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Therapeutic Application

Capturing the different health conditions that PAP may adress

No Difference in Brain Activation During Cognitive Performance Between Ecstasy (3,4-Methylenedioxymethamphetamine) Users and Control Subjects: A [H215O]-Positron Emission Tomography Study

Abstract

The long-term use of the serotonin-releaser and uptake-inhibitor 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”) has been associated with memory impairments and increased liability to depressive mood and anxiety attacks. It is unclear, however, whether these psychologic deviations are reflected in alterations of the underlying neurophysiologic substrate. The authors compared mood and regional cerebral blood flow (rCBF) profiles between regular polytoxic Ecstasy users and Ecstasy-naive controls. Brain activity as indexed by rCBF was measured during cognitive activation by an attentional task using positron emission tomography and [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”][H2(15)O]. Mood was assessed by means of the Hamilton Rating Scale for Depression (HAM-D) and the EWL Mood Rating Scale. Statistical parametric mapping revealed that brain activity did not differ between the two groups. Both groups also performed equally on the cognitive task requiring sustained attention. However, significantly higher levels of depressiveness as determined by the HAM-D and EWL scales were found in Ecstasy-using subjects. These data indicate that, despite differences in mood, polytoxic Ecstasy users do not differ from Ecstasy-naive controls in terms of local brain activity. Heightened depressiveness in the Ecstasy group was consistent with results from previous studies and could be related to serotonergic hypofunction resulting from repeated MDMA consumption. However, this study cannot exclude the possibility that the observed differences are preexisting rather than a result of Ecstasy use.

 

Gamma, A., Buck, A., Berthold, T., & Vollenweider, F. X. (2001). No difference in brain activation during cognitive performance between ecstasy (3, 4-methylenedioxymethamphetamine) users and control subjects: a [H215O]-positron emission tomography study. Journal of clinical psychopharmacology, 21(1), 66-71. http://dx.doi.org/10.1097/00004714-200102000-00012

 

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Psilocybin induces schizophrenia‐like psychosis in humans via a serotonin‐2 agonist action

Abstract

Psilocybin, an indoleamine hallucinogen, produces a psychosis-like syndrome in humans that resembles first episodes of schizophrenia. In healthy human volunteers, the psychotomimetic effects of psilocybin were blocked dose-dependently by the serotonin-2A antagonist ketanserin or the atypical antipsychotic risperidone, but were increased by the dopamine antagonist and typical antipsychotic haloperidol. These data are consistent with animal studies and provide the first evidence in humans that psilocybin-induced psychosis is due to serotonin-2A receptor activation, independently of dopamine stimulation. Thus, serotonin-2A overactivity may be involved in the pathophysiology of schizophrenia and serotonin-2A antagonism may contribute to therapeutic effects of antipsychotics.

Vollenweider, F. X., Vollenweider-Scherpenhuyzen, M. F., Bäbler, A., Vogel, H., & Hell, D. (1998). Psilocybin induces schizophrenia‐like psychosis in humans via a serotonin‐2 agonist action. Neuroreport, 9(17), 3897-3902. https://dx.doi.org/doi:10.1097/00001756-199812010-00024
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Serotonergic Agents That Activate 5HT2A Receptors Prevent NMDA Antagonist Neurotoxicity

Abstract

Phencyclidine, ketamine, and other agents that block NMDA glutamate receptors trigger a schizophrenia-like psychosis in humans and induce pathomorphological changes in cerebrocortical neurons in rat brain. Accumulating evidence suggests that a complex network disturbance involving multiple transmitter receptor systems is responsible for the neuronal injury, and it is proposed that a similar network disturbance is responsible for the psychotomimetic effects of NMDA antagonists, and might also be involved in the pathophysiology of schizophrenia. In the present study we present evidence that serotonergic agents possessing 5HT2A agonist activity prevent NMDA antagonist neurotoxicity in rat brain. It isproposed that 5HT2A agonists may also prevent the psychotomimetic effects of NMDA antagonists. Among the 5HT2A agonists examined and found to be neuroprotective are LSD and related hallucinogens. The apparent contradiction in proposing that these agents might have antipsychotic properties is resolved by evidence linking their hallucinogenic activity to agonist action at 5HT2C receptors, whereas antipsychotic activity would be attributable to agonist action at 5HT2A receptors.

Farber, N. B., Hanslick, J., Kirby, C., McWilliams, L., & Olney, J. W. (1998). Serotonergic Agents That Activate 5HT2A Receptors Prevent NMDA Antagonist Neurotoxicity. Neuropsychopharmacology, 18(1), 57-62. http://dx.doi.org/doi:10.1016/S0893-133X(97)00127-9

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Ketamine psychedelic therapy (KPT): a review of the results of ten years of research

