History repeating: guidelines to address common problems in psychedelic science

Therapeutic Advances in Psychopharmacology, Год журнала: 2023, Номер 13

Опубликована: Янв. 1, 2023

Research in the last decade has expressed considerable optimism about clinical potential of psychedelics for treatment mental disorders. This is reflected an increase research papers, investments by pharmaceutical companies, patents, media coverage, as well political and legislative changes. However, psychedelic science facing serious challenges that threaten validity core findings raise doubt regarding efficacy safety. In this paper, we introduce 10 most pressing challenges, grouped into easy, moderate, hard problems. We show how these problems internal (treatment effects are due to factors unrelated treatment), external (lack generalizability), construct (unclear working mechanism), or statistical conclusion (conclusions do not follow from data methods). These tend co-occur studies, limiting conclusions can be drawn safety therapy. provide a roadmap tackling share checklist researchers, journalists, funders, policymakers, other stakeholders use assess quality science. Addressing today’s necessary find out whether therapeutic been warranted avoid history repeating itself.

Язык: Английский

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Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin

Med, Год журнала: 2024, Номер 5(3), С. 190 - 200.e5

Опубликована: Фев. 14, 2024

Язык: Английский

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Are “mystical experiences” essential for antidepressant actions of ketamine and the classic psychedelics?

European Archives of Psychiatry and Clinical Neuroscience, Год журнала: 2024, Номер unknown

Опубликована: Фев. 27, 2024

The growing interest in the rapid and sustained antidepressant effects of dissociative anesthetic ketamine classic psychedelics, such as psilocybin, is remarkable. However, both psychedelics are known to induce acute mystical experiences; can cause symptoms out-of-body experience, while typically bring about hallucinogenic experiences, like a profound sense unity with universe or nature. role these experiences enhancing outcomes for patients depression currently an area ongoing investigation debate. Clinical studies have shown that following administration (S)-ketamine (esketamine) not directly linked their properties. In contrast, potential (R)-ketamine (arketamine), thought lack side effects, has yet be conclusively proven large-scale clinical trials. Moreover, although activation serotonin 5-HT

Язык: Английский

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Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research

American Journal of Psychiatry, Год журнала: 2025, Номер 182(1), С. 21 - 32

Опубликована: Янв. 1, 2025

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain are effective safe treatment of major depressive disorder, treatment-resistant depression, posttraumatic stress disorder. Preliminary evidence also supports efficacy other disorders (e.g., tobacco alcohol use disorders). Notwithstanding promise psychedelics, concerns have arisen with respect to interpretability translatability study results. For example, aspects related short- long-term safety, abuse liability, essentiality psychedelic "trip" psychological support are, inter alia, insufficiently characterized agents. The overarching aims this overview 1) review methodological affect inferences interpretation extant studies disorders, 2) provide guidance future development psychiatry, critical clinical implementation.

Язык: Английский

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Uncovering Psychedelics: From Neural Circuits to Therapeutic Applications

Pharmaceuticals, Год журнала: 2025, Номер 18(1), С. 130 - 130

Опубликована: Янв. 19, 2025

Psychedelics, historically celebrated for their cultural and spiritual significance, have emerged as potential breakthrough therapeutic agents due to profound effects on consciousness, emotional processing, mood, neural plasticity. This review explores the mechanisms underlying psychedelics’ effects, focusing ability modulate brain connectivity circuit activity, including default mode network (DMN), cortico-striatal thalamo-cortical (CSTC) loops, relaxed beliefs under psychedelics (REBUS) model. Advanced neuroimaging techniques reveal capacity enhance functional between sensory cerebral areas while reducing connections associative areas, decreasing rigidity rendering more plastic susceptible external changings, offering insights into outcome. The most relevant clinical trials of 3,4-methylenedioxymethamphetamine (MDMA), psilocybin, lysergic acid diethylamide (LSD) demonstrate significant efficacy in treating treatment-resistant psychiatric conditions such post-traumatic stress disorder (PTSD), depression, anxiety, with favorable safety profiles. Despite these advancements, critical gaps remain linking molecular actions efficacy. highlights need further research integrate mechanistic optimize tools both therapy understanding human cognition.

Язык: Английский

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History repeating: A roadmap to address common problems in psychedelic science

Опубликована: Март 10, 2023

Research in the last decade has expressed considerable optimism about clinical potential of psychedelics for treatment mental disorders. This is reflected a increase research papers, investments by pharmaceutical companies, patents, media coverage, as well political and legislative changes. However, psychedelic science facing serious challenges that threaten validity core findings raise doubt regarding efficacy safety. In this paper, we introduce 10 most pressing challenges, grouped into easy, moderate, hard problems. We show how these problems internal (treatment effects are due to factors unrelated treatment), external (lack generalizability), construct (unclear working mechanism) or statistical conclusion (conclusions do not follow from data methods). These tend co-occur studies, strongly limiting conclusions can be drawn safety therapy. provide roadmap tackling next science, share checklist researchers, journalists, funders, policy makers, other stakeholders use assess quality science. Addressing today’s necessary find out whether been warranted avoid history repeating itself.

