OPEN Foundation

Author name: OPEN Foundation

Neurovascular Plasticity of the Hippocampus One Week after a Single Dose of Ketamine in Genetic Rat Model of Depression

Abstract

Glutamatergic system and the structural plasticity hypothesis are principal components for rapid and sustained antidepressant effects of novel antidepressant therapeutics. This study represents the first investigation of the structural plasticity of the hippocampus as one of the main contributed mechanisms to the sustained anti-depressive effect of ketamine. Flinders Sensitive Line (FSL) and Flinders Resistant Line (FRL) rats were given a single intraperitoneal injection of ketamine (15 mg/kg) or saline 7 days before perfusion-fixed. The optical fractionator method was used to estimate the total number of neurons in the granular cell layer. Microvessel length in the molecular layer of DG was evaluated with global spatial sampling method. By use of the physical disector method, the number of synapses was estimated. The volume of the hippocampus was larger in the FRL-vehicle rats compared with FSL-vehicle group and in FSL-ketamine versus FSL-vehicle rats (P < 0.05). The number of non-perforated synapses was significantly higher in the FSL-ketamine versus FSL-vehicle group, (P = 0.01). A significant effect of ketamine on enhancement of the number of neurons in DG in FSL rats was observed (P = 0.01). The total length of the microvessels 1 week after ketamine treatment in the FSL rats significantly increased (P  < 0.05). Our results indicate that neurovascular changes of hippocampus could be one of the possible mechanisms underlying the sustained antidepressant effect of ketamine by reversing alteration of the number of the excitatory synapses, neuronal number and length of the microvessels in the hippocampus.

Ardalan, M., Wegener, G., Polsinelli, B., Madsen, T. M., & Nyengaard, J. R. (2016). Neurovascular Plasticity of the Hippocampus One Week after a Single Dose of Ketamine in Genetic Rat Model of Depression. Hippocampus. http://dx.doi.org/10.1002/hipo.22617
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Long-term follow up of psilocybin-assisted smoking cessation

Abstract

Background: A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. Objectives: To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration.
Methods: The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin.
Results: All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16–57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.
Conclusion: These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

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Jeff Guss – Psilocybin-assisted therapy for treatment of existential distress in cancer patients

Existential distress in reaction to a life-threatening illness is often undertreated and mistreated in western medicine.  A randomized clinical trial of psilocybin assisted therapy for treatment of existential distress in cancer patients was recently completed at NYU School of Medicine with Stephen Ross, MD, Principal Investigator and Drs. Anthony Bossis, PhD and Dr. Guss as Co-Principal Investigators.   The results will be published as “Rapid and Sustained Symptom Reduction following Psilocybin Treatment for Anxiety and Depression in Patients with Life-Threatening Cancer:  A Randomized Controlled Trial” during 2016. During talk, Dr. Guss will describe the NYU study in detail, including its history, the structure and content of the therapy sessions and our method for training clinicians to work as study therapists.   After presenting outcome data from the study, a short film with participants from the study will be shown.
Biography
Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with a specializations in psychoanalytic therapy and the treatment of substance used disorders. He is a Co-Principal Investigator, study therapist and the Director of Therapist Training for the NYU School of Medicine’s study on psilocybin-assisted psychotherapy in the treatment of existential distress related to cancer diagnosis and treatment, and is a co-author of “Rapid and Sustained Symptom Reduction Following Psilocybin Treatment for Anxiety and Depression in Patients with Life-Threatening Cancer: A Randomized Clinical Trial”. He is also a study therapist for NYU School of Medicine’s “Psilocybin Treatment of Alcohol Dependence” RCT study.
Dr Guss is particularly interested in the integration of psychedelic therapies with contemporary models of psychodynamic therapy and exploration of the practice models for future use of psychedelic medicines in clinical practice. He is an Instructor, Mentor and on the Council of Advisors for the California Institute of Integral Studies’ Center for Psychedelic Therapies and Research and on the Advisory Board for the Center for Optimal Living’s Psychedelic Education and Continuing Care Program. He has published on the topics of gender and sexuality in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. Dr. Guss maintains a private practice of psychiatry and psychotherapy in New York City.

