris Saclay University Île-de-France, Hôpital Paul Brousse AP-HP12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Vincent Verroust
- Unité de Recherche Psychiatrie-Comorbidités-Addictions-PSYCOMADD-Paris Saclay University Île-de-France, Hôpital Paul Brousse AP-HP12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France
- Université Picardie-Jules Vernes, Chemin du Thil, 80000 Amiens, France
| | - Pascale Piolino
- Laboratoire Mémoire, Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Site Boulogne-Centre Henri Pié ron71, avenue Edouard Vaillant 92774 Boulogne-Billancourt, Paris, France
| | - Bruno Romeo
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif F-94800, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions-PSYCOMADD-Paris Saclay University Île-de-France, Hôpital Paul Brousse AP-HP12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Amine Benyamina
- Department of Psychiatry and Addictology, APHP, Paul Brousse Hospital, Villejuif F-94800, France
- Unité de Recherche Psychiatrie-Comorbidités-Addictions-PSYCOMADD-Paris Saclay University Île-de-France, Hôpital Paul Brousse AP-HP12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France
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16
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Sherwood AM, Burkhartzmeyer EK, Williamson SE, Baumann MH, Glatfelter GC. Psychedelic-like Activity of Norpsilocin Analogues. ACS Chem Neurosci 2024; 15:315-327. [PMID: 38189238 PMCID: PMC10797613 DOI: 10.1021/acschemneuro.3c00610] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Primary metabolites of mushroom tryptamines, psilocybin and baeocystin (i.e., psilocin and norpsilocin), exhibit potent agonist activity at the serotonin 2A receptor (5-HT2A) in vitro but differ in their 5-HT2A-mediated effects in vivo. In particular, psilocin produces centrally mediated psychedelic effects in vivo, whereas norpsilocin, differing only by the loss of an N-methyl group, is devoid of psychedelic-like effects. These observations suggest that the secondary methylamine group in norpsilocin impacts its central nervous system (CNS) bioavailability but not its receptor pharmacodynamics. To test this hypothesis, eight norpsilocin derivatives were synthesized with varied secondary alkyl-, allyl-, and benzylamine groups, primarily aiming to increase their lipophilicity and brain permeability. Structure-activity relationships for the norpsilocin analogues were evaluated using the mouse head-twitch response (HTR) as a proxy for CNS-mediated psychedelic-like effects. HTR studies revealed that extending the N-methyl group of norpsilocin by a single methyl group, to give the corresponding secondary N-ethyl analogue (4-HO-NET), was sufficient to produce psilocin-like activity (median effective dose or ED50 = 1.4 mg/kg). Notably, N-allyl, N-propyl, N-isopropyl, and N-benzyl derivatives also induced psilocin-like HTR activity (ED50 = 1.1-3.2 mg/kg), with variable maximum effects (26-77 total HTR events). By contrast, adding bulkier tert-butyl or cyclohexyl groups in the same position did not elicit psilocin-like HTRs. Pharmacological assessments of the tryptamine series in vitro demonstrated interactions with multiple serotonin receptor subtypes, including 5-HT2A, and other CNS signaling proteins (e.g., sigma receptors). Overall, our data highlight key structural requirements for CNS-mediated psychedelic-like effects of norpsilocin analogues.
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Affiliation(s)
| | | | | | - Michael H. Baumann
- Designer
Drug Research Unit, National Institute on
Drug Abuse, Intramural Research Program, Baltimore, Maryland 21224, United States
| | - Grant C. Glatfelter
- Designer
Drug Research Unit, National Institute on
Drug Abuse, Intramural Research Program, Baltimore, Maryland 21224, United States
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17
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James E, Erritzoe D, Benway T, Joel Z, Timmermann C, Good M, Agnorelli C, Weiss BM, Barba T, Campbell G, Baker Jones M, Hughes C, Topping H, Boyce M, Routledge C. Safety, tolerability, pharmacodynamic and wellbeing effects of SPL026 (dimethyltryptamine fumarate) in healthy participants: a randomized, placebo-controlled phase 1 trial. Front Psychiatry 2024; 14:1305796. [PMID: 38274414 PMCID: PMC10810248 DOI: 10.3389/fpsyt.2023.1305796] [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: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Background Due to their potential impact on mood and wellbeing there has been increasing interest in the potential of serotonergic psychedelics such as N,N-dimethyltryptamine (DMT) in the treatment of major depressive disorder (MDD). Aim The aim of Part A of this study was to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamic (PD) profile of escalating doses of SPL026 (DMT fumarate) in psychedelic-naïve healthy participants to determine a dose for administration to patients with MDD in the subsequent Phase 2a part of the trial (Part B: not presented in this manuscript). Methods In the Phase 1, randomized, double-blind, placebo-controlled, parallel-group, single dose-escalation trial, psychedelic-naïve participants were randomized to placebo (n = 8) or four different escalating doses [9, 12, 17 and 21.5 mg intravenously (IV)] of SPL026 (n = 6 for each dose) together with psychological support from 2 therapy team members. PK and acute (immediately following dosing experience) psychometric measures [including mystical experience questionnaire (MEQ), ego dissolution inventory (EDI), and intensity rating visual analogue scale (IRVAS)] were determined. Additional endpoints were measured as longer-term change from baseline to days 8, 15, 30 and 90. These measures included the Warwick and Edinburgh mental wellbeing scale and Spielberger's state-trait anxiety inventory. Results SPL026 was well tolerated, with an acceptable safety profile, with no serious adverse events. There was some evidence of a correlation between maximum plasma concentration and increased IRVAS, MEQ, and EDI scores. These trends are likely to require confirmation in a larger sample size. Using the analysis of the safety, tolerability, PD, PK results, doses of 21.5 mg SPL026 were the most likely to provide an intense, tolerated experience. Conclusion Based on the data obtained from this part of the trial, a dose of 21.5 mg SPL026 given as a 2-phase IV infusion over 10 min (6 mg/5 min and 15.5 mg/5 min) was selected as the dose to be taken into patients in Part B (to be presented in a future manuscript).Clinical trial registration:www.clinicaltrials.gov, identifier NCT04673383; https://www.clinicaltrialsregister.eu, identifier 2020-000251-13; https://www.isrctn.com/, identifier ISRCTN63465876.
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Affiliation(s)
| | - David Erritzoe
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Zelah Joel
- Small Pharma Ltd., London, United Kingdom
| | - Christopher Timmermann
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Claudio Agnorelli
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Brandon M. Weiss
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tommaso Barba
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | | | | | - Helen Topping
- Hammersmith Medicines Research, London, United Kingdom
| | - Malcolm Boyce
- Hammersmith Medicines Research, London, United Kingdom
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18
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Ching THW, Amoroso L, Bohner C, D’Amico E, Eilbott J, Entezar T, Fitzpatrick M, Fram G, Grazioplene R, Hokanson J, Jankovsky A, Kichuk SA, Martins B, Patel P, Schaer H, Shnayder S, Witherow C, Pittenger C, Kelmendi B. Safety, feasibility, tolerability, and clinical effects of repeated psilocybin dosing combined with non-directive support in the treatment of obsessive-compulsive disorder: protocol for a randomized, waitlist-controlled trial with blinded ratings. Front Psychiatry 2024; 14:1278823. [PMID: 38264632 PMCID: PMC10803438 DOI: 10.3389/fpsyt.2023.1278823] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Background To date, few randomized controlled trials of psilocybin with non-directive support exist for obsessive-compulsive disorder (OCD). Results and participant feedback from an interim analysis of an ongoing single-dose trial (NCT03356483) converged on the possibility of administering a higher fixed dose and/or more doses of psilocybin in future trials for presumably greater benefits. Objectives This trial aims to evaluate the safety, feasibility, tolerability, and clinical effects of two doses of psilocybin paired with non-directive support in the treatment of OCD. This trial also seeks to examine whether two doses of psilocybin lead to greater OCD symptom reduction than a single dose, and to elucidate psychological mechanisms underlying the effects of psilocybin on OCD. Design A randomized (1:1), waitlist-controlled design with blinded ratings will be used to examine the effects of two doses of oral psilocybin paired with non-directive support vs. waitlist control on OCD symptoms. An adaptive dose selection strategy will be implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods and analysis This single-site trial will enroll 30 adult participants with treatment-refractory OCD. Aside from safety, feasibility, and tolerability metrics, primary outcomes include OCD symptoms assessed on the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A blinded independent rater will assess primary outcomes at baseline and the primary endpoint at the end of the second dosing week. Participants will be followed up to 12 months post-second dosing. Participants randomized to waitlist will be rescreened after 7 weeks post-randomization, and begin their delayed treatment phase thereafter if still eligible. Ethics Written informed consent will be obtained from participants. The institutional review board has approved this trial (protocol v. 1.7; HIC #2000032623). Discussion This study seeks to advance our ability to treat refractory OCD, and catalyze future research seeking to optimize the process of psilocybin treatment for OCD through understanding relevant psychological mechanisms.Clinical trial registration: ClinicalTrials.gov, identifier NCT05370911.
