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Immunological Effects of Ayahuasca in Humans

Abstract

Ayahuasca is a botanical hallucinogen traditionally used by indigenous groups of the northwest Amazon. In the last decade, the use of ayahuasca has spread from Brazil, Colombia, Ecuador, and Peru to the U.S., Europe, Asia, and Africa. Despite acute and long-term evidence of good tolerability and safety for ayahuasca administered in the laboratory or ritually consumed in religious contexts, little is known about the immunological impact of ayahuasca on humans. Since ayahuasca is used by an increasing number of consumers, and considering its therapeutic potential, more information is needed regarding ayahuasca potential risks. This article presents a brief overview of the available data regarding the immunological impact of ayahuasca in humans.

dos Santos, R. G. (2014). Immunological Effects of Ayahuasca in Humans. Journal of psychoactive drugs, 46(5), 383-388. https://dx.doi.org/10.1080/02791072.2014.960113

Link to full text

On the transmethylation hypothesis: stress, N,N-dimethyltryptamine, and positive symptoms of psychosis

Abstract

Past research suggests a relationship between stress and positive symptoms of psychosis. However, the biological substrate of this relationship remains unknown. According to the transmethylation hypothesis, schizophrenia could result from a biochemical disruption in the stress mechanism. This biochemical disruption would lead to the production of a substance that would account for the symptoms of psychosis. Moreover, some studies have tested endogenous N,N-dimethyltryptamine (DMT) in the context of the transmethylation hypothesis. Stress has been found to elevate DMT levels in rodents. Also, elevated DMT levels have been associated with positive features of psychosis in psychiatric patients. Additionally, healthy participants treated with exogenous DMT experience predominantly positive symptoms of psychosis. The present paper examines endogenous DMT as a possible biological mediator of the relationship between stress and positive symptoms of psychosis.

Grammenos, D., & Barker, S. A. (2014). On the transmethylation hypothesis: stress, N, N-dimethyltryptamine, and positive symptoms of psychosis. Journal of Neural Transmission, 1-7. https://dx.doi.org/10.1007/s00702-014-1329-5
Link to full text

The potential religious relevance of entheogens

At least since William James, scholars of religion have wondered if mystical experiences induced by means of chemical substances are similar or identical to, and have the same value as, naturally occurring ones. Lengthy debates ensued throughout the 20th century, fuelled in part by scientific research such as the classic Good Friday experiment conducted in 1962 by Walter Pahnke. As the discussion on these experiences induced by external means, and their implications, goes on today, Zygon: Journal of Religion and Science (vol. 49, no. 3) has devoted a section of its September 2014 issue to the potential religious relevance of entheogens [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].

In the first of four articles, Ron Cole-Turner focuses on the recent psilocybin research at the neuropsychopharmacology group at Imperial College London by Carhart-Harris et al. (2014), whose findings depart from the view that psychedelics increase neural activity in the brain. On the contrary, the researchers found that psilocybin decreases neural activity in the default mode network [2], which they suggest is the “seat of the ego”. This result is “highly suggestive in terms of how psilocybin might function in the brain to “occasion” mystical experience,” Cole-Turner writes. The author however takes issue with the “pejorative” label of “magical thinking” the London researchers associate with the subjects’ supernatural interpretations of their experiences. Here, he draws a line between the London research team and the team at Johns Hopkins [3] that also studies psilocybin. For the former, mystical quality seems to be an unwanted side-effect, writes the author, while for the latter it is the very focus of research, and a desirable feature. “More than science is at play here, and more than religion is at stake”, Cole-Turner concludes, wondering what we will make of what we are about to discover.

In the second article, William Richards, who worked with Walter Pahnke in the 1960s and has himself worked on recent psilocybin research, starts by stating that psychedelics “provide two new factors critical for religious scholarship […], namely potency and reliability”. This means that meaningful experiences can be safely induced in most subjects, and the author notes that over 200 persons have now safely received psilocybin within the framework of the Johns Hopkins psilocybin research. He goes on to define mystical experiences and distinguishes them along three binary dimensions: complete and incomplete, unitive and personal, and internal and external mystical experience. His research [4] has shown that both aspects of these dimensions are not mutually exclusive, as some scholars of religion have argued, and can be experienced by the same person. Richards lays out two avenues of potential interdisciplinary research for scholars of religion: the study of religious groups that use entheogens in a sacramental way, and collaborations with colleagues from other fields in the design of interdisciplinary studies with entheogens.

