Tieteelliset julkaisut

Tulokset kategoriasta tagi hakusanalla pilotti. Takaisin


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


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 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...


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...