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Affiliation(s)
- Terence H. W. Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D’Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Tara Entezar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Madison Fitzpatrick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Geena Fram
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A. Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Bradford Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah Shnayder
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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19
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Toker D, Müller E, Miyamoto H, Riga MS, Lladó-Pelfort L, Yamakawa K, Artigas F, Shine JM, Hudson AE, Pouratian N, Monti MM. Criticality supports cross-frequency cortical-thalamic information transfer during conscious states. eLife 2024; 13:e86547. [PMID: 38180472 PMCID: PMC10805384 DOI: 10.7554/elife.86547] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Consciousness is thought to be regulated by bidirectional information transfer between the cortex and thalamus, but the nature of this bidirectional communication - and its possible disruption in unconsciousness - remains poorly understood. Here, we present two main findings elucidating mechanisms of corticothalamic information transfer during conscious states. First, we identify a highly preserved spectral channel of cortical-thalamic communication that is present during conscious states, but which is diminished during the loss of consciousness and enhanced during psychedelic states. Specifically, we show that in humans, mice, and rats, information sent from either the cortex or thalamus via δ/θ/α waves (∼1-13 Hz) is consistently encoded by the other brain region by high γ waves (52-104 Hz); moreover, unconsciousness induced by propofol anesthesia or generalized spike-and-wave seizures diminishes this cross-frequency communication, whereas the psychedelic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) enhances this low-to-high frequency interregional communication. Second, we leverage numerical simulations and neural electrophysiology recordings from the thalamus and cortex of human patients, rats, and mice to show that these changes in cross-frequency cortical-thalamic information transfer may be mediated by excursions of low-frequency thalamocortical electrodynamics toward/away from edge-of-chaos criticality, or the phase transition from stability to chaos. Overall, our findings link thalamic-cortical communication to consciousness, and further offer a novel, mathematically well-defined framework to explain the disruption to thalamic-cortical information transfer during unconscious states.
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Affiliation(s)
- Daniel Toker
- Department of Neurology, University of California, Los AngelesLos AngelesUnited States
- Department of Psychology, University of California, Los AngelesLos AngelesUnited States
| | - Eli Müller
- Brain and Mind Centre, University of SydneySydneyAustralia
| | - Hiroyuki Miyamoto
- Laboratory for Neurogenetics, RIKEN Center for Brain ScienceSaitamaJapan
- PRESTO, Japan Science and Technology AgencySaitamaJapan
- International Research Center for Neurointelligence, University of TokyoNagoyaJapan
| | - Maurizio S Riga
- Andalusian Center for Molecular Biology and Regenerative MedicineSevilleSpain
| | - Laia Lladó-Pelfort
- Departament de Ciències Bàsiques, Universitat de Vic-Universitat Central de CatalunyaBarcelonaSpain
| | - Kazuhiro Yamakawa
- Laboratory for Neurogenetics, RIKEN Center for Brain ScienceSaitamaJapan
- Department of Neurodevelopmental Disorder Genetics, Institute of Brain Science, Nagoya City University Graduate School of Medical ScienceNagoyaJapan
| | - Francesc Artigas
- Departament de Neurociències i Terapèutica Experimental, CSIC-Institut d’Investigacions Biomèdiques de BarcelonaBarcelonaSpain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos IIIMadridSpain
| | - James M Shine
- Brain and Mind Centre, University of SydneySydneyAustralia
| | - Andrew E Hudson
- Department of Anesthesiology, Veterans Affairs Greater Los Angeles Healthcare SystemLos AngelesUnited States
- Department of Anesthesiology and Perioperative Medicine, University of California, Los AngelesLos AngelesUnited States
| | - Nader Pouratian
- Department of Neurological Surgery, UT Southwestern Medical CenterDallasUnited States
| | - Martin M Monti
- Department of Psychology, University of California, Los AngelesLos AngelesUnited States
- Department of Neurosurgery, University of California, Los AngelesLos AngelesUnited States
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20
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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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21
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Affiliation(s)
- Guy M Goodwin
- COMPASS Pathways Plc, London (Goodwin, Malievskaia); Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin (Fonzo, Nemeroff)
| | - Ekaterina Malievskaia
- COMPASS Pathways Plc, London (Goodwin, Malievskaia); Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin (Fonzo, Nemeroff)
| | - Gregory A Fonzo
- COMPASS Pathways Plc, London (Goodwin, Malievskaia); Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin (Fonzo, Nemeroff)
| | - Charles B Nemeroff
- COMPASS Pathways Plc, London (Goodwin, Malievskaia); Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin (Fonzo, Nemeroff)
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22
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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23
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Ona G, Reverte I, Rossi GN, Dos Santos RG, Hallak JE, Colomina MT, Bouso JC. Main targets of ibogaine and noribogaine associated with its putative anti-addictive effects: A mechanistic overview. J Psychopharmacol 2023; 37:1190-1200. [PMID: 37937505 DOI: 10.1177/02698811231200882] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND There is a growing interest in studying ibogaine (IBO) as a potential treatment for substance use disorders (SUDs). However, its clinical use has been hindered for mainly two reasons: First, the lack of randomized, controlled studies informing about its safety and efficacy. And second, IBO's mechanisms of action remain obscure. It has been challenging to elucidate a predominant mechanism of action responsible for its anti-addictive effects. OBJECTIVE To describe the main targets of IBO and its main metabolite, noribogaine (NOR), in relation to their putative anti-addictive effects, reviewing the updated literature available. METHODS A comprehensive search involving MEDLINE and Google Scholar was undertaken, selecting papers published until July 2022. The inclusion criteria were both theoretical and experimental studies about the pharmacology of IBO. Additional publications were identified in the references of the initial papers. RESULTS IBO and its main metabolite, NOR, can modulate several targets associated with SUDs. Instead of identifying key targets, the action of IBO should be understood as a complex modulation of multiple receptor systems, leading to potential synergies. The elucidation of IBO's pharmacology could be enhanced through the application of methodologies rooted in the polypharmacology paradigm. Such approaches possess the capability to describe multifaceted patterns within multi-target drugs. CONCLUSION IBO displays complex effects through multiple targets. The information detailed here should guide future research on both mechanistic and therapeutic studies.
