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Mehtani NJ, Anderson BT, Mitchell JM. Psychedelics in Addiction Treatment-Navigating a Sociopolitical Rift. JAMA Neurol 2024:2813589. [PMID: 38227310 DOI: 10.1001/jamaneurol.2023.5173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
This Viewpoint discusses the use of psychedelics in treatment for substance use disorders.
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Affiliation(s)
- Nicky J Mehtani
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco
- Whole Person Integrated Care, San Francisco Department of Public Health, San Francisco, California
| | - Brian T Anderson
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco
| | - Jennifer M Mitchell
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco
- Department of Neurology, University of California, San Francisco, San Francisco
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Mitchell JM, Anderson BT. Psychedelic therapies reconsidered: compounds, clinical indications, and cautious optimism. Neuropsychopharmacology 2024; 49:96-103. [PMID: 37479859 PMCID: PMC10700471 DOI: 10.1038/s41386-023-01656-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/23/2023]
Abstract
The clinical investigation of psychedelic medicines has blossomed over the last 5 years. Data from a Phase 3 industry trial and a multicenter Phase 2 industry trial, in addition to multiple early phase investigator-initiated and industry trials, have now been published in peer-reviewed journals. This narrative review summarizes both the recent data and the current clinical trials that are being conducted with various classes of "psyche-manifesting" substances, which may prove beneficial in the treatment of a broad range of conditions. Methodological considerations, unique challenges, and next steps for research are discussed in keeping with the uniquely "experiential" nature of these therapies.
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Affiliation(s)
- Jennifer M Mitchell
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA.
- Department of Veterans Affairs, Research Service, San Francisco VA Medical Center, San Francisco, CA, USA.
- Berkeley Center for the Science of Psychedelics, University of California Berkeley, Berkeley, CA, USA.
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- Berkeley Center for the Science of Psychedelics, University of California Berkeley, Berkeley, CA, USA
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3
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O'Donnell KC, Anderson BT, Barrett FS, Bogenschutz MP, Grob CS, Hendricks PS, Kelmendi B, Nayak SM, Nicholas CR, Paleos CA, Stauffer CS, Gukasyan N. Misinterpretations and Omissions: A Critical Response to Goodwin and Colleagues' Commentary on Psilocybin-Assisted Therapy. Am J Psychiatry 2024; 181:74-75. [PMID: 38161295 DOI: 10.1176/appi.ajp.20230661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Kelley C O'Donnell
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Brian T Anderson
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Frederick S Barrett
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Michael P Bogenschutz
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Charles S Grob
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Peter S Hendricks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Benjamin Kelmendi
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Sandeep M Nayak
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Christopher R Nicholas
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Casey A Paleos
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Christopher S Stauffer
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
| | - Natalie Gukasyan
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NYU Langone Center for Psychedelic Medicine, New York (O'Donnell, Bogenschutz); Department of Psychiatry & Behavioral Sciences, UCSF School of Medicine, San Francisco, UC Berkeley Center for the Science of Psychedelics, Berkeley, Calif. (Anderson); Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Department of Neuroscience, Department of Psychological and Brain Sciences, Johns Hopkins University School of Medicine, Baltimore (Barrett, Nayak); Johns Hopkins University, Baltimore (Barrett); Department of Psychiatry and Biobehavioral Sciences and Pediatrics, UCLA School of Medicine, Los Angeles (Grob); Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Ala. (Hendricks); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Kelmendi); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Transdisciplinary Center for Research in Psychoactive Substances, Madison, Wisc. (Nicholas); Nautilus Sanctuary, New York (Paleos); Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health & Science University, Portland, Ore. (Stauffer); Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York (Gukasyan)
