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Fonseka LN, Woo BKP. Therapeutic role of psilocybin and 3,4- methylenedioxymethamphetamine in trauma: A literature review. World J Psychiatry 2023; 13:182-190. [PMID: 37303932 PMCID: PMC10251361 DOI: 10.5498/wjp.v13.i5.182] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/28/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
With the Food and Drug Administration designation in 2017 of 3,4-methylenedioxymethamphetamine (MDMA) as a breakthrough therapy in post-traumatic stress disorder and psilocybin in treatment-resistant depression, psychedelic drugs have continued to garner the attention of researchers and clinicians for their promise of unmatched, rapid improvement in a multitude of psychiatric conditions. Classic psychedelic drugs including psilocybin, lysergic acid diethylamide, and ayahuasca, as well as non-classic drugs such as MDMA and ketamine, are currently being investigated for a potential therapeutic role in trauma, depressive disorders, and other psychopathologies. However, psilocybin and MDMA each have a functional profile well-suited for integration with psychotherapy. The present review focuses on psilocybin and MDMA in psychedelic-assisted therapy (PAT), as these studies compose most of the literature pool. In this review, we discuss the current and future uses of psychedelic drugs, with an emphasis on the role of MDMA and psilocybin in PAT in the setting of trauma and related comorbidities on the efficacy of psychedelic drugs across multiple psychiatric disorders. The article concludes with thoughts for future research, such as incorporating wearables and standardization of symptom scales, therapy styles, and assessment of adverse drug reactions.
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Affiliation(s)
- Lakshan N Fonseka
- Harvard South Shore-Psychiatry Residency Program, Veteran Affairs Boston Healthcare System, Brockton, MA 02301, United States
| | - Benjamin KP Woo
- Chinese American Health Promotion Laboratory, University of California, Los Angeles, Los Angeles, CA 90095, United States
- Department of Psychiatry and Biobehavioral Sciences, Olive View - University of California, Los Angeles Medical Center, Sylmar, CA 91342, United States
- Asian American Studies Center, University of California, Los Angeles, Los Angeles, CA 90095, United States
- Podiatric Medicine and Surgery, Western University of Health Sciences, Pomona, CA 91766, United States
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Chen Y, Tran HTN, Saber YH, Hall FS. High ambient temperature increases the toxicity and lethality of 3,4- methylenedioxymethamphetamine and methcathinone. Pharmacol Biochem Behav 2020; 192:172912. [PMID: 32201298 DOI: 10.1016/j.pbb.2020.172912] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 03/12/2020] [Accepted: 03/19/2020] [Indexed: 01/09/2023]
Abstract
RATIONALE Methylenedioxymethamphetamine (MDMA) and methcathinone (MCAT) are abused psychostimulant drugs that produce adverse effects in human users that include hepatotoxicity and death. Recent work has suggested a connection between hepatotoxicity, elevations in plasma ammonia, and brain glutamate function for methamphetamine (METH)-induced neurotoxicity. OBJECTIVES These experiments investigated the effect of ambient temperature on the toxicity and lethality produced by MDMA and MCAT in mice, and whether these effects might involve similar mechanisms to those described for METH neurotoxicity. RESULTS Under low (room temperature) ambient temperature conditions, MDMA induced hepatotoxicity, elevated plasma ammonia levels, and induced lethality. Under the same conditions, even a very high dose of MCAT produced limited toxic or lethal effects. High ambient temperature conditions potentiated the toxic and lethal effects of both MDMA and MCAT. CONCLUSION These studies suggest that hepatotoxicity, plasma ammonia, and brain glutamate function are involved in MDMA-induced lethality, as has been shown for METH neurotoxicity. The toxicity and lethality of both MDMA and MCAT were potentiated by high ambient temperatures. Although an initial mouse study reported that several cathinones were much less toxic than METH or MDMA, the present results suggest that it will be essential to assess the potential dangers posed by these drugs under high ambient temperatures.
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Affiliation(s)
- Yu Chen
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
| | - Huyen T N Tran
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
| | - Yasir H Saber
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA; Ninevah College of Medicine, Ninevah University, Mosul, Iraq
| | - F Scott Hall
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA.
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Muskiewicz DE, Resendiz-Gutierrez F, Issa O, Hall FS. Synthetic psychoactive cathinones: hypothermia and reduced lethality compared to methamphetamine and methylenedioxymethamphetamine. Pharmacol Biochem Behav 2020; 191:172871. [PMID: 32061662 DOI: 10.1016/j.pbb.2020.172871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/16/2019] [Accepted: 02/11/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Synthetic psychoactive cathinones (SPCs) are drugs with psychostimulant and entactogenic properties like methamphetamine (MA) and 3,4-methylenedioxymethamphetamine (MDMA). Despite clinical reports of human overdose, it remains to be determined if SPCs have greater propensity for adverse effects than MA or MDMA. OBJECTIVES To determine whether the SPCs cathinone (CAT), methcathinone (MCAT), mephedrone (MMC), and methylenedioxypyrovalerone (MDPV) have lower LD50 values than MA or MDMA. METHODS Male and female C57Bl/6J mice received single injections of one of 6 doses of a test drug (0-160 mg/kg IP). Temperature and behavioral observations were taken every 20 min for 2 h followed by euthanasia of surviving mice. Organs were weighed and evaluated for histopathological changes. RESULTS LD50 values for MA and MDMA, 84.5 and 100.9 mg/kg respectively, were similar to previous observations. The LD50 for MMC was 118.8 mg/kg, but limited lethality was observed for other SPCs (CAT, MCAT, MDPV), so LD50 values could not be calculated. For all drugs, death was associated with seizure, when it was observed. Rather than hyperthermia, dose-dependent hypothermia was observed for MMC, MDPV, CAT, and MCAT. Contrary to initial expectations, none of the SPCs studied here had LD50 values lower than MA or MDMA. CONCLUSIONS These data indicate that, under the conditions studied here: (1) SPCs exhibit less lethality than MA and MDMA; (2) SPCs impair thermoregulation; (3) effects of SPCs on temperature appear to be independent of effects on lethality.
