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Psychiatry

The Psychopharmacology of ±3,4 Methylenedioxymethamphetamine and its Role in the Treatment of Posttraumatic Stress Disorder

November 18, 2015 / Anxiety disorders / PTSD, MDMA, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By /

Abstract

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.

Amoroso, T. (2015). The Psychopharmacology of±3, 4 Methylenedioxymethamphetamine and its Role in the Treatment of Posttraumatic Stress Disorder. Journal of Psychoactive Drugs, 1-8. http://dx.doi.org/10.1080/02791072.2015.1094156

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Plant and Fungal Hallucinogens as Toxic and Therapeutic Agents

November 9, 2015 / Cacti / Mescaline, DMT, Ethnobotany, Indigenous use, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications, Salvia / Salvinorin A / By / ,

Abstract

This chapter aimed to provide an overview of the large number of hallucinogens of natural origin. Following a literature review, the following hallucinogens were selected for a detailed description that considered their essential chemical groups: indoleamines (N,N-dimethyltryptamine, 5-methoxy-N,N-dimethyltryptamine, bufotenine, psilocybin, and ibogaine), phenylethylamines (mescaline), tropane alkaloids (atropine and scopolamine), cannabinoids (Δ9-tetrahydrocannabinol), and a neoclerodane diterpenoid (salvinorin A). The following species were included as representative of each drug class: Mimosa tenuiflora, Psychotria viridis, Banisteriopsis caapi, Virola spp., Psilocybe spp., Tabernanthe iboga, Tabernaemontana spp., Lophophora spp., Trichocereus spp., Atropa belladonna, Brugmansia spp., Cannabis sativa, and Salvia divinorum, among others. In addition to psychopharmacological effects, this chapter aims to address the sociocultural and historical use of these hallucinogenic plants and mushrooms, along with the importance of both the set and the setting factors that affect the profound consciousness-altering effects of these compounds. Moreover, the use of animal models to predict the hallucinogenic properties of psychoactive plants and compounds and to investigate the mechanisms of action of psychodysleptic drugs is discussed. This chapter also attempts to establish a parallel between hallucinogens and endogenous neurotransmitters in humans, to compare the pharmacological and psychic action of these compounds, to evaluate hallucinogens’ ability to produce symptoms typical of certain mental disorders during their use, and to investigate the role of these compounds as therapeutic agents in several psychopathological conditions.

Carlini, E. A., & Maia, L. O. (2015). Plant and Fungal Hallucinogens as Toxic and Therapeutic Agents.

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Comparative phenomenology of psilocybin experiences in research and non-research settings

November 1, 2015 / Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Publications, Substance Use Disorder / By / , , ,

Abstract

This study sought to compare questionnaire ratings of subjective experiences after psilocybin when administered in controlled research settings vs. uncontrolled, non-research settings.

Carbonaro, T. M., Klinedinst, M., Johnson, M. W., & Griffiths, R. R. (2015). Comparative phenomenology of psilocybin experiences in research and non-research settings. Drug and Alcohol Dependence, 156, e36-e37.  http://dx.doi.org/10.1016/j.drugalcdep.2015.07.1017
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Meta-analysis of short- and mid-term efficacy of ketamine in unipolar and bipolar depression

October 29, 2015 / Depression, Ketamine, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / , , ,

Abstract

Among treatments currently assessed in major depression, ketamine, has been proposed of great interest, especially because of its very rapid action. However, the time-course of the antidepressive action of ketamine remained unclear. In the present meta-analysis, we provided a clear and objective view regarding the putative antidepressive effect of ketamine and its time-course. We searched the MEDLINE and PsycINFO databases through December 2013, without limits on year of publication, using the key words ketamine and synonyms for mood disorder or episode. Six randomized, double-blind and placebo-controlled trials of ketamine in major depression (n=103 patients) were thus identified. Authors were contacted and they all provided original data necessary for this meta-analysis. Standardized mean differences (SMD) were calculated between the depression scores in ketamine and placebo groups at days 1, 2, 3–4, 7 and 14. Ketamine showed an overall antidepressive efficacy from day 1 to day 7. However, the maintenance of its efficacy over time failed to reach significance in bipolar depression after day 3–4. Significant SMDs were not explained by demographic or clinical characteristics of included samples. The present meta-analysis provides a high level of evidence that ketamine has a rapid antidepressive action during one week, especially in unipolar disorder.

