Tieteelliset julkaisut

Tulokset kategoriasta substanssi hakusanalla MDMA. Takaisin


Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. (Carhart-Harris RL, Bolstridge M, Day CMJ, Rucker J, Watts R,.., 2018)
Julkaisu:Psychopharmacology
Tiivistelmä: RATIONALE:
Recent clinical trials are reporting marked improvements in mental health outcomes with psychedelic drug-assisted psychotherapy.

OBJECTIVES:
Here, we report on safety and efficacy outcomes for up to 6 months in an open-label trial of psilocybin for treatment-resistant depression.

METHODS:
Twenty patients (six females) with (mostly) severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 and 25 mg, 7 days apart) in a supportive setting. Depressive symptoms were assessed from 1 week to 6 months post-treatment, with the self-rated QIDS-SR16 as the primary outcome measure.

RESULTS:
Treatment was generally well tolerated. Relative to baseline, marked reductions in depressive symptoms were observed for the first 5 weeks post-treatment (Cohen's d = 2.2 at week 1 and 2.3 at week 5, both p < 0.001); nine and four patients met the criteria for response and remission at week 5. Results remained positive at 3 and 6 months (Cohen's d = 1.5 and 1.4, respectively, both p < 0.001). No patients sought conventional antidepressant treatment within 5 weeks of psilocybin. Reductions in depressive symptoms at 5 weeks were predicted by the quality of the acute psychedelic experience.

CONCLUSIONS:
Although limited conclusions can be drawn about treatment efficacy from open-label trials, tolerability was good, effect sizes large and symptom improvements appeared rapidly after just two psilocybin treatment sessions and remained significant 6 months post-treatment in a treatment-resistant cohort. Psilocybin represents a promising paradigm for unresponsive depression that warrants further research in double-blind randomised control trials.
Yhdiste:Psilosybiini
Aihe:Masennus
Menetelmät:open label, seuranta
Otoskoko:20
Muuta:Seurantatutkimus tutkimuksesta Carhart-Harris ym. (2016).
Tagit:
DOI:10.1007/s00213-017-4771-x
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813086/


Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression. (Roseman L, Nutt DJ, Carhart-Harris RL, 2018)
Julkaisu:Frontiers in Pharmacology
Tiivistelmä: Introduction: It is a basic principle of the "psychedelic" treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value.

Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest.

Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC (p < 0.05).

Discussion: This report further bolsters the view that the quality of the acute psychedelic experience is a key mediator of long-term changes in mental health. Future therapeutic work with psychedelics should recognize the essential importance of quality of experience in determining treatment efficacy and consider ways of enhancing mystical-type experiences and reducing anxiety.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset, masennus
Menetelmät:Open label, seuranta, haastattelu, kysely
Otoskoko:20
Muuta:
Tagit:
DOI:10.3389/fphar.2017.00974
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776504/


Serotonergic hallucinogens in the treatment of anxiety and depression in patients suffering from a life-threatening disease: A systematic review. (Reiche S, Hermle L, Gutwinski S, Jungaberle H, Gasser P, Maj.., 2018)
Julkaisu:Progress in Neuro-Psychopharmacology & Biological Psychiatry
Tiivistelmä: Anxiety and depression are some of the most common psychiatric symptoms of patients suffering with life-threatening diseases, often associated with a low quality of life and a poor overall prognosis. 5-HT2A-receptor agonists (serotonergic hallucinogens, 'psychedelics') like lysergic acid diethylamide (LSD) and psilocybin were first investigated as therapeutic agents in the 1960s.

Recently, after a long hiatus period of regulatory obstacles, interest in the clinical use of these substances has resumed. The current article provides a systematic review of studies investigating psychedelics in the treatment of symptoms of existential distress in life-threatening diseases across different periods of research, highlighting how underlying concepts have developed over time.

A systematic search for clinical trials from 1960 to 2017 revealed 11 eligible clinical trials involving a total number of N=445 participants, of which 7 trials investigated the use of lysergic acid diethylamide (LSD) (N=323), 3 trials investigated the use of psilocybin (N=92), and one trial investigated the use of dipropyltryptamine (DPT) (N=30). The 4 more recent randomized controlled trials (RCTs) (N=104) showed a significantly higher methodological quality than studies carried out in the 1960s and 1970s.

Evidence supports that patients with life threatening diseases associated with symptoms of depression and anxiety benefit from the anxiolytic and antidepressant properties of serotonergic hallucinogens. Some studies anecdotally reported improvements in patients´ quality of life and reduced fear of death.

Moreover, low rates of side effects were reported in studies that adhered to safety guidelines. Further studies are needed to determine how these results can be transferred into clinical practice.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini
Aihe:Kuolemaan liittyvä ahdistus, masennus
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1016/j.pnpbp.2017.09.012
URL: https://www.sciencedirect.com/science/article/pii/S02785846173063...


Safety pharmacology of acute MDMA administration in healthy subjects (Vizeli P & Liechti ME, 2017)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: 3,4-Methylenedioxymethamphetamine (MDMA; ecstasy) is being investigated in MDMA-assisted psychotherapy. The present study characterized the safety pharmacology of single-dose administrations of MDMA (75 or 125 mg) using data from nine double-blind, placebo-controlled, crossover studies performed in the same laboratory in a total of 166 healthy subjects.

The duration of the subjective effects was 4.2 ± 1.3 h (range: 1.4–8.2 h). The 125 mg dose of MDMA produced greater ‘good drug effect’ ratings than 75 mg. MDMA produced moderate and transient ‘bad drug effect’ ratings, which were greater in women than in men. MDMA increased systolic blood pressure to >160 mmHg, heart rate >100 beats/min, and body temperature >38°C in 33%, 29% and 19% of the subjects, respectively. These proportions of subjects with hypertension (>160 mmHg), tachycardia, and body temperature >38°C were all significantly greater after 125 mg MDMA compared with the 75 mg dose.

Acute and subacute adverse effects of MDMA as assessed by the List of Complaints were dose-dependent and more frequent in females. MDMA did not affect liver or kidney function at EOS 29 ± 22 days after use. No serious adverse events occurred.

In conclusion, MDMA produced predominantly acute positive subjective drug effects. Bad subjective drug effects and other adverse effects were significantly more common in women. MDMA administration was overall safe in physically and psychiatrically healthy subjects and in a medical setting. However, the risks of MDMA are likely higher in patients with cardiovascular disease and remain to be investigated in patients with psychiatric disorders.
Yhdiste:MDMA
Aihe:haitta-arvio
Menetelmät:yhdistetty analyysi
Otoskoko:166
Muuta:
Tagit: faasi I, käyttöturvallisuus, MDMA, yhdistetty analyysi
DOI:10.1177/0269881117691569
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881117691569


Lifetime experience with (classic) psychedelics predicts pro-environmental behavior through an increase in nature relatedness. (Forstmann M & Sagioglou C, 2017)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: In a large-scale (N = 1487) general population online study, we investigated the relationship between past experience with classic psychedelic substances (e.g. LSD, psilocybin, mescaline), nature relatedness, and ecological behavior (e.g. saving water, recycling).

Using structural equation modeling we found that experience with classic psychedelics uniquely predicted self-reported engagement in pro-environmental behaviors, and that this relationship was statistically explained by people's degree of self-identification with nature. Our model controlled for experiences with other classes of psychoactive substances (cannabis, dissociatives, empathogens, popular legal drugs) as well as common personality traits that usually predict drug consumption and/or nature relatedness (openness to experience, conscientiousness, conservatism).

Although correlational in nature, results suggest that lifetime experience with psychedelics in particular may indeed contribute to people's pro-environmental behavior by changing their self-construal in terms of an incorporation of the natural world, regardless of core personality traits or general propensity to consume mind-altering substances. Thereby, the present research adds to the contemporary literature on the beneficial effects of psychedelic substance use on mental wellbeing, hinting at a novel area for future research investigating their potentially positive effects on a societal level. Limitations of the present research and future directions are discussed.
Yhdiste:psykedeelit yleisesti
Aihe:päihdekäyttö
Menetelmät:kyselytutkimus
Otoskoko:1487
Muuta:
Tagit: ekologia, luonto, luontoarvot, luontoyhteys, ympäristöystävällisyys
DOI:10.1177/0269881117714049
URL: http://journals.sagepub.com/doi/full/10.1177/0269881117714049


Psychedelics, Personality and Political Perspectives. (Nour MM, Evans L, Carhart-Harris RL, 2017)
Julkaisu:Journal of Psychoactive Drugs
Tiivistelmä: The psychedelic experience (including psychedelic-induced ego dissolution) can effect lasting change in a person's attitudes and beliefs. Here, we aimed to investigate the association between naturalistic psychedelic use and personality, political perspectives, and nature relatedness using an anonymous internet survey.

Participants (N = 893) provided information about their naturalistic psychedelic, cocaine, and alcohol use, and answered questions relating to personality traits of openness and conscientiousness (Ten-Item Personality Inventory), nature relatedness (Nature-Relatedness Scale), and political attitudes (one-item liberalism-conservatism measure and five-item libertarian-authoritarian measure). Participants also rated the degree of ego dissolution experienced during their "most intense" recalled psychedelic experience (Ego-Dissolution Inventory).

Multivariate linear regression analysis indicated that lifetime psychedelic use (but not lifetime cocaine use or weekly alcohol consumption) positively predicted liberal political views, openness and nature relatedness, and negatively predicted authoritarian political views, after accounting for potential confounding variables. Ego dissolution experienced during a participant's "most intense" psychedelic experience positively predicted liberal political views, openness and nature relatedness, and negatively predicted authoritarian political views.

Further work is needed to investigate the nature of the relationship between the peak psychedelic experience and openness to new experiences, egalitarian political views, and concern for the environment.
Yhdiste:psykedeelit yleisesti
Aihe:päihdekäyttö
Menetelmät:kyselytutkimus
Otoskoko:893
Muuta:
Tagit: avoimuus, ego, liberalismi, luontoyhteys, tunnollisuus
DOI:10.1080/02791072.2017.1312643
URL: https://www.ncbi.nlm.nih.gov/pubmed/28443703


Psychedelic drug use in healthy individuals: A review of benefits, costs, and implications for drug policy (Elsey JWB, 2017)
Julkaisu:Drug Science, Policy and Law
Tiivistelmä: The potential of psychedelic drugs in the treatment of mental health problems is increasingly being recognized. However, relatively little thrust has been given to the suggestion that individuals without any mental health problems may benefit from using psychedelic drugs, and that they may have a right to do so.

