Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Current Neuropharmacology, Год журнала: 2023, Номер 22(4), С. 557 - 635

Опубликована: Май 3, 2023

Abstract: This narrative state-of-the-art review paper describes the progress in understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over last four decades, scientific landscape has matured, with many interdisciplinary contributions to its diagnosis, etiology, epidemiology. Advances genetics, neurobiology, stress pathophysiology, brain imaging have made it apparent that chronic PTSD is a systemic disorder high allostatic load. The current state includes wide variety pharmacological psychotherapeutic approaches, which are evidence-based. However, myriad challenges inherent disorder, such as individual barriers good outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, trauma-related guilt shame, often render response suboptimal. These discussed drivers for emerging novel including early interventions Golden Hours, interventions, medication augmentation use psychedelics, well targeting nervous system. All this aims improve symptom relief clinical outcomes. Finally, phase orientation recognized tool strategize position step progression pathophysiology. Revisions guidelines systems care will be needed incorporate innovative treatments evidence emerges they become mainstream. generation well-positioned address devastating disabling impact traumatic events through holistic, cutting-edge efforts research.

Язык: Английский

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Therapeutic effect of psilocybin in addiction: A systematic review

Frontiers in Psychiatry, Год журнала: 2023, Номер 14

Опубликована: Фев. 9, 2023

Background Psychedelic-assisted therapy [e.g., with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted last 25 years, but they may have missed that were before 1980s, given much research been done psychedelics mid-20th century. In this review, we specifically assessed patients a SUD or non-substance-related disorder no publication date restrictions our search strategy. Methods A literature was performed according to Preferred Reporting Items Systematic and Meta-Analysis (PRISMA) guidelines from earliest published manuscript up September 2, 2022, seven electronic databases, including evaluating psilocybin. Results total four studies (six articles, which two articles long-term follow-up same trial) review. Psilocybin-assisted administered n = 151 dose ranging 6 40 mg. Three focused on alcohol disorder, one study tobacco disorder. pilot ( 10), percentage heavy drinking days decreased significantly between baseline weeks 5–12 (mean difference 26.0, 95% CI 8.7–43.2, p 0.008). another single-arm 31), 32% (10/31) became completely abstinent duration years). double-blind, placebo-controlled randomized controlled trial (RCT, 95), during 32-week double-blind period lower compared placebo 13.9, 3.0–24.7, 0.01). 15), 7-day point prevalence smoking abstinence at 26 80% (12/15), 52 67% (10/15). Conclusion Only RCT three small identified combined some form psychotherapy All indicated beneficial effect psilocybin-assisted symptoms. Larger RCTs need evaluate whether is effective SUD.

Язык: Английский

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Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study

Nature Medicine, Год журнала: 2023, Номер 29(8), С. 1947 - 1953

Опубликована: Июль 24, 2023

Abstract Anorexia nervosa (AN) is a deadly illness with no proven treatments to reverse core symptoms and medications approved by the US Food Drug Administration. Novel are urgently needed improve clinical outcomes. In this open-label feasibility study, 10 adult female participants (mean body mass index 19.7 kg m − 2 ; s.d. 3.7) who met Diagnostic Statistical Manual of Mental Disorders , Fifth Edition (DSM-5) criteria for AN or pAN (partial remission) were recruited study conducted at an academic research institute. Participants received single 25-mg dose synthetic psilocybin in conjunction psychological support. The primary aim was assess safety, tolerability post-treatment incidences occurrences adverse events (AEs) clinically significant changes electrocardiogram (ECG), laboratory tests, vital signs suicidality. No observed ECG, Two developed asymptomatic hypoglycemia post-treatment, which resolved within 24 h. other values. All AEs mild transient nature. Participants’ qualitative perceptions suggest that treatment acceptable most participants. Results therapy safe, tolerable AN, promising finding given physiological dangers problems engagement. ClinicalTrials.gov identifier NCT04661514 .

