OPEN Foundation

Author name: OPEN Foundation

Psychedelics in the treatment of unipolar mood disorders: A systematic review

Abstract

Unipolar mood disorders, including major depressive disorder and persistent depressive disorder (dysthymia), confer high rates of disability and mortality and a very high socioeconomic burden. Current treatment is suboptimal in most cases and there is little of note in the pharmaceutical development pipeline. The psychedelic drugs, including lysergic acid diethylamide and psilocybin, were used extensively in the treatment of mood disorders, and other psychiatric conditions, before their prohibition in the late 1960s. They are relatively safe when used in medically controlled environments, with no reported risk of dependence. Here, we present a systematic review of published clinical treatment studies using psychedelics in patients with broadly defined unipolar mood disorder, and consider their place in psychiatry. Whilst all the included studies have methodological shortcomings, of 423 individuals in 19 studies, 335 (79.2%) showed clinician-judged improvement after treatment with psychedelics. A recently completed pilot study in the UK favours the use of psilocybin with psychological support in treatment resistant depressive disorder. The evidence overall strongly suggests that psychedelics should be re-examined in modern clinical trials for their use in unipolar mood disorders and other non-psychotic mental health conditions.

Rucker, J. J., Jelen, L. A., Flynn, S., Frowde, K. D., & Young, A. H. Psychedelics in the Treatment of Unipolar Mood Disorders: A Systematic Review.
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Lysergic Acid Diethylamide and mystical experiences

Abstract

The term psychedelic (“mind-manifesting”) was coined by British psychiatrist Humphry Osmond in 1956 to refer to a unique class of mind-altering chemicals with distinctive effects that set them apart from other drugs with hallucinogenic properties. Some psychedelics come from natural sources that have been traditionally featured in religious, ritual, and healing practices of indigenous cultures of the Americas (Anderson, 1980; Hofmann, 1983; Salak, 2007; Smith, 2000); such drugs include mescaline (from peyote and San Pedro cacti), psilocybin and psilocin (from Psilocybe mushrooms), and dimethyltryptamine or DMT (from the leaves of Psychotria viridis). Many other psychedelics have partly or wholly synthetic origins. The most potent psychedelic agent yet discovered is the semisynthetic ergot derivative lysergic acid diethylamide (LSD), which has distinctive effects at the microscopic dose of 25 μg; a typical psychedelic dose ranges from 50 to 200 μg. There are also a number of purely synthetic psychedelics, many of which are chemically related to both amphetamine and mescaline (Shulgin & Shulgin, 1991). One of the most potent of these is dimethoxymethylamphetamine, or DOM, which was known as “STP” when introduced to the hippie subculture of San Francisco in the late 1960s. More familiar today is methylenedioxymethamphetamine (MDMA, ecstasy), which has only mild or partial psychedelic effects as opposed to full psychedelics such as LSD, psilocybin, and mescaline; MDMA is thus sometimes described as an “entactogen,” meaning “touch within” (Bravo, 2001; Smith, 2000), as opposed to full psychedelics or “entheogens,” meaning “God within.” A newer, extremely potent synthetic psychedelic, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[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-methoxyphenyl)methyl] ethanamine (2CI-NBOMe, or “N-Bomb”), was invented in 2003 and is useful as a laboratory tool to map brain serotonin receptors (Ettrup et al., 2010). The threshold dose is several hundred micrograms, making this psychedelic second in potency only to LSD. Media reports indicate that 2CI-NBOMe has been sold to drug users on pieces of blotter paper, like LSD, and often misrepresented as the latter drug. Unfortunately 2CI-NBOMe has a much lower therapeutic index than LSD, hence several highly publicized deaths appear to have been caused by this drug (e.g., Hastings, 2013; Poklis et al., 2014) and, in some cases, possibly misattributed to LSD. Some of the deaths resulted from drug-induced seizures, whereas in other cases the individuals killed themselves accidentally or purposefully in a drug-induced psychotic or delirious state. By contrast, fatal reactions are extremely uncommon with the “classic” psychedelics LSD, psilocybin, and mescaline.