Romeo, B., Choucha, W., Fossati, P., & Rotge, J. Y. (2015). Meta-analysis of short-and mid-term efficacy of ketamine in unipolar and bipolar depression. Psychiatry research.  http://dx.doi.org/10.1016/j.psychres.2015.10.032
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The Ups and Downs of 3,4-Methylenedioxymethamphetamine: Linking Subjective Effects to Spontaneous Brain Function

October 15, 2015 / MDMA, Neuroscience, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / , ,

Abstract

Psychoactive drugs, especially drugs with so-called psychedelic properties, exert profound effects on sensory perception, cognition, and emotion by modulating target neurotransmitter systems. The compound 3,4-methylenedioxymethamphetamine (MDMA) exerts stimulant and psychedelic effects through its actions on dopamine, norepinephrine, and serotonin (5-hydroxytryptamine, [5-HT]) transporters, by inhibiting their reuptake and stimulating their release. In addition to producing euphoria and positive mood, MDMA appears to produce unique “prosocial” or “empathogenic” feelings.

de Wit, H., Gorka, S. M., & Phan, K. L. (2015). The Ups and Downs of 3, 4-Methylenedioxymethamphetamine: Linking Subjective Effects to Spontaneous Brain Function. Biological psychiatry, 78(8), 519-521. http://dx.doi.org/10.1016/j.biopsych.2015.08.015
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The Effects of Acutely Administered 3,4-Methylenedioxymethamphetamine on Spontaneous Brain Function in Healthy Volunteers Measured with Arterial Spin Labeling and Blood Oxygen Level-Dependent Resting State Functional Connectivity

October 15, 2015 / MDMA, Neuroscience, Papers, Personal development, Psychiatry, Psychology, Psychopharmacology, Publications / By / , , , , , ,

Abstract

BACKGROUND:

The compound 3,4-methylenedioxymethamphetamine (MDMA) is a potent monoamine releaser that produces an acute euphoria in most individuals.

METHODS:

In a double-blind, placebo-controlled, balanced-order study, MDMA was orally administered to 25 physically and mentally healthy individuals. Arterial spin labeling and seed-based resting state functional connectivity (RSFC) were used to produce spatial maps displaying changes in cerebral blood flow (CBF) and RSFC after MDMA administration. Participants underwent two arterial spin labeling and two blood oxygen level-dependent scans in a 90-minute scan session; MDMA and placebo study days were separated by 1 week.

RESULTS:

Marked increases in positive mood were produced by MDMA. Decreased CBF only was observed after MDMA, and this was localized to the right medial temporal lobe (MTL), thalamus, inferior visual cortex, and the somatosensory cortex. Decreased CBF in the right amygdala and hippocampus correlated with ratings of the intensity of global subjective effects of MDMA. The RSFC results complemented the CBF results, with decreases in RSFC between midline cortical regions, the medial prefrontal cortex, and MTL regions, and increases between the amygdala and hippocampus. There were trend-level correlations between these effects and ratings of intense and positive subjective effects.

CONCLUSIONS:

The MTLs appear to be specifically implicated in the mechanism of action of MDMA, but further work is required to elucidate how the drug’s characteristic subjective effects arise from its modulation of spontaneous brain activity.

Carhart-Harris, R. L., Murphy, K., Leech, R., Erritzoe, D., Wall, M. B., Ferguson, B., … & Tanner, M. (2014). The Effects of Acutely Administered 3, 4-Methylenedioxymethamphetamine on Spontaneous Brain Function in Healthy Volunteers Measured with Arterial Spin Labeling and Blood Oxygen Level–Dependent Resting State Functional Connectivity. Biological psychiatry. http://dx.doi.org/10.1016/j.biopsych.2013.12.015

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Return of the lysergamides. Part I: Analytical and behavioural characterization of 1-propionyl-d-lysergic acid diethylamide (1P-LSD)

October 12, 2015 / LSD, Neuroscience, New substances, Other substances, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / , , , , , ,

Abstract

1-Propionyl-d-lysergic acid diethylamide hemitartrate (1P-LSD) has become available as a ‘research chemical’ in the form of blotters and powdered material. This non-controlled derivative of d-lysergic acid diethylamide (LSD) has previously not been described in the published literature despite being closely related to 1-acetyl-LSD (ALD-52), which was developed in the 1950s. This study describes the characterization of 1P-LSD in comparison with LSD using various chromatographic and mass spectrometric methods, infrared and nuclear magnetic resonance spectroscopy. An important feature common to LSD and other serotonergic hallucinogens is that they produce 5-HT2A-receptor activation and induce the head-twitch response (HTR) in rats and mice. In order to assess whether 1P-LSD displays LSD-like properties and activates the 5-HT2A receptor, male C57BL/6 J mice were injected with vehicle (saline) or 1P-LSD (0.025–0.8 mg/kg, IP) and HTR assessed for 30 min using magnetometer coil recordings. It was found that 1P-LSD produced a dose-dependent increase in HTR counts, and that it had ~38% (ED50 = 349.6 nmol/kg) of the potency of LSD (ED50 = 132.8 nmol/kg). Furthermore, HTR was abolished when 1P-LSD administration followed pretreatment with the selective 5-HT2A receptor antagonist M100907 (0.1 mg/kg, SC), which was consistent with the concept that the behavioural response was mediated by activation of the 5-HT2A receptor. These results indicate that 1P-LSD produces LSD-like effects in mice, consistent with its classification as a serotonergic hallucinogen. Nevertheless, the extent to which 1P-LSD might show psychoactive effects in humans similar to LSD remains to be investigated.