This review considers contemporary research into the use of psychedelic drugs in healthy individuals, including neurobiological and subjective effects.

In line with findings suggesting positive effects in the treatment of mental health problems, such research highlights the potential of psychedelic drugs for the enhancement of wellbeing even in healthy individuals. The relatively low risk associated with usage does not appear to align with stringent drug laws that impose heavy penalties for their use. Some policy implications, and suggestions for future research, are considered.
Yhdiste:psykedeelit yleisesti
Aihe:päihdekäyttö
Menetelmät:kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit: haitallisuusarvio, hyödyllisyysarvio, itselääkintä, päihdepolitiikka
DOI:10.1177/2050324517723232
URL: http://journals.sagepub.com/doi/10.1177/2050324517723232


Studies with psychedelic drugs in human volunteers. (Sellers EM, Romach MK, Leiderman DB, 2017)
Julkaisu:Neuropharmacology
Tiivistelmä: Scientific curiosity and fascination have played a key role in human research with psychedelics along with the hope that perceptual alterations and heightened insight could benefit well-being and play a role in the treatment of various neuropsychiatric disorders. These motivations need to be tempered by a realistic assessment of the hurdles to be cleared for therapeutic use. Development of a psychedelic drug for treatment of a serious psychiatric disorder presents substantial although not insurmountable challenges. While the varied psychedelic agents described in this chapter share some properties, they have a range of pharmacologic effects that are reflected in the gradation in intensity of hallucinogenic effects from the classical agents to DMT, MDMA, ketamine, dextromethorphan and new drugs with activity in the serotonergic system. The common link seems to be serotonergic effects modulated by NMDA and other neurotransmitter effects. The range of hallucinogens suggest that they are distinct pharmacologic agents and will not be equally safe or effective in therapeutic targets. Newly synthesized specific and selective agents modeled on the legacy agents may be worth considering. Defining therapeutic targets that represent unmet medical need, addressing market and commercial issues, and finding treatment settings to safely test and use such drugs make the human testing of psychedelics not only interesting but also very challenging.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini, MDMA
Aihe:Yleiset vaikutukset, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1016/j.neuropharm.2017.11.029
URL: https://www.sciencedirect.com/science/article/pii/S00283908173054...


Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy. (Wagner MT, Mithoefer MC, Mithoefer AT, MacAulay RK, Jerome L.., 2017)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy.

There is evidence that lasting changes in the personality feature of "openness" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures.

Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found.

These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, stressihäiriö
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, satunnaistettu, haastattelu, seuranta
Otoskoko:20
Muuta:Tutkimus on jatkoa artikkelille Mithoefer ym. (2011).
Tagit:
DOI:10.1177/0269881117711712
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544120/


Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. (Carhart-Harris RL, Roseman L, Bolstridge M, Demetriou L, Pan.., 2017)
Julkaisu:Scientific Reports
Tiivistelmä: Psilocybin with psychological support is showing promise as a treatment model in psychiatry but its therapeutic mechanisms are poorly understood. Here, cerebral blood flow (CBF) and blood oxygen-level dependent (BOLD) resting-state functional connectivity (RSFC) were measured with functional magnetic resonance imaging (fMRI) before and after treatment with psilocybin (serotonin agonist) for treatment-resistant depression (TRD).

Quality pre and post treatment fMRI data were collected from 16 of 19 patients. Decreased depressive symptoms were observed in all 19 patients at 1-week post-treatment and 47% met criteria for response at 5 weeks. Whole-brain analyses revealed post-treatment decreases in CBF in the temporal cortex, including the amygdala. Decreased amygdala CBF correlated with reduced depressive symptoms. Focusing on a priori selected circuitry for RSFC analyses, increased RSFC was observed within the default-mode network (DMN) post-treatment. Increased ventromedial prefrontal cortex-bilateral inferior lateral parietal cortex RSFC was predictive of treatment response at 5-weeks, as was decreased parahippocampal-prefrontal cortex RSFC.

These data fill an important knowledge gap regarding the post-treatment brain effects of psilocybin, and are the first in depressed patients. The post-treatment brain changes are different to previously observed acute effects of psilocybin and other 'psychedelics' yet were related to clinical outcomes. A 'reset' therapeutic mechanism is proposed.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset, aivotutkimus
Menetelmät:fMRI
Otoskoko:16
Muuta:
Tagit:
DOI:10.1038/s41598-017-13282-7
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640601/


Long-term follow-up of psilocybin-facilitated smoking cessation. (Johnson MW, Garcia-Romeu A, Griffiths RR, 2017)
Julkaisu:The American Journal of Drug and Alcohol Abuse
Tiivistelmä: BACKGROUND:
A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone.

OBJECTIVES:
To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration.

METHODS:
The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin.

RESULTS:
All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.

CONCLUSION:
These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.
Yhdiste:Psilosybiini
Aihe:Addiktio
Menetelmät:Open label, seuranta
Otoskoko:15
Muuta:Seurantatutkimus tutkimuksesta Johnson ym. 2014
Tagit:
DOI:10.3109/00952990.2016.1170135
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641975/


An online survey of tobacco smoking cessation associated with naturalistic psychedelic use. (Johnson MW, Garcia-Romeu A, Johnson PS, Griffiths RR, 2017)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Data suggest psychedelics such as psilocybin and lysergic acid diethylamide (LSD) may hold therapeutic potential in the treatment of addictions, including tobacco dependence.

This retrospective cross-sectional anonymous online survey characterized 358 individuals (52 females) who reported having quit or reduced smoking after ingesting a psychedelic in a non-laboratory setting ⩾1 year ago. On average, participants smoked 14 cigarettes/day for 8 years, and had five previous quit attempts before their psychedelic experience. Of the 358 participants, 38% reported continuous smoking cessation after psychedelic use (quitters).

Among quitters, 74% reported >2 years' abstinence. Of the 358 participants, 28% reported a persisting reduction in smoking (reducers), from a mode of 300 cigarettes/month before, to a mode of 1 cigarette/month after the experience. Among reducers, 62% reported >2 years of reduced smoking. Finally, 34% of the 358 participants (relapsers) reported a temporary smoking reduction before returning to baseline smoking levels, with a mode time range to relapse of 3-6 months.

Relapsers rated their psychedelic experience significantly lower in personal meaning and spiritual significance than both other groups. Participants across all groups reported less severe affective withdrawal symptoms (e.g. depression, craving) after psychedelic use compared with previous quit attempts, suggesting a potential mechanism of action for psychedelic-associated smoking cessation/reduction.

Changes in life priorities/values were endorsed as the most important psychological factor associated with smoking cessation/reduction. Results suggest psychedelics may hold promise in treating tobacco addiction as potentially mediated by spiritual experience, changed priorities/values, and improved emotional regulation.
Yhdiste:Psilosybiini
Aihe:Addiktio
Menetelmät:Kyselytutkimus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881116684335
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881116684335


Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. (Griffiths RR, Johnson MW, Carducci MA, Umbricht A, Richards .., 2016)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety.

This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study.

High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes.
Yhdiste:psilosybiini
Aihe:kuolemaan liittyvä ahdistus, masennus
Menetelmät:vaihtovuoroinen, kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:56
Muuta:
Tagit: kuolemaan liittyvä ahdistus, masennus, psilosybiini
DOI:10.1177/0269881116675513
URL: http://journals.sagepub.com/doi/pdf/10.1177/0269881116675513


Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study (Carhart-Harris RL, Bolstridge M, Rucker J, Day CM, Erritzoe .., 2016)
Julkaisu:The Lancet Psychiatry
Tiivistelmä: Background

Psilocybin is a serotonin receptor agonist that occurs naturally in some mushroom species. Recent studies have assessed the therapeutic potential of psilocybin for various conditions, including end-of-life anxiety, obsessive-compulsive disorder, and smoking and alcohol dependence, with promising preliminary results. Here, we aimed to investigate the feasibility, safety, and efficacy of psilocybin in patients with unipolar treatment-resistant depression.

Methods

In this open-label feasibility trial, 12 patients (six men, six women) with moderate-to-severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 mg and 25 mg, 7 days apart) in a supportive setting. There was no control group. Psychological support was provided before, during, and after each session. The primary outcome measure for feasibility was patient-reported intensity of psilocybin's effects. Patients were monitored for adverse reactions during the dosing sessions and subsequent clinic and remote follow-up. Depressive symptoms were assessed with standard assessments from 1 week to 3 months after treatment, with the 16-item Quick Inventory of Depressive Symptoms (QIDS) serving as the primary efficacy outcome. This trial is registered with ISRCTN, number ISRCTN14426797.

Findings

Psilocybin's acute psychedelic effects typically became detectable 30–60 min after dosing, peaked 2–3 h after dosing, and subsided to negligible levels at least 6 h after dosing. Mean self-rated intensity (on a 0–1 scale) was 0·51 (SD 0·36) for the low-dose session and 0·75 (SD 0·27) for the high-dose session. Psilocybin was well tolerated by all of the patients, and no serious or unexpected adverse events occurred. The adverse reactions we noted were transient anxiety during drug onset (all patients), transient confusion or thought disorder (nine patients), mild and transient nausea (four patients), and transient headache (four patients). Relative to baseline, depressive symptoms were markedly reduced 1 week (mean QIDS difference −11·8, 95% CI −9·15 to −14·35, p=0·002, Hedges' g=3·1) and 3 months (−9·2, 95% CI −5·69 to −12·71, p=0·003, Hedges' g=2) after high-dose treatment. Marked and sustained improvements in anxiety and anhedonia were also noted.

Interpretation

This study provides preliminary support for the safety and efficacy of psilocybin for treatment-resistant depression and motivates further trials, with more rigorous designs, to better examine the therapeutic potential of this approach.

Funding

Medical Research Council.
Yhdiste:psilosybiini
Aihe:masennus, haitta-arvio
Menetelmät:open label, seuranta
Otoskoko:12
Muuta:
Tagit: masennus, pilotti, psilosybiini
DOI:10.1016/S2215-0366(16)30065-7
URL: http://www.sciencedirect.com/science/article/pii/S221503661630065...


Neural correlates of the LSD experience revealed by multimodal neuroimaging (Carhart-Harris RL, Muthukumaraswamy S, Roseman L, Kaelen M, .., 2016)
Julkaisu:Proceedings of the National Academy of Sciences of the United States of America
Tiivistelmä: LSD:n vaikutuksia aivoissa tutkittiin kolmen aivokuvantamismenetelmän avulla. Kohderyhmänä olivat terveet koehenkilöt. Tutkimuksessa todettiin, että LSD vähentää oletushermoverkostoon luettujen aivoalueiden välistä integraatiota ja toisaalta lisää eri aivoalueiden välistä kytkeytyneisyyttä.