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Bouchet L, Sager Z, Yrondi A, Nigam KB, Anderson BT, Ross S, Petridis PD, Beaussant Y. Older adults in psychedelic-assisted therapy trials: A systematic review. J Psychopharmacol 2024; 38:33-48. [PMID: 38240068 DOI: 10.1177/02698811231215420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Growing clinical interest in psychedelic-assisted therapies has led to a second wave of research involving psilocybin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA) and other substances. Data suggests that these compounds have the potential to treat mental health conditions that are especially prevalent in older adults such as depression, anxiety, existential distress, and posttraumatic stress disorder. AIMS The goal of this study was to quantify the prevalence of older adults enrolled in psychedelic clinical trials and explore safety data in this population. METHODS A systematic review was conducted following the 2020 PRISMA guidelines. Search criteria included all trials published in English using psychedelic substances to treat psychiatric conditions, including addiction as well as existential distress related to serious illness. Articles were identified from literature searches on PubMed, EBSCO, and EMBASE. RESULTS 4376 manuscripts were identified, of which 505 qualified for further review, with 36 eventually meeting eligibility criteria. Of the 1400 patients enrolled in the 36 studies, only 19 were identified as 65 or older, representing less than 1.4% of all trial participants. For 10 of these 19 older adults, detailed safety data was obtained. No serious adverse events (AEs) occurred in any older adults and only transient mild-to-moderate AEs related to anxiety, gastrointestinal upset, and hypertension were reported during the psychedelic dosing sessions. CONCLUSIONS While existing data in older adults is limited, it suggests that psychedelic-assisted psychotherapy can be safe and well tolerated in older adults. Therefore, psychedelic-assisted psychotherapy should be more rigorously investigated for the treatment of psychiatric conditions in this population.
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Affiliation(s)
- Lisa Bouchet
- Department of Psychiatry and Medical Psychology, Purpan University Hospital, Toulouse, France
- Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Zachary Sager
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Antoine Yrondi
- Department of Psychiatry and Medical Psychology, Purpan University Hospital, Toulouse, France
- Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Kabir B Nigam
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Stephen Ross
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Petros D Petridis
- Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvan Beaussant
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Urrutia J, Anderson BT, Belouin SJ, Berger A, Griffiths RR, Grob CS, Henningfield JE, Labate BC, Maier LJ, Maternowska MC, Weichold F, Yaden DB, Magar V. Psychedelic Science, Contemplative Practices, and Indigenous and Other Traditional Knowledge Systems: Towards Integrative Community-Based Approaches in Global Health. J Psychoactive Drugs 2023; 55:523-538. [PMID: 37747281 DOI: 10.1080/02791072.2023.2258367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023]
Abstract
As individuals and communities around the world confront mounting physical, psychological, and social threats, three complimentary mind-body-spirit pathways toward health, wellbeing, and human flourishing remain underappreciated within conventional practice among the biomedical, public health, and policy communities. This paper reviews literature on psychedelic science, contemplative practices, and Indigenous and other traditional knowledge systems to make the case that combining them in integrative models of care delivered through community-based approaches backed by strong and accountable health systems could prove transformative for global health. Both contemplative practices and certain psychedelic substances reliably induce self-transcendent experiences that can generate positive effects on health, well-being, and prosocial behavior, and combining them appears to have synergistic effects. Traditional knowledge systems can be rich sources of ethnobotanical expertise and repertoires of time-tested practices. A decolonized agenda for psychedelic research and practice involves engaging with the stewards of such traditional knowledges in collaborative ways to codevelop evidence-based models of integrative care accessible to the members of these very same communities. Going forward, health systems could consider Indigenous and other traditional healers or spiritual guides as stakeholders in the design, implementation, and evaluation of community-based approaches for safely scaling up access to effective psychedelic treatments.
