Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study

Preparations for rave music parties and consequences for attendees who consume psychedelic drugs

INTRODUCTION

A few studies have shown that rave music parties (RMP) enabled long-term positive transformative experiences. However, phenomenological inquiry on the subjective meaning of RMP attendees' experience before and after such parties is scant. The present study explored the preparations for participation in RMP and the parties' consequences for attendees who consume psychedelic drugs.

METHOD

The study used interpretative phenomenological analysis to analyze transcriptions of semi-structured interviews with 27 Israeli rave party attendees.

RESULTS

The study found five themes regarding attendees' preparations for RMP: physical preparations; anticipation and body sensations; cognitive preparations; social preparations; and logistic preparations. Four themes relate to the attendees' experienced consequences after RMP: physical consequences; emotional consequences; cognitive effects; and positive social consequences.

CONCLUSIONS

In light of liminality and rite of passage theories, the study highlights the importance of the pre-liminal rites of separation, including physical preparations, anticipation and body sensations, and cognitive, social and logistic preparations. The consequences after the party correspond to the post-liminal stage where the participants return to their normal life, yet with changes in physical, emotional, cognitive, and social aspects. Israeli policymakers should consider adopting European drug-checking policy as a harm reduction measure to minimize negative consequences of drug use in the pre-liminal and post-liminal stages of RMP.

Down the Rabbit Hole: A Large-Scale Survey of Psychedelic Users' Patterns of Use and Perceived Effects

The ever-changing landscape surrounding legality and accessibility of psychedelics and their increasing popularity make it imperative to better understand the nature of psychedelic use by the general population. To this end, 1,486 eligible respondents (Mage = 29.58, 67.1% male) residing in the United States completed an online survey designed to assess the types of psychedelics used, methods of administration and dosing, frequency of use, intentions for use, context/environments in which they are used, perceived acute effects, frequency of those effects and distress about them, and their perceived residual effects and distress about them. Respondents predominantly endorsed using MDMA, LSD, DMT, and psilocybin. The predominant methods of administration were oral. Most reported using psychedelics for recreational purposes. The most endorsed acute effects were hallucinations, increased heart rate, positive mood, and visual tracers, while the most endorsed residual effects were headaches/migraine, dry mouth, nausea, hallucinations, and anxiety. Participants were most distressed by negative mood states, vomiting, and nausea when under the acute effects of psychedelics, but mean distress ratings were low. These results can help inform clinical trials, reform policy regarding legal access to psychedelics, and track changes in these metrics as sociocultural and legal landscapes continue to shift.

Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm

BACKGROUND

Traditional treatments for post-traumatic stress disorder (PTSD) often show limited success with high dropout. Ketamine, an N-methyl-D-aspartate antagonist known for rapid antidepressant effects, has decreased PTSD symptoms in some studies but not in others. Administering ketamine in ways that parallel psychedelic-assisted treatments-including preparatory, integration, sensory immersion, and psychotherapy sessions-could decrease PTSD symptoms meaningfully.

METHODS

A retrospective sample of 117 screened outpatients with elevated PTSD Checklist for DSM-5 (PCL-5) scores received intravenous ketamine in supportive environments. The protocol included preparation, intention-setting, and integration sessions accompanying at least six administrations. Administration sessions included eye shades and evocative music paralleling typical psychedelic therapy trials.

RESULTS

Mean PCL scores decreased from 52.54 (SD = 12.01) to 28.78 (SD = 16.61), d = 1.64. Patients tolerated treatment well, with no serious adverse events. Covariates, including age, gender, days between PCL assessments, number of psychiatric medications, and suicidal ideation were not significant moderators; concomitant psychotherapy did reach significance, d = 0.51. Of the 117 patients' final PCL scores, 88 (75.21%) measures suggested clinically meaningful improvement and 72 (61.54%) suggested remission of PTSD symptoms.

CONCLUSION

Intravenous ketamine in supportive environments, with hallmarks of psychedelic therapy, preceded large reductions in PTSD symptoms. These results highlight ketamine's potential when delivered in this manner, suggesting environmental factors might account for some variation seen in previous work. Given the molecule's cost, minimal interaction with other psychiatric medications, and legal status, intravenous ketamine in a psychedelic paradigm may be a promising option for PTSD unresponsive to other treatments.

