Psychedelic medicine (New Rochelle, N.Y.)最新文献

Introduction: Despite widespread popular interest in the use of low doses of Lysergic acid diethylamide (LSD) to improve mood, little is known about how these doses affect emotional processing in the brain. In this study, we tested the effect of a single low dose of LSD (26 µg) compared with placebo on electroencephalogram (EEG) event-related potentials (ERP: N170, P300 and Mismatch Negativity) in healthy adults, while participants viewed angry, happy, and neutral faces. We hypothesized that the drug might affect either neutral faces, which are sometimes perceived as threatening, or emotional faces.

Methods: Healthy young adults (n = 39) received LSD (26 µg or placebo sublingually) before completing an oddball task with emotional facial expressions during EEG recording. The N170 and P300 evoked potentials were recorded using EEG. LSD and placebo were administered in double-blind, randomized order separated by at least 7 days. During the oddball task, three emotional faces were presented infrequently (angry, happy, neutral) in a block design, and a cartoon face was presented frequently.

Results: LSD significantly reduced the amplitude of the occipitotemporal N170 ERP to Neutral faces, but not angry or happy faces. LSD also reduced the amplitude of the midline posterior parietal P300 ERP to neutral and happy faces, but not angry faces.

Discussion: These differential effects of LSD on the amplitude of the N170 and P300 to neutral and emotional faces add to our understanding of how low doses of LSD might affect the brain response to social and emotional information.

Background: There is increasing interest in the use of psychedelics for therapeutic and recreational use. Research has been hindered by federal prohibition, put in place in 1970. Despite the regulatory difficulty, research has rapidly expanded in the past decade. Multiple states and cities have drafted their own policies regarding the use of psychedelics. Assuming interest in psychedelics continues to expand; every opportunity should be explored to better understand how psychedelics may be helping or harming people.

Objective: This study examined underground psychedelic-assisted psychotherapy providers' protocols and perspectives, to better inform policy and public health, as psychedelics increasingly are used in the United States.

Methods: Transcripts of interviews were examined through qualitative content analysis.

Results: The following four themes were identified: (1) personal experiences and self-healing motivated sharing and promotion of the positive effects of psychedelics as an expression of altruism, (2) guides articulated consistent, yet flexible processes, (3) guides believed that the client benefit was actualized through their own intrinsic ability to heal themselves, and (4) guides expressed an overwhelming sense of dissonance regarding psychedelic legalization, not only desiring increased access and decreased risk but also expressing concern about potential negative impacts on provider flexibility, and depersonalization that could come with standardizing this field of practice.

Conclusion: In order for current research and policy to be best informed, information must be gathered from both clinical trials and observational studies of current practice. This study identified themes within the latter to provide perspectives, practices, and insights of current underground practice, so it can be used to inform research and policy moving forward.

Introduction: This perspective on experiential training delves into the potential benefits and counterarguments related to integrating firsthand experience of psychedelic-assisted therapy (PaT) to enhance the competency of trainees.

The case for experiential training as a core pat competency: Experiential training serves a dual purpose: promoting therapists' mental wellness and refining their skills in facilitating healing in nonordinary states of consciousness. With a rising demand for PaT amid a growing mental health crisis, therapists are increasingly seeking PaT training, including experiential training from underground sources. Educators actively strive to establish formal PaT competencies and training standards, recognizing the need to consider both perspectives in this discourse.

Counter arguments: The emergence of differing opinions on the therapeutic value of firsthand exposure to PaT and concerns about potential bias underscores the necessity for further research to substantiate claims on both sides.

Access: Whether or not consensus is achieved, the persistent demand for experiential training remains. Offering this form of training in regulated settings has the potential to reduce reliance on illicit sources for this sought-after form of training, ensuring a more controlled and ethical approach.

[This corrects the article DOI: 10.1089/psymed.2023.0046.].

Clinical trials support the promise of psychedelic-assisted therapy (PAT) and reveal potential mechanisms underlying efficacy. Out of necessity, initial studies of PAT have focused on feasibility and impact with special attention to acute responses to the molecules, but investigations of the psychotherapy components of PAT have lagged other work. Years of research on other forms of psychotherapy reveal that one of the most important contributors to outcome is the therapeutic alliance, a cooperative connection between clients and providers. The alliance has accounted for meaningful variance in psychotherapies independent of their theoretical orientation, number of sessions, and rates of change in improvement. Nevertheless, recent critiques suggest that previous estimates of the alliance's impact were exaggerated because of statistical problems. This controversy only underscores the idea that the alliance could prove a valuable target for understanding mechanisms and enhancing PAT's impact. Initial work shows promise, but only two publications address the issue directly despite decades of emphasis on the alliance in published recommendations for conducting PAT. Adding alliance measures to clinical trials would not require extensive effort or resources. Each practitioner could improve alliance relatively easily, regardless of theoretical orientation, through increases in uncontroversial clinician behaviors that focus on respect for client autonomy, listening skills, and current practical concerns. This article details support for the alliance construct, reviews relevant measurement strategies, and underscores implications for researchers and clinicians. Increased attention to the therapeutic alliance could enhance our understanding of mechanisms underlying PAT and improve outcomes, potentially decreasing human suffering more efficiently.