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Affiliation(s)
- Julian Urrutia
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Prisons Group Legal Clinic, Universidad de los Andes Medical School, Bogotá, Colombia
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Sean J Belouin
- United States Public Health Service, Department of Health and Human Services (DHHS), Rockville, MD, USA
- Substance Abuse and Mental Health Services Administration (SAMHSA), DHHS, Rockville, MD, USA
- Office of Science and Medicine, DHHS, Washington, DC, USA
- Office of the Assistant Secretary, DHHS, Washington, DC, USA
- Pain and Palliative Care, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Ann Berger
- Pain and Palliative Care, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles S Grob
- David Geffen School of Medicine, University of California (UCLA), Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Research, Health Policy and Abuse Liability, Pinney Associates, Bethesda, MD, USA
| | | | | | - M Catherine Maternowska
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Frank Weichold
- Office of the Chief Scientist, Office of the Commissioner, US Food and Drug Administration, Silver Spring, MD, USA
| | - David B Yaden
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Veronica Magar
- (formerly) Office of the Director General, World Health Organization, Geneva, Switzerland
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Magar V, Urrutia J, Anderson BT. Psychedelic Research and Therapeutic Practices: Embracing Communities, Groups, and Traditional Knowledge. J Psychoactive Drugs 2023; 55:519-522. [PMID: 37842876 DOI: 10.1080/02791072.2023.2268610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
The global prevalence of substance abuse and mental disorders continues to challenge healthcare systems, with one in eight individuals affected. The therapeutic potential of psychedelics is recognized not only for treating mental disorders but also for enhancing well-being and promoting pro-social behaviors. Conventional biomedical research models fall short in addressing the broader health needs of populations and poorly suited for overcoming barriers to service delivery. This special issue includes six articles that explore alternative approaches to psychedelic research and practice, emphasizing collaboration with diverse actors, including indigenous communities, and incorporating traditional knowledge systems into contemporary psychedelic research. They underscore the need for innovative research methods that engage multidisciplinary approaches while promoting culturally relevant outcome measures. They emphasize the importance of shifting from punitive drug policies to those grounded in public health and human rights, allowing for multi-country studies and the development of evidence-based care models for community mental health. Incorporating traditional knowledge and community-based methodologies into psychedelic science is vital for its evolution beyond biomedical research for widespread dissemination, offering new avenues for improved health outcomes and promotion of human flourishing.
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Affiliation(s)
- Veronica Magar
- Formerly Office of Director General, World Health Organization, Geneva, Switzerland
| | - Julian Urrutia
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Prisons Group Legal Clinic, Universidad de los Andes Law School, Bogota, Colombia
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
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Thomas KL, Jesse R, Mehtani NJ, Mitchell JM, Anderson BT. Commentary: Evidence-Informed Recommendation to Achieve Approximate Parity in the Allowed Number of Doses for Common Psychedelics. J Psychoactive Drugs 2023:1-5. [PMID: 37061961 DOI: 10.1080/02791072.2023.2201244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
In recent years, policymakers have proposed and implemented regulatory changes promoting the deprioritization, decriminalization, or state-level legalization of one or more psychedelic substances, usually referencing data from clinical trials as reasons to support liberalizing drug control policies. As psychedelic policies continue to be drafted, personal possession limits may be considered for inclusion in those regulations. If "allowable amount" limits are to be written into law to set personal possession limits, then such amounts should be more consistently related to psychedelic doses found to be safe and efficacious in clinical trials, existing data on moderate-high doses commonly used in various naturalistic settings, and the few studies that estimate psychedelic dose equivalence based on the intensity of subjective effects. In this commentary, we provide an evidence-informed table of typical moderate-high doses for seven commonly used psychedelic substances. These estimates of comparable moderate-high doses can be used to inform "allowable amount" values for psychedelic substances. When such limits are written into legislation, the adoption of evidence-informed comparable limits akin to those presented here would be an important first step toward ensuring greater parity and consistency in drug policy, relative to limits that have little or no scientific basis.
