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Psychiatry

Ketamine for Depression: An Update

August 24, 2016 / Depression, Ketamine, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By /

Abstract

A decade has now passed since research into the antidepressant effects of ketamine began in earnest, after the clinical trial reported by Zarate et al. in 2006 (1). In that proof-of-concept study, 18 medication-free patients with treatment-resistant major depressive disorder (TRD) showed a large reduction in core depressive symptoms within hours of receiving a single low-dose 0.5 mg/kg intravenous infusion of ketamine as measured by the 21-item Hamilton Depression Rating Scale compared with saline placebo.

Murrough, J. W. (2016). Ketamine for Depression: An Update. Biological Psychiatry, 80(6), 416-418. http://dx.doi.org/10.1016/j.biopsych.2016.07.005
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It’s time to take psilocybin seriously as a possible treatment for substance use disorders.

August 24, 2016 / Depression, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By /

Bogenschutz, M. P. (2016). It’s time to take psilocybin seriously as a possible treatment for substance use disorders. The American Journal of Drug and Alcohol Abuse, 1-3. http://dx.doi.org/10.1080/00952990.2016.1200060
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It's time to take psilocybin seriously as a possible treatment for substance use disorders.

August 24, 2016 / Depression, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By /

Bogenschutz, M. P. (2016). It’s time to take psilocybin seriously as a possible treatment for substance use disorders. The American Journal of Drug and Alcohol Abuse, 1-3. http://dx.doi.org/10.1080/00952990.2016.1200060
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Psilocybin: panacea or placebo?

August 24, 2016 / Depression, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By / ,

Abstract

We write with reference to the study on psilocybin for treatment-resistant depression, reported by Robin L Carhart-Harris and colleagues in The Lancet Psychiatry. Although we are relieved that attention is once again being given to basic research into depression—after the hiatus created the effective abandonment of this area of research by Big Pharma from 2010 onwards—we are nonetheless deeply concerned that the mistakes that led to this withdrawal are in danger of being repeated. Carhart-Harris and colleagues’ study included 12 patients, and although the investigators reported that eight patients achieved complete remission at 1 week, only five of these patients were still in complete remission after 3 months of follow-up.

Hendrie, C., & Pickles, A. (2016). Psilocybin: panacea or placebo?. The Lancet Psychiatry, 3(9), 805-806. http://dx.doi.org/10.1016/S2215-0366(16)30103-1
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Question-based Drug Development for psilocybin

August 24, 2016 / Depression, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Publications / By / , ,

Abstract

In The Lancet Psychiatry, Robin Carhart-Harris and colleagues conclude that there is preliminary support for the safety and efficacy of psilocybin for treatment-resistant unipolar depression. This finding is important because more effective pharmacological treatments with acceptable side-effects are urgently needed for patients suffering from depression. We support the limitations the authors have pointed out about the study population and trial design. We also recognise the paucity of well-designed trials in psychiatry that are based on the principles of clinical pharmacology.

Dijkstra, F. M., Jacobs, G. E., & Cohen, A. F. (2016). Question-based Drug Development for psilocybin. The Lancet Psychiatry, 3(9), 806-807. http://dx.doi.org/10.1016/S2215-0366(16)30214-0
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Return of the psychedelics: Psilocybin for treatment resistant depression

August 23, 2016 / Depression, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By /

Abstract

Psilocybin, the clinically most researched classic psychedelic has recently been tested for its safety and efficacy in a clinical population of treatment resistant depression. The efficacy of psilocybin in clinical depression previously demonstrated in the elecrophysiologic and neuroimaging findings as also in neuropsychological assessments is further validated by the findings of this rigorously conducted randomized trial. Mechanism of action of psilocybin and efficacy in treatment resistant depression are discussed in this paper. Ethical issues of conducting clinical trials with psychedelics are also discussed with particular emphasis on their relative safety and absence of addiction potential. Implications of these issues for conduct of larger trials for establishing risk benefit ratio in treatment resistant depression are further suggested.

Patra, S. (2016). Return of the psychedelics: Psilocybin for treatment resistant depression. Asian Journal of Psychiatry, 24, 51-52. http://dx.doi.org/10.1016/j.ajp.2016.08.010
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The antidepressant effect of ketamine: Mediated by AMPA receptors?

August 20, 2016 / Depression, Ketamine, Neuroscience, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / , , , ,

Inta, D., Sprengel, R., Borgwardt, S., Lang, U. E., & Gass, P. (2016). The antidepressant effect of ketamine: Mediated by AMPA receptors?. European Neuropsychopharmacology. http://dx.doi.org/10.1016/j.euroneuro.2016.08.002
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Psilocybin for treating substance use disorders?

August 12, 2016 / Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Publications, Substance Use Disorder / By / , , ,

Abstract

INTRODUCTION: Evidence based treatment for Substance use disorders (SUD) includes psychotherapy and pharmacotherapy. However, these are only partially effective. Hallucinogens, such as psilocybin, may represent potential new treatment options for SUD. This review provides a summary of (human) studies on the putative therapeutic effects of psilocybin, and discusses the receptor systems, brain regions and cognitive and emotional processes mediating psilocybin’s effects. Psilocybin’s chemical structure is similar to that of serotonin. Dysregulations in the serotonin system are associated with alterations in stress hormones, such as cortisol, and mood disorders. After psilocybin administration cortisol levels spike and activate the executive control network, with subsequent increased control over emotional processes, and relief of negative thinking and persistent negative emotions. Preliminary data of ongoing alcohol and smoking addiction studies in humans shows promising effects of psilocybin administration on substance use. Importantly, psilocybin has a low risk of toxicity and dependence and can be used safely under controlled clinical conditions.

AREAS COVERED: This paper is a narrative review based on the search terms: psilocybin, substance use disorder, addiction, depression, serotonin. Literature on potential efficacy and mechanisms of action of psilocybin in SUD is discussed. Expert commentary: Recent positive findings with psilocybin need confirmation in well-designed placebo controlled randomized trials employing a large sample size.

de Veen, B. T., Schellekens, A. F., Verheij, M. M., & Homberg, J. R. (2016). Psilocybin for treating substance use disorders?. Expert Review of Neurotherapeutics, 1-10. 10.1080/14737175.2016.1220834
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