Язык: Английский

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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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Mind, Mood and Microbiota—Gut–Brain Axis in Psychiatric Disorders

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(6), С. 3340 - 3340

Опубликована: Март 15, 2024

Psychiatric disorders represent a primary source of disability worldwide, manifesting as disturbances in individuals’ cognitive processes, emotional regulation, and behavioral patterns. In the quest to discover novel therapies expand boundaries neuropharmacology, studies from field have highlighted gut microbiota’s role modulating these disorders. These alterations may influence brain’s processes through brain–gut axis, multifaceted bidirectional system that establishes connection between enteric central nervous systems. Thus, probiotic prebiotic supplements are meant overall health play an insightful alleviating psychiatric symptoms, such templates major depressive disorder, anxiety, or schizophrenia. Moreover, administration psychotropic drugs has been revealed induce specific changes microbiome’s diversity, suggesting their potential utility combating bacterial infections. This review emphasizes intricate correlations microbiota, mentioning promising approaches regard modulation treatments, well antimicrobial effects medication.

Язык: Английский

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Clinically relevant acute subjective effects of psychedelics beyond mystical experience

Nature Reviews Psychology, Год журнала: 2024, Номер 3(9), С. 606 - 621

Опубликована: Сен. 3, 2024

Язык: Английский

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Psilocybin: From Psychiatric Pariah to Perceived Panacea

American Journal of Psychiatry, Год журнала: 2025, Номер 182(1), С. 54 - 78

Опубликована: Янв. 1, 2025

The authors critically examine the evidence base for psilocybin administered with psychological support/therapy (PST) in treatment of psychiatric disorders and offer practical recommendations to guide future research endeavors.

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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More than meets the eye: The role of sensory dimensions in psychedelic brain dynamics, experience, and therapeutics

Neuropharmacology, Год журнала: 2022, Номер 223, С. 109300 - 109300

Опубликована: Ноя. 10, 2022

Psychedelics are undergoing a major resurgence of scientific and clinical interest. While multiple theories frameworks have been proposed, there is yet no universal agreement on the mechanisms underlying complex effects psychedelics subjective experience brain dynamics, nor their therapeutic benefits. Despite being prominent in psychedelic phenomenology distinct from those elicited by other classes hallucinogens, low-level sensory - particularly visual dimensions experience, corresponding often disregarded contemporary research as ‘epiphenomenal byproducts’. Here, we review available evidence neuroimaging, pharmacology, questionnaires, studies; propose extensions to existing models, provide testable hypotheses for potential roles psychedelic-induced hallucinations, simulations phenomena relying cortical dynamics. In sum, show that alterations 1) unlikely be entirely causally reconducible high-level alterations, but rather co-occur with them dialogical interplay, 2) likely play relevant role determining outcomes. We conclude reevaluating currently underappreciated states will highly valuable neuroscience practice, integrating domain-specific aspects into nonspecific models necessary step further understand how these substances effect both acute long-term change human brain.

Язык: Английский

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Psilocybin induces acute and persisting alterations in immune status in healthy volunteers: An experimental, placebo-controlled study

Brain Behavior and Immunity, Год журнала: 2023, Номер 114, С. 299 - 310

Опубликована: Сен. 7, 2023

Patients characterized by stress-related disorders such as depression display elevated circulating concentrations of pro-inflammatory cytokines and a hyperactive HPA axis. Psychedelics are demonstrating promising results in treatment disorders, however the mechanisms their therapeutic effects still unknown. To date evidence acute persisting psychedelics on immune functioning, axis activity response to stress, associated psychological outcomes is preliminary. address this, we conducted placebo-controlled, parallel group design comprising 60 healthy participants who received either placebo (n = 30) or 0.17 mg/kg psilocybin 30). Blood samples were taken assess (7 day) changes status. Seven days' post-administration, each further subdivided: 15 underwent stress induction protocol, control protocol. Ultra-high field (7-Tesla) magnetic resonance spectroscopy was used whether glutamate glial with functioning. Finally, questionnaires assessed self-report mood social behavior. Psilocybin immediately reduced cytokine tumor necrosis factor-α (TNF-α), while other inflammatory markers (interleukin (IL)- 1β, IL-6, C-reactive protein (CRP)) remained unchanged. days later, TNF-α returned baseline, IL-6 CRP persistently group. Changes profile related neurometabolic reductions linked lower hippocampus. Additionally, more reduction seven after psilocybin, positive reported. Regarding response, psychosocial stressor, did not significantly alter response. Results discussed regards demonstrated ongoing patient trials.

Язык: Английский

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