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Affiliation(s)
- Kelan L Thomas
- College of Pharmacy, Touro University California, Vallejo, CA, USA
| | - Robert Jesse
- Council on Spiritual Practices, Occidental, CA, USA
| | - Nicky J Mehtani
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer M Mitchell
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
- Center for the Science of Psychedelics, University of California Berkeley, Berkeley, CA, USA
| | - Brian T Anderson
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
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8
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Di Lorenzo E, Xu T, Zhao Y, Newman M, Capotondi A, Stevenson S, Amaya DJ, Anderson BT, Ding R, Furtado JC, Joh Y, Liguori G, Lou J, Miller AJ, Navarra G, Schneider N, Vimont DJ, Wu S, Zhang H. Modes and Mechanisms of Pacific Decadal-Scale Variability. Ann Rev Mar Sci 2023; 15:249-275. [PMID: 36112981 DOI: 10.1146/annurev-marine-040422-084555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The modes of Pacific decadal-scale variability (PDV), traditionally defined as statistical patterns of variance, reflect to first order the ocean's integration (i.e., reddening) of atmospheric forcing that arises from both a shift and a change in strength of the climatological (time-mean) atmospheric circulation. While these patterns concisely describe PDV, they do not distinguish among the key dynamical processes driving the evolution of PDV anomalies, including atmospheric and ocean teleconnections and coupled feedbacks with similar spatial structures that operate on different timescales. In this review, we synthesize past analysis using an empirical dynamical model constructed from monthly ocean surface anomalies drawn from several reanalysis products, showing that the PDV modes of variance result from two fundamental low-frequency dynamical eigenmodes: the North Pacific-central Pacific (NP-CP) and Kuroshio-Oyashio Extension (KOE) modes. Both eigenmodes highlight how two-way tropical-extratropical teleconnection dynamics are the primary mechanisms energizing and synchronizing the basin-scale footprint of PDV. While the NP-CP mode captures interannual- to decadal-scale variability, the KOE mode is linked to the basin-scale expression of PDV on decadal to multidecadal timescales, including contributions from the South Pacific.
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Affiliation(s)
- E Di Lorenzo
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, Rhode Island, USA;
| | - T Xu
- Physical Sciences Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
| | - Y Zhao
- Deep-Sea Multidisciplinary Research Center, Pilot National Laboratory for Marine Science and Technology (Qingdao), Qingdao, China
| | - M Newman
- Physical Sciences Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, Colorado, USA
| | - A Capotondi
- Physical Sciences Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, Colorado, USA
| | - S Stevenson
- Bren School of Environmental Science and Management, University of California, Santa Barbara, California, USA
| | - D J Amaya
- Physical Sciences Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
| | - B T Anderson
- Department of Earth and Environment, Boston University, Boston, Massachusetts, USA
| | - R Ding
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China
| | - J C Furtado
- School of Meteorology, University of Oklahoma, Norman, Oklahoma, USA
| | - Y Joh
- Atmospheric and Oceanic Sciences Program, Princeton University, Princeton, New Jersey, USA
| | - G Liguori
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
- School of Earth, Atmosphere, and Environment, Monash University, Melbourne, Victoria, Australia
| | - J Lou
- Physical Sciences Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, Colorado, USA
| | - A J Miller
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California, USA
| | - G Navarra
- Program in Ocean Science and Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - N Schneider
- International Pacific Research Center and Department of Oceanography, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - D J Vimont
- Department of Atmospheric and Oceanic Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - S Wu
- Laboratory for Climate and Ocean-Atmosphere Studies, Department of Atmospheric and Oceanic Sciences, School of Physics, Peking University, Beijing, China
| | - H Zhang
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, Texas, USA
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9
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Belouin SJ, Averill LA, Henningfield JE, Xenakis SN, Donato I, Grob CS, Berger A, Magar V, Danforth AL, Anderson BT. Policy considerations that support equitable access to responsible, accountable, safe, and ethical uses of psychedelic medicines. Neuropharmacology 2022; 219:109214. [PMID: 35973601 PMCID: PMC9536012 DOI: 10.1016/j.neuropharm.2022.109214] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022]
Abstract
There is mounting evidence suggesting psychedelic and entactogen medicines (namely psilocybin and 3,4-methylenedioxymethamphetamine [MDMA]), in conjunction with proper psychosocial support, hold the potential to provide safe, rapid acting, and robust clinical improvements with durable effects. In the US, both psilocybin and MDMA have been granted Breakthrough Therapy designations by the US Food and Drug Administration and may potentially receive full FDA approval with similar regulatory considerations occurring in multiple countries. At the same time, regulatory changes are poised to increase access to legal or decriminalized psychedelic use in various non-medical settings. This review provides a brief discussion on the historical use of psychedelic medicines, the status of the empirical evidence, and numerous significant policy considerations that must be thoughtfully addressed regarding standards-of-practice, consumer protection, engagement of communities, safeguarding access for all, and developing data standards, which supports the responsible, accountable, safe, and ethical uses of these medicines in clinical, faith-based, and other contexts. We provide suggestions for how public health and harm reduction can be supported through a public-private partnership that engages a community of stakeholders from various disciplines in the co-creation and dissemination of best practices and public policies.
