1
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Tap SC. The potential of 5-methoxy-N,N-dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action. Addict Biol 2024; 29:e13386. [PMID: 38600715 PMCID: PMC11007263 DOI: 10.1111/adb.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/24/2023] [Accepted: 02/13/2024] [Indexed: 04/12/2024]
Abstract
Alcohol use disorder (AUD) remains one of the most prevalent psychiatric disorders worldwide with high economic costs. Current treatment options show modest efficacy and relapse rates are high. Furthermore, there are increases in the treatment gap and few new medications have been approved in the past 20 years. Recently, psychedelic-assisted therapy with psilocybin and lysergic acid diethylamide has garnered significant attention in the treatment of AUD. Yet, they require significant amounts of therapist input due to prolonged subjective effects (~4-12 h) leading to high costs and impeding implementation. Accordingly, there is an increasing interest in the rapid and short-acting psychedelic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). This paper offers a first look at potential therapeutic mechanisms for AUD by reviewing the current literature on 5-MeO-DMT. Primarily, 5-MeO-DMT is able to induce mystical experiences and ego-dissolution together with increases in psychological flexibility and mindfulness. This could decrease AUD symptoms through the alleviation of psychiatric mood-related comorbidities consistent with the negative reinforcement and self-medication paradigms. In addition, preliminary evidence indicates that 5-MeO-DMT modulates neural oscillations that might subserve ego-dissolution (increases in gamma), psychological flexibility and mindfulness (increases in theta), and the reorganization of executive control networks (increases in coherence across frequencies) that could improve emotion regulation and inhibition. Finally, animal studies show that 5-MeO-DMT is characterized by neuroplasticity, anti-inflammation, 5-HT2A receptor agonism, and downregulation of metabotropic glutamate receptor 5 with clinical implications for AUD and psychiatric mood-related comorbidities. The paper concludes with several recommendations for future research to establish the purported therapeutic mechanisms of action.
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Affiliation(s)
- Stephan C. Tap
- Department of PsychiatryGroningen University Medical CenterGroningenThe Netherlands
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2
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Davis AK, Timmermann C, Ortiz Bernal AM, Lancelotta R, Nayak S, Sepeda ND, Nikolaidis A, Griffiths RR. Translation and Initial Psychometric Evaluation of Spanish Versions of Three Psychedelic Acute Effects Measures: Mystical, Challenging, and Insight Experiences. J Psychoactive Drugs 2023:1-11. [PMID: 37449499 DOI: 10.1080/02791072.2023.2232379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/10/2023] [Accepted: 05/04/2023] [Indexed: 07/18/2023]
Abstract
This study translated and tested the psychometric properties of acute psychedelic effects measures among Spanish-speaking people. The Psychological Insight Questionnaire (PIQ), Challenging Experiences Questionnaire (CEQ), and Mystical Experiences Questionnaire (MEQ) were translated before being incorporated into a web-based survey. We recruited native Spanish-speakers (N = 442; Mage = 30.8, SD = 10.9; Latino/Latina = 62%; Hispanic = 91.4%; male = 71.5%) to assess their previous experience with one of two psychedelics (LSD = 58.4%; Psilocybin = 41.6%) and their acute and enduring effects. Confirmatory factor analysis (confirming factor structure based on the English version) revealed a good fit for the MEQ, PIQ and the CEQ. Repeating our analysis in each drug subsample revealed consistency in factor structure for each assessment tool. Construct validity was supported by significant positive associations between the PIQ and MEQ, and between the PIQ and MEQ and changes in cognitive fusion and negative associations between changes in prosocial behaviors. As a signal of predictive validity, persisting effects (PEQ) were strongly related to scores on the MEQ and PIQ. Findings demonstrate that the Spanish versions of these measures can be reliably employed in studies of psychedelic use or administration in Spanish-speaking populations.
