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Ibogaine: useful in treating addiction to non-opioids?

iboga508It has been known for some time that ibogaine can probably help in the treatment of drug addiction. But up until now researchers focused primarily on the addiction to opioids like heroin and morphine. A group of scientists in Brazil found out that ibogaine might also help against addiction to alcohol, cannabis and cocaine, implying a wider range of potential therapeutic applications.

Treating drug dependence can be hard. Conventional therapies often are lengthy and costly. Nowadays the increased interest in the potential of psychedelics in the battle against addiction has urged new investigations. Several studies on the use of LSD and psilocybin for this purpose have been published [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][1]. Ibogaine is another psychedelic that has gained the attention of scientists. This is an alkaloid that can be found in the root bark of the Tabernanthe iboga plant, growing in West central Africa. As early as 1962 the substance was used in trials to overcome heroin addiction. But further investigation was made difficult by a statutory ban in many countries. In Brazil however, ibogaine is not an illegal substance, allowing research to continue. A group of scientists from the University of São Paulo, led by Eduardo Schenberg, retrospectively evaluated data from a private clinic in Curitiba, which treated patients with pure ibogaine HCl in a professional environment and as part of a larger psychotherapeutic program [2]. The patients in the study were addicts to alcohol, cannabis, cocaine, and/or crack cocaine. The researchers concluded that 61% of these patients were still abstinent after five to eight months, and that none of them experienced long-lasting negative side effects. Repeated sessions (two or three times) appeared to be especially effective.

Using ibogaine in the treatment of drug addiction is not without risks however. The substance can cause serious arrhythmia, which has led to several fatalities in the past. But according to Schenberg et al., most of these cases were probably due to a pre-existing heart disorder (e.g. “long-QT-syndrome”, a condition causing severe irregular heartbeat). Moreover, the ibogaine or iboga extracts in those cases were often used without quality control and without the supervision of trained and qualified medical staff. Using other psychoactive substances and certain prescription drugs shortly before the ibogaine ingestion can also cause adverse effects. For that reason, the clinic in which this study took place implemented a protocol to ensure that patients are abstinent at least thirty days before the ibogaine is administered. If this is observed and sessions are accompanied in a professional way, then ibogaine can probably be a good aid in the treatment of addiction, according to the researchers. They admit however that more research is necessary, also into the potential adverse effects of ibogaine on the heart.


 
[1] Johnson et al. (2014) and Krebs & Johansen (2012)
[2] Schenberg et al. (2014)
 
References

Schenberg, E. E., de Castro Comis, M. A., Rasmussen Chaves, B. & da Silveira, D. X. (2014). Treating drug dependence with the aid of ibogaine: A retrospective study. Journal of Psychopharmacology, 28(11), 993-1000. [Abstract]
Krebs, T. S. & Johansen, P. Ø. (2012). Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. Journal of Psychopharmacology, 26(11), 994-1002. [Abstract]
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983-992. [Abstract][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

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Ibogaïne: ook bruikbaar tegen verslaving aan niet-opioïden?

iboga508Het is al langer bekend dat ibogaïne mogelijk kan helpen tegen verslaving. Maar tot op heden richtte men zich in onderzoek vooral op de bestrijding van verslaving aan opioïden, zoals heroïne en morfine. Een groep wetenschappers in Brazilië heeft nu aangetoond dat het middel mogelijk ook effectief is bij de behandeling van verslaving aan alcohol, cannabis en cocaïne, en misschien dus breder ingezet kan worden.

Verslavingen kunnen moeilijk te behandelen zijn. Conventionele therapieën zijn meestal langdurig en kostbaar. Tegenwoordig wordt steeds vaker geopperd om onderzoek te doen naar de potentie van psychedelica in de strijd tegen verslaving. Zo zijn er al diverse wetenschappelijke publicaties over de toepassing van LSD en psilocybine voor dit doeleinde verschenen [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][1]. Ook Ibogaïne komt de laatste tijd meer in de belangstelling te staan. Dit is een alkaloïde dat voorkomt in de wortel(bast) van de West-Afrikaanse plant Tabernanthe iboga. Al sinds 1962 wordt dit psychedelicum toegepast in pogingen om verslaving te behandelen. Maar wetenschappelijk onderzoek hiernaar was niet eenvoudig omdat de stof in veel landen verboden is. In Brazilië staat ibogaïne echter niet op de lijst van verboden middelen, zodat daar ongehinderd met de stof geëxperimenteerd kan worden. Een groep onderzoekers van de Universiteit van São Paulo onder leiding van Eduardo Schenberg heeft de resultaten van een verslavingskliniek in Curitiba onder de loep genomen [2], waarbij binnen een psychotherapeutische behandeling zuiver ibogaïne-HCl werd toegediend aan verslaafden aan niet-opioïden zoals alcohol, cannabis en cocaïne (inclusief crack cocaïne). De onderzoekers stelden vast dat 61% van de behandelden vijf tot acht maanden later nog abstinent was, en dat bij geen van de patiënten blijvende nadelige neveneffecten werden geconstateerd. Vooral herhaalde sessies (twee à drie keer) met het middel bleken effectief.

