Tieteelliset julkaisut

Tulokset kategoriasta aihe hakusanalla masennus. Takaisin

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.
Aihe:Yleiset vaikutukset, masennus
Menetelmät:Open label, seuranta, haastattelu, kysely
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
URL: https://www.sciencedirect.com/science/article/pii/S02785846173063...

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.
Aihe:kuolemaan liittyvä ahdistus, masennus
Menetelmät:vaihtovuoroinen, kaksoissokkoutettu, lumekontrolloitu, seuranta
Tagit: kuolemaan liittyvä ahdistus, masennus, psilosybiini
URL: http://journals.sagepub.com/doi/pdf/10.1177/0269881116675513

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).

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.

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.

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.
Aihe:Yleiset vaikutukset, masennus
URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-4446...

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.
Aihe:kuolemaan liittyvä ahdistus, masennus
Menetelmät:Kaksoissokkoutettu, lumekontrolloitu, vaihtovuoroinen
Tagit: kuolemaan liittyvä ahdistus, masennus, psilosybiini
URL: http://journals.sagepub.com/doi/full/10.1177/0269881116675512