OPEN Foundation

Other substances

Investigating the role of 5-HT2A and 5-HT2C receptor activation in the effects of psilocybin, DOI, and citalopram on marble burying in mice

Abstract

Psychedelic drugs acting as 5-hydroxyptryptamine 2A receptor (5-HT2AR) agonists have shown promise as viable treatments of psychiatric disorders, including obsessive-compulsive disorder. The marble burying test is a test of compulsive-like behavior in mice, and psychedelics acting as 5-HT2AR agonists can reduce digging in this test. We assessed the 5-HT2R contribution to the mechanisms of two 5-HT2A agonists on digging behavior in female NMRI mice, using citalopram as a reference compound. While the 5-HT2AR antagonist M100907 blocked the effect of DOI and the 5-HT2CR antagonist SB242084 blocked the effect of citalopram, neither antagonist blocked the effect of psilocybin. This study confirms 5-HT2AR agonism as a mechanism for reduced compulsive-like digging in the MB test and suggests that 5-HT2A and 5-HT2CRs can work in parallel on this type of behavior. Our results with psilocybin suggest that a 5-HT2R-independent mechanism also contributes to the effect of psilocybin on repetitive digging behavior.

Odland, A. U., Kristensen, J. L., & Andreasen, J. T. (2021). Investigating the role of 5-HT2A and 5-HT2C receptor activation in the effects of psilocybin, DOI, and citalopram on marble burying in mice. Behavioural brain research, 401, 113093. https://doi.org/10.1016/j.bbr.2020.113093

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How psychedelic researchers’ self-admitted substance use and their association with psychedelic culture affect people’s perceptions of their scientific integrity and the quality of their research

Abstract

Across three studies (total N = 952), we tested how self-admitted use of psychedelics and association with psychedelic culture affects the public’s evaluation of researchers’ scientific integrity and of the quality of their research. In Studies 1 and 2, we found that self-admitted substance use negatively affected people’s assessment of a fictitious researcher’s integrity (i.e. being unbiased, professional, and honest), but not of the quality of his research, or how much value and significance they ascribed to the findings. Study 3, however, found that an association with psychedelic culture (i.e. presenting work at a scientific conference that includes social activities stereotypically associated with psychedelic culture) negatively affected perceived research quality (e.g. less valid, true, unbiased). We further found that the latter effect was moderated by participants’ personal experience with psychedelic substances: only participants without such experience evaluated research quality more negatively when it was presented in a stereotyped context.

Forstmann, M., & Sagioglou, C. (2021). How psychedelic researchers’ self-admitted substance use and their association with psychedelic culture affect people’s perceptions of their scientific integrity and the quality of their research. Public understanding of science (Bristol, England), 30(3), 302–318. https://doi.org/10.1177/0963662520981728

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A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics

Abstract

Pilot studies have hinted that serotonergic psychedelics such as psilocybin may relieve depression, and could possibly do so by promoting neural plasticity. Intriguingly, another psychotomimetic compound, ketamine, is a fast-acting antidepressant and induces synapse formation. The similarities in behavioral and neural effects have been puzzling because the compounds target distinct molecular receptors in the brain. In this opinion article, we develop a conceptual framework that suggests the actions of ketamine and serotonergic psychedelics may converge at the dendrites, to both enhance and suppress membrane excitability. We speculate that mismatches in the opposing actions on dendritic excitability may relate to these compounds’ cell-type and region selectivity, their moderate range of effects and toxicity, and their plasticity-promoting capacities.

Savalia, N. K., Shao, L. X., & Kwan, A. C. (2021). A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics. Trends in neurosciences, 44(4), 260–275. https://doi.org/10.1016/j.tins.2020.11.008

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Psychedelics and Psychotherapy

Abstract

Psychedelics have shown great promise in modern clinical trials for treating various psychiatric conditions. As a transdiagnostic treatment that exerts its effects through subjective experiences that leave enduring effects, it is akin to psychotherapy. To date, there has been insufficient discussion of how psychedelic therapy is similar to and different from conventional psychotherapy. In this article, we review the shared features of effective conventional psychotherapies and situate therapeutic psychedelic effects within those. We then discuss how psychedelic drug effects might amplify conventional psychotherapeutic processes-particularly via effects on meaning and relationship-as well as features that make psychedelic treatment unique. Taking into account shared features of conventional psychotherapies and unique psychedelic drug effects, we create a framework for understanding why psychedelics are likely to be effective with very diverse types of psychotherapies. We also review the formal psychotherapies that have been adjunctively included in modern psychedelic trials and extend the understanding of psychedelics as psychotherapy towards implications for clinical ethics and trial design. We aim to provide some common conceptual vocabulary that can be used to frame therapeutic psychedelic effects beyond the confines of any one specific modality.