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Torsten Passie – Waves of research with psychedelics 1980-2015: an overview

This lecture provides a rough overview of four decades of research into psychedelics in Europe and the US.
Research “started again” in the mid-eighties, when European and American researchers penetrated through administrative barriers. Early MDMA psychotherapy research began in the end-1970s, modern German studies into mescaline and MDEA began in the late 1980s. Since 1985 the founding of the Swiss Physicans Society for Psycholytic therapy (SAEPT) and the European College for the Study of Consciousness (ECSC) by Leuner, Albert Hofmann and others triggered these developments. The founding of the Multidisciplinary Association for Psychedelic Studies (MAPS) in 1986 and the  Heffter Research Institute (HRI) in 1993 and later marked the stabilization of developments. A lot of research studies was initiated since the beginning 1990s, especially in respect to MDMA. MDE and psilocybin.
Since 2010 the scientific climate changed, partially because of ineffective antidepressants and malign side-effects of psychopharmacological medications. Another track came from the realization of the complexitiy of brain function. Substances which were formerly called “dirty drugs” for being not specific to one receptor (system) became interesting again because they may configurate a matrix of brain-functioning helpful for healing. Psychotherapy-promoting drugs like some psychedelics may become relevant therapeutic options in the future.
A retrospective view suggests a wave-like pattern of interest in psychedelics. Appropriate recognition of the limits of using these substances in everyday psychiatric/psychotherapeutic practice is discussed.
Biography
Torsten Passie (*1961) is currently Visiting Professor at Harvard Medical School (Boston, USA). He studied philosophy, sociology (M.A.) at Leibniz-University, Hannover and medicine at Hannover Medical School. His medical dissertation was on existential psychiatry. He worked at the Psychiatric University Clinic in Zürich (Switzerland) and with Professor Hanscarl Leuner (Göttingen), the leading European authority on hallucinogenic drugs. His extensive research at Hannover Medical School covers the psychophysiology of altered states of consciousness and their healing potential, including clinical research with hallucinogenic drugs (cannabis, ketamin, nitrous oxide, MDMA, psilocybin). He is an internationally known expert on altered states of consciousness and the pharmacology of hallucinogenic drugs. His publications appeared in Journal of Psychopharmacology, Neuropsychobiology, Addiction, CNS Neuroscience and Therapeutics, Journal of Nervous and Mental Disease and others.

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A Public-Health-Based Vision for the Management and Regulation of Psychedelics

Abstract

The Health Officers Council of British Columbia has proposed post-prohibition regulatory models for currently illegal drugs based on public health principles, and this article continues this work by proposing a model for the regulation and management of psychedelics. This article outlines recent research on psychedelic substances and the key determinants of benefit and harm from their use. It then describes a public-health-based model for the regulation of psychedelics, which includes governance, supervision, set and setting controls, youth access, supply control, demand limitation, and evaluation.

Haden, M., Emerson, B., & Tupper, K. W. (2016). A Public-Health-Based Vision for the Management and Regulation of Psychedelics. Journal of Psychoactive Drugs, 1-10. 10.1080/02791072.2016.1202459

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MDMA as a Probe and Treatment for Social Behaviors

Abstract

MDMA, better known as the recreational drug “ecstasy,” is well known for stimulating a feeling of closeness and empathy in its users. We advocate that exploring its mechanism of action could lead to new treatments for psychiatric conditions characterized by impairments in social behavior.

Heifets, B. D., & Malenka, R. C. (2016). MDMA as a Probe and Treatment for Social Behaviors. Cell, 166(2), 269-272. http://dx.doi.org/10.1016/j.cell.2016.06.045
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From Psychiatry to Flower Power and Back Again: The Amazing Story of Lysergic Acid Diethylamide

Abstract

Among the psychedelic drugs that enjoyed a period of popularity in psychiatric research during the 1950s and 1960s, lysergic acid diethylamide (LSD) is the most prominent one. Psychiatrists of that time had seen LSD not only as a tool for psychotherapy but also as a potential therapeutic for anxiety, depression, alcohol abuse, autism, and even schizophrenia. When it became a quasi-religious epitome of the Hippie counterculture in the mid 1960s, and cases of what we now call hallucinogen persisting perception disorder and acute psychotic “flashbacks” mounted, authorities moved to make LSD illegal. Although research was never actually forbidden, the field almost completely dried out until the early 2010s. Using today’s tools of molecular pharmacology, functional imaging, and neuronal network theory, neuropsychiatry is now resurrecting LSD research-with implications that leave us with many medical and ethical questions. Few people are aware that this is a repurposed compound, originally developed in an effort to synthesize a new analeptic. On top of all potential LSD might have in psychiatry, it also serves as a reminder of the unexpected potential that discarded early-stage compounds can have.