Brandt, S. D., Kavanagh, P. V., Westphal, F., Stratford, A., Elliott, S. P., Hoang, K., … & Halberstadt, A. L. (2015). Return of the lysergamides. Part I: Analytical and behavioural characterization of 1‐propionyl‐d‐lysergic acid diethylamide (1P‐LSD). Drug Testing and Analysis. http://dx.doi.org/10.1002/dta.1884
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Kappa Opioids, Salvinorin A and Major Depressive Disorder

October 1, 2015 / Depression, Papers, Psychiatry, Psychology, Psychopharmacology, Publications, Salvia / Salvinorin A / By / ,

Abstract

Opioids are traditionally associated with pain, analgesia and drug abuse. It is now clear, however, that the opioids are central players in mood. The implications for mood disorders, particularly clinical depression, suggest a paradigm shift from the monoamine neurotransmitters to the opioids either alone or in interaction with monoamine neurons. We have a special interest in dynorphin, the last of the major endogenous opioids to be isolated and identified. Dynorphin is derived from the Greek word for power, dynamis, which hints at the expectation that the neuropeptide held for its discoverers. Yet, dynorphin and its opioid receptor subtype, kappa, has always taken a backseat to the endogenous b – endorphin and the exogenous morphine that both bind the mu opioid receptor subtype. That may be changing as the dynorphin/ kappa system has been shown to have different, often opposite, neurophysiological and behavioral influences. This includes major depressive disorder (MDD). Here, we have undertaken a review of dynorphin/ kappa neurobiology as related to behaviors, especially MDD. Highlights include the unique features of dynorphin and kappa receptors and the special relation of a plant- based agonist of the kappa receptor salvinorin A. In addition to acting as a kappa opioid agonist, we conclude that salvinorin A has a complex pharmacologic profile , with potential additional mechanisms of action. Its unique neurophysiological effects make Salvinorina A an ideal candidate for MDD treatment research.

T Taylor and Francesca Manzella, G. Kappa Opioids, Salvinorin A and Major Depressive Disorder. Current Neuropharmacology, 13. http://dx.doi.org/10.2174/1570159X13666150727220944
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Current Status of Ketamine and Related Therapies for Mood and Anxiety Disorders

October 1, 2015 / Depression, Ketamine, Neuroscience, Other subjects, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / , ,

Abstract

Major depressive disorder (MDD) is a leading cause of disability worldwide. Despite a plethora of established treatments, less than one third of individuals with MDD achieve stable remission of symptoms. Given limited efficacy and significant lag time to onset of therapeutic action among conventional antidepressants, interest has shifted to treatments that act outside of the monoamine neurotransmitter systems (e.g., serotonin, norepinephrine, and dopamine). Preclinical and clinical research on the glutamate system has been particularly promising in this regard. Accumulating evidence shows support for a rapid antidepressant effect of ketamine—a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist. The present article reviews the pharmacology, safety, and efficacy of ketamine as a novel therapeutic agent for mood and anxiety disorders. The majority of clinical trials using ketamine have been conducted in patients with treatment-resistant forms of MDD; recent work has begun to examine ketamine in bipolar disorder, post-traumatic stress disorder, and obsessive–compulsive disorder. The impact of ketamine on suicidal ideation is also discussed. The current status and prospects for the identification of human biomarkers of ketamine treatment response and hurdles to treatment development are considered. We conclude by considering modulators of the glutamate system other than ketamine currently in development as potential novel treatment strategies for mood and anxiety disorders.

Costi, S., Van Dam, N. T., & Murrough, J. W. (2015). Current Status of Ketamine and Related Therapies for Mood and Anxiety Disorders. Current Behavioral Neuroscience Reports, 1-10. https://dx.doi.org/10.1007/s40473-015-0052-3
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Ketamine for depression: evidence, challenges and promise

September 25, 2015 / Depression, Ketamine, Neuroscience, Papers, Psychiatry, Psychology, Psychopharmacology, Publications / By / ,

Abstract

Major depressive disorder and bipolar depression are among the most prevalent and disabling mental disorders worldwide. Real-world effectiveness trials in major depressive disorder have underscored that most pharmacological options target monoamines, which are involved in a minority (15-20%) of synaptic contacts in the mammalian brain.

Most synapses (∼50%) use the amino acid glutamate as their primary neurotransmitter, and preclinical models of depression have implicated aberrant glutamatergic neurotransmission for 25 years. More recently, the N-methyl-D-aspartate (NMDA) glutamate receptor antagonist ketamine was shown to produce rapid and robust antidepressant effects in patients with treatment-resistant major depressive disorder and bipolar depression.

Zarate, C. A., & Niciu, M. J. (2015). Ketamine for depression: evidence, challenges and promise. World Psychiatry, 14(3), 348-350. http://dx.doi.org/10.1002/wps.20269
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