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Affiliation(s)
- Sean J Belouin
- United States Public Health Service, Germantown, MD, USA; Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD, USA; Pain and Palliative Care, NIH Clinical Research Center, Bethesda, MD, USA.
| | - Lynnette A Averill
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; US Department of Veterans Affairs, Michael E. DeBakey Veterans Administration Medical Center, Houston, TX, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veterans Affairs, National Center for PTSD - Clinical Neurosciences Division, Orange, CT, USA; Reason for Hope, New York, NY, USA
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Research, Health Policy and Abuse Liability, Pinney Associates, Bethesda, MD, USA
| | - Stephen N Xenakis
- Reason for Hope, New York, NY, USA; United States Army, Hallandale Beach, FL, USA; Uniformed Services University of the Health Sciences (UHSUS), Bethesda, MD, USA
| | - Ingrid Donato
- Office of Prevention Innovation, Center for Substance Abuse Prevention, SAMHSA, Rockville, MD, USA
| | - Charles S Grob
- David Geffen School of Medicine at University of California (UCLA), Los Angeles, CA, USA; Division of Child and Adolescent Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ann Berger
- Pain and Palliative Care, NIH Clinical Research Center, Bethesda, MD, USA
| | - Veronica Magar
- Gender, Equity and Human Rights, World Health Organization (WHO), Geneva, Switzerland
| | - Alicia L Danforth
- The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Brian T Anderson
- University of California San Francisco (UCSF) Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; University of California Berkeley Center for the Science of Psychedelics, Berkeley, CA, USA
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Fitzpatrick CM, Anderson BT, Agin-Liebes G, Guydish J. Comment and Response: (Lugo-Radillo & Cortez-Lopez, 2020) Long-Term Amelioration of OCD Symptoms in a Patient with Chronic Consumption of Psilocybin-Containing Mushrooms. J Psychoactive Drugs 2022; 54:324-327. [PMID: 35083957 DOI: 10.1080/02791072.2021.1983673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco CA
| | - Gabrielle Agin-Liebes
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco CA
| | - Joseph Guydish
- Institute for Health Policy Studies University of California San Francisco, San Francisco, CA, USA
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11
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Dworkin RH, Anderson BT, Andrews N, Edwards RR, Grob CS, Ross S, Satterthwaite TD, Strain EC. If the doors of perception were cleansed, would chronic pain be relieved? Evaluating the benefits and risks of psychedelics. J Pain 2022; 23:1666-1679. [PMID: 35643270 DOI: 10.1016/j.jpain.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
Psychedelic substances have played important roles in diverse cultures, and ingesting various plant preparations to evoke altered states of consciousness has been described throughout recorded history. Accounts of the subjective effects of psychedelics typically focus on spiritual and mystical-type experiences, including feelings of unity, sacredness, and transcendence. Over the past two decades, there has been increasing interest in psychedelics as treatments for various medical disorders, including chronic pain. Although concerns about adverse medical and psychological effects contributed to their controlled status, contemporary knowledge of psychedelics suggests that risks are relatively rare when patients are carefully screened, prepared, and supervised. Clinical trial results have provided support for the effectiveness of psychedelics in different psychiatric conditions. However, there are only a small number of generally uncontrolled studies of psychedelics in patients with chronic pain (e.g., cancer pain, phantom limb pain, migraine, and cluster headache). Challenges in evaluating psychedelics as treatments for chronic pain include identifying neurobiologic and psychosocial mechanisms of action and determining which pain conditions to investigate. Truly informative proof-of-concept and confirmatory randomized clinical trials will require careful selection of control groups, efforts to minimize bias from unblinding, and attention to the roles of patient mental set and treatment setting. Perspective: There is considerable promise for the use of psychedelic therapy for pain, but evidence-based recommendations for the design of future studies are needed to ensure that the results of this research are truly informative.