Näköaivokuoren voimistunut verenkierto, näköaivokuoren vaimentuneet alfa-aallot ja primäärisen näköaivokuoren toiminnallisten yhteyksien laajeneminen korreloivat vahvasti koehenkilöiden visuaalisista hallusinaatiosta tekemien arvioiden kanssa.

Lisäksi parahippokampuksen ja retrospleniaalisen aivokuoren välisten yhteyksien vaimeneminen korreloi koehenkilöiden arvioimien egon hälvenemisen ja merkityskokemuksen muuttumisen kanssa.

Myös eri kuvantamismenetelmien välillä havaittiin merkittäviä korrelaatioita.
Yhdiste:LSD
Aihe:aivotutkimus
Menetelmät:Aivokuvantaminen, fMRI, MEG
Otoskoko:20
Muuta:
Tagit: aivot, default mode network, LSD, tietoisuus
DOI:10.1073/pnas.1518377113
URL: http://www.pnas.org/content/113/17/4853.full


Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial (Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, .., 2016)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Tausta: Ahdistus ja masennusoireilu ovat yleisiä potilailla, joilla on pitkälle edennyt syöpäsairaus. Psykiatrinen oireilu on yhteydessä huonompaan hoidon ennusteeseen. Aiemmat tutkimustulokset viittaavat psilosybiinin soveltuvan syöpäsairauteen liittyvän ahdistuksen ja masennuksen hoitoon.

Metodit: Tässä satunnaistetussa plasebokontrolloidussa ristikkäistutkimuksessa 29 syöpää sairastavaa potilasta, joilla oli sairauteensa liittyvää ahdistusta ja masennusta saivat satunnaistetusti psykoterapian yhteydessä yhden annoksen joko psilosybiiniä (0.3mg/kg) tai niasiinia. Hoidon vaikuttavuutta arvioitiin ahdistus- ja masennusmittauksilla ennen koe- ja kontrolliryhmien yhdistämistä 7 viikkoa hoidon jälkeen.

Tulokset: Koehenkilöiden ahdistuneisuudessa ja mielialassa havaittiin tilastollisesti merkitseviä positiivisia muutoksia psilosybiinin jälkeen ennen koe- ja kontrolliryhmien yhdistämistä. Lisäksi syöpään liittyvässä toivottomuudessa ja demoralisaatiossa havaittiin laskua. Myös koehenkilöiden henkinen hyvinvointi ja elämänlaatu kohenivat. Kuuden kuukauden seurannassa psilosybiinin ahdistusta ja masentuneisuutta lieventävät vaikutukset säilyivät (60-80 % koehenkilöistä havaittiin kliinisesti merkitsevää vaikutusta ahdistukseen ja masentuneisuuteen). Seurannassa psilosybiini oli yhteydessä eksistentiaalisen ahdingon helpottumiseen, kohonneeseen elämänlaatuun ja muuntuneeseen asenteeseen kuolemaa kohtaan. Psilosybiinin terapeuttiset vaikutukset välittyivät sen tuottaman mystisen kokemuksen kautta.

Johtopäätökset: Kerta-annoksinen psilosybiiniavusteinen psykoterapia tuotti nopeita ja pysyviä muutoksia syöpää sairastavien potilaiden sairauteen liittyvässä masentuneisuudessa ja ahdistuneisuudessa.
Yhdiste:psilosybiini
Aihe:kuolemaan liittyvä ahdistus, masennus
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, vaihtovuoroinen
Otoskoko:29
Muuta:
Tagit: kuolemaan liittyvä ahdistus, masennus, psilosybiini
DOI:10.1177/0269881116675512
URL: http://journals.sagepub.com/doi/full/10.1177/0269881116675512


Classic hallucinogens in the treatment of addictions. (Bogenschutz MP, Johnson MW, 2016)
Julkaisu:Progress in Neuro-Psychopharmacology & Biological Psychiatry
Tiivistelmä: Addictive disorders are very common and have devastating individual and social consequences. Currently available treatment is moderately effective at best. After many years of neglect, there is renewed interest in potential clinical uses for classic hallucinogens in the treatment of addictions and other behavioral health conditions.

In this paper we provide a comprehensive review of both historical and recent clinical research on the use of classic hallucinogens in the treatment of addiction, selectively review other relevant research concerning hallucinogens, and suggest directions for future research. Clinical trial data are very limited except for the use of LSD in the treatment of alcoholism, where a meta-analysis of controlled trials has demonstrated a consistent and clinically significant beneficial effect of high-dose LSD.

Recent pilot studies of psilocybin-assisted treatment of nicotine and alcohol dependence had strikingly positive outcomes, but controlled trials will be necessary to evaluate the efficacy of these treatments. Although plausible biological mechanisms have been proposed, currently the strongest evidence is for the role of mystical or other meaningful experiences as mediators of therapeutic effects.

Classic hallucinogens have an excellent record of safety in the context of clinical research. Given our limited understanding of the clinically relevant effects of classic hallucinogens, there is a wealth of opportunities for research that could contribute important new knowledge and potentially lead to valuable new treatments for addiction.
Yhdiste:LSD
Aihe:addiktio
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit: alkoholismi, LSD
DOI:10.1016/j.pnpbp.2015.03.002
URL: https://www.sciencedirect.com/science/article/pii/S02785846150005...


Psychedelics. (Nichols DE, 2016)
Julkaisu:Pharmacological Reviews
Tiivistelmä: Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts

After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action.

Today there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed on apical dendrites of neocortical pyramidal cells in layer V. Several useful rodent models have been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics.

Recent and exciting developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybin-assisted psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently, blood oxygen level-dependent functional magnetic resonance imaging and magnetoencephalography have been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain's default mode network.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1124/pr.115.011478
URL: http://pharmrev.aspetjournals.org/content/68/2/264.long


The paradoxical psychological effects of lysergic acid diethylamide (LSD) (Carhart-Harris RL, Kaelen M, Bolstridge M, Williams TM, Will.., 2016)
Julkaisu:Psychological Medicine
Tiivistelmä: BACKGROUND:
Lysergic acid diethylamide (LSD) is a potent serotonergic hallucinogen or psychedelic that modulates consciousness in a marked and novel way. This study sought to examine the acute and mid-term psychological effects of LSD in a controlled study.

METHOD:
A total of 20 healthy volunteers participated in this within-subjects study. Participants received LSD (75 µg, intravenously) on one occasion and placebo (saline, intravenously) on another, in a balanced order, with at least 2 weeks separating sessions. Acute subjective effects were measured using the Altered States of Consciousness questionnaire and the Psychotomimetic States Inventory (PSI). A measure of optimism (the Revised Life Orientation Test), the Revised NEO Personality Inventory, and the Peter's Delusions Inventory were issued at baseline and 2 weeks after each session.

RESULTS:
LSD produced robust psychological effects; including heightened mood but also high scores on the PSI, an index of psychosis-like symptoms. Increased optimism and trait openness were observed 2 weeks after LSD (and not placebo) and there were no changes in delusional thinking.

CONCLUSIONS:
The present findings reinforce the view that psychedelics elicit psychosis-like symptoms acutely yet improve psychological wellbeing in the mid to long term. It is proposed that acute alterations in mood are secondary to a more fundamental modulation in the quality of cognition, and that increased cognitive flexibility subsequent to serotonin 2A receptor (5-HT2AR) stimulation promotes emotional lability during intoxication and leaves a residue of 'loosened cognition' in the mid to long term that is conducive to improved psychological wellbeing.
Yhdiste:LSD
Aihe:Yleiset vaikutukset
Menetelmät:Lumekontrolloitu, seuranta
Otoskoko:20
Muuta:
Tagit:
DOI:10.1017/S0033291715002901
URL: https://www.cambridge.org/core/journals/psychological-medicine/ar...


The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms. (Barrett FS, Bradstreet MP, Leoutsakos JS, Johnson MW, Griffi.., 2016)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Acute adverse psychological reactions to classic hallucinogens ("bad trips" or "challenging experiences"), while usually benign with proper screening, preparation, and support in controlled settings, remain a safety concern in uncontrolled settings (such as illicit use contexts). Anecdotal and case reports suggest potential adverse acute symptoms including affective (panic, depressed mood), cognitive (confusion, feelings of losing sanity), and somatic (nausea, heart palpitation) symptoms.

Responses to items from several hallucinogen-sensitive questionnaires (Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the Five-Dimensional Altered States of Consciousness questionnaire) in an Internet survey of challenging experiences with the classic hallucinogen psilocybin were used to construct and validate a Challenging Experience Questionnaire.

The stand-alone Challenging Experience Questionnaire was then validated in a separate sample. Seven Challenging Experience Questionnaire factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) provide a phenomenological profile of challenging aspects of experiences with psilocybin. Factor scores were associated with difficulty, meaningfulness, spiritual significance, and change in well-being attributed to the challenging experiences. The factor structure did not differ based on gender or prior struggle with anxiety or depression.

The Challenging Experience Questionnaire provides a basis for future investigation of predictors and outcomes of challenging experiences with classic hallucinogens.
Yhdiste:Psykedeelit yleisesti
Aihe:Yleiset vaikutukset
Menetelmät:Kyselytutkimus, kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881116678781
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881116678781


Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years. (Dos Santos RG, Osório FL, Crippa JA, Riba J, Zuardi AW, Hal.., 2016)
Julkaisu:Therapeutic Advances in Psychopharmacology
Tiivistelmä: To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties.

Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria.

Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents.

However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.
Yhdiste:LSD, psilosybiini, ayahuasca
Aihe:Masennus, addiktio
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/2045125316638008
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910400/


MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. (Danforth AL, Struble CM, Yazar-Klosinski B, Grob CS, 2016)
Julkaisu:Progress in Neuro-Psychopharmacology and Biological Psychiatry
Tiivistelmä: The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population.

Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations.

Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population.

As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, farmakologia, haitta-arvio, autismi
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1016/j.pnpbp.2015.03.011
URL: https://www.sciencedirect.com/science/article/pii/S02785846150006...


Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy. (Amoroso T, Workman M, 2016)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Since the wars in Iraq and Afghanistan, posttraumatic stress disorder (PTSD) has become a major area of research and development. The most widely accepted treatment for PTSD is prolonged exposure (PE) therapy, but for many patients it is intolerable or ineffective. ±3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has recently re-emerged as a new treatment option, with two clinical trials having been published and both producing promising results. However, these results have yet to be compared to existing treatments.