The Santo Daime religious movement, which uses the Amazonian brew ayahuasca as its main sacrament, is the focus of the third article, written by G. William Barnard. In the first, introductory part, the author distinguishes between the productive and transmissive theories of the brain. In the latter, consciousness pre-exists the brain, which serves as a transmitter to the human body and mind. The productive theory, on the other hand, posits that consciousness is altogether produced by the brain. If we were to take the transmissive perspective, then mystical or religious experiences are not just “the hallucinatory byproducts of cerebral malfunctions caused by the chemical activity of these substances”, the author writes. In the second part of the article, Barnard goes on to sketch the history and main theological tenets of Santo Daime. He suggests that “[Huston] Smith’s [5] desire to see the birth of a modern day mystery school that revolves around the sacramental use of entheogens has, in fact, been fulfilled”, citing the Native American Church, and the Brazilian União do Vegetal religious group as other examples. In Barnard’s view, one of the primary reasons for Santo Daime church members to uphold their strict discipline is the extent of spiritual transformation and physical healing their practice provides.

In the last article, Leonard Hummel underscores the importance of lasting effects from mystical experiences, and notes that the Johns Hopkins study [6] did look for and found desirable long-term effects in the lives of participants. Hummel contends that the validity of drug-induced mystical experience is hardly ever questioned anymore, despite criticism that research focuses on the individual religious experience (“a momentary sense of wow”) rather than on its repercussions in the community. In his view, these criticisms are not in line with the reality of either ongoing (clinical) trials (which include questionnaires about the effects on the community practices of participants), or of existing religious communities such as Santo Daime or peyote churches. He also hypothesizes that the Council on Spiritual Practices intends to give rise to recognized entheogen-based religious communities in the US. Hummel does not envision, however, the use of entheogens in Christian communities in the US, underscoring – among other things – possible health hazards, due to the possible lack of an adequate setting. Therefore the author concludes that the administration of entheogens had better remain confined to a therapeutic setting.

All articles appear in the September edition of Zygon: Journal of Religion and Science (volume 49, no. 3), The Potential Religious Relevance of Entheogens.


 
[1] “Entheogen” is a synonym for “psychedelic” that is often used in a religious context. Literally, it means a compound that “generates the divine within”.
[2] The default mode network is a network of brain areas that is mainly active in a state of rest, when attention is more focused inwards than outwards.
[3] See for example Griffiths et al. (2006).
[4] Richards (2008).
[5] Huston Cummings Smith is a well-known religious studies scholar from the United States.
[6] Griffiths et al. (2006).
 
References
Barnard, G. William (2014). Entheogens in a Religious Context: The Case of the Santo Daime Religious Tradition. Zygon: Journal of Religion and Science, 49(3), 666-684. [Abstract]
Carhart-Harris, Robin L., Robert Leech, Peter J. Hellyer, Murray Shanahan, Amanda Feilding, Enzo Tagliazucchi, Dante R. Chialvo, and David J. Nutt (2014). The Entropic Brain: A Theory of Conscious States Informed by Neuroimaging Research with Psychedelic Drugs. Frontiers in Human Neuroscience 8. doi : 10.3389/fnhum.2014.00020 [Abstract]
Cole-Turner, Ron (2014). Entheogens, Mysticism, and Neuroscience. Zygon: Journal of Religion and Science, 49(3), 642-651. [Abstract]
Griffiths, R. R., Richards, W. A., McCann, U. & Jesse, R. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance, Psychopharmacology, 187, 268–283. [Abtract]
Hummel, Leonard. By Its Fruits? Mystical and Visionary States of Consciousness Occasioned by Entheogens. Zygon: Journal of Religion and Science, 49(3), 685-695. [Abstract]
Richards, W. A. (2008). The Phenomenology and Potential Religious Import of States of Consciousness Facilitated by Psilocybin. Archive for the Psychology of Religion, 30, 189-199. [Abstract]
Richards William A. (2014). Here and Now: Discovering the Sacred with Entheogens. Zygon: Journal of Religion and Science, 49(3), 652-665. [Abstract][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

De potentiële religieuze relevantie van entheogenen

Ten minste sinds William James hebben religiewetenschappers zich afgevraagd of mystieke ervaringen die worden geïnduceerd door middel van chemische stoffen gelijkaardig of zelfs identiek zijn aan natuurlijk voorkomende mystieke ervaringen, en of ze dezelfde waarde hebben. Het debat woedde doorheen de 20e eeuw, en werd deels gevoed door wetenschappelijk onderzoek zoals het ondertussen klassiek geworden “Good Friday Experiment”, dat in 1962 door Walter Pahnke werd opgezet. Terwijl de discussie over deze ervaringen veroorzaakt door externe middelen, en de implicaties ervan, tot op heden voortduurt, heeft Zygon: Journal of Religion and Science (vol. 49, nr. 3) een thema gewijd aan de potentiële religieuze relevantie van entheogenen [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].