Abstract

Ketamine is a prescription drug used for general anesthesia. In subanesthetic doses, it induces profound psychedelic experiences and hallucinations. The subanesthetic effect of ketamine was the hypothesized therapeutic mechanism in the authors’ use of ketamine-assisted psychotherapy for alcoholism. The results of a controlled clinical trial demonstrated a considerable increase in efficacy of the authors’ standard alcoholism treatment when supplemented by ketamine psychedelic therapy (KPT). Total abstinence for more than one year was observed in 73 out of 111 (65.8%) alcoholic patients in the KPT group, compared to 24% (24 out of 100 patients) of the conventional treatment control group (p < 0.01). The authors’ studies of the underlying psychological mechanisms of KPT have indicated that ketamine-assisted psychedelic therapy of alcoholic patients induces a harmonization of the Minnesota Multiphasic Personality Inventory (MMPI) personality profile, positive transformation of nonverbalized (mostly unconscious) self-concept and emotional attitudes to various aspects of self and other people, positive changes in life values and purposes, important insights into the meaning of life and an increase in the level of spiritual development. Most importantly, these psychological changes were shown to favor a sober lifestyle. The data from biochemical investigations showed that pharmacological action of KPT affects both monoaminergic and opioidergic neurotransmitter metabolism, i.e., those neurochemical systems which are involved in the pathogenesis of alcohol dependence. The data from EEG computer-assisted analysis demonstrated that ketamine increases theta activity in cerebrocortical regions of alcoholic patients. This is evidence of the reinforcement of limbic cortex interaction during KPT session.

Krupitsky, E. M., & Grinenko, A. Y. (1997). Ketamine psychedelic therapy (KPT): a review of the results of ten years of research. Journal of psychoactive drugs, 29(2), 165-183. https://dx.doi.org/10.1080/02791072.1997.10400185

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Positron emission tomography and fluorodeoxyglucose studies of metabolic hyperfrontality and psychopathology in the psilocybin model of psychosis

Abstract

The effects of the indolehallucinogen psilocybin, a mixed 5-HT2 and 5-HT1 agonist, on regional cerebral glucose metabolism were investigated in 10 healthy volunteers with PET and [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”][F-18]-fluorodeoxyglucose (FDG) prior to and following a 15- or 20-mg dose of psilocybin.

Psychotomimetic doses of psilocybin were found to produce a global increase in cerebral metabolic rate of glucose (CMRglu) with significant and most marked increases in the frontomedial and frontolateral cortex (24.3%), anterior cingulate (24.9%), and temporomedial cortex (25.3%). Somewhat smaller increases of CMRglu were found in the basal ganglia (18.5%), and the smallest increases were found in the sensorimotor (14.7%) and occipital cortex (14.4%). The increases of CMRglu in the prefrontal cortex, anterior cingulate, temporomedial cortex, and putamen correlated positively with psychotic symptom formation, in particular with hallucinatory ego disintegration. The present data suggest that excessive 5-HT2 receptor activation results in a hyperfrontal metabolic pattern that parallels comparable metabolic findings associated with acute psychotic episodes in schizophrenics and contrasts with the hypofrontality in chronic schizophrenic patients.

Vollenweider, F. X., Leenders, K. L., Scharfetter, C., Maguire, P., Stadelmann, O., & Angst, J. (1997). Positron emission tomography and fluorodeoxyglucose studies of metabolic hyperfrontality and psychopathology in the psilocybin model of psychosis. Neuropsychopharmacology, 16(5), 357-372. http://dx.doi.org/10.1016/S0893-133X(96)00246-1
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The psychopharmacology of hallucinogens.

Abstract

Hallucinogenic drugs have been inhaled, ingested, worshipped, and reviled since prehistory. With the purification and synthesis of bontanical preparations and the ensuing discovery of chemically unique agents, hope was raised regarding their therapeutic potential, but this hope has been clouded by an epidemic of abuse and an inventory of adverse effects. This review examines aspects of that controversy, including the history of hallucinogens, epidemiology of current hallucinogen abuse, the association of LSD use with prolonged psychoses and hallucinogen persisting perception disorder, and the efforts to demonstrate the drug’s therapeutic efficacy. Human subject ramifications in hallucinogen experimentation are discussed. Future lines of research are suggested in human, animal, and tissue culture paradigms.

Abraham, H. D., Aldridge, A. M., & Gogia, P. (1996). The psychopharmacology of hallucinogens. Neuropsychopharmacology, 14(4), 285-298. https://dx.doi.org/10.1016/0893-133X(95)00136-2
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Receptor binding profile suggests multiple mechanisms of action are responsible for ibogaine's putative anti-addictive activity

Abstract

The indole alkaloid ibogaine (NIH 10567, Endabuse) is currently being examined for its potential utility in the treatment of cocaine and opioid addiction. However, a clearly defined molecular mechanism of action for ibogaine’s putative anti-addictive properties has not been delineated. Radioligand binding assays targeting over 50 distinct neurotransmitter receptors, ion channels, and select second messenger systems were employed to establish a broad in vitro pharmacological profile for ibogaine. These studies revealed that ibogaine interacted with a wide variety of receptors at concentrations of 1-100 microM. These included the mu, delta, kappa, opiate, 5HT2, 5HT3, and muscarinic1 and 2 receptors, and the dopamine, norepinephrine, and serotonin uptake sites. In addition, ibogaine interacted with N-methyl-D-aspartic acid (NMDA) associated ion and sodium ion channels as determined by the inhibition of [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”][3H]MK-801 and [3H]bactrachotoxin A 20-alpha-benzoate binding (BTX-B), respectively. This broad spectrum of activity may in part be responsible for ibogaine’s putative anti-addictive activity.