The present paper seeks to bridge this gap in the literature. Often the statistical significance of clinical trials is overemphasized, while the magnitude of the treatment effects is overlooked. The current meta-analysis aims to provide a comparison of the cumulative effect size of the MDMA-AP studies with those of PE. Effect sizes were calculated for primary and secondary outcome measures in the MDMA-AP clinical trials and compared to those of a meta-analysis including several PE clinical trials.

It was found that MDMA-AP had larger effect sizes in both clinician-observed outcomes than PE did (Hedges' g=1.17 vs. g=1.08, respectively) and patient self-report outcomes (Hedges' g=0.87 vs. g=0.77, respectively). The dropout rates of PE and MDMA-AP were also compared, revealing that MDMA-AP had a considerably lower percentage of patients dropping out than PE did. These results suggest that MDMA-AP offers a promising treatment for PTSD.
Yhdiste:MDMA
Aihe:Stressihäiriö, haitta-arvio
Menetelmät:Meta-analyysi, kaksoissokkoutettu, satunnaistettu, lumekontrolloitu
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881116642542
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881116642542


Classical hallucinogens and neuroimaging: A systematic review of human studies: Hallucinogens and neuroimaging. (Dos Santos RG, Osório FL, Crippa JAS, Hallak JEC, 2016)
Julkaisu:Neuroscience and Biobehavioural Reviews
Tiivistelmä: Serotonergic hallucinogens produce alterations of perceptions, mood, and cognition, and have anxiolytic, antidepressant, and antiaddictive properties. These drugs act as agonists of frontocortical 5-HT2A receptors, but the neural basis of their effects are not well understood. Thus, we conducted a systematic review of neuroimaging studies analyzing the effects of serotonergic hallucinogens in man.

Studies published in the PubMed, Lilacs, and SciELO databases until 12 April 2016 were included using the following keywords: "ayahuasca", "DMT", "psilocybin", "LSD", "mescaline" crossed one by one with the terms "mri", "fmri", "pet", "spect", "imaging" and "neuroimaging". Of 279 studies identified, 25 were included.

Acute effects included excitation of frontolateral/frontomedial cortex, medial temporal lobe, and occipital cortex, and inhibition of the default mode network. Long-term use was associated with thinning of the posterior cingulate cortex, thickening of the anterior cingulate cortex, and decreased neocortical 5-HT2A receptor binding.

Despite the high methodological heterogeneity and the small sample sizes, the results suggest that hallucinogens increase introspection and positive mood by modulating brain activity in the fronto-temporo-parieto-occipital cortex.
Yhdiste:Psykedeelit yleisesti, ayahuasca, psilosybiini, LSD
Aihe:Aivotutkimus, yleiset vaikutukset, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1016/j.neubiorev.2016.10.026
URL: https://www.sciencedirect.com/science/article/pii/S01497634163023...


The current state of research on ayahuasca: A systematic review of human studies assessing psychiatric symptoms, neuropsychological functioning, and neuroimaging. (Dos Santos RG, Balthazar FM, Bouso JC, Hallak JE, 2016)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: RATIONALE:
In recent decades, the use of ayahuasca (AYA) - a β-carboline- and dimethyltryptamine-rich hallucinogenic botanical preparation traditionally used by Northwestern Amazonian tribes for ritual and therapeutic purposes - has spread from South America to Europe and the USA, raising concerns about its possible toxicity and hopes of its therapeutic potential. Thus, it is important to analyze the acute, subacute, and long-term effects of AYA to assess its safety and toxicity.

OBJECTIVES:
The purpose of this study was to conduct a systematic review of human studies assessing AYA effects on psychiatric symptoms, neuropsychological functioning, and neuroimaging.

METHODS:
Papers published until 16 December 2015 were included from PubMed, LILACS and SciELO databases following a comprehensive search strategy and pre-determined set of criteria for article selection.

RESULTS:
The review included 28 full-text articles. Acute AYA administration was well tolerated, increased introspection and positive mood, altered visual perceptions, activated frontal and paralimbic regions and decreased default mode network activity. It also improved planning and inhibitory control and impaired working memory, and showed antidepressive and antiaddictive potentials. Long-term AYA use was associated with increased cortical thickness of the anterior cingulate cortex and cortical thinning of the posterior cingulate cortex, which was inversely correlated to age of onset, intensity of prior AYA use, and spirituality. Subacute and long-term AYA use was not associated with increased psychopathology or cognitive deficits, being associated with enhanced mood and cognition, increased spirituality, and reduced impulsivity.

CONCLUSIONS:
Acute, subacute, and long-term AYA use seems to have low toxicity. Preliminary studies about potential therapeutic effects of AYA need replication due to their methodological limitations.
Yhdiste:Ayahuasca
Aihe:Yleiset vaikutukset, aivotutkimus, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881116652578
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881116652578


Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study. (Sanches RF, de Lima Osório F, Dos Santos RG, Macedo LR, Mai.., 2016)
Julkaisu:Journal of Clinical Psychopharmacology
Tiivistelmä: Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow.

In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography.

Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake.

Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers.

Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.
Yhdiste:Ayahuasca
Aihe:Masennus, yleiset vaikutukset, aivotutkimus
Menetelmät:Open label, seuranta, SPECT
Otoskoko:17
Muuta:
Tagit:
DOI:10.1097/JCP.0000000000000436
URL: https://www.ncbi.nlm.nih.gov/pubmed/26650973


Antidepressive and anxiolytic effects of ayahuasca: a systematic literature review of animal and human studies.logical functioning, and neuroimaging. (Dos Santos RG, Osório FL, Crippa JA, Hallak JE, 2016)
Julkaisu:Revista brasileira de psiquiatria
Tiivistelmä: OBJECTIVE:
To conduct a systematic literature review of animal and human studies reporting anxiolytic or antidepressive effects of ayahuasca or some of its isolated alkaloids (dimethyltryptamine, harmine, tetrahydroharmine, and harmaline).

METHODS:
Papers published until 3 April 2015 were retrieved from the PubMed, LILACS and SciELO databases following a comprehensive search strategy and using a predetermined set of criteria for article selection.

RESULTS:
Five hundred and fourteen studies were identified, of which 21 met the established criteria. Studies in animals have shown anxiolytic and antidepressive effects of ayahuasca, harmine, and harmaline, and experimental studies in humans and mental health assessments of experienced ayahuasca consumers also suggest that ayahuasca is associated with reductions in anxiety and depressive symptoms. A pilot study reported rapid antidepressive effects of a single ayahuasca dose in six patients with recurrent depression.

CONCLUSION:
Considering the need for new drugs that produce fewer adverse effects and are more effective in reducing anxiety and depression symptomatology, the described effects of ayahuasca and its alkaloids should be further investigated.
Yhdiste:Ayahuasca
Aihe:Yleiset vaikutukset, masennus
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1590/1516-4446-2015-1701
URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-4446...


The use of illicit drugs as self-medication in the treatment of cluster headache: Results from an Italian online survey. (Di Lorenzo C, Coppola G, Di Lorenzo G, Bracaglia M, Rossi P,.., 2016)
Julkaisu:Cephalalgia
Tiivistelmä: BACKGROUND:
Cluster headache (CH) patients often receive unsatisfactory treatment and may explore illicit substances as alternatives. We aimed to explore this use of illicit drugs for CH treatment.

METHODS:
We invited CH patients from an Internet-based self-help group to complete a questionnaire regarding their therapeutic use of illicit substances.

RESULTS:
Of the 54 respondents, 29 were classified as chronic and 39 were drug-resistant cases. Fifty patients had previously tried subcutaneous sumatriptan, 40 had tried O2, and 48 had tried at least one prophylactic treatment. All 54 patients specified that they were dissatisfied with conventional treatments. Thirty-four patients had used cannabinoids, 13 cocaine, 8 heroin, 18 psilocybin, 12 lysergic acid amide (LSA), and 4 lysergic acid diethylamide (LSD).

DISCUSSION:
Some patients with intractable CH decided to try illicit drugs concomitantly with cessation of medical care. Most of these patients found suggestions for illicit drug use on the Internet. Many patients seemed to underestimate the judicial consequences of, and had an overestimated confidence in the safety of, such illicit treatments. Physicians are often not informed by patients of their choice to use illicit drugs. This leads to questions regarding the true nature of the physician-patient relationship among dissatisfied CH patients.
Yhdiste:LSD, psilosybiini
Aihe:Sarjoittainen päänsärky
Menetelmät:Kysely
Otoskoko:54
Muuta:
Tagit:
DOI:10.1177/0333102415583145
URL: http://journals.sagepub.com/doi/abs/10.1177/0333102415583145


Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study (Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa .., 2015)
Julkaisu:Journal of Psychopharmachology
Tiivistelmä: Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence.

We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions.

Participants’ responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p < 0.05). Gains were largely maintained at follow-up to 36 weeks. The intensity of effects in the first psilocybin session (at week 4) strongly predicted change in drinking during weeks 5–8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5.

There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms.
Yhdiste:psilosybiini
Aihe:addiktio
Menetelmät:Open label, seuranta
Otoskoko:10
Muuta:
Tagit: alkoholi, pilotti, psilosybiini, riippuvuus
DOI:10.1177/0269881114565144
URL: https://journals.sagepub.com/doi/abs/10.1177/0269881114565144


European rating of drug harms. (van Amsterdam J, Nutt D, Phillips L, van den Brink W, 2015)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: BACKGROUND:
The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms.

METHODS:
Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed criteria weights that would apply, on average, across the EU. Weighted averages of the scores provided a single, overall weighted harm score (range: 0-100) for each drug.

RESULTS:
Alcohol, heroin and crack emerged as the most harmful drugs (overall weighted harm score 72, 55 and 50, respectively). The remaining drugs had an overall weighted harm score of 38 or less, making them much less harmful than alcohol. The overall weighted harm scores of the EU experts correlated well with those previously given by the UK panel.