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Affiliation(s)
- Genís Ona
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain
- Department of Psychology and Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Tarragona, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Spain
| | - Ingrid Reverte
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Giordano N Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, 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 for Translational Medicine (INCT-TM), CNPq, Ribeirão Preto (SP), Brazil
| | - Jaime Ec Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, Ribeirão Preto (SP), Brazil
| | - Maria Teresa Colomina
- Department of Psychology and Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Tarragona, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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24
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Dornbierer DA, Marten L, Mueller J, Aicher HD, Mueller MJ, Boxler M, Kometer M, Kosanic D, von Rotz R, Puchkov M, Kraemer T, Landolt HP, Seifritz E, Scheidegger M. Overcoming the clinical challenges of traditional ayahuasca: a first-in-human trial exploring novel routes of administration of N,N-Dimethyltryptamine and harmine. Front Pharmacol 2023; 14:1246892. [PMID: 38089057 PMCID: PMC10711279 DOI: 10.3389/fphar.2023.1246892] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/10/2023] [Indexed: 04/19/2024] Open
Abstract
Recently, the Amazonian plant medicine "ayahuasca"-containing the psychedelic compound N,N-dimethyltryptamine (DMT) and numerous β-carboline alkaloids, such as harmine-has been suggested to exhibit beneficial effects in patients with affective and other mental health disorders. Although ayahuasca ingestion is considered safe, its pharmacokinetics/pharmacodynamics and tolerability profile pose some challenges and may limit the clinical applicability in vulnerable patient populations. While overdosing and the admixture of intolerable plant constituents may explain some of the common adverse reactions, the peroral route of administration may represent another relevant source of gastro-intestinal intolerabilities and unpredictable pharmacokinetics across users. To overcome these challenges, the present work aimed at creating ayahuasca-analogue formulations with improved pharmacokinetics and tolerability profiles. To this end, we developed peroral formulas and compared them with parenteral formulas specifically designed to circumvent the gastro-intestinal tract. In more detail, peroral administration of a capsule (containing purified DMT and harmine) was tested against a combined administration of an oromucosal harmine tablet and an intranasal DMT spray at two dose levels in an open-label within-subject study in 10 healthy male subjects. Pharmacokinetic and pharmacodynamic profiles were assessed by means of continuous blood sampling, vital sign monitoring, and psychometric assessments. Common side effects induced by traditional herbal ayahuasca such as nausea, vomiting, and diarrhea were significantly attenuated by our DMT/harmine formulations. While all preparations were well tolerated, the combined buccal/intranasal administration of harmine and DMT yielded substantially improved pharmacokinetic profiles, indicated by significantly reduced variations in systemic exposure. In conclusion, the combined buccal/intranasal administration of harmine and DMT is an innovative approach that may pave the way towards a safe, rapid-acting, and patient-oriented administration of DMT/harmine for the treatment of affective disorders. Clinical Trial Registration: clinicaltrials.gov, identifier NCT04716335.
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Affiliation(s)
- Dario A. Dornbierer
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Laurenz Marten
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Department of Chemistry and Applied Biosciences, Zurich, Switzerland
| | - Jovin Mueller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Helena D. Aicher
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Michael J. Mueller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Department of Health Science & Technology, Zurich, Switzerland
| | - Martina Boxler
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | | | | | - Robin von Rotz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Maxim Puchkov
- Institute of Pharmaceutical Technology, University of Basel, Basel, Switzerland
| | - Thomas Kraemer
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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25
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Cordova M. Looking for Ted: black trips, " psychedelic" humanism, and silence. Front Psychol 2023; 14:1198371. [PMID: 37941757 PMCID: PMC10629115 DOI: 10.3389/fpsyg.2023.1198371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 09/15/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Michael Cordova
- The University of Texas at Austin, Austin, TX, United States
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26
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Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Corrigendum: Ceremonial ayahuasca in amazonian retreats-mental health and epigenetic outcomes from a six-month naturalistic study. Front Psychiatry 2023; 14:1304503. [PMID: 37904854 PMCID: PMC10613463 DOI: 10.3389/fpsyt.2023.1304503] [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: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2021.687615.].
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Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
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27
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Chen X, Li J, Yu L, Maule F, Chang L, Gallant JA, Press DJ, Raithatha SA, Hagel JM, Facchini PJ. A cane toad (Rhinella marina) N-methyltransferase converts primary indolethylamines to tertiary psychedelic amines. J Biol Chem 2023; 299:105231. [PMID: 37690691 PMCID: PMC10570959 DOI: 10.1016/j.jbc.2023.105231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/31/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023] Open
Abstract
Psychedelic indolethylamines have emerged as potential medicines to treat several psychiatric pathologies. Natural sources of these compounds include 'magic mushrooms' (Psilocybe spp.), plants used to prepare ayahuasca, and toads. The skin and parotid glands of certain toads accumulate a variety of specialized metabolites including toxic guanidine alkaloids, lipophilic alkaloids, poisonous steroids, and hallucinogenic indolethylamines such as DMT, 5-methoxy-DMT, and bufotenin. The occurrence of psychedelics has contributed to the ceremonial use of toads, particularly among Mesoamerican peoples. Yet, the biosynthesis of psychedelic alkaloids has not been elucidated. Herein, we report a novel indolethylamine N-methyltransferase (RmNMT) from cane toad (Rhinella marina). The RmNMT sequence was used to identify a related NMT from the common toad, Bufo bufo. Close homologs from various frog species were inactive, suggesting a role for psychedelic indolethylamine biosynthesis in toads. Enzyme kinetic analyses and comparison with functionally similar enzymes showed that recombinant RmNMT was an effective catalyst and not product inhibited. The substrate promiscuity of RmNMT enabled the bioproduction of a variety of substituted indolethylamines at levels sufficient for purification, pharmacological screening, and metabolic stability assays. Since the therapeutic potential of psychedelics has been linked to activity at serotonergic receptors, we evaluated binding of derivatives at 5-HT1A and 5-HT2A receptors. Primary amines exhibited enhanced affinity at the 5-HT1A receptor compared with tertiary amines. With the exception of 6-substituted derivatives, N,N-dimethylation also protected against catabolism by liver microsomes.
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Affiliation(s)
- Xue Chen
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | - Jing Li
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | - Lisa Yu
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | - Francesca Maule
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Limei Chang
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | | | - David J Press
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | | | - Jillian M Hagel
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada
| | - Peter J Facchini
- Discovery Group, Enveric Biosciences Inc, Calgary, Alberta, Canada; Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada.
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28
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Halim HJ, Burk BG, Fargason RE, Birur B. Manic episode following psilocybin use in a man with bipolar II disorder: a case report. Front Psychiatry 2023; 14:1221131. [PMID: 37810598 PMCID: PMC10556490 DOI: 10.3389/fpsyt.2023.1221131] [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: 05/11/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
There has been an increase in research on the topic of psychedelic substances and their effects as treatment options in neuropsychiatric conditions. Psilocybin is a psychedelic drug that has recently garnered increased interest as an effective treatment modality for treatment-resistant depression, depression associated with terminal conditions, certain substance use disorders, and obsessive-compulsive disorder. However, sparse data exist as to the effects that psilocybin might have on patients at risk for mania, in large part secondary to the exclusion of this patient population from studies due to the concern for inducing mania or worsening illness course. We describe a case of a 21-year-old male with a recent diagnosis of bipolar II disorder who developed a manic episode following the ingestion of psilocybin in the form of hallucinogenic mushrooms. Given the incidence of depression in those with bipolar disorder, impulsivity, and a tendency to abuse substances associated with the illness, further research is needed into the risks of psilocybin and other psychedelic use in those with bipolar disorder.