Sweetnam, P. M., Lancaster, J., Snowman, A., Collins, J. L., Perschke, S., Bauer, C., & Ferkany, J. (1995). Receptor binding profile suggests multiple mechanisms of action are responsible for ibogaine’s putative anti-addictive activity. Psychopharmacology, 118(4), 369-376.
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LSD-assisted psychotherapy in patients with terminal cancer

Abstract

The paper describes the results of a clinical study exploring the potential of a complex psychotherapeutic program utilizing psychedelic compounds to alleviate the emotional and physical suffering of cancer patients. A total of 60 cancer patients participated in this experimental study. In 44 of these patients, LSD (200-500 ug per os) was administered as an adjunct to psychotherapy; in 19 patients, a new psychedelic compound, dipropyltryptamine (DPT) was administered (60-105 mg i.m.). Three of these patients received both LSD and DPT administered on different sessions.

The therapeutic results were assessed by means of a rating scale reflecting the degree of the patients’ depression, psychological isolation, anxiety, difficulty in management, fear of death, and pain. The ratings were done by attending physicians, nurses, family members, LSD therapists and cotherapists, and independent raters. In addition, the amount of narcotics required in the management of the patient was measured before and after the psychedelic sessions.

Systematic rating was carried out in a group of 31 cancer patients treated by LSD. The comparison of the means of individual ratings from pre- to posttreatment showed significant improvement in all the measured parameters for most of the raters. There was a definite reduction of the narcotic medication; it did not, however, reach the level of statistical significance. The pre- to post-treatment comparison of the global indexes used as gross indicators of the degree of emotional and physical distress, indicated that approximately 29 % of the patients showed dramatic improvement, and another 41.9 % moderate improvement, with 22.6 % essentially unchanged. In 6.4 % of the patients, global indexes showed a decrement in the post therapy ratings.

Grof, S., Goodman, L. E., Richards, W. A., & Kurland, A. A. (1972). LSD-assisted psychotherapy in patients with terminal cancer. International pharmacopsychiatry, 8(3), 129-144.
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LSD-Assisted Psychotherapy in Patients with Terminal Cancer

Abstract

The paper describes the results of a clinical study exploring the potential of a complex psychotherapeutic program utilizing psychedilic compounds to alleviate the emotional and physical suffering of cancer patients. A total of 60 cancer patients participated in this experimental study. In 44 of these patients, LSD (200-500 μg per os) was administered as an adjunct to psychotherapy; in 19 patients, a new psychedelic compound, dipropyltryptamine (DPT) was administered (60-105 mg i.m.). Three of these patients received both LSD and DPT administered on different sessions. The therapeutic results were assessed by means of a rating scale reflecting the degree of the patients’ depression, psychological isolation, anxiety, difficulty in management, fear of death, and pain. The ratings were done by attending physicians, nurses, family members, LSD therapists and cotherapists, and independent raters. In addition, the amount of narcotics required in the management of the patient was measured before and after the psychedelic sessions. Systematic rating was carried out in a group of 31 cancer patients treated by LSD. The comparison of the means of individual ratings from pre to posttreatment showed significant improvement in all the measured parameters for most of the raters. There was a definite reduction of the narcotic medication; it did not, however, reach the level of statistical significance. The pre to posttreatment comparison of the global indexes used as gross indicators of the degree of emotional and physical distress, indicated that approximately 29% of the patients showed dramatic improvement, and another 41.9% moderate improvement, with 22.6% essentially unchanged. In 6.4% of the patients, global indexes showed a decrement in the posttherapy ratings.
Grof, S., Goodman, L. E., Richards, W. A., & Kurland, A. A. (1973). LSD-assisted psychotherapy in patients with terminal cancer. International pharmacopsychiatry8, 129-144., 10.1159/000467984
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DPT as an adjunct in psychotherapy of alcoholics.

Abstract

The usefulness of dipropyltryptamine (DPT) as an adjunct to psychedelic therapy was explored in a pilot study carried out on 51 alcoholic patients from the Alcoholic Rehabilitation Unit at Spring Grove State Hospital. The evaluation of the results was based on the comparison of pre- and posttreatment results of a battery of psychological tests and of pretreatment and follow-up ratings of an independent team of social workers. The psychological tests involved the Minnesota multiphasic personality inventory (MMPI), Personal orientation inventory (POI), Raven progressive matrices, Psychiatric evaluation profile (PEP), and Benton visual retention test. The social history questionnaire used by the social workers for assessment of the patients’ adjustment consisted of 0-10-point scales measuring residential, occupational and interpersonal adjustment, abstinence, and global adjustment.
Grof, S., Soskin, R. A., Richards, W. A., & Kurland, A. A. (1973). DPT as an adjunct in psychotherapy of alcoholics. International pharmacopsychiatry8, 104-115., 10.1159/000467979
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