Язык: Английский

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A framework for assessment of adverse events occurring in psychedelic-assisted therapies

Journal of Psychopharmacology, Год журнала: 2024, Номер 38(8), С. 690 - 700

Опубликована: Июль 31, 2024

Objective: Despite considerable research examining the efficacy of psychedelic-assisted therapies (PATs) for treating psychiatric disorders, assessment adverse events (AEs) in PAT has lagged. Current AE reporting standards trials are poorly calibrated to features that distinguish it from other treatments, leaving many potential AEs unassessed. Methods: A multidisciplinary working group experts involved pooled formally and informally documented observed through experience published literature. This information was integrated with (a) current practices pharmacotherapy psychotherapy (b) findings documenting post-acute dosing impacts psychedelics on subjective states, meaning, psychosocial health variables, produce a set constructs important evaluate as well recommended methods time frames their monitoring. Correspondence between identified examined, including extent coverage by 25 existing measures used relevant research. Results: Fifty-four terms warranting systematized were identified, defined, categorized. Existing demonstrated substantial gaps constructs. Recommendations developed how assess (including patient, clinician, informant reports), when over preparation, session, integration, follow-up. Application this framework is preliminary protocol (available supplement). Conclusions: addresses need capture PAT, accounting its components, worldviews spirituality.

Язык: Английский

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Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences

SSRN Electronic Journal, Год журнала: 2024, Номер unknown

Опубликована: Янв. 1, 2024

Psychedelic induced mystical experiences have been largely assumed to drive the therapeutic effects of these substances, which may in part be mediated by changes metaphysical beliefs. However, there is growing evidence that psychedelic can also trigger long lasting distress and studies persisting difficulties suggest a high prevalence ontological challenges (related way people understand reality existence). We conducted semi-structured interviews with 26 who reported experiencing existential following experiences. explored phenomenology participants' ways they navigated them, including what found helpful unhelpful their process. Thematic analysis revealed kinds accompanied worldview identity shifts: persistent preoccupation making sense experience confusion about existence purpose. Along cognitive stemming from ungrounding prior frameworks for understanding, ontologically challenging had significant emotional, social, bodily, other functional impact. Participants primarily alleviated through 'grounding' practices embodiment, social normalization Findings are discussed context field psychedelic-related integration.

Язык: Английский

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Prolonged adverse effects from repeated psilocybin use in an underground psychedelic therapy training program: a case report

BMC Psychiatry, Год журнала: 2025, Номер 25(1)

Опубликована: Фев. 28, 2025

Psychedelic-assisted therapy has gained growing interest to improve a range of mental health outcomes. In response, numerous training programs have formed train the necessary workforce deliver psychedelic therapy. These include both legal and 'underground' (i.e., unregulated) that use psychedelics as part their training. Prolonged adverse experiences (PAEs) may arise from use, though they are poorly characterized in clinical literature. Thus, understanding potential harms related is critical consider strategies potentially integrate into We present case psychologist who underwent involved repeated high doses psilocybin-containing mushrooms subsequently developed prolonged effects including severe sleep impairment, anhedonia, suicidal ideation requiring hospitalization. Despite worsening symptoms, her trainers advised against seeking psychiatric support, delaying treatment. Ultimately, patient's symptoms resolved after course electroconvulsive (ECT). This highlights tensions between underground within programs, psychiatry neo-shamanism, interventions ECT) energy medicine address psychedelics. Clinicians should be aware these conflicts conceptualizations PAEs frameworks maintained community practices impacts on patients' presenting decision making, emotional challenges.

Язык: Английский

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Spiritual health practitioners’ contributions to psychedelic assisted therapy: A qualitative analysis

PLoS ONE, Год журнала: 2024, Номер 19(1), С. e0296071 - e0296071

Опубликована: Янв. 2, 2024

Background Psychedelic-assisted therapies hold early promise for treating multiple psychiatric conditions. However, absent standards the care, teams providing psychedelic-assisted therapy pose a major roadblock to safe administration. Psychedelics often produce spiritually and existentially meaningful experiences, spiritual health practitioners have been involved in administering settings, suggesting important qualifications delivering these therapies. roles competencies of not described research. Method This study examined interviews with 15 who facilitated therapy. Thematic analyses focused on their contributions, application expertise professional background, Results Seven themes emerged, comprising two domains: unique general contributions. Unique contributions included: competency work material, awareness power dynamics, familiarity non-ordinary states consciousness, holding space, offer counterbalance biomedical perspectives. General included use generalizable therapeutic repertoire when conducting PAT, contributing interdisciplinary collaboration. Implications Spiritual bring specific based training experience. They are skilled at interprofessional collaboration way that complements other clinical team members. may benefit from including practitioners. In order ensure rigorous quality further efforts delineate necessary clinicians needed.

Язык: Английский

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