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Affiliation(s)
- Haniya J. Halim
- PGY3 Psychiatry Resident, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bradley G. Burk
- Department of Pharmacy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rachel E. Fargason
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Badari Birur
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
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29
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Black T. Lifeboat ethics, risk, and therapeutic opportunity: an appeal for equitable psychedelic therapy access in the "high-risk" addiction patient. Front Psychiatry 2023; 14:1159843. [PMID: 37799400 PMCID: PMC10548230 DOI: 10.3389/fpsyt.2023.1159843] [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: 02/06/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Psychedelic-assisted treatment (PAT) for mental health is in renaissance. Psilocybin and MDMA stand near FDA approval, and US cities and states are decriminalizing or regulating the non-clinical use of psilocybin. However, neither FDA indications nor a regulated use model sufficiently address the complex needs and opportunities for an improved treatment of addiction. When paired with disability and social dispossession, addiction increasingly burdens informal care networks, public safety, and particularly healthcare systems. Stigma and mistreatment alienate people from opportunities for care and multiply the costs of providing care. This dynamic worsens socially determined resource limitations, enforcing stark ethical choices and perpetuating socioeconomic inequities, isolation, mental illness, medical illness, overdose, suicide, and violence. In order for psychedelic treatments to achieve their greatest utility to population health, we must intentionally develop regulatory, clinical, and payment systems supporting clinical research, rigorous safety monitoring, and implementation to address these immense needs and reduce the barriers to engagement for those who now bear the costs, including those who work at the front lines of addiction care. To achieve full fruition, I advocate for a collaborative approach, built from within networks of mutual social support but linked and accountable to public institutions charged with the equitable dissemination of these therapies for the greatest social and health equities. Rather than relegating PAT to the needs of the commercially insured or wellness markets, this is the moment to learn from ancient traditions of ritualized sacramental use, organized around faith in our mutual dependency and accountability, and to capture an opportunity to improve population health and equity. To miss this opportunity is to accept the status quo in the midst of a growing emergency, for lack of moral vision and intention to change our habits.
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Affiliation(s)
- Taylor Black
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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30
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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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Layzell M, Rands P, Good M, Joel Z, Cousins R, Benway T, James E, Routledge C. Discovery and In Vitro Characterization of SPL028: Deuterated N, N-Dimethyltryptamine. ACS Med Chem Lett 2023; 14:1216-1223. [PMID: 37736183 PMCID: PMC10510671 DOI: 10.1021/acsmedchemlett.3c00143] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023] Open
Abstract
The psychedelic N,N- dimethyltryptamine (DMT) is in clinical development for the treatment of major depressive disorder. However, when administered via intravenous infusion, its effects are short-lived due to rapid clearance. Here we describe the synthesis of deuterated analogues of DMT with the aim of prolonging the half-life and decreasing the clearance rate while maintaining similar pharmacological effects. The molecule with the greatest degree of deuteration at the α-carbon (N,N-D2-dimethyltryptamine, D2-DMT) demonstrated the longest half-life and intrinsic clearance in hepatocyte mitochondrial fractions when compared with DMT. The in vitro receptor binding profile of D2-DMT was comparable to that of DMT, with the highest affinity at the 5-HT1A, 5-HT2A, and 5-HT2C receptors. D2-DMT was therefore the preferred candidate to consider for further evaluation.
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Affiliation(s)
- Marie Layzell
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Peter Rands
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Meghan Good
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Zelah Joel
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Rick Cousins
- Cinnabar
Consulting Ltd., 43 Pedley
Lane, Clifton, Beds SG17
5QT, U.K.
| | - Tiffanie Benway
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Ellen James
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
| | - Carol Routledge
- Small
Pharma., 50 Featherstone
Street, London EC1Y 8RT, U.K.
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Abstract
OBJECTIVE To assess the role of psychedelics in the treatment of anxiety or depression among patients with cancer. DATA SOURCES PubMed search from inception to March 11, 2022, using the terms anxiety, depression, psychedelics, psilocybin, lysergic acid, methylenedioxymethamphetamine, or ayahuasca. STUDY SELECTION AND DATA EXTRACTION Studies assessing patients with cancer receiving psychedelics for the treatment of anxiety or depression. DATA SYNTHESIS Five unique randomized, double-blind, placebo-controlled trials were conducted. Significant reductions were found in 2 trials with 2 anxiety scales (State-Trait Anxiety Inventory-State, State-Trait Anxiety Inventory-Trait) and in 1 trial with 2 additional anxiety scales (Hamilton Rating Scale-Anxiety, Hospital Anxiety and Depression Scale-Anxiety). Significant reductions were found in 2 trials in 2 depression scales (Hospital Anxiety and Depression Scale-Depression, Beck Depression Inventory) and in 1 trial with an additional depression scale (Hamilton Rating Scale-Depression). Two studies assessed for clinically relevant reductions in anxiety and depression scores, and they occurred much more commonly in psychedelic-treated patients than those given placebo. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE There is a new potential option for treating patients with anxiety and depression along with cancer, which is important given the generally lackluster benefits with traditional antidepressants. Only a few sessions may also provide benefits extending out for 6 to 12 months and possibly beyond that. However, the studies were small, had many methodological limitations, and there were increases in blood pressure and heart rate. CONCLUSIONS Psychedelics have a unique mechanism of action that might be well suited for treating anxiety and depression associated with cancer. This offers new promise for patients who are not being sufficiently treated with current antianxiety or antidepressant medications.
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Affiliation(s)
- C Michael White
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Nissen Weisman
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Joseph Dalo
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
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Dubus Z, Grandgeorge E, Verroust V. History of the administration of psychedelics in France. Front Psychol 2023; 14:1131565. [PMID: 37744588 PMCID: PMC10513055 DOI: 10.3389/fpsyg.2023.1131565] [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] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 08/03/2023] [Indexed: 09/26/2023] Open
Abstract
This article reviews the historical protocols for the administration of "classic" psychedelics in France, from the 1920s to the 1960s. Taking a chronological approach, it investigates the way mescaline, LSD, and psilocybin were administered, the subjects involved, the route of administration, the dosage, and the epistemological context of the research. From the 1930s, the Sainte-Anne school dominated French experimentation with psychedelics, inserting these studies on "hallucinogens" into a biological conception of therapeutics, where the notion of "shock" dominated. The sessions show particularly anxious experiences, sometimes described as "torture" by the patients who underwent them. With just a few rare cases of recovery reported, these substances were not considered as medicines, but rather as tools for exploration in the context of experimental research; thought of not as psychedelics ("mind manifesters") but as psychodysleptics ("mind disruptors"). While these tools could be useful for the diagnosis of sick patients, French physicians did not manage to demonstrate clear therapeutic benefits in the use of psychedelics, perhaps because of their reluctance, in most cases, to determine an optimum dose, and also very often to appreciate the context of administration and the relationship with the patient. This article allows us to understand the reasons for the therapeutic failures reported by these early French psychedelic researchers, but also to help explain the current reluctance of French health professionals who in the face of the "psychedelic renaissance" remain strongly influenced by the very negative early representations of these substances.
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Affiliation(s)
- Zoe Dubus
- Laboratoire TELEMMe, Faculté des Arts, Lettres, Langues, Sciences Humaines, Aix-Marseille Université, Marseille, France
- Centre Hospitalier Universitaire Vaudois (CHUV), Institut des Humanités en Médecine, Lausanne, Switzerland
- Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Université Paris-Sud, Paris, France
| | - Elise Grandgeorge
- Histoire des arts et des Représentations, Université Paris Nanterre, Nanterre, France
| | - Vincent Verroust
- Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Université Paris-Sud, Paris, France
- Centre d'histoire des Sociétés, Des Sciences et des Conflits, University of Picardie Jules Verne, Amiens, France
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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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Buchborn T, Lyons T, Song C, Feilding A, Knöpfel T. Cortical Correlates of Psychedelic-Induced Shaking Behavior Revealed by Voltage Imaging. Int J Mol Sci 2023; 24:ijms24119463. [PMID: 37298417 DOI: 10.3390/ijms24119463] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
(1) From mouse to man, shaking behavior (head twitches and/or wet dog shakes) is a reliable readout of psychedelic drug action. Shaking behavior like psychedelia is thought to be mediated by serotonin 2A receptors on cortical pyramidal cells. The involvement of pyramidal cells in psychedelic-induced shaking behavior remains hypothetical, though, as experimental in vivo evidence is limited. (2) Here, we use cell type-specific voltage imaging in awake mice to address this issue. We intersectionally express the genetically encoded voltage indicator VSFP Butterfly 1.2 in layer 2/3 pyramidal neurons. We simultaneously capture cortical hemodynamics and cell type-specific voltage activity while mice display psychedelic shaking behavior. (3) Shaking behavior is preceded by high-frequency oscillations and overlaps with low-frequency oscillations in the motor cortex. Oscillations spectrally mirror the rhythmics of shaking behavior and reflect layer 2/3 pyramidal cell activity complemented by hemodynamics. (4) Our results reveal a clear cortical fingerprint of serotonin-2A-receptor-mediated shaking behavior and open a promising methodological avenue relating a cross-mammalian psychedelic effect to cell-type specific brain dynamics.
