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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The Psychedelic Future of Post-Traumatic Stress Disorder Treatment

Current Neuropharmacology, Год журнала: 2024, Номер 22(4), С. 636 - 735

Опубликована: Янв. 5, 2024

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological selective serotonin reuptake inhibitors (SSRIs)). However, significant proportion of patients receiving standard-of-care for PTSD remain symptomatic, new approaches other trauma-related conditions greatly needed. Psychedelic compounds alter cognition, perception, mood currently being examined their efficacy in treating despite current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value psychedelicassisted therapy treat psychiatric disorders. In comprehensive review, we summarize state science care, including shortcomings. We review studies psychedelic interventions PTSD, disorders, common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), N,N-dimethyltryptamine (DMT) DMT-containing ayahuasca, well entactogen 3,4-methylenedioxymethamphetamine (MDMA) dissociative anesthetic ketamine, reviewed. For each drug, present history use, somatic effects, pharmacology, safety profile. rationale proposed mechanisms use traumarelated disorders discussed. This concludes with an in-depth consideration future directions applications maximize therapeutic benefit minimize risk individuals communities impacted conditions.

Язык: Английский

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Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

Frontiers in Psychology, Год журнала: 2022, Номер 13

Опубликована: Июнь 2, 2022

The current standard of care in most uses psychedelic medicines for the treatment psychiatric indications includes provision a supportive therapeutic context before, during, and after drug administration. A diversity psychedelic-assisted psychotherapy (PAP) models has been created to meet this need. article briefly reviews strengths limitations these models, which are divided into basic support EBT-inclusive therapy models. It then discusses several shortcomings both types share, including lack adequate attention embodied relational elements treatment, insufficient ethical concerns. introduces EMBARK model, transdiagnostic, trans-drug framework PAP clinical trials training study therapists. was designed overcome challenges that prior have had conceptualizing change incorporating non-psychedelic evidence-based therapies, therapists' skills orientations, delimiting therapist interventions research standardization, determining specific factors contribute outcomes. explains EMBARK's six domains, represent parallel conceptualizations how therapists may benefit its four cornerstones, reflect broad responsibility participants. describes model come together structure inform during preparation, medicine, integration sessions. Additionally, will discuss is organized conducted. Finally, it demonstrate applicability by describing upcoming adopted as frame.

Язык: Английский

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Ethical and Practical Considerations for the Use of Psychedelics in Psychiatry

Psychiatric Services, Год журнала: 2023, Номер 74(8), С. 838 - 846

Опубликована: Март 29, 2023

In recent years, psychedelic-assisted psychotherapies have reentered the realm of rigorous scientific inquiry, garnering much attention from both psychiatric community and broader public. Headlines on major media platforms frequently tout psychedelic future psychiatry, patients increasingly ask about prospect using psychedelics during their sessions. Despite this enthusiasm, remain in an investigational stage, more research regulatory work are required before can be deemed appropriate for general clinical use. climate, psychiatrists curious prospects treatments. This review's goal was to help better understand complexities burgeoning field psychotherapy. The discussion encompasses issues surrounding current stage consider should become available broad review discusses equipoise context enthusiasm psychedelics, informed consent, patient vulnerability, equity access, differences between nonclinical uses, self-enhancement. As move closer toward approval beyond settings, it is vital that these promising treatments used ethically. unique features therapies, including altered states consciousness they produce vulnerability such entail patients, require careful consideration minimize potential ethical pitfalls. seeks ensure equipped use psychotherapy ethically effectively.

Язык: Английский

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Investigation of self-treatment with lysergic acid diethylamide and psilocybin mushrooms: Findings from the Global Drug Survey 2020

Journal of Psychopharmacology, Год журнала: 2023, Номер 37(7), С. 733 - 748

Опубликована: Март 6, 2023

Growing numbers of people are using psychedelics for personal psychotherapy outside clinical settings, but research on such use is scarce.

Язык: Английский

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A Comprehensive Overview of the Role of Visual Cortex Malfunction in Depressive Disorders: Opportunities and Challenges

Neuroscience Bulletin, Год журнала: 2023, Номер 39(9), С. 1426 - 1438

Опубликована: Март 30, 2023

Язык: Английский

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Psilocybin facilitates fear extinction in mice by promoting hippocampal neuroplasticity

Chinese Medical Journal, Год журнала: 2023, Номер unknown

Опубликована: Март 30, 2023

Abstract Background: Posttraumatic stress disorder (PTSD) and depression are highly comorbid. Psilocybin exerts substantial therapeutic effects on by promoting neuroplasticity. Fear extinction is a key process in the mechanism of first-line exposure-based therapies for PTSD. We hypothesized that psilocybin would facilitate fear hippocampal Methods: First, we assessed percentage freezing time an auditory cued conditioning (FC) paradigm mice. was administered 30 min before training. testing performed first day; retrieval renewal were tested sixth seventh days, respectively. Furthermore, verified effect neuroplasticity using Golgi staining dendritic complexity spine density, Western blotting protein levels brain derived neurotrophic factor (BDNF) mechanistic target rapamycin (mTOR), immunofluorescence numbers doublecortin (DCX)- bromodeoxyuridine (BrdU)-positive cells. Results: A single dose (2.5 mg/kg, i.p.) reduced increase induced FC at 24 h, 6th day 7th after administration. In terms structural neuroplasticity, rescued decrease density FC; related proteins, BDNF mTOR neurogenesis, DCX- BrdU-positive cells dentate gyrus FC. Conclusions: facilitated rapid sustained extinction; this might be partially mediated promotion This study indicates may useful adjunct to PTSD other mental disorders characterized failure extinction.

