This talk will describe recently completed fMRI and MEG research with psilocybin and MDMA. I will describe the methods and main results of these studies and discuss their potential implications, both for understanding how the drugs work in the brain and how their effects may be relevant to psychiatry.
Een onderzoek naar de psychiatrische en neuropsychologische effecten van ayahuasca, uitgevoerd door de ‘Human Experimental Neuropsychopharmacology’ onderzoeksgroep van het Sant Pau ziekenhuis in Barcelona, in samenwerking met IDEAA en onderzoeksteams uit Spanje en Brazilië, heeft geen bewijs gevonden voor nadelige effecten op de geestelijke gezondheid van mensen die al 15 jaar lang minimaal twee maal per maand ayahuasca drinken.
Het Spaans / Braziliaanse onderzoeksteam, geleid door psycholoog José Carlos Bouso, onderzocht verschillende domeinen van de geestelijke gezondheid in een groep van 127 lange termijn ayahuasca drinkers in een religieuze context. Deze deelnemers werden vergeleken met een controlegroep bestaande uit 115 niet-drinkers. Om de betrouwbaarheid van het onderzoek te bevestigen, zijn de test een jaar later herhaald. Er werden geen persoonlijkheidsstoornissen gevonden onder de ayahuasca-drinkers en – opmerkelijk genoeg had deze groep zelfs lagere scores op psychopathologisch gebied en scoorden ze beter op sommige cognitieve taken dan de controlegroep. Deze resultaten zijn consistent met eerdere onderzoeken bij kleinere groepen ayahuasca-drinkers. Dit is de eerste studie die een grote groep onderzoekt en de resultaten heeft weten te repliceren. De auteurs geven aan dat de onderzochte groep bestaat uit mensen die al lange tijd ayahuasca drinken, wat duidelijk laat zien dat ze goed kunnen omgaan met de effecten van ayahuasca. Hun aanbeveling is dan ook om toekomstig onderzoek te richten op beginnende gebruikers die stoppen met het gebruik van ayahuasca vanwege psychologische problemen.
José Carlos Bouso is lid van het International Center for Ethnobotanical Education, Research & Service (ICEERS) en geeft een lezing tijdens het door Stichting OPEN georganiseerde Interdisciplinary Conference on Psychedelic Research, waar hij bovenstaand onderzoek zal bespreken.
Het gepubliceerde artikel (zowel het abstract als de volledige tekst) is hier te vinden.
An investigation into the psychiatric and neuropsychological status of long-term ayahuasca users – conducted by the Human Experimental Neuropsychopharmacology group of Hospital Sant Pau (Barcelona), in cooperation with IDEAA and research centers in Brazil and Spain – found no evidence of adverse psychiatric or neuropsychological effects. The team performed a longitudinal study of ayahuasca users who had been drinking for at least 15 years, at least twice a month.
The Spanish and Brazilian research team, headed by psychologist José Carlos Bouso, evaluated several domains of mental health in 127 long-time ayahuasca users in religious contexts. They compared these participants with 115 non-users. To confirm the reliability of the results, they repeated the tests one year later. Interestingly, the ayahuasca users showed no personality disorders, and had lower psychopathological indices and better cognitive performance in some neuropsychological tests than the non-users. The study concludes that there is “no evidence of psychological maladjustment, mental health deterioration or cognitive impairment in the ayahuasca-using group.” These results are consistent with earlier results obtained by other research groups that had studied smaller samples of users. This is the first study with long-term ayahuasca users that both assessed a sample of this size and replicated the results. The authors indicate that the study sample was composed of people that have been using ayahuasca for many years, which is a clear sign that they tolerate the ayahuasca well. The researchers suggest that future studies should focus specifically on participants that initiate the use of ayahuasca and then stop because of a psychological issue possibly related to its use.
José Carlos Bouso is currently a member of the International Center for Ethnobotanical Education, Research & Service (ICEERS) and will be discussing the results of this study during the Interdisciplinary Conference on Psychedelic Research, to be held in Amsterdam on the 6th and 7th of October 2012.