Het gebruik van ibogaïne ter bestrijding van verslaving is echter niet helemaal zonder risico’s. Zo kunnen er ernstige hartritmestoornissen optreden, die in het verleden bij sommige patiënten tot de dood hebben geleid. Maar, zo stellen Schenberg et al., in al deze gevallen was het aannemelijk dat de patiënten al het zg. “lange-QT-syndroom” hadden, een hartaandoening die voor spontane en ernstige hartritmestoornissen zorgt. Bovendien, zo stellen de onderzoekers, was in veel van deze gevallen de ibogaïne van ongecontroleerde kwaliteit en was er geen professioneel toezicht. Ook het gebruik van drugs en medicijnen kort vóór het toedienen van ibogaïne kan nadelige gevolgen hebben. Om die reden wordt er in de kliniek waar dit onderzoek plaatsvond voor gezorgd dat patiënten al dertig dagen abstinent zijn alvorens de ibogaïne wordt toegediend. Zolang hier streng toezicht op is, en er professionele begeleiding plaatsvindt, kan ibogaïne volgens de onderzoekers waarschijnlijk effectief bij de behandeling van verslaving worden ingezet. De onderzoekers geven tegelijkertijd wel aan dat er nog nader onderzoek nodig is, o.a. naar de effecten van ibogaïne op het hart.

Verder dient te worden opgemerkt dat het onderzoek retrospectief was, gebaseerd op behandelresultaten uit het (nabije) verleden, en dat het al of niet abstinent zijn van de patiënten werd vastgesteld op grond van telefonische ondervraging in plaats van medische controle. Desalniettemin bieden de bevindingen van Schenberg et al. genoeg redenen voor verder onderzoek.


 
[1] Zie bijvoorbeeld Johnson et al. (2014) en Krebs & Johansen (2012)
[2] Schenberg et al. (2014)
 
Referenties

Schenberg, E. E., de Castro Comis, M. A., Rasmussen Chaves, B. & da Silveira, D. X. (2014). Treating drug dependence with the aid of ibogaine: A retrospective study. Journal of Psychopharmacology, 28(11), 993-1000. [Abstract]
Krebs, T. S. & Johansen, P. Ø. (2012). Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. Journal of Psychopharmacology, 26(11), 994-1002. [Abstract]
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983-992. [Abstract][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

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Seeking the Sacred with Psychoactive Substances: Chemical Paths to Spirituality and to God

seekingthesacredThe first of its kind, this intriguing two-volume set objectively reports on and assesses this modern psycho-social movement in world culture: the constructive medical use of entheogens and related mind-altering substances. Covering the use of substances such as ayahuasca, cannabis, LSD, peyote, and psilocybin, the work seeks to illuminate the topic in a scholarly and scientific fashion so as to lift the typical division between those who are supporters of research and exploration of entheogens and those who are strongly opposed to any such experimentation altogether. The volumes address the history and use of mind-altering drugs in medical research and religious practice in the endeavor to expand and heighten spirituality and the sense of the divine, providing unbiased coverage of the relevant arguments and controversies regarding the subject matter. Chapters include examinations of how psychoactive agents are used to achieve altered states in Judaism, Christianity, Islam, and Buddhism as well as in the rituals of shamanism and other less widely known faiths. This highly readable work will appeal to everyone from high school students to seasoned professors, in both the secular world and in devoted church groups and religious colleges.

Seeking the Sacred with Psychoactive Substances: Chemical Paths to Spirituality and to God (Psychology, Religion, and Spirituality) [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][2 delen], door J. Harold Ellens (Editor), Praeger, 830 pagina’s.