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Affiliation(s)
- Tobias Buchborn
- Laboratory for Neuronal Circuit Dynamics, Imperial College London, London W12 0NN, UK
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 69115 Heidelberg, Germany
| | - Taylor Lyons
- Laboratory for Neuronal Circuit Dynamics, Imperial College London, London W12 0NN, UK
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Chenchen Song
- Laboratory for Neuronal Circuit Dynamics, Imperial College London, London W12 0NN, UK
| | | | - Thomas Knöpfel
- Laboratory for Neuronal Circuit Dynamics, Imperial College London, London W12 0NN, UK
- Centre for Neurotechnology, Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
- Laboratory for Neuronal Circuit Dynamics, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Abstract
Just as psychedelic-assisted psychotherapy (PAP) represents a clinical innovation that may need to be accommodated with corresponding theoretical and methodological innovations, there is growing awareness that the tools, normative frameworks, and standard practices of our clinical ethics may also need to be adapted, renewed, or replaced to accommodate its unusual features. Drawing on L. A. Paul's work on "Transformative Experience," I argue that the acute and long-term effects that are repeatedly reported following the administration of psychedelic drugs, including in clinical contexts, are epistemically inaccessible at the point of deciding to take them. By virtue of both the so-called "mystical" experiences that frequently arise during PAP, and the long-term shifts to outlooks, values, and priorities that can follow treatment, the processes of decision-making that are normatively expected of patients run aground. If this framing is correct, then prospective patients cannot meet the requirement of understanding that is one of the principal analytic components of informed consent. The role of understanding in supporting two functions of informed consent-avoiding unauthorized trespass against patients and supporting values-aligned decision-making-is explored, and I argue that, while the normative standard for the first function may be met by extant suggestions for enhancing the consenting process for PAP, the latter function remains unattainable. In light of this, the consequences for the ethical preparation of prospective patients are considered.
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Affiliation(s)
- Edward Jacobs
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
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37
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Tsang VW, Tao B, Dames S, Walsh Z, Kryskow P. Safety and tolerability of intramuscular and sublingual ketamine for psychiatric treatment in the Roots To Thrive ketamine-assisted therapy program: a retrospective chart review. Ther Adv Psychopharmacol 2023; 13:20451253231171512. [PMID: 37256163 PMCID: PMC10225955 DOI: 10.1177/20451253231171512] [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: 08/24/2022] [Accepted: 04/06/2023] [Indexed: 06/01/2023] Open
Abstract
Background In the last few years, ketamine is becoming increasingly common in the treatment of mental health conditions, but there is a lack of safety data informing intramuscular and sublingual dosing in a community-focused group psychotherapy setting. The Roots To Thrive ketamine-assisted therapy (RTT-KaT) program is a unique 12-week RTT-KaT program with 12 community of practice (a form of group therapy) sessions and three ketamine medicine sessions. Objectives This study reports on adverse effects of intramuscular and sublingual ketamine dosing in a community group psychotherapy setting among 128 participants across four cohorts. Design Retrospective chart review. Methods A chart review of the RTT-KaT Program was performed retrospectively on four cohorts (n = 128) that participated in 448 sessions running between September 2020 and December 2021. Baseline characteristics and adverse events were captured including medication administration before, during, and after RTT-KaT sessions. Analyses by session and by individual were conducted. Chi-square test with Yates' continuity correction was used to assess side effects in subgroups from ketamine administration. Results RTT-KaT was well tolerated with none of the 128 participants dropping out of the program. Primarily, of the 448 sessions, 49.16% had elevated blood pressures post-KaT session by session. In terms of other adverse effects, 12.05% of participant-sessions experienced nausea, 2.52% had an episode of vomiting, 3.35% had a headache, and seven participant-sessions experienced dizziness. Analysis by individual revealed congruent findings. Conclusion These findings suggest good safety and tolerability for RTT-KaT among individuals seeking treatment for mental health issues. The majority of participants did not experience adverse reactions and the adverse events that were recorded involved transient symptoms that were resolved with rest and/or medications. The group therapy model described provides a comprehensive approach and presents a promising model for operating a KaT program in a community setting.
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Affiliation(s)
| | - Brendan Tao
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Shannon Dames
- Health Sciences and Human Services, Vancouver Island University, Nanaimo, BC, Canada
| | - Zach Walsh
- Department of Psychology, The University of British Columbia, Kelowna, BC, Canada
| | - Pam Kryskow
- Department of Family Medicine, The University of British Columbia, Vancouver, BC, Canada
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Batievsky D, Weiner M, Kaplan SB, Thase ME, Maglione DN, Vidot DC. Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches. Front Pain Res (Lausanne) 2023; 4:1127863. [PMID: 37273242 PMCID: PMC10235727 DOI: 10.3389/fpain.2023.1127863] [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] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Chronic pain and depression diagnoses are skyrocketing. There is an urgent need for more effective treatments. Ketamine was recently established to alleviate pain and depression, but many gaps remain in the scientific literature. This paper reports the findings of an observational preliminary study that explored the efficacy of ketamine-assisted psychotherapy (KAPT) for chronic pain/major depressive disorder (MDD) comorbidity. Researchers evaluated two KAPT approaches to determine optimal route of administration/dose. Ten individuals diagnosed with a chronic pain disorder and MDD receiving KAPT were recruited: five individuals pursuing the psychedelic approach (high doses administered intramuscularly 24 h before therapy) and five individuals pursuing the psycholytic approach (low doses administered sublingually via oral lozenges during therapy). To evaluate differences between altered states of consciousness each approach induces, participants completed the Mystical Experience Questionnaire (MEQ30) after their first (T-1), third (T-2) and sixth/final (T-3) treatment sessions. Primary outcomes were change in Beck Depression Inventory (BDI) scores and Brief Pain Inventory (BPI) Short Form scores from baseline (T0) to (T-1)-(T-3). Secondary outcomes were changes in Generalized Anxiety Disorder (GAD-7) Scale scores and Post-Traumatic Stress Disorder Checklist (PCL-5) scores at each timepoint. Statistically significant differences between each approach were not observed, but the small sample's limited statistical power makes changes seen worth noting. All participants' symptoms declined throughout treatment. Psychedelic treatment participants saw a larger, more consistent decrease. Researchers conclude that KAPT may be effective for treating chronic pain/MDD comorbidity, anxiety and Post-Traumatic Stress Disorder (PTSD). Findings imply that the psychedelic approach may be more effective. This pilot study serves as a basis for more extensive research that will inform how clinicians administer treatment to optimize outcomes.