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Abstract
Drug addicts face the dangers of accidental overdose, fatal intoxication, reduced tolerance and carelessness in consuming drugs. There is an increasing use of designer drugs in many cities. The body of a 29 year-old male, an event manager by profession with an alleged history of consumption of ecstasy tablets, was subjected to autopsy. The cause of death was found to be disseminated intravascular coagulation consequent upon consumption of methylenedioxymethamphetamine. This was based on the brief history, autopsy features and a chemical analysis report. This case is discussed with the background of the existing literature about the interplay of the actions of methylenedioxymethamphetamine, the hyperthermia that would result from physical exertion as in dancing in rave parties leading to hyponatremia and the causes of disseminated intravascular coagulation.
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Affiliation(s)
- Yp Girish Chandra
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
| | - Akshith R Shetty
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
| | - S H Jayanth
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
| | - Basappa S Hugar
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
| | - S Praveen
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
| | - S Harish
- Department of Forensic Medicine, M.S. Ramaiah Medical College, Bangalore, India
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Abstract
Sleep plays an important role in the consolidation and integration of memory in a process called overnight memory consolidation. Previous studies indicate that ecstasy users have marked and persistent neurocognitive and sleep-related impairments. We extend past research by examining overnight memory consolidation among regular ecstasy users (n=12) and drug naïve healthy controls (n=26). Memory recall of word pairs was evaluated before and after a period of sleep, with and without interference prior to testing. In addition, we assessed neurocognitive performances across tasks of learning, memory and executive functioning. Ecstasy users demonstrated impaired overnight memory consolidation, a finding that was more pronounced following associative interference. Additionally, ecstasy users demonstrated impairments on tasks recruiting frontostriatal and hippocampal neural circuitry, in the domains of proactive interference memory, long-term memory, encoding, working memory and complex planning. We suggest that ecstasy-associated dysfunction in fronto-temporal circuitry may underlie overnight consolidation memory impairments in regular ecstasy users.
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Affiliation(s)
- Vanessa Smithies
- School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Jillian Broadbear
- School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Antonio Verdejo-Garcia
- School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Russell Conduit
- School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Polesel DN, Fukushiro DF, Andersen ML, Nozoe KT, Mári-Kawamoto E, Saito LP, Carvalho FRS, Alvarenga TA, Freitas D, Tufik S, Frussa-Filho R, Lanaro R, Costa JL, Tavares MFM. Anxiety-like effects of meta-chlorophenylpiperazine in paradoxically sleep-deprived mice. Prog Neuropsychopharmacol Biol Psychiatry 2014; 49:70-7. [PMID: 24269663 DOI: 10.1016/j.pnpbp.2013.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 10/28/2013] [Accepted: 11/12/2013] [Indexed: 11/25/2022]
Abstract
Chlorophenylpiperazines (CPP) are psychotropic drugs used in nightclub parties and are frequently used in a state of sleep deprivation, a condition which can potentiate the effects of psychoactive drugs. This study aimed to investigate the effects of sleep deprivation and sleep rebound (RB) on anxiety-like measures in mCPP-treated mice using the open field test. We first optimized our procedure by performing dose-effect curves and examining different pretreatment times in naïve male Swiss mice. Subsequently, a separate cohort of mice underwent paradoxical sleep deprivation (PSD) for 24 or 48h. In the last experiment, immediately after the 24h-PSD period, mice received an injection of saline or mCPP, but their general activity was quantified in the open field only after the RB period (24 or 48h). The dose of 5mgmL(-1) of mCPP was the most effective at decreasing rearing behavior, with peak effects 15min after injection. PSD decreased locomotion and rearing behaviors, thereby inhibiting a further impairment induced by mCPP. Plasma concentrations of mCPP were significantly higher in PSD 48h animals compared to the non-PSD control group. Twenty-four hours of RB combined with mCPP administration produced a slight reduction in locomotion. Our results show that mCPP was able to significantly change the behavior of naïve, PSD, and RB mice. When combined with sleep deprivation, there was a higher availability of drug in plasma levels. Taken together, our results suggest that sleep loss can enhance the behavioral effects of the potent psychoactive drug, mCPP, even after a period of rebound sleep.
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Affiliation(s)
| | | | | | - Karen Tieme Nozoe
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Brazil
| | | | - Luís Paulo Saito
- Departamento de Farmacologia, Universidade Federal de São Paulo, Brazil
| | | | | | - Denise Freitas
- Departamento de Oftalmologia, Universidade Federal de São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Brazil
| | - Roberto Frussa-Filho
- Departamento de Farmacologia, Universidade Federal de São Paulo, Brazil; Departamento de Psicobiologia, Universidade Federal de São Paulo, Brazil
| | - Rafael Lanaro
- Centro de Controle de Intoxicações, Universidade Estadual de Campinas, Brazil
| | - José Luiz Costa
- Centro de Controle de Intoxicações, Universidade Estadual de Campinas, Brazil; Laboratório de Química e Toxicologia Forense, Superintendência da Polícia Técnico Científica do Estado de São Paulo, Brazil
| | - Marina Franco Maggi Tavares
- Departamento de Toxicologia e Análises Toxicológicas, Universidade de São Paulo, Brazil; Departamento de Química Fundamental, Universidade de São Paulo, Brazil
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