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Affiliation(s)
- Robert H Dworkin
- Departments of Anesthesiology and Perioperative Medicine, Neurology, and Psychiatry, and Center for Health + Technology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States.
| | - Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for the Neurosciences and Zuckerberg San Francisco General Hospital, San Francisco, CA, United States, and UC Berkeley Center for the Science of Psychedelics, Berkeley, CA, United States
| | - Nick Andrews
- Behavior Testing Core, Salk Institute of Biological Studies, La Jolla, CA, United States
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Charles S Grob
- Departments of Psychiatry and Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, United States, and UCLA School of Medicine, Los Angeles, CA, United States
| | - Stephen Ross
- Departments of Psychiatry and Child and Adolescent Psychiatry, and New York University Langone Center for Psychedelic Medicine, New York, NY, United States
| | - Theodore D Satterthwaite
- Department of Psychiatry, and Lifespan Informatics and Neuroimaging Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Eric C Strain
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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12
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Ortiz CE, Dourron HM, Sweat NW, Garcia-Romeu A, MacCarthy S, Anderson BT, Hendricks PS. Special considerations for evaluating psilocybin-facilitated psychotherapy in vulnerable populations. Neuropharmacology 2022; 214:109127. [DOI: 10.1016/j.neuropharm.2022.109127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/25/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
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13
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Stauffer CS, Anderson BT, Ortigo KM, Woolley J. Psilocybin-Assisted Group Therapy and Attachment: Observed Reduction in Attachment Anxiety and Influences of Attachment Insecurity on the Psilocybin Experience. ACS Pharmacol Transl Sci 2020; 4:526-532. [PMID: 33860182 DOI: 10.1021/acsptsci.0c00169] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 12/26/2022]
Abstract
Attachment insecurity is determined early in life, is a risk factor for psychopathology, and can be measured on two separate continuous dimensions: attachment anxiety and attachment avoidance. Therapeutic changes toward more secure attachment correlate with reduction in psychiatric symptoms. Psilocybin-assisted psychotherapy has demonstrated promise in the treatment of psychopathology, such as treatment-resistant depression and substance use disorders. We hypothesized that psilocybin-assisted psychotherapy would reduce attachment anxiety and attachment avoidance, thus increasing attachment security. We also hypothesized that baseline measures of attachment insecurity, which can reflect a diminished capacity for trust and exploration, would inform the quality of the psilocybin session. Participants were male long-term AIDS survivors with moderate-severe demoralization (n = 18). Using the Experiences in Close Relationships scale, we measured attachment insecurity at baseline as well as immediately, and 3 months, after completion of a brief group therapy course, which included a single midtreatment open-label psilocybin session conducted individually. Clinically important aspects of the psilocybin session were assessed using the revised Mystical Experience Questionnaire and the Challenging Experience Questionnaire the day following psilocybin administration. Self-reported ratings of attachment anxiety decreased significantly from baseline to 3-months post-intervention, t(16) = -2.2; p = 0.045; d rm = 0.45; 95% CI 0.01, 0.87. Attachment avoidance did not change significantly. Baseline attachment anxiety was strongly correlated with psilocybin-occasioned mystical-type experiences, r(15) = 0.53, p = 0.029, and baseline attachment avoidance was strongly correlated with psilocybin-related challenging experiences, r(16) = 0.62, p = 0.006. These findings have important implications for the general treatment of psychopathology as well as optimizing psilocybin-assisted psychotherapy as a broadly applicable treatment modality.