Mucke, H. A. (2016). From Psychiatry to Flower Power and Back Again: The Amazing Story of Lysergic Acid Diethylamide. ASSAY and Drug Development Technologies. 10.1089/adt.2016.747.

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MDMA and PTSD treatment: “PTSD: From novel pathophysiology to innovative therapeutics”

Abstract

There is a range of therapies to treat Post Traumatic Stress Disorder (PTSD) but treatment resistance remains high, with many sufferers experiencing the chronic condition. Engagement in trauma-focused psychotherapy is difficult for some patients with PTSD, especially those with extreme affect dysregulation associated with recall of traumatic memories. In recent years there have been a number of neuroscientific and clinical studies examining the potential role for adjunctive drug-assisted psychotherapy using 3,4,-methylenedioxmethamphetamine (MDMA) as a treatment for PTSD. re-visiting of a novel approach to trauma-focused psychotherapy with Used just two or three times, under careful medical supervision and specialised psychotherapy support MDMA appears to facilitate the recall of traumatic memories without the user feeling overwhelmed by the negative affect that usually accompanies such memories. This therapeutic approach began in the 1980s and was subsequently shelved in the midst of public health concerns surrounding the recreational use of the drug ecstasy. When pharmaceutical grade MDMA is used in a clinical setting it does not share the same risk profiles as ecstasy. Recent phase one neurophysiological studies and phase two clinical studies are showing promise as a potential new approach to managing treatment-resistant PTSD.

Sessa, B. (2016). MDMA and PTSD Treatment. Neuroscience Letters. http://dx.doi.org/10.1016/j.neulet.2016.07.004
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Efficacy and safety of ketamine in bipolar depression: A systematic review

Abstract

The depression is the most prevalent state throughout the life of the bipolar patient. Ketamine has been shown to be an effective and rapid treatment for depression. The objective of the present work is to perform a systematic review on the efficacy and safety of ketamine as treatment of bipolar depression, as well as its different patterns of administration. The search found 10 relevant manuscripts that met the inclusion criteria: one clinical trial, 5 cohort studies, and 4 case reports. Intravenous infusion was used in 60% of the studies. According to data, ketamine seems to be an effective and safe treatment for bipolar depression, although the length of its effect is short. Adverse effects observed generally occurred at the time of infusion, and tended to completely disappear within 1-2h. Therefore, more studies are necessary to explore new patterns of administration, as well as on its safety and adverse effects.

Alberich, S., Martínez-Cengotitabengoa, M., López, P., Zorrilla, I., Núñez, N., Vieta, E., & González-Pinto, A. (2016). Efficacy and safety of ketamine in bipolar depression: A systematic review. Revista de psiquiatria y salud mental. 10.1016/j.rpsm.2016.05.005

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Clinical Applications of Hallucinogens: A Review

Abstract

Hallucinogens fall into several different classes, as broadly defined by pharmacological mechanism of action, and chemical structure. These include psychedelics, entactogens, dissociatives, and other atypical hallucinogens. Although these classes do not share a common primary mechanism of action, they do exhibit important similarities in their ability to occasion temporary but profound alterations of consciousness, involving acute changes in somatic, perceptual, cognitive, and affective processes. Such effects likely contribute to their recreational use. However, a growing body of evidence indicates that these drugs may have therapeutic applications beyond their potential for abuse. This review will present data on several classes of hallucinogens with a particular focus on psychedelics, entactogens, and dissociatives, for which clinical utility has been most extensively documented. Information on each class is presented in turn, tracing relevant historical insights, highlighting similarities and differences between the classes from the molecular to the behavioral level, and presenting the most up-to-date information on clinically oriented research with these substances, with important ramifications for their potential therapeutic value.

Garcia-Romeu, A., Kersgaard, B., & Addy, P. H. (2016). Clinical applications of hallucinogens: A review. Experimental and clinical psychopharmacology, 24(4), 229. 10.1037/pha0000084
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Women and Psychedelics: Cycles, Care, and Conditions - October 23rd