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Affiliation(s)
- Alan K Davis
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | | | - Ana Maria Ortiz Bernal
- Department of Human Development and Family Studies, University of Wisconsin-Madison - School of Human Ecology, Madison, Wisconsin, USA
| | - Rafaelle Lancelotta
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
| | - Sandeep Nayak
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | - Nathan D Sepeda
- College of Social Work, The Ohio State University - Center for Psychedelic Drug Research and Education, Columbus, Ohio, USA
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
| | - Aki Nikolaidis
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Roland R Griffiths
- Johns Hopkins University School of Medicine - Center for Psychedelic and Consciousness Research, Baltimore, Maryland, USA
- Johns Hopkins University - Department of Neuroscience
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3
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Michael P, Luke D, Robinson O. This is your brain on death: a comparative analysis of a near-death experience and subsequent 5-Methoxy-DMT experience. Front Psychol 2023; 14:1083361. [PMID: 37457069 PMCID: PMC10345338 DOI: 10.3389/fpsyg.2023.1083361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/02/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Much research has focused on the modeling of the near-death experience (NDE) by classical and atypical psychedelics; however, to date, no study has reported on the relationship between the NDE and the experience induced by the highly potent, endogenous psychedelic drug 5-Methoxy-DMT (5MeO-DMT). This article presents a case study of an individual who is popularly documented to have had a profound near-death experience while in a coma caused by bacterial meningoencephalitis. Additionally, the individual also subsequently underwent an experience with 5MeO-DMT. Methods A semi-structured interview was conducted with the subject concerning his experiences with both the NDE and 5MeO-DMT. A basic thematic analysis was performed on both the original text describing the NDE as well as the interview itself, which mainly focused on the subject's experience with 5MeO-DMT. This analysis was organized to identify both the similar and different emergent themes between the two states, with a particular emphasis on the subject's perceptions of the similarities and differences between the experiences. Results There is a very high level of comparability between the original NDE and psychedelic experiences in general, including shared characteristics such as entering other worlds, meeting menacing or benevolent entities, experiencing synesthesia, perinatal regression, and lucid dreamlike properties. Much comparability was also identified with the 5MeO-DMT experience, in particular the major mystical experiential domains, such as ego dissolution, but especially transcendence of time and space. However, there were also a few unique themes (life review, the deceased, and the threshold) that emerged in the NDE that were not present in the 5MeO-DMT experience or other psychedelic experience studies, suggesting that these themes may be more unique to the NDE. Discussion Despite such similarities, the participant asserted that his NDE and psychedelic experiences were not similar enough to be attributed to endogenous psychedelics. In this study, we discussed several mechanisms that could potentially account for the NDE, including lucid dreams and perinatal regression. However, the study also explored the possibility that the unique etiology of the participant's NDE, bacterial meningoencephalitis affecting the neocortex, may have triggered similar downstream neural activity as that initiated by psychedelic agents through pyramidal neuronal activation. This hypothesis is presented with appropriate caveats and acknowledged as speculative.
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Affiliation(s)
- Pascal Michael
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
| | - David Luke
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Oliver Robinson
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
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4
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Kopra EI, Ferris JA, Winstock AR, Kuypers KP, Young AH, Rucker JJ. Investigation of self-treatment with lysergic acid diethylamide and psilocybin mushrooms: Findings from the Global Drug Survey 2020. J Psychopharmacol 2023:2698811231158245. [PMID: 36876583 DOI: 10.1177/02698811231158245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Growing numbers of people are using psychedelics for personal psychotherapy outside clinical settings, but research on such use is scarce. AIMS This study investigated the patterns of use, self-reported outcomes and outcome predictors of psychedelic 'self-treatment' of mental health conditions or specific worries/concerns in life. METHODS We use data from the Global Drug Survey 2020, a large online survey on drug use collected between November 2019 and February 2020. In all, 3364 respondents reported their self-treatment experiences with lysergic acid diethylamide (N = 1996) or psilocybin mushrooms (N = 1368). The primary outcome of interest was the 17-item self-treatment outcome scale, items reflecting aspects of well-being, psychiatric symptoms, social-emotional skills, and health behaviours. RESULTS Positive changes were observed across all 17 outcome items, with the strongest benefits on items related to insight and mood. Negative effects were reported by 22.5% of respondents. High intensity of psychedelic experience, seeking advice before treatment, treating with psilocybin mushrooms and treating post-traumatic stress disorder were associated with higher scores on the self-treatment outcome scale after averaging values across all 17 items. Younger age, high intensity of experience and treating with LSD were associated with increased number of negative outcomes. CONCLUSIONS This study brings important insights into self-treatment practices with psychedelics in a large international sample. Outcomes were generally favourable, but negative effects appeared more frequent than in clinical settings. Our findings can help inform safe practices of psychedelic use in the community, and inspire clinical research. Future research can be improved with utilisation of prospective designs and additional predictive variables.