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Affiliation(s)
- Christopher S Stauffer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California 94143, United States.,San Francisco Veterans Affairs Medical Center Mental Health, San Francisco, California 94121, United States.,Department of Psychiatry and VA Portland Health Care System, Oregon Health & Science University, Portland, Oregon 97239, United States
| | - Brian T Anderson
- San Francisco Veterans Affairs Medical Center Mental Health, San Francisco, California 94121, United States.,Zuckerberg San Francisco General Hospital, San Francisco, California 94110, United States
| | - Kile M Ortigo
- Center for Existential Exploration, Palo Alto, California 94306, United States
| | - Joshua Woolley
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California 94143, United States.,San Francisco Veterans Affairs Medical Center Mental Health, San Francisco, California 94121, United States
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14
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Affiliation(s)
- Brian T Anderson
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Alicia L Danforth
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA 90509, USA
| | - Charles S Grob
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA 90509, USA; Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
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15
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Anderson BT, Danforth A, Daroff PR, Stauffer C, Ekman E, Agin-Liebes G, Trope A, Boden MT, Dilley PJ, Mitchell J, Woolley J. Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot study. EClinicalMedicine 2020; 27:100538. [PMID: 33150319 PMCID: PMC7599297 DOI: 10.1016/j.eclinm.2020.100538] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psilocybin therapy has shown promise as a rapid-acting treatment for depression, anxiety, and demoralization in patients with serious medical illness (e.g., cancer) when paired with individual psychotherapy. This study assessed the safety and feasibility of psilocybin-assisted group therapy for demoralization in older long-term AIDS survivor (OLTAS) men, a population with a high degree of demoralization and traumatic loss. METHODS Self-identified gay men OLTAS with moderate-to-severe demoralization (Demoralization Scale-II ≥8) were recruited from the community of a major US city for a single-site open-label study of psilocybin-assisted group therapy comprising 8-10 group therapy visits and one psilocybin administration visit (0·3-0·36 mg/kg po). Primary outcomes were rate and severity of adverse events, and participant recruitment and retention. The primary clinical outcome was change in mean demoralization from baseline to end-of-treatment and to 3-month follow-up assessed with a two-way repeated measures ANOVA. Trial registration: Clinicaltrials.gov (NCT02950467). FINDINGS From 17 July 2017 to 16 January 2019, 18 participants (mean age 59·2 years (SD 4·4)) were enrolled, administered group therapy and psilocybin, and included in intent-to-treat analyses. We detected zero serious adverse reactions and two unexpected adverse reactions to psilocybin; seven participants experienced self-limited, severe expected adverse reactions. We detected a clinically meaningful change in demoralization from baseline to 3-month follow-up (mean difference -5·78 [SD 6·01], ηp 2 = 0·47, 90% CI 0·21-0·60). INTERPRETATION We demonstrated the feasibility, relative safety, and potential efficacy of psilocybin-assisted group therapy for demoralization in OLTAS. Groups may be an effective and efficient means of delivering psychotherapy pre- and post-psilocybin to patients with complex medical and psychiatric needs. FUNDING Carey Turnbull, Heffter Research Institute, NIMH R25 MH060482, NIH UL1 TR001872, River Styx Foundation, Saisei Foundation, Sarlo Foundation, Stupski Foundation, Usona Institute, US Department of Veterans Affairs (Advanced Neurosciences Fellowship and IK2CX001495).
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Affiliation(s)
- Brian T Anderson
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
- Corresponding author at: Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA.
| | - Alicia Danforth
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Prof Robert Daroff
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
| | - Christopher Stauffer
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Portland VA Medical Center/Oregon Health & Science University, Portland, OR, USA
| | - Eve Ekman
- Department of Psychology, Greater Good Science Center, UC Berkeley, CA, USA
| | - Gabrielle Agin-Liebes
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
| | - Alexander Trope
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Matthew Tyler Boden
- Center for Innovation to Implementation, Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, CA, USA
| | - Prof James Dilley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Bldg 5 (PES), San Francisco, CA 94110, USA
| | - Jennifer Mitchell
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Department of Neurology, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
| | - Joshua Woolley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, UCSF, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA
- Corresponding author at: Mental Health Service, San Francisco VA Medical Center, 4150 Clement St, Bldg 16, San Francisco, CA 94121, USA.
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Abstract
Contemporary research with classic psychedelic drugs (e.g., lysergic acid diethylamide (LSD) and psilocybin) is indebted to the twentieth-century researchers and clinicians who generated valuable clinical knowledge of these substances through experimentation. Several recent reviews that highlight the contributions of this early literature have focused on psychedelic-assisted individual psychotherapy modalities. None have attempted to systematically identify and compile experimental studies of psychedelic-assisted group therapy. In therapeutic settings, psychedelics were often used to enhance group therapy for a variety of populations and clinical indications. We report on the results of a systematic review of the published literature in English and Spanish on psychedelic-assisted group therapies. Publications are characterized by their clinical approach, experimental method, and clinical outcomes. Given the renewed interest in the clinical use of psychedelic medicines, this review aims to stimulate hypotheses to be tested in future research on psychedelic-assisted psychotherapy, group process, and interpersonal functioning.