The scientific article (both abstract and full text) can be found here.
Een artikel in de Volkskrant van vanochtend (13 augustus 2012) laat zien dat er in Nijmegen plannen zijn voor onderzoek naar de effectiviteit van ibogaïne bij de behandeling van verslaving. Alhoewel ibogaïne al sporadisch wordt gebruikt, is er nog nauwelijks wetenschappelijk onderzoek met mensen gedaan.
Een onderzoeksteam, onder meer bestaande uit verslavingsarts Maarten Belgers en psychiater Toon van Oosteren wil – in samenwerking met de Radboud Universiteit in Nijmegen – onderzoeken of ibogaïne onder strikte begeleiding in een medische setting, effectief kan zijn in de behandeling van verslaving. Afgezien van onderzoek in dieren is er nog geen klinisch onderzoek in mensen gedaan.
Toon van Oosteren zegt in de Volkskrant dat ze tien tot vijftien verslaafden een ibogaïnebehandeling willen laten ondergaan. Het team concentreert zich nu eerst op de zoektocht naar ibogaïne die voldoet aan de strenge eisen voor wetenschappelijk onderzoek.
Lees hier het artikel in de Volkskrant.
An article in Dutch newspaper de Volkskrant shows there are plans to study the effectiveness of ibogaine in the treatment of addiction in Nijmegen.
The research team, consisting of addiction doctor Maarten Belgers and psychiatrist Toon van Oosteren, works in cooperation with the Radboud University in Nijmegen – to study whether ibogaine can – under strict medical conditions – be used effectively in the treatment of substance dependence. Despite various studies in animals, there has yet been no clinical study in humans. This study would be the first.
In de Volkskrant, Toon van Oosteren states that the researchers intend to subject ten to fifteen people with substance dependence to a treatment with ibogaine. Presently, the team is looking for ibogaine that is pure enough to comply with the rigorous scientific standards for medicines.
Read the whole article in Dutch here.
Ayahuasca is an Amazonian psychoactive plant beverage containing the serotonergic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and monoamine oxidase-inhibiting alkaloids (harmine, harmaline and tetrahydroharmine) that render it orally active. Ayahuasca ingestion is a central feature in several Brazilian syncretic churches that have expanded their activities to urban Brazil, Europe and North America. Members of these groups typically ingest ayahuasca at least twice per month. Prior research has shown that acute ayahuasca increases blood flow in prefrontal and temporal brain regions and that it elicits intense modifications in thought processes, perception and emotion. However, regular ayahuasca use does not seem to induce the pattern of addiction-related problems that characterize drugs of abuse. To study the impact of repeated ayahuasca use on general psychological well-being, mental health and cognition, here we assessed personality, psychopathology, life attitudes and neuropsychological performance in regular ayahuasca users (n = 127) and controls (n = 115) at baseline and 1 year later. Controls were actively participating in non-ayahuasca religions. Users showed higher Reward Dependence and Self-Transcendence and lower Harm Avoidance and Self-Directedness. They scored significantly lower on all psychopathology measures, showed better performance on the Stroop test, the Wisconsin Card Sorting Test and the Letter-Number Sequencing task from the WAIS-III, and better scores on the Frontal Systems Behavior Scale. Analysis of life attitudes showed higher scores on the Spiritual Orientation Inventory, the Purpose in Life Test and the Psychosocial Well-Being test. Despite the lower number of participants available at follow-up, overall differences with controls were maintained one year later. In conclusion, we found no evidence of psychological maladjustment, mental health deterioration or cognitive impairment in the ayahuasca-using group.