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Affiliation(s)
- Emma I Kopra
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adam R Winstock
- Institute of Epidemiology and Health Care, University College London, London, UK.,Global Drug Survey Ltd, London, UK
| | - Kim Pc Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - James J Rucker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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5
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Nikolaidis A, Lancelotta R, Gukasyan N, Griffiths RR, Barrett FS, Davis AK. Subtypes of the psychedelic experience have reproducible and predictable effects on depression and anxiety symptoms. J Affect Disord 2023; 324:239-249. [PMID: 36584715 PMCID: PMC9887654 DOI: 10.1016/j.jad.2022.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/24/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Subjective experiences seem to play an important role in the enduring effects of psychedelic experiences. Although the importance of the subjective experience on the impact of psychedelics is frequently discussed, a more detailed understanding of the subtypes of psychedelic experiences and their associated impacts on mental health has not been well documented. METHODS In the current study, machine learning cluster analysis was used to derive three subtypes of psychedelic experience in a large (n = 985) cross sectional sample. RESULTS These subtypes are not only associated with reductions in anxiety and depression symptoms and other markers of psychological wellbeing, but the structure of these subtypes and their subsequent impact on mental health are highly reproducible across multiple psychedelic substances. LIMITATIONS Data were obtained via retrospective self-report, which does not allow for definitive conclusions about the direction of causation between baseline characteristics of respondents, qualities of subjective experience, and outcomes. CONCLUSIONS The present analysis suggests that psychedelic experiences, in particular those that are associated with enduring improvements in mental health, may be characterized by reproducible and predictable subtypes of the subjective psychedelic effects. These subtypes appear to be significantly different with respect to the baseline demographic characteristics, baseline measures of mental health, and drug type and dose. These findings also suggest that efforts to increase psychedelic associated personal and mystical insight experiences may be key to maximizing beneficial impact of clinical approaches using this treatment in their patients.
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Affiliation(s)
- Aki Nikolaidis
- Child Mind Institute, Center for the Developing Brain, United States of America
| | - Rafaelle Lancelotta
- College of Social Work, The Ohio State University, Columbus, United States of America
| | - Natalie Gukasyan
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, United States of America; Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
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6
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Nygart VA, Pommerencke LM, Haijen E, Kettner H, Kaelen M, Mortensen EL, Nutt DJ, Carhart-Harris RL, Erritzoe D. Antidepressant effects of a psychedelic experience in a large prospective naturalistic sample. J Psychopharmacol 2022; 36:932-942. [PMID: 35924888 PMCID: PMC9353970 DOI: 10.1177/02698811221101061] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Over the last two decades, a number of studies have highlighted the potential of psychedelic therapy. However, questions remain to what extend these results translate to naturalistic samples, and how contextual factors and the acute psychedelic experience relate to improvements in affective symptoms following psychedelic experiences outside labs/clinics. The present study sought to address this knowledge gap. AIM Here, we aimed to investigate changes in anxiety and depression scores before versus after psychedelic experiences in naturalistic contexts, and how various pharmacological, extrapharmacological and experience factors related to outcomes. METHOD Individuals who planned to undergo a psychedelic experience were enrolled in this online survey study. Depressive symptoms were assessed at baseline and 2 and 4 weeks post-psychedelic experience, with self-rated Quick Inventory of Depressive Symptomatology (QIDS-SR-16) as the primary outcome. To facilitate clinical translation, only participants with depressive symptoms at baseline were included. Sample sizes for the four time points were N = 302, N = 182, N = 155 and N = 109, respectively. RESULTS Relative to baseline, reductions in depressive symptoms were observed at 2 and 4 weeks. A medicinal motive, previous psychedelic use, drug dose and the type of acute psychedelic experience (i.e. specifically, having an emotional breakthrough) were all significantly associated with changes in self-rated QIDS-SR-16. CONCLUSION These results lend support to therapeutic potential of psychedelics and highlight the influence of pharmacological and non-pharmacological factors in determining response. Mindful of a potential sample and attrition bias, further controlled and observational longitudinal studies are needed to test the replicability of these findings.
