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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Management of Depression in Adults

JAMA, Год журнала: 2024, Номер 332(2), С. 141 - 141

Опубликована: Июнь 10, 2024

Importance Approximately 9% of US adults experience major depression each year, with a lifetime prevalence approximately 17% for men and 30% women. Observations Major is defined by depressed mood, loss interest in activities, associated psychological somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment severity as well risk self-harm, suspected bipolar disorder, psychotic symptoms, substance use, co-occurring anxiety disorder. First-line treatments specific psychotherapies antidepressant medications. A network meta-analysis randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving interpersonal brief psychodynamic mindfulness-based psychotherapy all had medium-sized effects symptom improvement over usual care without (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 0.52-0.95]). 21 medications small- placebo (SMD 0.23 0.19-0.28] fluoxetine 0.48 0.41-0.55] amitriptyline). Psychotherapy combined medication may be preferred, especially more severe or chronic depression. greater treatment than alone (SMD, 0.30 0.14-0.45]) 0.33 0.20-0.47]). When initial not effective, second-line includes changing medication, adding second antidepressant, augmenting nonantidepressant which have equal likelihood success based on meta-analysis. Collaborative programs, including systematic follow-up outcome assessment, improve effectiveness, 1 reporting significantly compared 0.42 0.23-0.61]). Conclusions Relevance Effective first-line forms 20 Close monitoring improves the success.

Язык: Английский

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Efficacy of psilocybin for treating symptoms of depression: systematic review and meta-analysis

BMJ, Год журнала: 2024, Номер unknown, С. e078084 - e078084

Опубликована: Май 1, 2024

To determine the efficacy of psilocybin as an antidepressant compared with placebo or non-psychoactive drugs.

Язык: Английский

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Patient perspectives and experiences with psilocybin treatment for treatment-resistant depression: a qualitative study

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Фев. 5, 2024

Psilocybin is the most researched classic psychedelic for Treatment-Resistant Depression (TRD). While optimizing set and setting are considered essential efficacy safety, patient perspectives on these aspects have rarely been investigated. To address this knowledge gap, current paper explored experiences of 11 TRD patients (8 women, 3 men) participating in a double-blind randomized clinical trial with single session oral (1, 10 or 25 mg) psilocybin treatment. After qualitative analysis, three major themes were identified: (1) challenges trust-building expectation management; (2) navigating experience; (3) need more comprehensive Subthemes first theme include general distrust mental healthcare, trust study therapists, limited time preparation, managing expectations. The second included following subthemes: trusting to surrender, profound overwhelming experiences, music as guide. third addressed desire multiple sessions, sensemaking. Patients' provided important insights into potential optimization treatment TRD, including individualized investment trust-building, offering additional providing access sustained (psycho)therapy trusted personalizing approaches, which may also enhance real-world adaption treatments.

Язык: Английский

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A Systematic Review of Participant Diversity in Psychedelic-Assisted Psychotherapy Trials

Psychiatry Research, Год журнала: 2025, Номер 345, С. 116359 - 116359

Опубликована: Янв. 11, 2025

Язык: Английский

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Discovering the Potential Mechanisms of Medicinal Mushrooms Antidepressant Activity: A Review

Antioxidants, Год журнала: 2023, Номер 12(3), С. 623 - 623

Опубликована: Март 2, 2023

Major Depression Disease is a common mental illness that affects more than 322 million people worldwide and it one of the leading causes physical disability. The etiology depression complex interplay psychological, social, biological factors. Currently, psychopharmacotherapy based mainly on monoamine theory, which states caused by an insufficient level monoamines such as serotonin, norepinephrine, and/or dopamine. Due to relatively low efficacy typical antidepressant high prevalence treatment-resistant (~30%), seeking new ways prophylaxis, adjuvant therapy, or novel compounds with activity, priority. According studies analyzed mushroom consumption patterns prevalence, was concluded ingestion lowers odds depression. Medicinal mushrooms are considered functional foods because their ability synthesize accumulate different types metabolites, enhance health-promoting properties. review aims explain activity edible/medicinal elucidating mechanism from perspectives: edible source serotonin precursors psilocybin rapid-acting antidepressant. These exhibit anti-neuroinflammatory antioxidant activities impact neurotrophin expression, neurogenesis process, influence gut–brain axis.

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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Giving Consent to the Ineffable

Neuroethics, Год журнала: 2024, Номер 17(1)

Опубликована: Фев. 15, 2024

Abstract A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials growing steadily, and some countries already grant psychiatrists special permission to use psychedelics non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing question involves whether patients can even give informed consent therapy: the treatment’s transformative nature seems block its assessment, suggesting that are unable understand what undergoing actually means for them it aligns with their values. present paper argues often have sufficient knowledge because they know want change negative status quo offers an effective way do so. Accordingly, a make value-aligned choice if anticipate manifestation experience.

Язык: Английский

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Mind the Psychedelic Hype: Characterizing the Risks and Benefits of Psychedelics for Depression

Psychoactives, Год журнала: 2024, Номер 3(2), С. 215 - 234

Опубликована: Апрель 16, 2024

Rationale: Psychedelic research re-emerged from a period of suppression into the so-called psychedelic renaissance. In parallel, most media reporting has shifted overstatement risks psychedelics to overly positive hype. As empirical evidence is more equivocal than frequently portrayed, conclusions about effectiveness should be considered preliminary. Poor science communication psychedelics’ therapeutic potential may lead participants or patients feel misled and policy decisions misinformed. An evidence-informed characterization their benefits needed. Objectives: This article assesses state for treating depression effect sizes on outcomes, risk bias, prevalence adverse effects. We review discuss how following treatments have shown decreasing over time: (1) cognitive behavioral therapy, (2) mindfulness interventions, (3) selective serotonin reuptake inhibitors, (4) ketamine. speculate that similar trend occur treatments. Results conclusions: It likely larger better-controlled trials will demonstrate smaller are comparable other conventional emerging mood disorders. Clear critical setting public expectations policy. With this evidence-based assessment, we aim cut through misinformation benefits, risks, future prospects

Язык: Английский

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The effect of psychedelics on the level of brain-derived neurotrophic factor: A systematic review and meta-analysis

Journal of Psychopharmacology, Год журнала: 2024, Номер 38(5), С. 425 - 431

Опубликована: Фев. 22, 2024

Background: Recent interest in the potential therapeutic effects of psychedelics has led to investigations into their influence on molecular signaling pathways within brain. Aims: Integrated review and analysis different studies this field. Methods: A systematic search was conducted across international databases including Embase, Scopus, Web Science, PubMed from inception 9 July 2023. Eligibility criteria encompassed published peer-reviewed evaluating changes brain-derived neurotrophic factor (BDNF) levels after psychedelic consumption. Outcomes: total nine were included our study. The meta-analysis demonstrated significantly higher BDNF consumers compared healthy controls, with a pooled standardized mean difference 0.26 (95% CI: 0.10–0.42, I 2 = 38.51%, p < 0.001). Leave-one-out indicated robustness results upon removal individual psychedelics. No significant publication bias observed. highlight neuroplasticity by altering levels. Conclusions: More precisely, documented rise indicates neurobiological mechanism which could enhance synaptic plasticity foster growth neurons. Given limited data available topic, conclusions remain uncertain. Consequently, we highly recommend additional research more extensive sample sizes yield reliable evidence

Язык: Английский

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