Lyvers, M. (2016). Lysergic Acid Diethylamide and mystical experiences. 10.1016/B978-0-12-800212-4.00078-9
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The Relationship between depression and use of ecstasy among adolescents in Taiwan

Abstract

Introduction: The aim of this cross-sectional study was to examine the relationship between depression and ecstasy use among adolescents in Taiwan by controlling for the effects of demographic characteristics and cannabis use.

Methods: A total of 10,262 adolescents aged 12-18 years completed research questionnaires that assessed their severity of depression, status of ecstasy use, and history of cannabis use. The participants were grouped into non-users, ex-users, and current users. Severity of depression among these three adolescent groups was compared using analysis of covariance (ANCOVA), considering the history of cannabis use and demographic characteristics as covariates.
Results: After controlling for history of cannabis use and age, the study found that current ecstasy users experienced more severe depressive symptoms than ex-users and non-users. The difference between ex-users and non-users was not significant.
Conclusion: This study found that current ecstasy users had more severe depressive symptoms than non-users and ex-users. Psychological health professionals must monitor depressive symptoms among adolescent ecstasy users and provide emotional regulation strategies and psychological intervention for those with significant depression.
Lee, K. H., Su, C. H., Hsiao, R. C., Yen, C. N., & Yen, C. F. (2016). The Relationship between depression and use of ecstasy among adolescents in Taiwan. Neuropsychiatry (London), 6(4), 124-127. 10.4172/Neuropsychiatry.1000130
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The Entheogen Reformation

Abstract

In addition to promising leads for treating PTSD, addictions, depression, and death anxiety, 21st Century research at medical schools finds that with careful screening, insightful attention to the variables of set, setting, and dosage, psychedelic drug administration often facilitates significant spiritual experiences, meaningfulness, altruism, well-being, and similar prospiritual effects. This article calls for theologians, professors of religious studies, philosophy, sociology, and psychology to update their courses. It challenges leaders of religious organizations, ‘‘How can your institution incorporate these practices and benefit from them?’’

Roberts, T. B. (2016). THE ENTHEOGEN REFORMATION. Association for Transpersonal Psychology, 26.

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Psychedelic Psychotherapy Insights From 25 Years of Research

Abstract

Presented at a conference titled “Psychedelic Science 2013,” highlighting the resumption of investigations with psychedelic substances (i.e., psilocybin, DMT, LSD, MDMA, etc.) in the United States and Europe after a dormant period of more than two decades, the author presents insights and perspectives gleaned from his 25 years of clinical research experience. After acknowledging the vastness and potential significance of this research frontier, the article focuses on the “cartography of inner space”; the unique therapeutic potential of transcendental states of consciousness; the entelechy of the interpersonally grounded psyche; the importance of integration in drug-free therapy sessions; the roles of expectation, religious education and faith; the role of music; and future research directions.

Richards, W. A. (2016). Psychedelic Psychotherapy Insights From 25 Years of Research. Journal of Humanistic Psychology, 0022167816670996.
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Abraham Maslow’s Interest in Psychedelic Research: A Tribute

In this brief tribute to Abraham Maslow, a founder of the Journal of Humanistic Psychology, his interests in psychedelic research are described by the author who served as his research assistant from 1966 to 1967.
Richards, W. A. (2016). Abraham Maslow’s Interest in Psychedelic Research: A Tribute. Journal of Humanistic Psychology, 0022167816670997.
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A Case of 3,4-Dimethoxyamphetamine (3,4-DMA) and 3,4 Methylendioxymethamphetamine (MDMA) Toxicity with Possible Metabolic Interaction

Abstract

BACKGROUND: We present a case of “ecstasy” ingestion revealing 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-dimethoxyamphetamine (3,4-DMA) and absence of cytochrome P450 (CYP)-2D6 MDMA metabolites.

