Policy considerations that support equitable access to responsible, accountable, safe, and ethical uses of psychedelic medicines

New perspective on sustained antidepressant effect: focus on neurexins regulating synaptic plasticity

“…Psilocybin, a drug approved by the FDA as a breakthrough therapy for the treatment of major depressive disorder, is another hot topic in the field of sustained antidepressant effect [ 21 ]. Its sustained antidepressant effect is well established in the literature [ 21 – 23 ], but unfortunately its chronotropic changes following administration and the mechanisms involved have not been as extensively studied as with ketamine.…”

“…Psilocybin, a drug approved by the FDA as a breakthrough therapy for the treatment of major depressive disorder, is another hot topic in the field of sustained antidepressant effect [ 21 ]. Its sustained antidepressant effect is well established in the literature [ 21 – 23 ], but unfortunately its chronotropic changes following administration and the mechanisms involved have not been as extensively studied as with ketamine. In these literatures, Barrett, FS found that after a single oral administration of psilocybin to healthy volunteers for 30 days, functional magnetic resonance imaging (fMRI) results showed that the number of significant functional connections remained high in the resting-state brain, providing collateral evidence for the effect of psilocybin on human brain plasticity [ 37 ].…”

“…In the context of synaptic plasticity, priority is given to the currently hotly researched class of hallucinogens. Hallucinogens such as ketamine and psilocybin are known for their sustained antidepressant effects and alterations in synaptic plasticity [ 16 , 18 , 21 ]. Traditionally, hallucinogens can be categorized into classical hallucinogens and non-classical hallucinogens depending on whether they act on 5-HT2A or not.…”

“…Hallucinogens are the hot topic in research on sustained antidepressant effect [ 16 ]. Ketamine is currently the best-studied hallucinogen in the field of sustained antidepressant effect [ 17 – 20 ], and with psilocybin being granted breakthrough therapy for the treatment of depression by the U.S. Food and Drug Administration (FDA) in recent years [ 21 ], the concept of the sustained antidepressant has once again been promoted and renewed, and its attention has once again been taken to the next level [ 21 – 23 ]. Among these hypotheses about the mechanisms of sustained antidepressant effect, several studies have highlighted that the focus of the mechanism of sustained antidepressant pharmacodynamics should be centered on the downstream, long-term events of change induced by sustained antidepressant action.…”

Psilocybin for Depression: From Credibility to Feasibility, What’s Missing?

“…Finally, there are clear concerns relating to the toxicological drug test screening (with psychedelics not typically being identified [ 100 ]) in cases of potential abuse/misuse. Overall, it clearly appears that the future of psychopharmacological research should focus on safe practices and inclusive public policies [ 101 , 102 ] without an exasperated emphasis on spirituality.…”