Background: Psilocybin has demonstrated promising clinical outcomes for nicotine and alcohol use disorders, yet its potential clinical utility in the treatment of opioid use disorder (OUD) remains unreported in modern literature. This technical report presents methodological considerations and preliminary data from a safety-feasibility trial examining the interaction between psilocybin and buprenorphine in two adults diagnosed with OUD.

Procedures: Two adults meeting eligibility criteria for long-term stabilization of buprenorphine/naloxone (≥6 months) enrolled and underwent two psilocybin dosing sessions in a supportive setting. Preliminary data pertaining to the safety, clinical outcomes, and subjective effects of psilocybin were collected.

Main findings: Two participants received psilocybin and completed all study visits. Feasibility considerations were identified, including limitations in provider-based recruitment strategies, participant accessibility, flexibility of the study schedule, and initial eligibility criteria. There were no serious adverse events or significant baseline changes on measures of opioid craving or withdrawal, and the subjective effects associated with psilocybin were consistent with previous studies.

Principal conclusions: Coadministration of psilocybin and buprenorphine was safely tolerated and did not demonstrate contraindicating effects vis-à-vis effectiveness of buprenorphine or the subjective effects of psilocybin. Challenges in feasibility led to modifications in the sample population and eligibility criteria and strategies to improve accessibility, minimize burden, and enhance overall generalizability.clinicaltrials.gov ID: NCT05242029.

Recent trials of psychedelic-assisted therapy have suggested potential efficacy for the treatment of many health conditions that disproportionately impact sexual and gender minority (SGM) people, including major depressive disorder and alcohol and tobacco use disorders. Despite these promising findings, the potential benefits of psychedelics for SGM people have been largely ignored. First, we highlight SGM health inequities and discuss therapeutic applications of psychedelics based on current research. Next, grounded by the minority stress model and the psychological mediation framework, we describe the role of shame as a significant mediator between stigma-related stressors and negative health outcomes for SGM people. We then apply self-entropic broadening theory to examine the potential therapeutic applications of psychedelics to reduce chronic shame among SGM people, potentially mitigating health inequities, by (1) alleviating self-focused attention, (2) prompting positive behavioral changes, and (3) encouraging adaptive perspectives on faith and spirituality. Finally, we consider the limitations of psychedelic-assisted therapy and recommend tangible next steps for future research directions.

The reemergence of psychedelic medicines as clinical treatments has generated considerable interest in both professional and popular arenas. Although evidence is promising for psychedelic-assisted therapy (PAT), there is much that is not yet known and needs to be researched so as to understand how to safely and effectively utilize PAT in clinical populations and to most effectively deploy PAT to patients. In addition, non-clinical stakeholders introduce interests and agendas that may differ from those of clinicians. This article reviews the history of how psychedelics were initially outlawed and then introduces research questions that will help to fill these gaps in knowledge.

Background: Recent studies suggest that one to two administrations of psilocybin have acute antidepressant effects for people with major depressive disorder. These data on psilocybin have generated considerable enthusiasm, but little empirical attention has been paid to the therapy that adjoins psilocybin treatment (psychedelic-assisted therapy, or PAT).

Materials and methods: In this study, we present the initial protocol and plans to empirically test the psychosocial therapy that adjoins psilocybin treatment with the goal of optimizing this therapeutic approach for adults with major depressive disorder. The psychotherapy is based on the principles of cognitive-behavioral therapy (CBT), an evidence-based treatment for major depressive disorder. Participants will be 30 adults with a history of major depressive disorder and current, active depressive symptoms. Following psychiatric and medical safety evaluations, eligible participants will be enrolled in a 12-session CBT that includes classic PAT safety elements (termed psilocybin-assisted CBT; PA-CBT). Following the third and sixth PA-CBT sessions, participants will engage in two psilocybin drug administration sessions (10 and 25 mg, respectively). Participants will provide feedback about the PA-CBT and complete measures of mood symptoms, psychosocial functioning, cognitive schemas, and affective experiences immediately following each drug administration session, at the completion of PA-CBT, and 3 months following treatment completion.

Conclusions: The trial will provide preliminary data on the feasibility, safety, acceptability, and psychosocial effects of PA-CBT. Results will inform randomized clinical trials to test the effects of PA-CBT for patients with depression and other mental health conditions, as well as hypotheses concerning mediating mechanisms at the cognitive and affective levels. ClinicalTrials.gov ID: NCT05227612.