CASE REPORT: A 19-year-old presented following a seizure. Initial vital signs were normal. Laboratories were normal with the exception of sodium 127 mEq/L and urine drugs of abuse screen positive for amphetamines. Twelve hours later, serum sodium was 114 mEq/L and a second seizure occurred. After receiving hypertonic saline (3%), the patient had improvement in mental status and admitted to taking “ecstasy” at a rave prior to her initial presentation. Liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS) of serum and urine revealed MDMA, 3,4-DMA, and the CYP-2B6 MDMA metabolites 3,4-methylendioxyamphetamine (MDA) and 4-hydroxy-3-methoxyamphetamine (HMA). The CYP2D6 metabolites of MDMA, 3,4-dihydromethamphetamine (HHMA) and 4-hydroxy-3-methoxymethamphetamine (HMMA), were detected at very low levels.

CONCLUSION: This case highlights the polypharmacy which may exist among users of psychoactive illicit substances and demonstrates that concurrent use of MDMA and 3,4-DMA may predispose patients to severe toxicity. Toxicologists and other healthcare providers should be aware of this potential toxicity.

Darracq, M. A., Thornton, S. L., Minns, A. B., & Gerona, R. R. (2016). A Case of 3, 4-Dimethoxyamphetamine (3, 4-DMA) and 3, 4 Methylendioxymethamphetamine (MDMA) Toxicity with Possible Metabolic Interaction. Journal of Psychoactive Drugs, 1-4. 10.1080/02791072.2016.1225324
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Ayahuasca and Sumak Kawsay: Challenges to the Implementation of the Principle of “Buen Vivir,” Religious Freedom, and Cultural Heritage Protection

Abstract

The current environmental crisis can be approached, through many perspectives, as a civilizational crisis. Alternatives of human transcendence are identified in the Inca civilization to compensate for the malaise that characterizes the actual crisis. There is a multicultural dimension to the manifestations of Hoasca (or Ayahuasca) occurring in Amazonian countries. As employed by the Beneficent Spiritist Center União do Vegetal (UDV) in a religious context, it can contribute to the reconstruction of buen vivir (or in Quechua, sumak kawsay, meaning complete wellness), which served as the principle of the civilizations that preceded the colonization of the Americas by Europeans. Today, the State openly confronts the manifestation of the constitutional principles of buen vivir, religious freedom, and the protection of this cultural heritage. Here, the implications of the civilizational crisis and ways of overcoming it are approached from the standpoint of deep ecology, but the implications also reflect the doctrinal vision of the UDV to which the authors are affiliated.

Irigaray, C. T. J., Girard, P., Irigaray, M., & Silva, C. J. (2016). Ayahuasca and Sumak Kawsay: Challenges to the Implementation of the Principle of “Buen Vivir,” Religious Freedom, and Cultural Heritage Protection. Anthropology of Consciousness, 27(2), 204-225. 10.1111/anoc.12057
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Ayahuasca Treatment Center Safety for the Western Seeker

Abstract

Ayahuasca, an ancient Amazonian psychedelic tea traditionally used ceremonially among indigenous peoples, has recently become known as a possible treatment for a wide range of disorders. The awareness of this sacred medicine has grown exponentially over the past decade, attracting westerners from a wide variety of backgrounds, hoping to find treatment for a myriad of emotional and physical illnesses, as well as spiritual needs. In the wake of the commercialization and westernization of the use of ayahuasca, and the subsequent proliferation of ayahuasca treatment centers, this paper examines the benefits and possible risks of this form of therapy in an effort to create a safety protocol for Westerners in this context. The most practical approach to increasing safety for Westerners attending these Amazonian treatment centers is to educate the seeker prior to treatment and to provide access to specialized therapeutic aftercare services.

Ray, R. R., & Lassiter, K. S. (2016). Ayahuasca Treatment Center Safety for the Western Seeker. Anthropology of Consciousness, 27(2), 121-150. 10.1111/anoc.12060
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Women and Psychedelics: Cycles, Care, and Conditions - October 23rd