Single-dose 1cp-LSD administration for canine anxiety: a pilot study

Anxiety affects 14-20% of dogs. Pharmacological treatments often fail. Psychedelics have shown to be useful for anxiety and depression in humans, but their veterinary use remains unexplored. We aimed to determine the effects of low-dose 1-cyclopropionyl-d-lysergic acid diethylamide (1cp-LSD) administered in a single dose to a dog, to observe the effect and establish the safety of the substance. The patient was a 13-year-old female dog, weighing 13 kg, mixed breed, and spayed. A total of 5 µg was administered orally, equivalent to 0.38 µg/kg. The animal has had a history of separation related behavioral problems throughout her life. To objectively assess the degree of anxiety in the dog, a validated scale was utilized. The trial was scheduled at the house where the animal lives. The owner was present throughout the experience. Informed consent was obtained prior to the assay. The trial began at 12:15 p.m. on January 10, 2024, lasting for 5 and a half hours. The response to anxiety-inducing stimuli was equally anxious during the first two hours. From that point onwards, a significant change in the animal's behavior was observed, with no signs/mild signs of anxiety. The trial concluded without any adverse effects on the animal. The patient did not show signs of having a psychedelic experience. This is the first time that a study of this nature has been conducted and reported in the canine species. 1cp-LSD proved to be safe and exerted the desired effect on the animal's behavior, significantly reducing the patient's anxiety.

Moving psychedelic-assisted therapies from promising research into routine clinical practice: Lessons from the field of implementation science

Psychedelics (e.g., 3,4-Methylenedioxymethamphetamine [MDMA], lysergic acid diethylamide [LSD], psilocybin) are molecules that have the potential to produce rapid therapeutic effects when paired with psychotherapy. Randomized clinical trials of psychedelic-assisted psychotherapy (PAT) have shown promising results for post-traumatic stress disorder (PTSD), depression, and substance use disorders. The U.S. Food and Drug Administration has acknowledged the promise of PAT, signaling potential approval of psilocybin-assisted therapy for depression by 2026. Given this timeline, implementation scientists must engage with PAT researchers, policymakers, and practitioners to think critically about bringing these promising new treatments into routine practice settings while maintaining quality and safety. This commentary aims to initiate a dialogue between implementation scientists and PAT researchers and practitioners on addressing these questions with a lens toward equity. Specifically, we discuss how the field of implementation science can support PAT stakeholders to accelerate the translational process from research into practice, focusing specifically on safety-net settings (i.e., Federally Qualified Health Centers and Veterans Affairs health systems) that serve historically marginalized populations. We use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to illustrate five critical areas where implementation science can help move PAT from research into real-world practice. For each RE-AIM dimension, we highlight ways the field of implementation science can contribute tools (e.g., implementation strategies), methodologies (e.g., pragmatic hybrid implementation-effectiveness trials), and approaches (community-based participatory research) for establishing the safety, effectiveness, and accessibility of PAT for historically underserved communities.

Psilocybin-enhanced fear extinction linked to bidirectional modulation of cortical ensembles

The serotonin 2 receptor (5HT2R) agonist psilocybin displays rapid and persistent therapeutic efficacy across neuropsychiatric disorders characterized by cognitive inflexibility. However, the impact of psilocybin on patterns of neural activity underlying sustained changes in behavioral flexibility has not been characterized. To test the hypothesis that psilocybin enhances behavioral flexibility by altering activity in cortical neural ensembles, we performed longitudinal single-cell calcium imaging in the retrosplenial cortex across a five-day trace fear learning and extinction assay. A single dose of psilocybin induced ensemble turnover between fear learning and extinction days while oppositely modulating activity in fear- and extinction- active neurons. The acute suppression of fear-active neurons and delayed recruitment of extinction-active neurons were predictive of psilocybin-enhanced fear extinction. A computational model revealed that acute inhibition of fear-active neurons by psilocybin is sufficient to explain its neural and behavioral effects days later. These results align with our hypothesis and introduce a new mechanism involving the suppression of fear-active populations in the retrosplenial cortex.