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Affiliation(s)
- Daniella Batievsky
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle Weiner
- Spine and Wellness Centers of America, Miami, FL, United States
| | | | - Michael Edward Thase
- Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, United States
- Corporal Michael J. Crescenz VA Medical Center, United States Department of Veterans Affairs, Philadelphia, PA, United States
| | | | - Denise Christina Vidot
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, United States
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Davis O. Henri Michaux's program for the psychedelic humanities. Front Psychol 2023; 14:1152896. [PMID: 37275714 PMCID: PMC10236947 DOI: 10.3389/fpsyg.2023.1152896] [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] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/18/2023] [Indexed: 06/07/2023] Open
Abstract
This article presents an analytical reading of the extraordinarily rich cultural production around drugs by the 20th-century French poet, writer, critic, and visual artist Michaux (1899-1984). Over about a decade, from the mid-1950's, the otherwise habitually sober Michaux wrote five books, included within which were dozens of drawings, and made one half-hour film, charting his adventures as an initially reluctant yet persistent psychonaut, principally with mescaline, but also with psilocybin, LSD, and cannabis. This has rightly been described as one of the most creative cultural explorations of mescaline. It is more extensive, texturally complex, and esthetically demanding than Aldous Huxley's far better known near-contemporaneous published work on psychedelics in English, which is well-known within and arguably foundational for psychedelic studies. Yet, this very complexity, as well as the national-linguistic context of its articulation-there was no mass psychedelic counterculture in France-have limited wider engagement with it. I argue that Michaux's esthetic reconstruction of psychedelics' effects on his creative brain can be read as a "program" for the emerging field of the psychedelic humanities and that it makes a substantial contribution, which I sketch in outline here, to the following of core concerns: (1) the role of psychedelics in enhancing "creativity"; (2) conceptualization of the politics of psychedelics; and (3) the meaning and value of psychedelic mysticism. I aim to show that Michaux's work on drugs has much to contribute to the cultural understanding of psychedelics today and accordingly that this unjustly neglected classic of French-and global-drug culture deserves to be far better known.
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40
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Ching THW, Grazioplene R, Bohner C, Kichuk SA, DePalmer G, D’Amico E, Eilbott J, Jankovsky A, Burke M, Hokanson J, Martins B, Witherow C, Patel P, Amoroso L, Schaer H, Pittenger C, Kelmendi B. Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive-compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial. Front Psychiatry 2023; 14:1178529. [PMID: 37181888 PMCID: PMC10166878 DOI: 10.3389/fpsyt.2023.1178529] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Background Psilocybin may help treat obsessive-compulsive disorder (OCD). To date, only one open-label study of psilocybin for OCD exists, necessitating further investigation with a randomized controlled design. The neural correlates of psilocybin's effects on OCD have also not been studied. Objectives This first-of-its-kind trial aims to evaluate the feasibility, safety, and tolerability of psilocybin in the treatment of OCD, provide preliminary evidence on the effects of psilocybin on OCD symptoms, and elucidate neural mechanisms that may mediate psilocybin's effects on OCD. Design We use a randomized (1:1), double-blind, placebo-controlled, non-crossover design to examine the clinical and neural effects of either a single dose of oral psilocybin (0.25 mg/kg) or active placebo-control agent (250 mg of niacin) on OCD symptoms. Methods and analysis We are enrolling 30 adult participants at a single site in Connecticut, USA who have failed at least one trial of standard care treatment (medication/psychotherapy) for OCD. All participants will also receive unstructured, non-directive psychological support during visits. Aside from safety, primary outcomes include OCD symptoms over the past 24 h, assessed by the Acute Yale-Brown Obsessive-Compulsive Scale and Visual Analog Scale ratings. These are collected by blinded, independent raters at baseline and the primary endpoint of 48 h post-dosing. Total follow-up is 12 weeks post-dosing. Resting state neuroimaging data will be collected at baseline and primary endpoint. Participants randomized to placebo will be offered the chance to return for an open-label dose of 0.25 mg/kg. Ethics statement All participants will be required to provide written informed consent. The trial (protocol v. 5.2) was approved by the institutional review board (HIC #2000020355) and registered with ClinicalTrials.gov (NCT03356483). Discussion This study may represent an advance in our ability to treat refractory OCD, and pave the way for future studies of neurobiological mechanisms of OCD that may respond to psilocybin.
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Affiliation(s)
- Terence H. W. Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A. Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Giuliana DePalmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D’Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Michelle Burke
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brad Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Thomas KL, Jesse R, Mehtani NJ, Mitchell JM, Anderson BT. Commentary: Evidence-Informed Recommendation to Achieve Approximate Parity in the Allowed Number of Doses for Common Psychedelics. J Psychoactive Drugs 2023:1-5. [PMID: 37061961 DOI: 10.1080/02791072.2023.2201244] [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] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
In recent years, policymakers have proposed and implemented regulatory changes promoting the deprioritization, decriminalization, or state-level legalization of one or more psychedelic substances, usually referencing data from clinical trials as reasons to support liberalizing drug control policies. As psychedelic policies continue to be drafted, personal possession limits may be considered for inclusion in those regulations. If "allowable amount" limits are to be written into law to set personal possession limits, then such amounts should be more consistently related to psychedelic doses found to be safe and efficacious in clinical trials, existing data on moderate-high doses commonly used in various naturalistic settings, and the few studies that estimate psychedelic dose equivalence based on the intensity of subjective effects. In this commentary, we provide an evidence-informed table of typical moderate-high doses for seven commonly used psychedelic substances. These estimates of comparable moderate-high doses can be used to inform "allowable amount" values for psychedelic substances. When such limits are written into legislation, the adoption of evidence-informed comparable limits akin to those presented here would be an important first step toward ensuring greater parity and consistency in drug policy, relative to limits that have little or no scientific basis.
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Affiliation(s)
- Kelan L Thomas
- College of Pharmacy, Touro University California, Vallejo, CA, USA
| | - Robert Jesse
- Council on Spiritual Practices, Occidental, CA, USA
| | - Nicky J Mehtani
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer M Mitchell
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
- Center for the Science of Psychedelics, University of California Berkeley, Berkeley, CA, USA
| | - Brian T Anderson
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
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Kelly DF, Heinzerling K, Sharma A, Gowrinathan S, Sergi K, Mallari RJ. Psychedelic-Assisted Therapy and Psychedelic Science: A Review and Perspective on Opportunities in Neurosurgery and Neuro-Oncology. Neurosurgery 2023; 92:680-694. [PMID: 36512813 PMCID: PMC9988324 DOI: 10.1227/neu.0000000000002275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/26/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
After a decades-long pause, psychedelics are again being intensely investigated for treating a wide range of neuropsychiatric ailments including depression, anxiety, addiction, post-traumatic stress disorder, anorexia, and chronic pain syndromes. The classic serotonergic psychedelics psilocybin and lysergic acid diethylamide and nonclassic psychedelics 3,4-methylenedioxymethamphetamine and ketamine are increasingly appreciated as neuroplastogens given their potential to fundamentally alter mood and behavior well beyond the time window of measurable exposure. Imaging studies with psychedelics are also helping advance our understanding of neural networks and connectomics. This resurgence in psychedelic science and psychedelic-assisted therapy has potential significance for the fields of neurosurgery and neuro-oncology and their diverse and challenging patients, many of whom continue to have mental health issues and poor quality of life despite receiving state-of-the-art care. In this study, we review recent and ongoing clinical trials, the set and setting model of psychedelic-assisted therapy, potential risks and adverse events, proposed mechanisms of action, and provide a perspective on how the safe and evidence-based use of psychedelics could potentially benefit many patients, including those with brain tumors, pain syndromes, ruminative disorders, stroke, SAH, TBI, and movement disorders. By leveraging psychedelics' neuroplastic potential to rehabilitate the mind and brain, novel treatments may be possible for many of these patient populations, in some instances working synergistically with current treatments and in some using subpsychedelic doses that do not require mind-altering effects for efficacy. This review aims to encourage broader multidisciplinary collaboration across the neurosciences to explore and help realize the transdiagnostic healing potential of psychedelics.