Koop dit boek via bookdepository.com en steun daarmee Stichting OPEN

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Single Ketamine Infusion and Neurocognitive Performance in Bipolar Depression

Abstract

We estimated neurocognitive performance using the trail making test (TMT) and the Stroop color-word interference test before, and on the 3rd day after a single infusion of ketamine, in 18 bipolar depressed patients receiving mood-stabilizing drugs. The performance on all tests significantly improved on the 3rd day after ketamine infusion which correlated positively with baseline intensity of neuropsychological impairment and was not associated either with baseline intensity of depression or reduction of depressive symptoms after 3 or 7 days. The results suggest that in such population of patients, single ketamine infusion may improve neuropsychological performance independently of antidepressant effect.

Permoda-Osip, A., Kisielewski, J., Bartkowska-Sniatkowska, A., & Rybakowski, J. K. (2014). Single Ketamine Infusion and Neurocognitive Performance in Bipolar Depression. Pharmacopsychiatry. https://dx.doi.org/10.1055/s-0034-1394399

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Effect of psilocin on extracellular dopamine and serotonin levels in the mesoaccumbens and mesocortical pathway in awake rats

Abstract

Psilocin (3-[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][2-(dimethylamino)ethyl]-1H-indol-4-ol) is a hallucinogenic component of the Mexican mushroom Psilocybe mexicana and a skeletal serotonin (5-HT) analogue. Psilocin is the active metabolite of psilocybin (3-[2-(dimethylamino)ethyl]-1H-indol-4-yl dihydrogen phosphate). In the present study, we examined the effects of systemically administered psilocin on extracellular dopamine and 5-HT concentrations in the ventral tegmental area (VTA), nucleus accumbens, and medial prefrontal cortex of the dopaminergic pathway in awake rats using in vivo microdialysis. Intraperitoneal administration of psilocin (5 and 10 mg/kg) significantly increased extracellular dopamine levels in the nucleus accumbens. Psilocin did not affect the extracellular 5-HT level in the nucleus accumbens. Conversely, systemic administration of psilocin (10 mg/kg) significantly increased extracellular 5-HT levels in the medial prefrontal cortex of rats, but dopamine was decreased in this region. However, neither extracellular dopamine nor 5-HT levels in the VTA were altered by administration of psilocin. Behaviorally, psilocin significantly increased the number of head twitches. Thus, psilocin affects the dopaminergic system in the nucleus accumbens. In the serotonergic system, psilocin contribute to a crucial effect in the medial prefrontal cortex. The present data suggest that psilocin increased both the extracellular dopamine and 5-HT concentrations in the mesoaccumbens and/or mesocortical pathway.

Sakashita, Y., Abe, K., Katagiri, N., Kambe, T., Saitoh, T., Utsunomiya, I., … & Taguchi, K. (2014). Effect of psilocin on extracellular dopamine and serotonin levels in the mesoaccumbens and mesocortical pathway in awake rats. Biological and Pharmaceutical Bulletin, 38(1), 134-138. http://dx.doi.org/10.1248/bpb.b14-00315
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Ketamine: Promising Path or False Prophecy in the Development of Novel Therapeutics for Mood Disorders?

Abstract

Large ‘real world’ studies demonstrating the limited effectiveness and slow onset of clinical response associated with our existing antidepressant medications has highlighted the need for the development of new therapeutic strategies for major depression and other mood disorders. Yet, despite intense research efforts, the field has had little success in developing antidepressant treatments with fundamentally novel mechanisms of action over the past six decades, leaving the field wary and skeptical about any new developments. However, a series of relatively small proof-of-concept studies conducted over the last 15 years has gradually gained great interest by providing strong evidence that a unique, rapid onset of sustained, but still temporally limited, antidepressant effects can be achieved with a single administration of ketamine. We are now left with several questions regarding the true clinical meaningfulness of the findings and the mechanisms underlying the antidepressant action. In this Circumspectives piece, Dr Sanacora and Dr Schatzberg share their opinions on these issues and discuss paths to move the field forward.