Nayak, S., & Johnson, M. W. (2021). Psychedelics and Psychotherapy. Pharmacopsychiatry, 54(4), 167–175. https://doi.org/10.1055/a-1312-7297

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The History of Psychedelics in Psychiatry

Abstract

Initial interest in the value of psychedelic drugs (“psychotomimetics”) in psychiatry began in the early 20th century, with explorations of the possibility that mescaline or peyote could produce psychosis-like effects. Over time, interest was focused on whether the effects of psychedelics could inform as to the underlying basis for psychiatric disorders. As research continued, and especially after the discovery of LSD in 1943, increasing interest in a role for psychedelics as adjuncts to psychotherapy began to evolve and became the major focus of work with psychedelics up to the present day.

Nichols, D. E., & Walter, H. (2021). The History of Psychedelics in Psychiatry. Pharmacopsychiatry, 54(4), 151–166. https://doi.org/10.1055/a-1310-3990

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The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health

Abstract

Therapeutic psychedelic administration and contact with nature have been associated with the same psychological mechanisms: decreased rumination and negative affect, enhanced psychological connectedness and mindfulness-related capacities, and heightened states of awe and transcendent experiences, all processes linked to improvements in mental health amongst clinical and healthy populations. Nature-based settings can have inherently psychologically soothing properties which may complement all stages of psychedelic therapy (mainly preparation and integration) whilst potentiating increases in nature relatedness, with associated psychological benefits. Maximising enhancement of nature relatedness through therapeutic psychedelic administration may constitute an independent and complementary pathway towards improvements in mental health that can be elicited by psychedelics.

Gandy, S., Forstmann, M., Carhart-Harris, R. L., Timmermann, C., Luke, D., & Watts, R. (2020). The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health. Health psychology open, 7(2), 2055102920978123. https://doi.org/10.1177/2055102920978123

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Psychedelic-assisted therapy for functional neurological disorders: A theoretical framework and review of prior reports

Abstract

Functional neurological disorders (FNDs), which are sometimes also referred to as psychogenic neurological disorders or conversion disorder, are common disabling neuropsychiatric disorders with limited treatment options. FNDs can present with sensory and/or motor symptoms, and, though they may mimic other neurological conditions, they are thought to occur via mechanisms other than those related to identifiable structural neuropathology and, in many cases, appear to be triggered and sustained by recognizable psychological factors. There is intriguing preliminary evidence to support the use of psychedelic-assisted therapy in a growing number of psychiatric illnesses, including FNDs. We review the theoretical arguments for and against exploring psychedelic-assisted therapy as a treatment for FNDs. We also provide an in-depth discussion of prior published cases detailing the use of psychedelics for psychosomatic conditions, analyzing therapeutic outcomes from a contemporary neuroscientific vantage as informed by several recent neuroimaging studies on psychedelics and FNDs.

Stewart, B., Dean, J. G., Koek, A., Chua, J., Wabl, R., Martin, K., Davoodian, N., Becker, C., Himedan, M., Kim, A., Albin, R., Chou, K. L., & Kotagal, V. (2020). Psychedelic-assisted therapy for functional neurological disorders: A theoretical framework and review of prior reports. Pharmacology research & perspectives, 8(6), e00688. https://doi.org/10.1002/prp2.688

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Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System

Abstract

Introduction: Esketamine nasal spray received approval for treatment-resistant depression in March 2019.

Objective: Using the FDA Adverse Event Reporting System (FAERS) database (March 2019-March 2020), we analysed esketamine-related adverse events (AEs) to detect and characterize relevant safety signals.

Methods: We used the consolidated case/non-case approach to estimate the reporting odds ratio (ROR) and information component (IC) with relevant confidence intervals (95% CI) for esketamine-related AEs with ≥4 counts. Comparisons between serious and non-serious AEs were performed using non-parametric tests.