Язык: Английский

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Psilocybin-assisted massed cognitive processing therapy for chronic posttraumatic stress disorder: Protocol for an open-label pilot feasibility trial

PLoS ONE, Год журнала: 2025, Номер 20(1), С. e0313741 - e0313741

Опубликована: Янв. 17, 2025

Background Posttraumatic stress disorder (PTSD) affects 3.9% of the general population. While massed cognitive processing therapy (CPT) has demonstrated efficacy in treating chronic PTSD, a substantial proportion patients still continue to meet PTSD criteria after treatment, highlighting need for novel therapeutic approaches. Preliminary evidence supports potential action psilocybin alleviate symptoms. This open-label pilot study aims evaluate feasibility, tolerability, and preliminary single dose 25 mg combination with one week CPT PTSD. Method Fifteen participants will undergo 12 sessions, two psilocybin-related psychotherapy dosing session over 7-days period. The primary outcomes are feasibility which be measured by recruitment rates, withdrawal, data completion, adherence, number nature adverse events. Secondary objectives include assessing psilocybin-assisted reducing severity, self-reported treatment exploring putative mechanisms change. Participants monitored weekly weeks post-treatment passive relevant mental health well-being collected using wearable device. Discussion trial generate important on use findings guide design multi-site, large-scale randomized control more rigorously assess this intervention. De-identified from available upon request publication results. represents promising innovative approach potentially offering an alternative option individuals unresponsive conventional therapies. Trial registration ClinicalTrials.gov NCT06386003 .

Язык: Английский

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Study protocol of an open-label proof-of-concept trial examining the safety and clinical efficacy of psilocybin-assisted therapy for veterans with PTSD

BMJ Open, Год журнала: 2023, Номер 13(5), С. e068884 - e068884

Опубликована: Май 1, 2023

Introduction Psilocybin-assisted therapy has shown significant promise in treating the cluster of mood and anxiety symptoms that comprise post-traumatic stress disorder (PTSD) but yet to be tested specifically this condition. Furthermore, current pharmacological psychotherapeutic treatments for PTSD are difficult tolerate limited efficacy, especially US Military Veteran (USMV) population. This open-label pilot study will examine safety efficacy two psilocybin administration sessions (15 mg 25 mg), combined with psychotherapy, among USMVs severe, treatment resistant PTSD. Methods analysis We recruit 15 Participants receive one low dose mg) moderate/high (25 conjunction preparatory post-psilocybin sessions. The primary outcome type, severity frequency adverse events suicidal ideation/behaviour, as measured by Columbia Suicide Severity Rating Scale. measure Clinician Administered Scale-5. endpoint 1 month following second session, total follow-up time 6 months. Ethics dissemination All participants required provide written informed consent. trial been authorised Ohio State University Institutional Review Board (study number: 2022H0280). Dissemination results occur via a peer-reviewed publication other relevant media. Trial registration number NCT05554094 .

Язык: Английский

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Extraction Yields of Psilocybin and Psilocin: A Short Review of Current Methods and Their Implications

Pharmaceuticals, Год журнала: 2025, Номер 18(3), С. 380 - 380

Опубликована: Март 7, 2025

The growing body of evidence supporting the therapeutic efficacy psychoactive substances, like psilocybin, has driven significant interest in recent decades due to their low toxicity and potential applications treating various mental health disorders. However, producing pharmaceutical-grade psilocybin remains challenging, with three primary approaches: chemical synthesis, biosynthesis, extraction from Psilocybe mushroom fruiting bodies. This systematic review evaluates quantification methods for psilocin, aiming contribute development standardized protocols that ensure compound quality purity. A total 25 relevant studies were selected an initial pool 9152 publications indexed platforms such as Scopus, ScienceDirect, Web Science, PubMed. findings indicate both method choice species significantly influence yields. Ultrasonic bath was identified most efficient technique, particularly including cyanescens cubensis. High-performance liquid chromatography (HPLC) most-used identifying quantifying these compounds. Furthermore, polar solvents critical effective solubilization, parameters temperature, solvent-to-material ratio, time playing key roles optimizing serves a scientific reference advancing research, enhancing analytical precision, ensuring reproducibility through standardization protocols.

Язык: Английский

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