In het eerste van vier artikelen spitst Ron Cole-Turner zich toe op het recente psilocybine-onderzoek vanuit de neuropsychofarmacologie vakgroep aan Imperial College Londen door Carhart-Harris et al. (2014), waarvan de resultaten suggereren dat het idee dat psychedelica de neurale activiteit in de hersenen zouden doen toenemen niet klopt. De onderzoekers vonden integendeel dat deze stoffen de neurale activiteit in het defaultnetwerk [2] – dat ze bestempelen als de “zetel van het ego” – doen afnemen. Dit resultaat is “zeer sprekend wat betreft de manier waarop psilocybine mogelijk in het brein te werk gaat om mystieke ervaringen te ‘veroorzaken’,” schrijft Cole-Turner. De auteur maakt echter bezwaar tegen het “negatieve etiket” van “magisch denken” dat het Londens onderzoekteam associeert met bovennatuurlijke interpretaties die deelnemers over hun ervaringen vormen. Hij trekt hier een scheidingslijn tussen het Londens team en het team van de Johns Hopkins universiteit [3] dat eveneens psilocybine bestudeert. Het eerste ziet mystiek gehalte volgens de auteur als een ongewenst neveneffect, terwijl dit voor het andere team net het brandpunt van het onderzoek vormt, en dus een wenselijke eigenschap. “Er speelt hier meer dan wetenschap mee, en er staat meer dan religie op het spel,” besluit Cole-Turner, die zich tot slot afvraagt wat we zullen halen uit wat ons te ontdekken staat.

In het tweede artikel steekt William Richards, die in de jaren ’60 heeft samengewerkt met Walter Pahnke en ook heeft gewerkt aan recent psilocybine-onderzoek, van wal met de stelling dat psychedelica “twee nieuwe cruciale factoren [bieden] die cruciaal zijn voor religieonderzoek […], namelijk werkzaamheid en betrouwbaarheid”. Dit betekent dat bij de meeste deelnemers op een veilige manier zeer zinvolle ervaringen kunnen worden veroorzaakt, en de auteur merkt daarbij op dat al meer dan 200 personen in alle veiligheid psilocybine toegediend kregen in het kader van het Johns Hopkins psilocybine-onderzoek. Voorts definieert hij de mystieke ervaring, en maakt hij een onderscheid volgens drie binaire dimensies: volledige en onvolledige, unitieve en persoonlijke, en interne en externe mystieke ervaringen. Zijn onderzoekswerk [4] heeft uitgewezen dat beide aspecten van deze dimensies elkaar niet uitsluiten, zoals sommige religie-onderzoekers hebben beweerd, en dat ze dus door één en dezelfde persoon beleefd kunnen worden. Voor religie-onderzoekers ziet Richards twee onmiddellijk betreedbare onderzoekspaden: het bestuderen van religieuze groepen die entheogenen als sacrament gebruiken, en samenwerking met collega’s uit andere vakgebieden bij het ontwerpen van interdisciplinaire studies met entheogenen.

De religieuze beweging Santo Daime, die het Amazonebrouwsel ayahuasca als voornaamste sacrament gebruikt, staat centraal in het derde artikel, geschreven door G. William Barnard. In het inleidende eerste deel maakt de auteur een onderscheid tussen de productieve en de transmissieve theorie van het brein. In de tweede theorie is het bewustzijn pre-existent aan de hersenen, die in dat geval enkel fungeren als een transmitter naar geest en lichaam. De productieve, wetenschappelijk gangbare theorie, stelt integendeel dat het bewustzijn volledig door het brein geproduceerd wordt. Als we het transmissieve perspectief nemen, dan betekent dit volgens de auteur dat mystieke of religieuze ervaringen niet zomaar “hallucinatoire nevenproducten zijn van storingen veroorzaakt door de chemische werking van deze stoffen”. In het tweede deel schetst Barnard de geschiedenis en de belangrijkste theologische beginselen van Santo Daime. Hij suggereert dat “de wens van [Huston] Smith [5] om de geboorte mee te maken van een hedendaagse mysterieschool die draait rond het sacramenteel gebruik van entheogenen daadwerkelijk [is] uitgekomen”, waarbij hij de Native American Church en de Braziliaanse religieuze groepering União do Vegetal als andere voorbeelden aanhaalt. Volgens Barnard is één van de voornaamste redenen dat leden van Santo Daime hun strikte discipline volhouden het feit dat ze belangrijke spirituele transformatie en fysieke heling aan hun praktijken overhouden.