CONCLUSION:
The outcome of this study shows that the previous national rankings based on the relative harms of different drugs are endorsed throughout the EU. The results indicates that EU and national drug policy measures should focus on drugs with the highest overall harm, including alcohol and tobacco, whereas drugs such as cannabis and ecstasy should be given lower priority including a lower legal classification.
Yhdiste:päihteet yleisesti, LSD, psilosybiini, MDMA
Aihe:haitta-arvio
Menetelmät:Kirjallisuuskatsaus, asiantuntijalausunto
Otoskoko:0
Muuta:
Tagit: alkoholi, haitallisuusarvio, päihteet, tupakka
DOI:10.1177/0269881115581980
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881115581980


Acute Effects of Lysergic Acid Diethylamide in Healthy Subjects. (Schmid Y, Enzler F, Gasser P, Grouzmann E, Preller KH, Volle.., 2015)
Julkaisu:Biological Psychiatry
Tiivistelmä: BACKGROUND:
After no research in humans for >40 years, there is renewed interest in using lysergic acid diethylamide (LSD) in clinical psychiatric research and practice. There are no modern studies on the subjective and autonomic effects of LSD, and its endocrine effects are unknown. In animals, LSD disrupts prepulse inhibition (PPI) of the acoustic startle response, and patients with schizophrenia exhibit similar impairments in PPI. However, no data are available on the effects of LSD on PPI in humans.

METHODS:
In a double-blind, randomized, placebo-controlled, crossover study, LSD (200 μg) and placebo were administered to 16 healthy subjects (8 women, 8 men). Outcome measures included psychometric scales; investigator ratings; PPI of the acoustic startle response; and autonomic, endocrine, and adverse effects.

RESULTS:
Administration of LSD to healthy subjects produced pronounced alterations in waking consciousness that lasted 12 hours. The predominant effects induced by LSD included visual hallucinations, audiovisual synesthesia, and positively experienced derealization and depersonalization phenomena. Subjective well-being, happiness, closeness to others, openness, and trust were increased by LSD. Compared with placebo, LSD decreased PPI. LSD significantly increased blood pressure, heart rate, body temperature, pupil size, plasma cortisol, prolactin, oxytocin, and epinephrine. Adverse effects produced by LSD completely subsided within 72 hours. No severe acute adverse effects were observed.

CONCLUSIONS:
In addition to marked hallucinogenic effects, LSD exerts methylenedioxymethamphetamine-like empathogenic mood effects that may be useful in psychotherapy. LSD altered sensorimotor gating in a human model of psychosis, supporting the use of LSD in translational psychiatric research. In a controlled clinical setting, LSD can be used safely, but it produces significant sympathomimetic stimulation.
Yhdiste:LSD
Aihe:haitta-arvio, yleiset vaikutukset
Menetelmät:kaksoissokkoutettu, satunnaistettu, lumekontrolloitu, vaihtovuoroinen
Otoskoko:16
Muuta:
Tagit: LSD
DOI:10.1016/j.biopsych.2014.11.015
URL: https://www.biologicalpsychiatryjournal.com/article/S0006-3223(14...


The Psychopharmacology of ±3,4 Methylenedioxymethamphetamine and its Role in the Treatment of Posttraumatic Stress Disorder. (Amoroso T, 2015)
Julkaisu:Journal of Psychoactive Drugs
Tiivistelmä: Prior to 1985, ±3,4-methylenedioxymethamphetamine (MDMA) was readily used as a psychotherapeutic adjunct. As MDMA became popular in treating various psychiatric illnesses by mental health professionals, the public started to abuse the MDMA-containing recreational drug "ecstasy." This alarmed the DEA, which led to emergency scheduling of MDMA as a Schedule I drug. Due to its scheduling in 1985, human research and clinical use has been limited.

The majority of research on MDMA has been focused on the drug's potential harmful effects rather than its possible therapeutic effects. The limitations on retrospective human studies and preclinical animal models of MDMA neurotoxicity are examined in this analysis. New research has shown that MDMA, used as a catalyst in psychotherapy, is effective in treating posttraumatic stress disorder (PTSD).

This review also examines the psychopharmacological basis for the efficacy of MDMA-assisted psychotherapy. Specifically, the brain regions involved with both PTSD and those activated by MDMA (i.e., amygdala, anterior cingulate cortex, and hippocampus) are examined. Also, the possible neurochemical mechanisms involved in MDMA's efficacy in treating PTSD are reviewed.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, farmakologia, stressihäiriö
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1080/02791072.2015.1094156
URL: https://www.ncbi.nlm.nih.gov/pubmed/26579955


Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report. (Osório Fde L, Sanches RF, Macedo LR, Santos RG, Maia-de-Oli.., 2015)
Julkaisu:Revista Brasileira de Psiquiatria
Tiivistelmä: OBJECTIVES:
Ayahuasca (AYA), a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT) and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode.

METHODS:
Open-label trial conducted in an inpatient psychiatric unit.

RESULTS:
Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS). AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS) scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement.

CONCLUSIONS:
These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.
Yhdiste:Ayahuasca
Aihe:Masennus
Menetelmät:Open label, seuranta
Otoskoko:6
Muuta:
Tagit:
DOI:10.1590/1516-4446-2014-1496
URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-4446...


Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey. (Schindler EA, Gottschalk CH, Weil MJ, Shapiro RE, Wright DA,.., 2015)
Julkaisu:Journal of Psychoactive Drugs
Tiivistelmä: Cluster headache is one of the most debilitating pain syndromes. A significant number of patients are refractory to conventional therapies. The Clusterbusters.org medication use survey sought to characterize the effects of both conventional and alternative medications used in cluster headache.

Participants were recruited from cluster headache websites and headache clinics. The final analysis included responses from 496 participants. The survey was modeled after previously published surveys and was available online. Most responses were chosen from a list, though others were free-texted. Conventional abortive and preventative medications were identified and their efficacies agreed with those previously published.

The indoleamine hallucinogens, psilocybin, lysergic acid diethylamide, and lysergic acid amide, were comparable to or more efficacious than most conventional medications. These agents were also perceived to shorten/abort a cluster period and bring chronic cluster headache into remission more so than conventional medications. Furthermore, infrequent and non-hallucinogenic doses were reported to be efficacious.

Findings provide additional evidence that several indoleamine hallucinogens are rated as effective in treating cluster headache.

These data reinforce the need for further investigation of the effects of these and related compounds in cluster headache under experimentally controlled settings.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini
Aihe:Sarjoittainen päänsärky
Menetelmät:Kysely
Otoskoko:496
Muuta:
Tagit:
DOI:10.1080/02791072.2015.1107664
URL: https://www.ncbi.nlm.nih.gov/pubmed/26595349


Pilot Study of the 5-HT2AR Agonist Psilocybin in the Treatment of Tobacco Addiction (Johnson MW, Garcia-Romeu A, Cosimano MP, Griffiths RR, 2014)
Julkaisu:Journal of Psychopharmachology
Tiivistelmä: Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted.

To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol.

Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake.

Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%).

Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.
Yhdiste:psilosybiini
Aihe:addiktio
Menetelmät:Open label, seuranta
Otoskoko:15
Muuta:
Tagit: pilotti, psilosybiini, riippuvuus, tupakka
DOI:10.1177/0269881114548296
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881114548296


Psilocybin–summary of knowledge and new perspectives (Tylš F, Páleníček T, Horáček J, 2014)
Julkaisu:European Neuropsychopharmacology
Tiivistelmä: Psilocybin, a psychoactive alkaloid contained in hallucinogenic mushrooms, is nowadays given a lot of attention in the scientific community as a research tool for modeling psychosis as well as due to its potential therapeutic effects. However, it is also a very popular and frequently abused natural hallucinogen.

This review summarizes all the past and recent knowledge on psilocybin. It briefly deals with its history, discusses the pharmacokinetics and pharmacodynamics, and compares its action in humans and animals. It attempts to describe the mechanism of psychedelic effects and objectify its action using modern imaging and psychometric methods. Finally, it describes its therapeutic and abuse potential.
Yhdiste:psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit: farmakodynamiikka, farmakokinetiikka, psilosybiini
DOI:10.1016/j.euroneuro.2013.12.006
URL: https://www.ncbi.nlm.nih.gov/pubmed/24444771


Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. (Gasser P, Holstein D, Michel Y, Doblin R, Yazar-Klosinski B,.., 2014)
Julkaisu:The Journal of Nervous and Mental disease
Tiivistelmä: A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with life-threatening diseases.

Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 μg of LSD (n = 8) or 20 μg of LSD with an open-label crossover to 200 μg of LSD after the initial blinded treatment was unmasked (n = 4).

At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety (p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced (p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months.

These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted.
Yhdiste:LSD
Aihe:kuolemaan liittyvä ahdistus
Menetelmät:kaksoissokkoutettu, satunnaistettu, lumekontrolloitu, seuranta
Otoskoko:12
Muuta:
Tagit: LSD, pilotti
DOI:10.1097/NMD.0000000000000113
URL: https://journals.lww.com/jonmd/fulltext/2014/07000/Safety_and_Eff...


Psilocybin - summary of knowledge and new perspectives. (Tylš F, Páleníček T, Horáček J, 2014)
Julkaisu:European Neuropsychopharmacology
Tiivistelmä: Psilocybin, a psychoactive alkaloid contained in hallucinogenic mushrooms, is nowadays given a lot of attention in the scientific community as a research tool for modeling psychosis as well as due to its potential therapeutic effects. However, it is also a very popular and frequently abused natural hallucinogen.

This review summarizes all the past and recent knowledge on psilocybin. It briefly deals with its history, discusses the pharmacokinetics and pharmacodynamics, and compares its action in humans and animals. It attempts to describe the mechanism of psychedelic effects and objectify its action using modern imaging and psychometric methods. Finally, it describes its therapeutic and abuse potential.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1016/j.euroneuro.2013.12.006
URL: https://www.europeanneuropsychopharmacology.com/article/S0924-977...


The potential dangers of using MDMA for psychotherapy. (Parrott AC, 2014)
Julkaisu:Journal of Psychoactive Drugs
Tiivistelmä: MDMA has properties that may make it attractive for psychotherapy, although many of its effects are potentially problematic. These contrasting effects will be critically reviewed in order to assess whether MDMA could be safe for clinical usage. Early studies from the 1980s noted that MDMA was an entactogen, engendering feelings of love and warmth. However, negative experiences can also occur with MDMA since it is not selective in the thoughts or emotions it releases. This unpredictability in the psychological material released is similar to another serotonergic drug, LSD. Acute MDMA has powerful neurohormonal effects, increasing cortisol, oxytocin, testosterone, and other hormone levels. The release of oxytocin may facilitate psychotherapy, whereas cortisol may increase stress and be counterproductive. MDMA administration is followed by a period of neurochemical recovery, when low serotonin levels are often accompanied by lethargy and depression. Regular usage can also lead to serotonergic neurotoxicity, memory problems, and other psychobiological problems. Proponents of MDMA-assisted therapy state that it should only be used for reactive disorders (such as PTSD) since it can exacerbate distress in those with a prior psychiatric history. Overall, many issues need to be considered when debating the relative benefits and dangers of using MDMA for psychotherapy.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, haitta-arvio
Menetelmät:Kirjallisuuskatsaus, asiantuntijalausunto
Otoskoko:0
Muuta:
Tagit:
DOI:10.1080/02791072.2014.873690
URL: https://www.ncbi.nlm.nih.gov/pubmed/24830184


Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. (Garcia-Romeu A, Griffiths RR, Johnson MW, 2014)
Julkaisu:Current Drug Abuse Reviews
Tiivistelmä: Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation.

Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions.

These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.
Yhdiste:Psilosybiini
Aihe:Addiktio
Menetelmät:Open label, seuranta
Otoskoko:15
Muuta:Jatkotutkimus tutkimuksesta Johnson ym. 2014
Tagit:
DOI:-
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342293/


Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after ±3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study (Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Martin SF, .., 2013)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011).

All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months after the original study's final MDMA session (mean = 45.4; SD = 17.3). Our primary outcome measure used was the Clinician-Administered PTSD Scale (CAPS). Secondary outcome measures were the Impact of Events Scale-Revised (IES-R) and the Neuroticism Extroversion Oppenness Personality Inventory-Revised (NEO PI-R) Personality Inventory.

We also collected a long-term follow-up questionnaire. Results for the 16 CAPS completers showed there were no statistical differences between mean CAPS score at LTFU (mean = 23.7; SD = 22.8) (t (matched) = 0.1; df = 15, p = 0.91) and the mean CAPS score previously obtained at Study Exit (mean = 24.6, SD = 18.6).

On average, subjects maintained statistically and clinically-significant gains in symptom relief, although two of these subjects did relapse. It was promising that we found the majority of these subjects with previously severe PTSD who were unresponsive to existing treatments had symptomatic relief provided by MDMA-assisted psychotherapy that persisted over time, with no subjects reporting harm from participation in the study.
Yhdiste:MDMA
Aihe:stressihäiriö
Menetelmät:Seuranta
Otoskoko:16
Muuta:Seurantatutkimus tutkimuksesta Mithoefer ym. (2011)
Tagit: MDMA, PTSD
DOI:10.1177/0269881112456611
URL: https://www.researchgate.net/publication/233746130_Durability_of_...


A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD). (Oehen P, Traber R, Widmer V, Schnyder U, 2013)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988–1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results.

Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups.

We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016).
Yhdiste:MDMA
Aihe:stressihäiriö
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, satunnaistettu, seuranta
Otoskoko:12
Muuta:
Tagit: MDMA, PTSD
DOI:10.1177/0269881112464827
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881112464827


Psychedelics and Mental Health: A Population Study (Krebs TS & Johansen PØ, 2013)
Julkaisu:PLoS One
Tiivistelmä: BACKGROUND:
The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline.

OBJECTIVE:
To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population.

METHOD:
Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events.

RESULTS:
21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems.

CONCLUSION:
We did not find use of psychedelics to be an independent risk factor for mental health problems.
Yhdiste:psykedeelit yleisesti, LSD, psilosybiini
Aihe:päihdekäyttö, haitta-arvio
Menetelmät:National Survey on Drug Use and Health 2001-2004
Otoskoko:130152
Muuta:
Tagit: mielenterveys, psykedeelit
DOI:10.1371/journal.pone.0063972
URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone....


Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. (Krebs TS, Johansen PØ, 2012)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Assessments of lysergic acid diethylamide (LSD) in the treatment of alcoholism have not been based on quantitative meta-analysis. Hence, we performed a meta-analysis of randomized controlled trials in order to evaluate the clinical efficacy of LSD in the treatment of alcoholism. Two reviewers independently extracted the data, pooling the effects using odds ratios (ORs) by a generic inverse variance, random effects model. We identified six eligible trials, including 536 participants.

There was evidence for a beneficial effect of LSD on alcohol misuse (OR, 1.96; 95% CI, 1.36-2.84; p = 0.0003). Between-trial heterogeneity for the treatment effects was negligible (I² = 0%). Secondary outcomes, risk of bias and limitations are discussed. A single dose of LSD, in the context of various alcoholism treatment programs, is associated with a decrease in alcohol misuse.
Yhdiste:LSD
Aihe:addiktio
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881112439253
URL: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0048020/


The safety and efficacy of 3,4-methylenedioxymethamphetamine- assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study (Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Doblin R, 2011)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Case reports indicate that psychiatrists administered 3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as ‘Ecstasy’ resulted in its criminalization in 1985.

Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy.

The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed.

After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline.

The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.
Yhdiste:MDMA
Aihe:stressihäiriö
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, satunnaistettu, seuranta
Otoskoko:20
Muuta:
Tagit: MDMA, PTSD
DOI:10.1177/0269881110378371
URL: http://journals.sagepub.com/doi/full/10.1177/0269881110378371


Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer (Grob CS, Danforth AL, Chopra GS, Hagerty M, McKay CR, Halber.., 2011)
Julkaisu:Archives of General Psychiatry
Tiivistelmä: Tarkoitus: Tutkimuksessa arvioidaan hallusinogeenien kliinistä soveltuvuutta ahdistuksen hoitoon, joka on syntynyt reaktiona pitkälle edenneeseen syöpään.

Koeasetelma: Psilosybiinin (0.2 mg/kg) tehoa ja turvallisuutta tutkittiin plasebokontrolloidulla kaksoissokko asetelmalla, jossa koehenkilöt toimivat omana kontrollinaan.

Koehenkilöt: 12 pitkälle edennyttä syöpää sairastavaa aikuista, joilla on myös kuolemaan liittyvää ahdistusta.

Käytetyt mittarit: Koehenkilöiden kehon lämpötilaa ja verenapainetta mitattiin kokeen aikana ja sitä ennen. Seurantamittaukset sisälsivät BDI (Beck Depression Inventory), POMS (Profile of Mood States) ja STAI (State-Trait Anxiety Inventory) asteikot, joihin koehenkilöt vastasivat sokkoutuksen purkamisen jälkeen kuuden kuukauden ajan.

Tulokset: Fysiologisten vasteiden ja psykologisten mittausten perusteella arvioituna hoito vaikutti turvalliselta. Psilosybiini ei aiheuttanut koehenkilöille kliinisesti merkittävää haittaa. Koehenkilöiden ahdistustaipumuksessa havaittiin tilastollisesti merkitsevää laskua 1 ja 3 kuukautta hoidon jälkeen. BDI:llä mitattuna koehenkilöiden mielialassa havaittiin tilastollisesti merkitsevää kohenemista kuusi kuukautta hoidon jälkeen. Myös POMS mittauksissa havaittiin koehenkilöiden mielialan kohenemista, joka ei kuitenkaan ollut tilastollisesti merkitsevää.

Johtopäätökset: Tämä tutkimus osoitti psilosybiinin annostelun olevan turvallista ja soveltuvaa pitkälle edenneestä syövästä sairastuneilla potilailla, joilla on kuolemaan liittyvää ahdistusta. Osa aineistosta viittasi positiivisiin muutoksiin koehenkilöiden mielialassa ja ahdistuneisuudessa. Tulosten valossa lisätutkimus vaikuttaa perustellulta tällä pitkään sivuutetulla alalla.
Yhdiste:psilosybiini
Aihe:kuolemaan liittyvä ahdistus
Menetelmät:kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:12
Muuta:
Tagit: kuolemaan liittyvä ahdistus, masennus, psilosybiini
DOI:10.1001/archgenpsychiatry.2010.116
URL: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/210962


Decoding the signaling of a GPCR heteromeric complex reveals a unifying mechanism of action of antipsychotic drugs. (Fribourg M, Moreno JL, Holloway T, Provasi D, Baki L, Mahaja.., 2011)
Julkaisu:Cell
Tiivistelmä: Klassiset serotonergiset psykedeelit aktivoivat 5-HT2A serotoniinireseptorin tavalla, joka heteromerisöi sen metabotrooppisen glutamaattisereptorin (mGluR2) kanssa, salvaten sen toiminnan. Reseptorikompleksin muodostuminen on olennainen psykedeelisille vaikutuksille, koska 5-HT2A agonistit, jotka eivät samalla salpaa mGlu-reseptoreita eivät myöskään tuota psykedeeleille tyypillisiä vaikutuksia.
Yhdiste:psykedeelit yleisesti
Aihe:aivotutkimus
Menetelmät:In vitro
Otoskoko:0
Muuta:
Tagit: 5-HT2A, psykedeelit, toimintamekanismi
DOI:10.1016/j.cell.2011.09.055
URL: https://www.cell.com/cell/fulltext/S0092-8674(11)01272-4


Harm potential of magic mushroom use: a review. (van Amsterdam J, Opperhuizen A, van den Brink W, 2011)
Julkaisu:Regulatory Toxicology and Pharmacology
Tiivistelmä: In 2007, the Minister of Health of the Netherlands requested the CAM (Coordination point Assessment and Monitoring new drugs) to assess the overall risk of magic mushrooms.

The present paper is an updated redraft of the review, written to support the assessment by CAM experts. It summarizes the literature on physical or psychological dependence, acute and chronic toxicity, risk for public health and criminal aspects related to the consumption of magic mushrooms.

In the Netherlands, the prevalence of magic mushroom use was declining since 2000 (last year prevalence of 6.3% in 2000 to 2.9% in 2005), and further declined after possession and use became illegal in December 2008. The CAM concluded that the physical and psychological dependence potential of magic mushrooms was low, that acute toxicity was moderate, chronic toxicity low and public health and criminal aspects negligible. The combined use of mushrooms and alcohol and the quality of the setting in which magic mushrooms are used deserve, however, attention.

In conclusion, the use of magic mushrooms is relatively safe as only few and relatively mild adverse effects have been reported. The low prevalent but unpredictable provocation of panic attacks and flash-backs remain, however, a point of concern.
Yhdiste:psilosybiini
Aihe:päihdekäyttö, haitta-arvio
Menetelmät:Asiantuntijalausunto, seuranta
Otoskoko:0
Muuta:
Tagit: haitallisuusarvio, psilosybiini
DOI:10.1016/j.yrtph.2011.01.006
URL: https://www.ncbi.nlm.nih.gov/pubmed/21256914


Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies. Journal of Psychopharmacology (Studerus E, Kometer M, Hasler F, Vollenweider FX, 2011)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Psilocybin and related hallucinogenic compounds are increasingly used in human research. However, due to limited information about potential subjective side effects, the controlled medical use of these compounds has remained controversial.

