Classical psychedelics for the treatment of depression and anxiety: A systematic review

Muttoni, Silvia; Ardissino, Maddalena; John, Christopher

doi:10.1016/j.jad.2019.07.076

Cited by 180 publications

(140 citation statements)

References 119 publications

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“…mushrooms have been used in sociocultural and ritual contexts since ancient times. They have recently regained interest for their therapeutic use (Araújo et al 2015;Carhart-Harris et al 2018;Muttoni et al 2019;Palhano-Fontes et al 2019;Roseman et al 2017). In addition to naturally occurring compounds, psychedelic properties of various synthetic tryptamines (Fig.…”

Section: Tryptaminesmentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at l-opioid receptors and c-aminobutyric acid-A (GABA A) or GABA B receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-D-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB 1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT 2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.

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Section: Tryptaminesmentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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“…Among these, two approaches that originate from spiritual practice traditions of indigenous and religious communities, namely mindfulness meditation (MM) and administration of classical psychedelics, have gained scientific interest in depression research (57,58). With regard to the latter, a limited number of clinical trials have been conducted in depressed patients who were administered ayahuasca and psilocybin (59). Although these studies give preliminary evidence of their potential in the treatment of depression, caution regarding efficacy conclusions in depression is warranted due to the currently limited number of studies and small sample sizes (60)(61)(62)(63).…”

Section: Alternative Treatments Of Depressionmentioning

confidence: 99%

Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review

Heuschkel

Kuypers

2020

Front. Psychiatry

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Depression is a major public health problem that affects approximately 4.4% of the global population. Since conventional pharmacotherapies and psychotherapies are only partially effective, as demonstrated by the number of patients failing to achieve remission, alternative treatments are needed. Mindfulness meditation (MM) and psilocybin represent two promising novel treatments that might even have complementary therapeutic effects when combined. Since the current literature is limited to theoretical and empirical underpinnings of either treatment alone, the present review aimed to identify possible complementary effects that may be relevant to the treatment of depression. To that end, the individual effects of MM and psilocybin, and their underlying working mechanisms, were compared on a non-exhaustive selection of six prominent psychological and biological processes that are well known to show impairments in patients suffering from major depression disorder, that is mood, executive functioning, social skills, neuroplasticity, core neural networks, and neuroendocrine and neuroimmunological levels. Based on predefined search strings used in two online databases (PubMed and Google Scholar) 1129 articles were identified. After screening title and abstract for relevance related to the question, 82 articles were retained and 11 were added after reference list search, resulting in 93 articles included in the review. Findings show that MM and psilocybin exert similar effects on mood, social skills, and neuroplasticity; different effects were found on executive functioning, neural core networks, and neuroendocrine and neuroimmune system markers. Potential mechanisms of MM's effects are enhanced affective self-regulation through mental strategies, optimization of stress reactivity, and structural and functional adjustments of prefrontal and limbic areas; psilocybin's effects might be established via attenuation of cognitive associations through deep personal insights, cognitive disinhibition, and global neural network disintegration. It is suggested that, when used in combination, MM and psilocybin could exert complementary effects by potentiating or prolonging mutual positive effects, for example, MM potentially facilitating psilocybin-induced peak

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“…Ayahuasca/DMT Tryptamine Anxiety, 10 depression, 11 substance misuse 12 Increased BDNF, 11 neurogenesis/ plasticity, 13 MAO Inhibition 11 LSD Tryptamine Anxiety, 14 depression, 15 substance misuse 16 Amygdala and DMN alterations, 17 mystical experience 18 Mescaline Phenethylamine No clinical applications studied to-date Psilocybin Tryptamine Anxiety, 19 depression, 20 OCD, 21 substance misuse 22 Amygdala and DMN alterations, 23 mystical experience, 22 neurogenesis/plasticity 24 BDNF, brain-derived neurotrophic factor; DMT, N,N-dimethyltryptamine; LSD, lysergic acid diethylamide; MAO, monoamine oxidase inhibitor; OCD, obsessive-compulsive disorder.…”

Section: Therapeutic Mechanismsmentioning

confidence: 99%

Psychedelics and virtual reality: parallels and applications

Aday

Davoli

Bloesch

2020

Therapeutic Advances in Psychopharmacology

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Psychedelic drugs and virtual reality (VR) each have the capacity to disrupt the rigidity and limitations of typical conscious experience. This article delineates the parallels among psychedelic and VR states as well as their potential synergistic applications in clinical and recreational settings. Findings indicate that, individually, psychedelics and VR are used in analogous ways to alter sensory experience and evoke awe. They are also both used in tandem with traditional therapies to treat a variety of mood disorders; their shared capacity to transiently alter perspective and disrupt rigid patterns of mental experience may underly their analogous and transdiagnostic therapeutic uses. In terms of their combined applications, a number of recreational users currently utilize psychedelics and VR together to enhance their experience. We propose that VR may be a useful tool for preparing hallucinogen-naïve participants in clinical trials for the sensory distortions experienced in psychedelic states. Given the critical role of “setting” in psychedelic treatment outcomes, we also detail how VR could be used to optimize the environment in psychedelic sessions. Finally, we provide considerations for future studies and detail how advancements in psychedelic and VR research can inform one another. Collectively, this article outlines a number of connections between psychedelics and VR, and, more broadly, is representative of growing scientific interest into the interactions among technology, psychopharmacology, and mental health.

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Classical psychedelics for the treatment of depression and anxiety: A systematic review

Cited by 180 publications

References 119 publications

Designer drugs: mechanism of action and adverse effects

Designer drugs: mechanism of action and adverse effects

Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review

Psychedelics and virtual reality: parallels and applications

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