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Affiliation(s)
- Victoria Amalie Nygart
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - Lis Marie Pommerencke
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Eline Haijen
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - Hannes Kettner
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - Mendel Kaelen
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - Erik Lykke Mortensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David John Nutt
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - Robin Lester Carhart-Harris
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
| | - David Erritzoe
- Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Centers for Neuropsychopharmacology and Psychedelic Research, Imperial College London, London, UK
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7
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Gandy S. Predictors and potentiators of psychedelic-occasioned mystical experiences. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Mystical experiences are often described as being among the most profound and meaningful events of a person’s life. Their occurrence, while a normal but uncommon phenomenon, is reliably occasioned by psychedelic substances under the appropriate conditions, although care is needed around the context of usage to help ensure safe and beneficial experiences. The occurrence of mystical experiences in psychedelic sessions is a key mediator of the sustained psychological benefits reported in both healthy and clinical populations. Certain factors including set and setting, drug dosage, trait absorption, drug type, intention and states of surrender and acceptance all predict or influence the occurrence of mystical experiences. Various additional factors may further contribute to the occurrence and intensity of mystical experiences and enhance their long-term benefits, including music, meditation and spiritual practices and nature-based settings. This review examines these factors and considers how they might be optimised to increase the chances of a mystical experience occurring, while also considering factors that are negatively associated with mystical experiences with suggestions on how these might be mitigated where applicable. Finally, potential future research avenues for furthering our knowledge of psychedelic mystical experiences and how their benefits might be enhanced is suggested. Maximising the potential for the occurrence of mystical experiences is an important aspect of the beneficial application of psychedelics.
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Affiliation(s)
- Sam Gandy
- Synthesis Institute, Zandvoort, Netherlands
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8
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Abstract
BACKGROUND 5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring, short-acting psychedelic tryptamine, produced by a variety of plant and animal species. Plants containing 5-MeO-DMT have been used throughout history for ritual and spiritual purposes. The aim of this article is to review the available literature about 5-MeO-DMT and inform subsequent clinical development. METHODS We searched PubMed database for articles about 5-MeO-DMT. Search results were cross-checked against earlier reviews and reference lists were hand searched. Findings were synthesised using a narrative synthesis approach. This review covers the pharmacology, chemistry and metabolism of 5-MeO-DMT, as well epidemiological studies, and reported adverse and beneficial effects. RESULTS 5-MeO-DMT is serotonergic agonist, with highest affinity for 5-HT1A receptors. It was studied in a variety of animal models, but clinical studies with humans are lacking. Epidemiological studies indicate that, like other psychedelics, 5-MeO-DMT induces profound alterations in consciousness (including mystical experiences), with potential beneficial long-term effects on mental health and well-being. CONCLUSION 5-MeO-DMT is a potentially useful addition to the psychedelic pharmacopoeia because of its short duration of action, relative lack of visual effects and putatively higher rates of ego-dissolution and mystical experiences. We conclude that further clinical exploration is warranted, using similar precautions as with other classic psychedelics.
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Affiliation(s)
- Anna O Ermakova
- Beckley Psytech, Beckley, UK,Psychedelic Trials Group, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Anna O Ermakova, Psychedelic Trials Group, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK.
| | | | - James Rucker
- Psychedelic Trials Group, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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9
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Reckweg JT, Uthaug MV, Szabo A, Davis AK, Lancelotta R, Mason NL, Ramaekers JG. The clinical pharmacology and potential therapeutic applications of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). J Neurochem 2022; 162:128-146. [PMID: 35149998 PMCID: PMC9314805 DOI: 10.1111/jnc.15587] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
5‐methoxy‐N,N‐dimethyltryptamine (5‐MeO‐DMT) is a naturally occurring tryptamine that primarily acts as an agonist at the 5‐HT1A and 5‐HT2A receptors, whereby affinity for the 5‐HT1A subtype is highest. Subjective effects following 5‐MeO‐DMT administration include distortions in auditory and time perception, amplification of emotional states, and feelings of ego dissolution that usually are short‐lasting, depending on the route of administration. Individual dose escalation of 5‐MeO‐DMT reliably induces a “peak” experience, a state thought to be a core predictor of the therapeutic efficacy of psychedelics. Observational studies and surveys have suggested that single exposure to 5‐MeO‐DMT can cause rapid and sustained reductions in symptoms of depression, anxiety, and stress. 5‐MeO‐DMT also stimulates neuroendocrine function, immunoregulation, and anti‐inflammatory processes, which may contribute to changes in mental health outcomes. To date, only one clinical trial has been published on 5‐MeO‐DMT, demonstrating the safety of vaporized dosing up to 18 mg. Importantly, the rapid onset and short duration of the 5‐MeO‐DMT experience may render it more suitable for individual dose‐finding strategies compared with longer‐acting psychedelics. A range of biotech companies has shown an interest in the development of 5‐MeO‐DMT formulations for a range of medical indications, most notably depression. Commercial development will therefore be the most important resource for bringing 5‐MeO‐DMT to the clinic. However, fundamental research will also be needed to increase understanding of the neurophysiological and neural mechanisms that contribute to the potential clinical effects of 5‐MeO‐DMT and its sustainability and dissemination over time. Such studies are less likely to be conducted as part of drug development programs and are more likely to rely on independent, academic initiatives.