We therefore analysed acute, short- and long-term subjective effects of psilocybin in healthy humans by pooling raw data from eight double-blind placebo-controlled experimental studies conducted between 1999 and 2008. The analysis included 110 healthy subjects who had received 1-4 oral doses of psilocybin (45-315 µg/kg body weight). Although psilocybin dose-dependently induced profound changes in mood, perception, thought and self-experience, most subjects described the experience as pleasurable, enriching and non-threatening. Acute adverse drug reactions, characterized by strong dysphoria and/or anxiety/panic, occurred only in the two highest dose conditions in a relatively small proportion of subjects.

All acute adverse drug reactions were successfully managed by providing interpersonal support and did not need psychopharmacological intervention. Follow-up questionnaires indicated no subsequent drug abuse, persisting perception disorders, prolonged psychosis or other long-term impairment of functioning in any of our subjects.

The results suggest that the administration of moderate doses of psilocybin to healthy, high-functioning and well-prepared subjects in the context of a carefully monitored research environment is associated with an acceptable level of risk.
Yhdiste:psilosybiini
Aihe:haitta-arvio
Menetelmät:Kirjallisuuskatsaus
Otoskoko:110
Muuta:
Tagit: psilosybiini
DOI:10.1177/0269881110382466
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881110382466


Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects. (Griffiths RR, Johnson MW, Richards WA, Richards BD, McCann U.., 2011)
Julkaisu:Psychopharmacology
Tiivistelmä: RATIONALE:
This dose-effect study extends previous observations showing that psilocybin can occasion mystical-type experiences having persisting positive effects on attitudes, mood, and behavior.

OBJECTIVES:
This double-blind study evaluated psilocybin (0, 5, 10, 20, 30 mg/70 kg, p.o.) administered under supportive conditions.

METHODS:
Participants were 18 adults (17 hallucinogen-naïve). Five 8-h sessions were conducted individually for each participant at 1-month intervals. Participants were randomized to receive the four active doses in either ascending or descending order (nine participants each). Placebo was scheduled quasi-randomly. During sessions, volunteers used eyeshades and were instructed to direct their attention inward. Volunteers completed questionnaires assessing effects immediately after and 1 month after each session, and at 14 months follow-up.

RESULTS:
Psilocybin produced acute perceptual and subjective effects including, at 20 and/or 30 mg/70 kg, extreme anxiety/fear (39% of volunteers) and/or mystical-type experience (72% of volunteers). One month after sessions at the two highest doses, volunteers rated the psilocybin experience as having substantial personal and spiritual significance, and attributed to the experience sustained positive changes in attitudes, mood, and behavior, with the ascending dose sequence showing greater positive effects. At 14 months, ratings were undiminished and were consistent with changes rated by community observers. Both the acute and persisting effects of psilocybin were generally a monotonically increasing function of dose, with the lowest dose showing significant effects.

CONCLUSIONS:
Under supportive conditions, 20 and 30 mg/70 kg psilocybin occasioned mystical-type experiences having persisting positive effects on attitudes, mood, and behavior. Implications for therapeutic trials are discussed.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:18
Muuta:
Tagit:
DOI:10.1007/s00213-011-2358-5
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308357/


Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. (MacLean KA, Johnson MW, Griffiths RR, 2011)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: A large body of evidence, including longitudinal analyses of personality change, suggests that core personality traits are predominantly stable after age 30. To our knowledge, no study has demonstrated changes in personality in healthy adults after an experimentally manipulated discrete event.

Intriguingly, double-blind controlled studies have shown that the classic hallucinogen psilocybin occasions personally and spiritually significant mystical experiences that predict long-term changes in behaviors, attitudes and values. In the present report we assessed the effect of psilocybin on changes in the five broad domains of personality - Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness.

Consistent with participant claims of hallucinogen-occasioned increases in aesthetic appreciation, imagination, and creativity, we found significant increases in Openness following a high-dose psilocybin session. In participants who had mystical experiences during their psilocybin session, Openness remained significantly higher than baseline more than 1 year after the session.

The findings suggest a specific role for psilocybin and mystical-type experiences in adult personality change.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:Kirjallisuuskatsaus, kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881111420188
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3537171/


The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. (Vollenweider FX, Kometer M, 2010)
Julkaisu:Nature Reviews. Neuroscience.
Tiivistelmä: After a pause of nearly 40 years in research into the effects of psychedelic drugs, recent advances in our understanding of the neurobiology of psychedelics, such as lysergic acid diethylamide (LSD), psilocybin and ketamine have led to renewed interest in the clinical potential of psychedelics in the treatment of various psychiatric disorders. Recent behavioural and neuroimaging data show that psychedelics modulate neural circuits that have been implicated in mood and affective disorders, and can reduce the clinical symptoms of these disorders. These findings raise the possibility that research into psychedelics might identify novel therapeutic mechanisms and approaches that are based on glutamate-driven neuroplasticity.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini
Aihe:Yleiset vaikutukset, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1038/nrn2884
URL: https://www.nature.com/articles/nrn2884


Human hallucinogen research: guidelines for safety. (Johnson M, Richards W, Griffiths R, 2008)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: There has recently been a renewal of human research with classical hallucinogens (psychedelics). This paper first briefly discusses the unique history of human hallucinogen research, and then reviews the risks of hallucinogen administration and safeguards for minimizing these risks.

Although hallucinogens are relatively safe physiologically and are not considered drugs of dependence, their administration involves unique psychological risks. The most likely risk is overwhelming distress during drug action ('bad trip'), which could lead to potentially dangerous behaviour such as leaving the study site. Less common are prolonged psychoses triggered by hallucinogens.

Safeguards against these risks include the exclusion of volunteers with personal or family history of psychotic disorders or other severe psychiatric disorders, establishing trust and rapport between session monitors and volunteer before the session, careful volunteer preparation, a safe physical session environment and interpersonal support from at least two study monitors during the session. Investigators should probe for the relatively rare hallucinogen persisting perception disorder in follow-up contact.

Persisting adverse reactions are rare when research is conducted along these guidelines. Incautious research may jeopardize participant safety and future research. However, carefully conducted research may inform the treatment of psychiatric disorders, and may lead to advances in basic science.
Yhdiste:Psykedeelit yleisesti, LSD, psilosybiini
Aihe:Haitta-arvio
Menetelmät:Kirjallisuuskatsaus, asiantuntijalausunto
Otoskoko:0
Muuta:
Tagit:
DOI:10.1177/0269881108093587
URL: http://journals.sagepub.com/doi/abs/10.1177/0269881108093587


Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. (Griffiths R, Richards W, Johnson M, McCann U, Jesse R, 2008)
Julkaisu:Journal of Psychopharmacology
Tiivistelmä: Psilocybin has been used for centuries for religious purposes; however, little is known scientifically about its long-term effects. We previously reported the effects of a double-blind study evaluating the psychological effects of a high psilocybin dose.

This report presents the 14-month follow-up and examines the relationship of the follow-up results to data obtained at screening and on drug session days. Participants were 36 hallucinogen-naïve adults reporting regular participation in religious/ spiritual activities. Oral psilocybin (30 mg/70 kg) was administered on one of two or three sessions, with methylphenidate (40 mg/70 kg) administered on the other session(s).

During sessions, volunteers were encouraged to close their eyes and direct their attention inward. At the 14-month follow-up, 58% and 67%, respectively, of volunteers rated the psilocybin-occasioned experience as being among the five most personally meaningful and among the five most spiritually significant experiences of their lives; 64% indicated that the experience increased well-being or life satisfaction; 58% met criteria for having had a 'complete' mystical experience. Correlation and regression analyses indicated a central role of the mystical experience assessed on the session day in the high ratings of personal meaning and spiritual significance at follow-up. Of the measures of personality, affect, quality of life and spirituality assessed across the study, only a scale measuring mystical experience showed a difference from screening.

When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences that, at 14-month follow-up, were considered by volunteers to be among the most personally meaningful and spiritually significant of their lives.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:36
Muuta:Seurantatutkimus tutkimuksesta Griffiths ym. (2006).
Tagit:
DOI:10.1177/0269881108094300
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050654/


The pharmacology of lysergic acid diethylamide: a review. (Passie T, Halpern JH, Stichtenoth DO, Emrich HM, Hintzen A, 2008)
Julkaisu:CNS Neuroscience & Therapeutics
Tiivistelmä: Lysergic acid diethylamide (LSD) was synthesized in 1938 and its psychoactive effects discovered in 1943. It was used during the 1950s and 1960s as an experimental drug in psychiatric research for producing so-called "experimental psychosis" by altering neurotransmitter system and in psychotherapeutic procedures ("psycholytic" and "psychedelic" therapy). From the mid 1960s, it became an illegal drug of abuse with widespread use that continues today. With the entry of new methods of research and better study oversight, scientific interest in LSD has resumed for brain research and experimental treatments.

Due to the lack of any comprehensive review since the 1950s and the widely dispersed experimental literature, the present review focuses on all aspects of the pharmacology and psychopharmacology of LSD. A thorough search of the experimental literature regarding the pharmacology of LSD was performed and the extracted results are given in this review. (Psycho-) pharmacological research on LSD was extensive and produced nearly 10,000 scientific papers.

The pharmacology of LSD is complex and its mechanisms of action are still not completely understood. LSD is physiologically well tolerated and psychological reactions can be controlled in a medically supervised setting, but complications may easily result from uncontrolled use by layman. Actually there is new interest in LSD as an experimental tool for elucidating neural mechanisms of (states of) consciousness and there are recently discovered treatment options with LSD in cluster headache and with the terminally ill.
Yhdiste:LSD
Aihe:Yleiset vaikutukset
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1111/j.1755-5949.2008.00059.x
URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1755-5949.2008....


MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder. (Bouso JC, Doblin R, Farré M, Alcázar MA, Gómez-Jarabo G, 2008)
Julkaisu:Journal of Psychoactive Drugs
Tiivistelmä: The purpose of this study was to investigate the safety of different doses of MDMA-assisted psychotherapy administered in a psychotherapeutic setting to women with chronic PTSD secondary to a sexual assault, and also to obtain preliminary data regarding efficacy. Although this study was originally planned to include 29 subjects, political pressures led to the closing of the study before it could be finished, at which time only six subjects had been treated. Preliminary results from those six subjects are presented here. We found that low doses of MDMA (between 50 and 75 mg) were both psychologically and physiologically safe for all the subjects. Future studies in larger samples and using larger doses are needed in order to further clarify the safety and efficacy of MDMA in the clinical setting in subjects with PTSD.
Yhdiste:MDMA
Aihe:stressihäiriö
Menetelmät:Kaksoissokkoutettu, satunnaistettu, lumekontrolloitum seuranta
Otoskoko:6
Muuta:
Tagit:
DOI:10.1080/02791072.2008.10400637
URL: https://www.ncbi.nlm.nih.gov/pubmed/19004414


Flashback to the 1960s: LSD in the treatment of autism (Sigafoos J, Green VA, Edrisinha C, Lancioni GE, 2007)
Julkaisu:Developmental Neurorehabilitation
Tiivistelmä: Between 1959 and 1974, several groups of researchers issued reports on the use of d-Lysergic Acid Diethylamide (LSD) in the treatment of children with autism. This paper reviews that literature to consider how the authors justified these studies, as well as their methods, results, and conclusions. The justification for using LSD was often based on the default logic that other treatment efforts had failed. Several positive outcomes were reported with the use of LSD, but most of these studies lacked proper experimental controls and presented largely narrative/descriptive data. Today there is renewed interest in the use of psychedelic drugs for therapeutic purposes. While this resurgence of research has not yet included children with autism, this review of the LSD studies from the 1960s and 1970s offers important lessons for future efforts to evaluate new or controversial treatments for children with autism.
Yhdiste:MDMA
Aihe:Autismi
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:-
URL: https://www.ncbi.nlm.nih.gov/pubmed/17608329


Response of cluster headache to psilocybin and LSD. (Sewell RA, Halpern JH, Pope HG Jr., 2006)
Julkaisu:Neurology
Tiivistelmä: The authors interviewed 53 cluster headache patients who had used psilocybin or lysergic acid diethylamide (LSD) to treat their condition. Twenty-two of 26 psilocybin users reported that psilocybin aborted attacks; 25 of 48 psilocybin users and 7 of 8 LSD users reported cluster period termination; 18 of 19 psilocybin users and 4 of 5 LSD users reported remission period extension. Research on the effects of psilocybin and LSD on cluster headache may be warranted.
Yhdiste:LSD, psilosybiini
Aihe:Sarjoittainen päänsärky
Menetelmät:Haastattelu
Otoskoko:53
Muuta:
Tagit:
DOI:10.1212/01.wnl.0000219761.05466.43
URL: http://n.neurology.org/content/66/12/1920.long


Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. (Griffiths RR, Richards WA, McCann U, Jesse R, 2006)
Julkaisu:Psychopharmacology
Tiivistelmä: RATIONALE:
Although psilocybin has been used for centuries for religious purposes, little is known scientifically about its acute and persisting effects.

OBJECTIVES:
This double-blind study evaluated the acute and longer-term psychological effects of a high dose of psilocybin relative to a comparison compound administered under comfortable, supportive conditions.

MATERIALS AND METHODS:
The participants were hallucinogen-naïve adults reporting regular participation in religious or spiritual activities. Two or three sessions were conducted at 2-month intervals. Thirty volunteers received orally administered psilocybin (30 mg/70 kg) and methylphenidate hydrochloride (40 mg/70 kg) in counterbalanced order. To obscure the study design, six additional volunteers received methylphenidate in the first two sessions and unblinded psilocybin in a third session. The 8-h sessions were conducted individually. Volunteers were encouraged to close their eyes and direct their attention inward. Study monitors rated volunteers' behavior during sessions. Volunteers completed questionnaires assessing drug effects and mystical experience immediately after and 2 months after sessions. Community observers rated changes in the volunteer's attitudes and behavior.

RESULTS:
Psilocybin produced a range of acute perceptual changes, subjective experiences, and labile moods including anxiety. Psilocybin also increased measures of mystical experience. At 2 months, the volunteers rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior consistent with changes rated by community observers.

CONCLUSIONS:
When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences. The ability to occasion such experiences prospectively will allow rigorous scientific investigations of their causes and consequences.
Yhdiste:Psilosybiini
Aihe:Yleiset vaikutukset
Menetelmät:kaksoissokkoutettu, lumekontrolloitu, seuranta
Otoskoko:30
Muuta:
Tagit:
DOI:10.1007/s00213-006-0457-5
URL: https://link.springer.com/article/10.1007%2Fs00213-006-0457-5


A review of the acute subjective effects of MDMA/ecstasy. (Baylen CA, Rosenberg H, 2006)
Julkaisu:Addiction
Tiivistelmä: AIM:
Although several relatively recent reviews have summarized the neuropsychiatric effects associated with chronic ecstasy use, there is no published comprehensive review of studies on the acute subjective effects (ASEs) of MDMA/ecstasy.

DESIGN:
The present study reviewed the prevalence, intensity and duration of ASEs collected from 24 studies that provided frequency data on the prevalence of self-reported ecstasy effects and/or provided data on the intensity of ecstasy effects.

FINDINGS:
Although hundreds of ASEs have been reported following MDMA consumption, we identified a subset of effects reported repeatedly by meaningful proportions and large numbers of participants across multiple investigations, most of which were either emotional (e.g. anxiety, depression, closeness, fear, euphoria, calmness) or somatic (e.g. nausea/vomiting, bruxism, muscle aches/headache, sweating, numbness, body temperature changes, fatigue, dizziness, dry mouth, increased energy). Only one sexual ASE (sexual arousal/increased sensual awareness), one cognitive ASE (confused thought), one sensory-perceptual ASE (visual effects/changes in visual perception), one sleep-related ASE (sleeplessness) and one appetite-related ASE (decreased appetite) were reported across five or more investigations. Three factors-number of hours between ingestion and assessment, dose level, and gender-have been associated with the acute subjective experience of MDMA/ecstasy.

CONCLUSIONS:
This review provides useful information for clinicians and researchers who want to understand the desirable and undesirable ASEs that may motivate and restrain ecstasy use, for public health advocates who seek to reduce biomedical harms (e.g. fainting, dehydration, shortness of breath, bruxism) associated with recreational use of MDMA/ecstasy, and for educators who wish to design credible prevention messages that neither underestimate nor exaggerate users' experiences of this drug.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, päihdekäyttö
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:10.1111/j.1360-0443.2006.01423.x
URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2006....


Human pharmacology of MDMA: pharmacokinetics, metabolism, and disposition. (de la Torre R, Farré M, Roset PN, Pizarro N, Abanades S, Se.., 2004)
Julkaisu:Therapeutic Drug Monitoring
Tiivistelmä: MDMA (3,4-methylenedioxymethamphetamine, ecstasy) is a widely misused psychostimulant drug abused among large segments of the young population. Pharmacologically it displays effects related to amphetamine-type drugs and a set of distinctive effects (closeness to others, facilitation to interpersonal relationship, and empathy) that have been named by some authors "entactogen" properties. MDMA is a potent releaser and/or reuptake inhibitor of presynaptic serotonin (5-HT), dopamine (DA), and norepinephrine (NE). These actions result from the interaction of MDMA with the membrane transporters involved in neurotransmitter reuptake and vesicular storage systems.

The most frequent effects after MDMA/ecstasy administration are euphoria, well-being, happiness, stimulation, increased energy, extroversion, feeling close to others, increased empathy, increased sociability, enhanced mood, mild perceptual disturbances, changed perception of colors and sounds, somatic symptoms related to its cardiovascular and autonomic effects (blood pressure and heart rate increase, mydriasis), and moderate derealization but not hallucinations. Acute toxic effects are related to its pharmacologic actions. The serotonin syndrome (increased muscle rigidity, hyperreflexia, and hyperthermia), among others, is characteristic of acute toxicity episodes.

MDMA metabolism is rather complex and includes 2 main metabolic pathways: (1) O-demethylenation followed by catechol-O-methyltransferase (COMT)-catalyzed methylation and/or glucuronide/sulfate conjugation; and (2) N-dealkylation, deamination, and oxidation to the corresponding benzoic acid derivatives conjugated with glycine. The fact that the polymorphic enzyme CYP2D6 partially regulates the O-demethylenation pathway prompted some expectations that subjects displaying the poor metabolizer phenotype may be at higher risk of acute toxicity episodes. In this metabolic pathway a mechanism-based inhibition of the enzyme operates because the formation of an enzyme-metabolite complex that renders all subjects, independently of genotype, phenotypically poor metabolizers after the administration of 2 consecutive doses. Therefore, the impact of CYP2D6 pharmacogenetics on acute toxicity is limited. One of the interesting features of MDMA metabolism is its potential involvement in the development of mid- to long-term neurotoxic effects as a result of progressive neurodegeneration of the serotonergic neurotransmission system.
Yhdiste:MDMA
Aihe:Yleiset vaikutukset, farmakologia
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit:
DOI:-
URL: https://insights.ovid.com/pubmed?pmid=15228154


The pharmacology of psilocybin. (Passie T, Seifert J, Schneider U, Emrich HM, 2002)
Julkaisu:Addiction Biology
Tiivistelmä: Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) is the major psychoactive alkaloid of some species of mushrooms distributed worldwide. These mushrooms represent a growing problem regarding hallucinogenic drug abuse. Despite its experimental medical use in the 1960s, only very few pharmacological data about psilocybin were known until recently. Because of its still growing capacity for abuse and the widely dispersed data this review presents all the available pharmacological data about psilocybin.
Yhdiste:psilosybiini
Aihe:yleiset vaikutukset
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit: kirjallisuuskatsaus, psilosybiini
DOI:10.1080/1355621021000005937
URL: https://www.ncbi.nlm.nih.gov/pubmed/14578010


Toward a comparative overview of dependence potential and acute toxicity of psychoactive substances used nonmedically (Gable RS, 1993)
Julkaisu:The American Journal of Drug and Alcohol Abuse
Tiivistelmä: A procedure is outlined for comparing dependence potential and acute toxicity across a broad range of abused psychoactive substances. Tentative results, based on an extensive literature review of 20 substances, suggested that the margin of safety ("therapeutic index") varied dramatically between substances.

Intravenous heroin appeared to have the greatest risk of dependence and acute lethality; oral psilocybin appeared to have the least. Hazards due to behavioral deficits, perceptual distortion, or chronic illness were not factored into the assessments.
Yhdiste:päihteet yleisesti
Aihe:haitta-arvio
Menetelmät:Kirjallisuuskatsaus
Otoskoko:0
Muuta:
Tagit: haitallisuusarvio, päihteet, psilosybiini
DOI:-
URL: https://www.ncbi.nlm.nih.gov/pubmed/8213692