Results: The FAERS database contained 962 cases of esketamine-related AEs, with signals detected for several AEs, such as dissociation (ROR = 1,612.64, 95% CI = 1,354.63, 1,919.79; IC = 8.19, 95% CI = 7.96, 8.35), sedation (ROR = 238.46, 95% CI = 202.98, 280.15; IC = 7, 95% CI = 6.75, 7.18), feeling drunk (ROR = 96.17, 95% CI = 61.42, 150.57; IC = 4.84, 95% CI = 4.09, 5.36), suicidal ideation (ROR = 24.03, 95% CI = 18.72, 30.84; IC = 4.31, 95% CI = 3.9, 4.61), and completed suicide (ROR = 5.75, 95% CI = 3.18, 10.41; IC = 2.25, 95% CI = 1.23, 2.94). Signals for suicidal and self-injurious ideation, but not suicide attempt and completed suicide, remained when comparing esketamine to venlafaxine. Females and patients receiving antidepressant polypharmacy, co-medication with mood stabilizers, antipsychotics, benzodiazepines, or somatic medications were more likely to suffer from serious versus non-serious AEs (χ2 = 125.29, p < 0.001, χ2 = 9.08, p = 0.003, χ2 = 8.14, p = 0.004, χ2 = 19.48, p < 0.001, χ2 = 25.62, p < 0.001, and χ2 = 16.79, p < 0.001, respectively).

Conclusions: Esketamine may carry a clear potential for serious AEs, which deserves urgent clarification by means of further prospective studies.

Gastaldon, C., Raschi, E., Kane, J. M., Barbui, C., & Schoretsanitis, G. (2021). Post-marketing safety concerns with esketamine: a disproportionality analysis of spontaneous reports submitted to the FDA adverse event reporting system. Psychotherapy and psychosomatics90(1), 41-48; 10.1159/000510703
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Rethinking enhancement substance use: A critical discourse studies approach

Abstract

Background: We draw on both interdisciplinary enhancement substance use research and critical drug studies scholarship to reconceptualise enhancement substance use. Our critical discourse approach illuminates how a variety of substances are positioned as tools for self-improvement. In reconceptualising enhancement substance use, we ask what different substances can be positioned as providing enhancement? How are they positioned as tools for achieving enhancement or self-improvement goals? What discursive repertoires are employed to achieve these aims?

Methods: Forty interviews were conducted with people who use substances, such as ayahuasca, psilocybin, cocaine, alcohol, nootropics and non-prescription pharmaceuticals, including Adderall and modafinil. To explore the meanings of and motivations for substance consumption, we apply the sociocognitive approach (SCA) pioneered by Teun van Dijk (2014; 2015) and examine language through the triangulation of cognition, discourse and society. We analyse how different substances are positioned as tools for achieving enhancement or self-improvement goals.

Results: We identify three distinct discursive repertoires that frame substance use as enhancement: the discourse of transformation, the discourse of healing and the discourse of productivity. When accounting for enhancement substance use, our participants employ a number of discursive strategies, including ideological polarisation or ‘othering’, analogies, examples, maxims, metaphors and figurative speech. We also find evidence of interdiscursivity with most participants drawing on more than one discourse when speaking about how substances are positioned as providing enhancement.

Conclusion: We conclude that the concept of enhancement has wider applicability than current understandings allow. We argue that if we reframe all substance use as providing enhancement or achieving a self-improvement goal, we have the potential to destigmatise substance use and eliminate the over-simplistic binaries that surround it.

Askew, R., & Williams, L. (2021). Rethinking enhancement substance use: A critical discourse studies approach. The International journal on drug policy, 95, 102994. https://doi.org/10.1016/j.drugpo.2020.102994

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The Psychedelic Personality: Personality Structure and Associations in a Sample of Psychedelics Users

Abstract

Research on the relationship between personality and psychedelics use has found evidence of a two-way influence where the personality structure predicts individual responses to psychedelics, and psychedelics use results in lasting changes to the individual’s personality structure. This study used brief personality measures in the form of the Ten-Item Personality Inventory (TIPI) and a simplified version of the Risk Taking Index (RTI) in order to measure personality traits in a sample of psychedelics users (N = 319). The participants in the study scored consistently higher than norms on each of the Big Five traits except Extraversion, and on every dimension of risk taking in the RTI. In multivariate logistic regression analyses, personality structure was associated with characteristics of the psychedelic experience that included the feelings of fear, love, and peace as well as states of perceived contact with non-ordinary beings and transcendent forces.

Johnstad P. G. (2021). The Psychedelic Personality: Personality Structure and Associations in a Sample of Psychedelics Users. Journal of psychoactive drugs, 53(2), 97–103. https://doi.org/10.1080/02791072.2020.1842569

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30 April - Q&A with Rick Strassman

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