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Affiliation(s)
- Daniel F. Kelly
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, California, USA
| | - Keith Heinzerling
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, California, USA
| | - Akanksha Sharma
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, California, USA
| | - Shanthi Gowrinathan
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, California, USA
| | - Karina Sergi
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
| | - Regin Jay Mallari
- Treatment & Research in Psychedelics Program, Pacific Neuroscience Institute, Santa Monica, California, USA
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Lewis V, Bonniwell EM, Lanham JK, Ghaffari A, Sheshbaradaran H, Cao AB, Calkins MM, Bautista-Carro MA, Arsenault E, Telfer A, Taghavi-Abkuh FF, Malcolm NJ, El Sayegh F, Abizaid A, Schmid Y, Morton K, Halberstadt AL, Aguilar-Valles A, McCorvy JD. A non-hallucinogenic LSD analog with therapeutic potential for mood disorders. Cell Rep 2023; 42:112203. [PMID: 36884348 PMCID: PMC10112881 DOI: 10.1016/j.celrep.2023.112203] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/30/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
Hallucinations limit widespread therapeutic use of psychedelics as rapidly acting antidepressants. Here we profiled the non-hallucinogenic lysergic acid diethylamide (LSD) analog 2-bromo-LSD (2-Br-LSD) at more than 33 aminergic G protein-coupled receptors (GPCRs). 2-Br-LSD shows partial agonism at several aminergic GPCRs, including 5-HT2A, and does not induce the head-twitch response (HTR) in mice, supporting its classification as a non-hallucinogenic 5-HT2A partial agonist. Unlike LSD, 2-Br-LSD lacks 5-HT2B agonism, an effect linked to cardiac valvulopathy. Additionally, 2-Br-LSD produces weak 5-HT2A β-arrestin recruitment and internalization in vitro and does not induce tolerance in vivo after repeated administration. 2-Br-LSD induces dendritogenesis and spinogenesis in cultured rat cortical neurons and increases active coping behavior in mice, an effect blocked by the 5-HT2A-selective antagonist volinanserin (M100907). 2-Br-LSD also reverses the behavioral effects of chronic stress. Overall, 2-Br-LSD has an improved pharmacological profile compared with LSD and may have profound therapeutic value for mood disorders and other indications.
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Affiliation(s)
- Vern Lewis
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Emma M Bonniwell
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Janelle K Lanham
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Abdi Ghaffari
- BetterLife Pharma Inc., Vancouver, BC V6H 1A6, Canada
| | | | - Andrew B Cao
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Maggie M Calkins
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Emily Arsenault
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Andre Telfer
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | | | - Nicholas J Malcolm
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Fatema El Sayegh
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Alfonso Abizaid
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Yasmin Schmid
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA
| | - Kathleen Morton
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA
| | - Adam L Halberstadt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA.
| | | | - John D McCorvy
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Sudakin DL. Psilocybin services in Oregon: a call for awareness among clinical toxicologists. Clin Toxicol (Phila) 2023; 61:143-145. [PMID: 36815350 DOI: 10.1080/15563650.2023.2182664] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND In 2023, Oregon enacted laws regulating the manufacture and use of psilocybin products in licensed facilities for supervised sessions with trained facilitators. COMMENTARY This commentary summarizes the final rules for psilocybin services in Oregon, and provides perspectives from a clinical toxicologist on some of the issues that may arise. These include the scope of practice for non-clinical facilitators, prevention and management of adverse drug reactions, and toxicological uncertainties with regards to dose considerations for people with mental health and other medical conditions. CONCLUSION This commentary addresses some common misperceptions relating to the program, and provides perspective on some of the challenges that clinical toxicologists may encounter as legislative reform initiatives for psilocybin move forward throughout the United States.
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Rodríguez-Cano BJ, Kohek M, Ona G, Alcázar-Córcoles MÁ, Dos Santos RG, Hallak JEC, Bouso JC. Underground ibogaine use for the treatment of substance use disorders: A qualitative analysis of subjective experiences. Drug Alcohol Rev 2023; 42:401-414. [PMID: 36456173 DOI: 10.1111/dar.13587] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 06/27/2022] [Revised: 10/16/2022] [Accepted: 11/12/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Ibogaine is one of the alkaloids naturally found in plants such as Tabernanthe iboga, which has been traditionally used by members of the Bwiti culture. Since the discovery of its anti-addictive properties by Howard S. Lotsof in 1962, ibogaine has been used experimentally to treat substance use disorders (SUD), especially those involving opioids. We aim to provide a detailed understanding of the underlying psychological aspects of underground ibogaine use for the treatment of SUD. METHODS Semi-structured interviews were carried out with 13 participants with SUD, which motivated their self-treatment with ibogaine. The data were analysed using the grounded theory approach and considered the context of the treatment, and the nature of the occurring hallucinogenic and cognitive phenomena during the treatment experience. RESULTS We identified several psychological effects that the study respondents experienced, which seem to play a substantial role in the therapeutic process concerning SUD. The evoking of interpersonal and transpersonal experiences, autobiographical memories, and preparation, integration and motivation for a lifestyle change are important components that participants reported during and after ibogaine intake. DISCUSSION AND CONCLUSION Ibogaine is increasingly being used for the treatment of SUD, due in part to the limited treatment options currently available. Its beneficial effects seem to be related not only to its complex pharmacology but also to the subjective experience that ibogaine induces. The main aspects of this experience are related to autobiographical memories and valuable personal insights, which together appear to help individuals cope with their SUD.
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Affiliation(s)
- Borja J Rodríguez-Cano
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
| | - Maja Kohek
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Genís Ona
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Rafael G Dos Santos
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine, Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine, Brazil
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
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Oommen AM, Roberts KJ, Joshi L, Cunningham S. Transcriptomic Analysis of Glycosylation and Neuroregulatory Pathways in Rodent Models in Response to Psychedelic Molecules. Int J Mol Sci 2023; 24:ijms24021200. [PMID: 36674723 PMCID: PMC9867456 DOI: 10.3390/ijms24021200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
The potential for psychedelic molecules in impacting cognitive flexibility has long been supported and acknowledged across scientific reports. In the current study, an approach leveraging knowledge-based gene-set information analysis has been adopted to explore the potential impact of psychedelic molecules on both glycosylation, (a post-translational modifications (PTM)) and on neuro-regulatory pathways. Though limitations and restrictions rise from the scarcity of publicly available 'omics' data, targeted analysis enabled us to identify a number of key glycogenes (Hexb, Hs6st2, Col9a2, B3gat2, Mgat5, Bgn) involved the structural organization of extracellular matrix and neuroprotective factors (Kl, Pomc, Oxt, Gal, Avp, Cartpt) which play vital roles in neuron protection, development as well as synaptic stability. In response to psychedelic molecules, we found that these genes and associated pathways are transcriptional altered in rodent models. The approach used indicates the potential to exploit existing datasets for hypothesis generation and testing for the molecular processes which play a role in the physiological response to psychedelic molecule effects. These reported findings, which focused on alterations in glycogenes and neuro-regulatory factors may provide a novel range of biomarkers to track the beneficial, as well as potential toxicological effects of psychedelic molecules.
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Affiliation(s)
- Anup M. Oommen
- Advanced Glycoscience Research Cluster (AGRC), University of Galway, H91 W2TY Galway, Ireland
- CÚRAM, SFI Research Centre for Medical Devices, Biomedical Sciences, University of Galway, H91 W2TY Galway, Ireland
| | - Katherine J. Roberts
- Department of Health and Behaviour Studies, Teachers College, Columbia University, New York, NY 10027, USA
| | - Lokesh Joshi
- Advanced Glycoscience Research Cluster (AGRC), University of Galway, H91 W2TY Galway, Ireland
- CÚRAM, SFI Research Centre for Medical Devices, Biomedical Sciences, University of Galway, H91 W2TY Galway, Ireland
- Correspondence: (L.J.); (S.C.)
| | - Stephen Cunningham
- Advanced Glycoscience Research Cluster (AGRC), University of Galway, H91 W2TY Galway, Ireland
- CÚRAM, SFI Research Centre for Medical Devices, Biomedical Sciences, University of Galway, H91 W2TY Galway, Ireland
- Correspondence: (L.J.); (S.C.)