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Affiliation(s)
- Alexander Trope
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA
| | - Brian T Anderson
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
| | - Andrew R Hooker
- c Osher Center for Integrative Medicine , UCSF , San Francisco , CA , USA
| | - Giancarlo Glick
- d School of Medicine , Brown University , Providence , RI , USA
| | - Christopher Stauffer
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
| | - Joshua D Woolley
- a Department of Psychiatry , Weill Institute for Neurosciences, UCSF , San Francisco , CA , USA.,b Mental Health Service , San Francisco VA Medical Center , San Francisco , CA , USA
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Abstract
A previously unknown Spanish-language mutual aid resource for substance use and mental health concerns is available in Latino communities across the USA and much of Latin America. This kind of '4th and 5th step' group is a 'culturally adapted' version of the 12-step programme and provides empirical grounds on which to re-theorise the importance of spirituality and culture in mutual aid recovery groups. This article presents ethnographic data on this organisation.
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Hagen CA, Hawrylewicz EJ, Anderson BT, Cephus ML. Effect of ultraviolet on the survival of bacteria airborne in simulated Martian dust clouds. Life Sci Space Res 2003; 8:53-8. [PMID: 12664918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A chamber was constructed to create simulated Martian dust storms and thereby study the survival of airborne micro-organisms while exposed to the rigors of the Martian environment, including ultraviolet irradiation. Representative types of sporeforming and non-sporeforming bacteria present in spacecraft assembly areas and indigenous to humans were studied. It was found that daily ultraviolet irradiation of 2 to 9 X 10(7) erg cm-2 was not sufficient to sterilize the dust clouds. The soil particles protected the organisms from ultraviolet irradiation since the numbers of survivors from irradiated environments were similar to those from unirradiated environments. Pending further data of the Martian environment, the contamination and dissemination of Mars with terrestrial micro-organisms is still a distinct possibility.
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Affiliation(s)
- C A Hagen
- IIT Research Institute, Chicago, Illinois, USA
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Herbelin JM, Henshaw TL, D. Rafferty B, Anderson BT, Tate RF, Madden TJ, Manke GC, Hager GD. The measurement of gain on the 1.315 μm transition of atomic iodine in a subsonic flow of chemically generated NCl(a1Δ). Chem Phys Lett 1999. [DOI: 10.1016/s0009-2614(98)01292-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Anderson BT, Forman PR, Jahoda FC. Self-pumped phase conjugation in BaTiO(3) at 1.06 microm. Opt Lett 1985; 10:627-628. [PMID: 19730507 DOI: 10.1364/ol.10.000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report the first observation to our knowledge of self-pumped phase conjugation in BaTiO(3) at 1.06 microm. An essential feature is the lower threshold external ring configuration rather than total internal reflection geometry. Although the product of incident power (1 W/cm(2)) and formation time (600 sec) is much larger than the corresponding values at 0.80 microm (0.15 W/cm(2); 120 sec), the effect was observed in two crystals purchased more than a year apart and poled at separate facilities.
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Bwibo NO, Anderson BT. Sclerema neonatorum (a study of 16 cases in the special care unit, Mulago Hospital, Kampala). East Afr Med J 1970; 47:50-5. [PMID: 5436180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
Scanning electron microscopy was used for viewing Bacillus cereus and Staphylococcus aureus in three different soils. Both organisms were detected in the test soils at an approximate concentration of 10(7) cells per gram of soil; theoretically, the minimal number of microorganisms required for detection with the scanning electron microscope technique was between 10(7) and 10(10) cells per gram of soil. Because the concentration of cells was critical, the use of scanning electron microscopy as an extraterrestrial life detection instrument would be limited with soils containing more than 10(7) bacteria per gram of soil.
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