Sanacora, G., & Schatzberg, A. F. (2015). Ketamine: Promising Path or False Prophecy in the Development of Novel Therapeutics for Mood Disorders&quest. Neuropsychopharmacology, 40(2), 259-267. https://dx.doi.org/10.1038/npp.2014.261

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Online enquête naar het gebruik van Salvia

OLYMPUS DIGITAL CAMERAHeb je wel eens Salvia divinorum gebruikt? Onderzoekers van Harvard University in de VS zijn benieuwd naar je bevindingen. In een anonieme online enquête worden vragen gesteld over je gebruik, je ervaringen, en enkele persoonlijkheidskenmerken. De antwoorden zullen worden gebruikt voor een wetenschappelijk onderzoek. De enquête is geheel vrijblijvend, en er zullen geen identiteitsgegevens worden verzameld. Het beantwoorden zal ongeveer 45 minuten tot 1 uur in beslag nemen. De resultaten van het onderzoek worden gepubliceerd in een gerenommeerd tijdschrift. Wil je jouw ervaring(en) delen en tegelijkertijd een bijdrage leveren aan de wetenschap? Doe dan mee!

Klik hier om mee te doen.

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Online questionnaire about the use of Salvia

OLYMPUS DIGITAL CAMERADid you ever use Salvia divinorum? Researchers at Harvard University are eager to know what you experienced. In a completely anonymous online questionnaire you will be asked questions about your use, experiences, and some personality characteristics. The outcomes will be used for a scientific study. Participation is without any obligations, and no personally-identifiable information will be collected. Answering all questions will approximately take 45 minutes to 1 hour. The results of this study will be published in a renowned scientific magazine. Would you like to share your Salvia experience(s) and contribute to science? Then this is your chance!

Click here to participate.

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Ketamine and Rapid-Acting Antidepressants: A Window into a New Neurobiology for Mood Disorder Therapeutics

Abstract

Ketamine is the prototype for a new generation of glutamate-based antidepressants that rapidly alleviate depression within hours of treatment. Over the past decade, there has been replicated evidence demonstrating the rapid and potent antidepressant effects of ketamine in treatment-resistant depression. Moreover, preclinical and biomarker studies have begun to elucidate the mechanism underlying the rapid antidepressant effects of ketamine, offering a new window into the biology of depression and identifying a plethora of potential treatment targets. This article discusses the efficacy, safety, and tolerability of ketamine, summarizes the neurobiology of depression, reviews the mechanisms underlying the rapid antidepressant effects of ketamine, and discusses the prospects for next-generation rapid-acting antidepressants.

Abdallah, C. G., Sanacora, G., Duman, R. S., & Krystal, J. H. (2015). Ketamine and Rapid-Acting Antidepressants: A Window into a New Neurobiology for Mood Disorder Therapeutics. Medicine, 66. https://dx.doi.org/10.1146/annurev-med-053013-062946

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Anti-anhedonic effect of ketamine and its neural correlates in treatment-resistant bipolar depression

Abstract

Anhedonia—which is defined as diminished pleasure from, or interest in, previously rewarding activities—is one of two cardinal symptoms of a major depressive episode. However, evidence suggests that standard treatments for depression do little to alleviate the symptoms of anhedonia and may cause reward blunting. Indeed, no therapeutics are currently approved for the treatment of anhedonia. Notably, over half of patients diagnosed with bipolar disorder experience significant levels of anhedonia during a depressive episode. Recent research into novel and rapid-acting therapeutics for depression, particularly the noncompetitive N-Methyl-D-aspartate receptor antagonist ketamine, has highlighted the role of the glutamatergic system in the treatment of depression; however, it is unknown whether ketamine specifically improves anhedonic symptoms. The present study used a randomized, placebo-controlled, double-blind crossover design to examine whether a single ketamine infusion could reduce anhedonia levels in 36 patients with treatment-resistant bipolar depression. The study also used positron emission tomography imaging in a subset of patients to explore the neurobiological mechanisms underpinning ketamine’s anti-anhedonic effects. We found that ketamine rapidly reduced the levels of anhedonia. Furthermore, this reduction occurred independently from reductions in general depressive symptoms. Anti-anhedonic effects were specifically related to increased glucose metabolism in the dorsal anterior cingulate cortex and putamen. Our study emphasizes the importance of the glutamatergic system in treatment-refractory bipolar depression, particularly in the treatment of symptoms such as anhedonia.

Lally, N., Nugent, A. C., Luckenbaugh, D. A., Ameli, R., Roiser, J. P., & Zarate, C. A. (2014). Anti-anhedonic effect of ketamine and its neural correlates in treatment-resistant bipolar depression. Translational psychiatry, 4(10). https://dx.doi.org/10.1038/tp.2014.105

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Healing culture and its somewhat humorous discontents - July 22