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Affiliation(s)
- J T Reckweg
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - M V Uthaug
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - A Szabo
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - A K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - R Lancelotta
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - N L Mason
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
| | - J G Ramaekers
- Faculty of Psychology and Neuroscience, Dept of Neuropsychology and psychopharmacology, Maastricht University, The Netherlands
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10
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Golden TL, Magsamen S, Sandu CC, Lin S, Roebuck GM, Shi KM, Barrett FS. Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature. Curr Top Behav Neurosci 2022; 56:35-70. [PMID: 35138585 DOI: 10.1007/7854_2021_298] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The health and well-being impacts of art and aesthetic experiences have been rigorously studied by a range of disciplines, including cognitive neuroscience, psychiatry, public health, and translational clinical research. These experiences, encompassed in the concepts of set and setting, have long been claimed to be pivotal in determining the acute and enduring effects of psychedelic experiences. Responding to the field's longstanding emphasis on the role and value of setting, a rapid scoping review was undertaken to identify the extent to which effects of setting and aesthetics on psychedelic experiences and therapies have been explicitly studied. It offers an analysis of the strengths and limitations of the extant literature and discusses evidentiary gaps as well as evidentiary opportunities for the field. The 43 included studies indicate apparent consensus regarding the importance of setting in psychedelic therapies, as well as consistent interest in theorizing about these effects. However, this consensus has yet to generate consistent, prospective, rigorous tests of setting and its complexities. As a result, the field continues to lack understanding or agreement regarding the effects of various specific elements of setting, the mechanisms by which they affect outcomes, for whom these effects occur, under what circumstances, given what conditions, and other critical factors. Further studies of setting and aesthetics in the context of psychedelic therapies are likely to not only improve these therapies and their delivery, but also inform considerations of setting and aesthetics for non-psychedelic interventions.
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Affiliation(s)
- Tasha L Golden
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Susan Magsamen
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clara C Sandu
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shuyang Lin
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Grace Marie Roebuck
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathy M Shi
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick S Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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11
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Aday JS, Davis AK, Mitzkovitz CM, Bloesch EK, Davoli CC. Predicting Reactions to Psychedelic Drugs: A Systematic Review of States and Traits Related to Acute Drug Effects. ACS Pharmacol Transl Sci 2021; 4:424-435. [PMID: 33860172 PMCID: PMC8033773 DOI: 10.1021/acsptsci.1c00014] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Indexed: 12/21/2022]
Abstract
Psychedelic drugs are increasingly being incorporated into therapeutic contexts for the purposes of promoting mental health. However, they can also induce adverse reactions in some individuals, and it is difficult to predict before treatment who is likely to experience positive or adverse acute effects. Although consideration of setting and dosage as well as excluding individuals with psychotic predispositions has thus far led to a high degree of safety, it is imperative that researchers develop a more nuanced understanding of how to predict individual reactions. To this end, the current systematic review coalesced the results of 14 studies that included baseline states or traits predictive of the acute effects of psychedelics. Individuals high in the traits of absorption, openness, and acceptance as well as a state of surrender were more likely to have positive and mystical-type experiences, whereas those low in openness and surrender or in preoccupied, apprehensive, or confused psychological states were more likely to experience acute adverse reactions. Participant sex was not a robust predictor of drug effects, but 5-HT2AR binding potential, executive network node diversity, and rACC volume may be potential baseline biomarkers related to acute reactions. Finally, increased age and experience with psychedelics were individual differences related to generally less intense effects, indicating that users may become slightly less sensitive to the effects of the drugs after repeated usage. Although future well-powered, placebo-controlled trials directly comparing the relative importance of these predictors is needed, this review synthesizes the field's current understanding of how to predict acute reactions to psychedelic drugs.