Bouso, J. C, González, D., Fondevila, S., Cutchet, M., Fernández, X., Barbosa, P. C. R., … Riba, J. (2012). Personality, Psychopathology, Life Attitudes and Neuropsychological Performance among Ritual Users of Ayahuasca: A Longitudinal Study. PLoS ONE 7(8), 1-13. http://dx.doi.org/10.1371/journal.pone.0042421
Link to full text
Ayahuasca is a medicinal plant mixture utilized by indigenous peoples throughout the Amazon River basin for healing purposes. The “vine of the soul” or “vine of death,” as it is known in South America, contains a combination of monoamine oxidase inhibitors and N,N-dimethyltryptamine (DMT). When ingested together, these medicines produce profound alterations in consciousness. Increasingly, ayahuasca is being utilized to treat addictions. However, the mechanism of action by which ayahuasca treats addictions remains unclear. We offer four hypotheses to explain possible biochemical, physiological, psychological, and transcendent mechanisms by which ayahuasca may exert its anti-addiction effects.
Liester, M. B., & Prickett, J. I. (2012). Hypotheses regarding the mechanisms of ayahuasca in the treatment of addictions. Journal of psychoactive drugs, 44(3), 200-208. 10.1080/02791072.2012.704590
Link to full text
Rationale
Both glutamate and serotonin (5-HT) play a key role in the pathophysiology of emotional biases. Recent studies indicate that the glutamate N-methyl-D-aspartate (NMDA) receptor antagonist ketamine and the 5-HT receptor agonist psilocybin are implicated in emotion processing. However, as yet, no study has systematically compared their contribution to emotional biases.
Objectives
This study used event-related potentials (ERPs) and signal detection theory to compare the effects of the NMDA (via S-ketamine) and 5-HT (via psilocybin) receptor system on non-conscious or conscious emotional face processing biases.
Methods
S-ketamine or psilocybin was administrated to two groups of healthy subjects in a double-blind within-subject placebo-controlled design. We behaviorally assessed objective thresholds for non-conscious discrimination in all drug conditions. Electrophysiological responses to fearful, happy, and neutral faces were subsequently recorded with the face-specific P100 and N170 ERP.
Results
Both S-ketamine and psilocybin impaired the encoding of fearful faces as expressed by a reduced N170 over parieto-occipital brain regions. In contrast, while S-ketamine also impaired the encoding of happy facial expressions, psilocybin had no effect on the N170 in response to happy faces.
Conclusion
This study demonstrates that the NMDA and 5-HT receptor systems differentially contribute to the structural encoding of emotional face expressions as expressed by the N170. These findings suggest that the assessment of early visual evoked responses might allow detecting pharmacologically induced changes in emotional processing biases and thus provides a framework to study the pathophysiology of dysfunctional emotional biases.
Schmidt, A., Kometer, M., Bachmann, R., Seifritz, E., & Vollenweider, F.X. (2012). The NMDA antagonist ketamine and the 5-HT agonist psilocybin produce dissociable effects on structural encoding of emotional face expressions. Psychopharmacology, 225(1), 227-239. http://dx.doi.org/doi:10.1007/s00213-012-2811-0
Link to full text
<br />
<br />
Ayahuasca is a psychedelic brew originally used for magico-religious purposes by Amerindian populations of the western Amazon Basin. Throughout the last four decades, the use of ayahuasca spread towards major cities in all regions of Brazil and abroad. This trend has raised concerns that regular use of this N,N-dimethyltryptamine- and harmala-alkaloid-containing tea may lead to mental and physical health problems associated typically with drug abuse. To further elucidate the mental and physical health of ayahuasca users, we conducted a literature search in the international medical PubMed database. Inclusion criteria were evaluation of any related effect of ayahuasca use that occurred after the resolution of acute effects of the brew. Fifteen publications were related to emotional, cognitive, and physical health of ayahuasca users. The accumulated data suggest that ayahuasca use is safe and may even be, under certain conditions, beneficial. However, methodological bias of the reviewed studies might have contributed to the preponderance of beneficial effects and to the few adverse effects reported. The data up to now do not appear to allow for definitive conclusions to be drawn on the effects of ayahuasca use on mental and physical health, but some studies point in the direction of beneficial effects. Additional studies are suggested to provide further clarification.
Barbosa, P. C. R., Mizumoto, S., Bogenschutz, M. P., & Strassman, R. J. (2012). Health status of ayahuasca users. Drug testing and analysis, 4(7-8), 601-609. https://dx.doi.org/10.1002/dta.1383
Link to full text