In het laatste artikel onderstreept Leonard Hummel het belang van langdurige effecten van mystieke ervaringen. Hij merkt bovendien op dat hier bij de Johns Hopkins psilocybinestudies [6] ook aandacht voor is geweest, en dat er diverse positieve langetermijneffecten bij de deelnemers werden gevonden. Hummel geeft aan dat de authenticiteit van mystieke ervaringen die door psychedelica worden veroorzaakt dezer dagen eigenlijk nog amper wordt aangevochten, behalve door de kritiek dat onderzoek zich eerder toelegt op de individuele religieuze ervaring (“een voorbijgaand wow-gevoel”) dan op de weerslag ervan op de gemeenschap. Volgens de auteur heeft deze bezorgdheid geen uitstaans met de realiteit van de lopende (klinische) studies (die bevragingen bevatten over de effecten op de sociale beleving van de deelnemers), noch van bestaande religieuze gemeenschappen zoals Santo Daime of peyotekerken. Hij formuleert ook de hypothese dat het Council on Spiritual Practices de bedoeling heeft om in de VS erkende religieuze gemeenschappen te doen ontstaan gebaseerd op entheogenen. Niettemin kan Hummel zich het gebruik van entheogenen in christelijke gemeenschappen in de VS niet voorstellen, en hamert hij onder andere op gezondheidsrisico’s wegens mogelijk gebrek aan een aangepaste setting. Daarom besluit de auteur dat het toedienen van entheogenen beter beperkt blijft tot een therapeutische context.

Alle artikelen zijn verschenen in het septembernummer van Zygon: Journal of Religion and Science (volume 49, no. 3), in het thema The Potential Religious Relevance of Entheogens


 
[1] “Entheogeen” is een synoniem voor “psychedelicum”, en wordt vaak in een religieuze context gebruikt. Letterlijk betekent het een stof die “het goddelijke binnenin (de mens) tot uiting doet komen”.
[2] Het defaultnetwerk is een netwerk van hersengebieden dat vooral actief is in rusttoestand, waarbij de aandacht eerder inwaarts is gericht.
[3] Zie onder andere Griffiths et al. (2006).
[4] Richards (2008).
[5] Huston Cummings Smith is een befaamde Amerikaanse religie-wetenschapper.
[6] Griffiths et al. (2006).
 
Referenties
Barnard, G. William (2014). Entheogens in a Religious Context: The Case of the Santo Daime Religious Tradition. Zygon: Journal of Religion and Science, 49(3), 666-684. [Abstract]
Carhart-Harris, Robin L., Robert Leech, Peter J. Hellyer, Murray Shanahan, Amanda Feilding, Enzo Tagliazucchi, Dante R. Chialvo, and David J. Nutt (2014). The Entropic Brain: A Theory of Conscious States Informed by Neuroimaging Research with Psychedelic Drugs. Frontiers in Human Neuroscience 8. doi : 10.3389/fnhum.2014.00020 [Abstract]
Cole-Turner, Ron (2014). Entheogens, Mysticism, and Neuroscience. Zygon: Journal of Religion and Science, 49(3), 642-651. [Abstract]
Griffiths, R. R., Richards, W. A., McCann, U. & Jesse, R. (2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance, Psychopharmacology, 187, 268–283. [Abtract]
Hummel, Leonard. By Its Fruits? Mystical and Visionary States of Consciousness Occasioned by Entheogens. Zygon: Journal of Religion and Science, 49(3), 685-695. [Abstract]
Richards, W. A. (2008). The Phenomenology and Potential Religious Import of States of Consciousness Facilitated by Psilocybin. Archive for the Psychology of Religion, 30, 189-199. [Abstract]
Richards William A. (2014). Here and Now: Discovering the Sacred with Entheogens. Zygon: Journal of Religion and Science, 49(3), 652-665. [Abstract][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

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]

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]

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.

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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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