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Affiliation(s)
- Jacob S. Aday
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Alan K. Davis
- College
of Social Work, The Ohio State University, 1947 College Road, Columbus, Ohio 43210, United States
- Center
for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, Maryland 21224, United
States
| | - Cayla M. Mitzkovitz
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Emily K. Bloesch
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
| | - Christopher C. Davoli
- Department
of Psychology, Central Michigan University, 1200 South Franklin Street, Mount Pleasant, Michigan 48859, United States
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12
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Sherwood AM, Claveau R, Lancelotta R, Kaylo KW, Lenoch K. Synthesis and Characterization of 5-MeO-DMT Succinate for Clinical Use. ACS OMEGA 2020; 5:32067-32075. [PMID: 33344861 PMCID: PMC7745443 DOI: 10.1021/acsomega.0c05099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/16/2020] [Indexed: 05/03/2023]
Abstract
To support clinical use, a multigram-scale process has been developed to provide 5-MeO-DMT, a psychedelic natural product found in the parotid gland secretions of the toad, Incilius alvarius. Several synthetic routes were initially explored, and the selected process featured an optimized Fischer indole reaction to 5-MeO-DMT freebase in high-yield, from which the 1:1 succinate salt was produced to provide 136 g of crystalline active pharmaceutical ingredient (API) with 99.86% peak area by high-performance liquid chromatography (HPLC) and a net yield of 49%. The report provides in-process monitoring, validated analytical methods, impurity formation and removal, and solid-state characterization of the API essential for subsequent clinical development.
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Affiliation(s)
| | - Romain Claveau
- Almac
Sciences, 20 Seagoe Industrial Estate, Craigavon BT63 5QD, United Kingdom
| | - Rafael Lancelotta
- Habituating
to Wholeness, 6500 W
13th Avenue, Lakewood, Colorado 80214, United States
| | - Kristi W. Kaylo
- Usona
Institute, 2800 Woods
Hollow Road, Madison, Wisconsin 53711, United States
| | - Kelsey Lenoch
- Usona
Institute, 2800 Woods
Hollow Road, Madison, Wisconsin 53711, United States
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13
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Aday JS, Davoli CC, Bloesch EK. Psychedelics and virtual reality: parallels and applications. Ther Adv Psychopharmacol 2020; 10:2045125320948356. [PMID: 32922734 PMCID: PMC7446267 DOI: 10.1177/2045125320948356] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/14/2020] [Indexed: 01/29/2023] Open
Abstract
Psychedelic drugs and virtual reality (VR) each have the capacity to disrupt the rigidity and limitations of typical conscious experience. This article delineates the parallels among psychedelic and VR states as well as their potential synergistic applications in clinical and recreational settings. Findings indicate that, individually, psychedelics and VR are used in analogous ways to alter sensory experience and evoke awe. They are also both used in tandem with traditional therapies to treat a variety of mood disorders; their shared capacity to transiently alter perspective and disrupt rigid patterns of mental experience may underly their analogous and transdiagnostic therapeutic uses. In terms of their combined applications, a number of recreational users currently utilize psychedelics and VR together to enhance their experience. We propose that VR may be a useful tool for preparing hallucinogen-naïve participants in clinical trials for the sensory distortions experienced in psychedelic states. Given the critical role of "setting" in psychedelic treatment outcomes, we also detail how VR could be used to optimize the environment in psychedelic sessions. Finally, we provide considerations for future studies and detail how advancements in psychedelic and VR research can inform one another. Collectively, this article outlines a number of connections between psychedelics and VR, and, more broadly, is representative of growing scientific interest into the interactions among technology, psychopharmacology, and mental health.
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Affiliation(s)
- Jacob S. Aday
- Department of Psychology, Central Michigan University, 101 Sloan Hall, Mount Pleasant, MI 48858, USA
| | | | - Emily K. Bloesch
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
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