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Alper K, Cange J, Sah R, Schreiber-Gregory D, Sershen H, Vinod KY. Psilocybin sex-dependently reduces alcohol consumption in C57BL/6J mice. Front Pharmacol 2023; 13:1074633. [PMID: 36686713 PMCID: PMC9846572 DOI: 10.3389/fphar.2022.1074633] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
The classical psychedelic psilocybin is of interest as a treatment for alcohol use disorder (AUD). This study investigated the effects of psilocybin on voluntary ethanol consumption in adult male and female C57BL/6J mice administered saline or psilocybin intraperitoneally as a single dose of 0.1, 0.5, 1.0 or 2.0 mg/kg and provided 20% ethanol utilizing a two-bottle choice alcohol drinking paradigm. Ethanol was provided continuously for 3 days immediately following the administration of psilocybin, then withheld for 2 days, and then provided continuously for two subsequent additional days. A multilevel model (MLM) for repeated measures was used to compare ethanol consumption and preference in psilocybin-treated groups versus controls. Ethanol consumption and preference were reduced in male mice during the 3-day interval that immediately followed psilocybin administration. The effect of psilocybin on ethanol consumption was dose-related and was consistent across the 3-day interval at dosages of 0.5 mg/kg or greater. Psilocybin had no effect on consumption or preference when ethanol was subsequently reintroduced after 2 days of withdrawal. In contrast to males, psilocybin had no significant effect on ethanol consumption or preference in female mice at any dosage or time point. The lack of an effect of psilocybin on quinine preference, and its limited interaction with locomotor activity indicated that the observed reduction in voluntary ethanol consumption was not attributable to altered taste perception or motor effects. Total fluid consumption was increased in males at some time points and psilocybin dosages and unchanged in females, and the absence of any decrease in either group at any time point indicated that the observed reduction in ethanol consumption was not mediated by nonspecific effects on consummatory behavior. The finding of a sex-dependent effect of psilocybin on ethanol consumption suggests that the C57BL/6J mouse may provide a useful experimental approach to modeling sex differences in vulnerability to AUD in addition to investigation of the neurobiological basis of the effect of classical psychedelics on alcohol drinking behavior.
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Affiliation(s)
- Kenneth Alper
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States,Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States,*Correspondence: Kenneth Alper, ; K. Yaragudri Vinod,
| | - Janelle Cange
- Division of Laboratory Animal Resources of Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Ria Sah
- Department of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | | | - Henry Sershen
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States,Department of Neurochemistry, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - K. Yaragudri Vinod
- Department of Analytical Psychopharmacology, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States,Emotional Brain Institute, Orangeburg, NY, United States,Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States,*Correspondence: Kenneth Alper, ; K. Yaragudri Vinod,
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48
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Kinderlehrer DA. The Effectiveness of Microdosed Psilocybin in the Treatment of Neuropsychiatric Lyme Disease: A Case Study. Int Med Case Rep J 2023; 16:109-115. [PMID: 36896410 PMCID: PMC9990519 DOI: 10.2147/imcrj.s395342] [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] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/25/2023] [Indexed: 03/06/2023] Open
Abstract
Lyme disease can result in severe neuropsychiatric symptoms that may be resistant to treatment. The pathogenesis of neuropsychiatric Lyme disease is associated with autoimmune induced neuroinflammation. This case report describes an immunocompetent male with serologically positive neuropsychiatric Lyme disease who did not tolerate antimicrobial or psychotropic medications and whose symptoms remitted when he began psilocybin in microdosed (sub-hallucinogenic) amounts. A literature review of its therapeutic benefits reveals that psilocybin is both serotonergic and anti-inflammatory and therefore may offer significant therapeutic benefits to patients with mental illness secondary to autoimmune inflammation. The role of microdosed psilocybin in the treatment of neuropsychiatric Lyme disease and autoimmune encephalopathies warrants further study.
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Rudin D, Areesanan A, Liechti ME, Gründemann C. Classic psychedelics do not affect T cell and monocyte immune responses. Front Psychiatry 2023; 14:1042440. [PMID: 36741125 PMCID: PMC9895091 DOI: 10.3389/fpsyt.2023.1042440] [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: 09/12/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Classic psychedelics have been shown to exert therapeutic potential for the treatment of various psychiatric disorders, neuropsychiatric diseases, and neuronal damage. Besides their psychopharmacological activity, psychedelics have been reported to modulate immune functions. There has thus far been a sparse exploration of the direct immune-modulating effect of psychedelics on human immune cells in vitro. Since T cells are key mediators of several immune functions, inhibition of their function would increase the risk of infections. METHODS We investigated the effect of the classic psychedelics lysergic acid diethylamide (LSD), psilocin, N,N-dimethyltryptamine (DMT), and mescaline on the proliferation and stimulated cytokine release of primary human T lymphocytes and on the stimulated NF-κB induction of monocytes. RESULTS We did not observe any relevant direct immune-modulatory effects of the tested classic psychedelics in either cell line. DISCUSSION We concluded that LSD, psilocin, DMT, or mescaline did not directly stimulate the proliferation or cytokine secretion of primary human T lymphocytes or stimulate NF-κB induction of monocytes. Our findings support the future safe use of classic psychedelics in assisted psychotherapy in patients with life-threatening diseases where immune suppression and diminished immune function would be detrimental.
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Affiliation(s)
- Deborah Rudin
- Clinical Pharmacology and Toxicology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland.,Clinical Pharmacology and Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Alexander Areesanan
- Translational Complementary Medicine, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Clinical Pharmacology and Toxicology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland.,Clinical Pharmacology and Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Carsten Gründemann
- Translational Complementary Medicine, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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50
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Shukuroglou M, Roseman L, Wall M, Nutt D, Kaelen M, Carhart-Harris R. Changes in music-evoked emotion and ventral striatal functional connectivity after psilocybin therapy for depression. J Psychopharmacol 2023; 37:70-79. [PMID: 36433778 PMCID: PMC9834320 DOI: 10.1177/02698811221125354] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 11/28/2022]
Abstract
BACKGROUND Music listening is a staple and valued component of psychedelic therapy, and previous work has shown that psychedelics can acutely enhance music-evoked emotion. AIMS The present study sought to examine subjective responses to music before and after psilocybin therapy for treatment-resistant depression, while functional magnetic resonance imaging (fMRI) data was acquired. METHODS Nineteen patients with treatment-resistant depression received a low oral dose (10 mg) of psilocybin, and a high dose (25 mg) 1 week later. fMRI was performed 1 week prior to the first dosing session and 1 day after the second. Two scans were conducted on each day: one with music and one without. Visual analogue scale ratings of music-evoked 'pleasure' plus ratings of other evoked emotions (21-item Geneva Emotional Music Scale) were completed after each scan. Given its role in musical reward, the nucleus accumbens (NAc) was chosen as region of interest for functional connectivity (FC) analyses. Effects of drug (vs placebo) and music (vs no music) on subjective and FC outcomes were assessed. Anhedonia symptoms were assessed pre- and post-treatment (Snaith-Hamilton Pleasure Scale). RESULTS Results revealed a significant increase in music-evoked emotion following treatment with psilocybin that correlated with post-treatment reductions in anhedonia. A post-treatment reduction in NAc FC with areas resembling the default mode network was observed during music listening (vs no music). CONCLUSION These results are consistent with current thinking on the role of psychedelics in enhancing music-evoked pleasure and provide some new insight into correlative brain mechanisms.
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Affiliation(s)
- Melissa Shukuroglou
- Independent Researcher,Melissa Shukuroglou, Centre for Psychedelic Research, Department of Medicine, Imperial College London, Du Cane Road, Hammersmith Campus, London W12 0NN, UK.
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK,Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Medicine, Imperial College London, UK
| | - Matt Wall
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK,Invicro, London, UK,Clinical Psychopharmacology Unit, UCL, UK
| | - David Nutt
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
| | - Mendel Kaelen
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Medicine, Imperial College London, UK,Wavepaths Ltd, London, UK
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK
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