Archives of General Psychiatry
September 7, 2010
Gurpreet S Chopra, Marycie Hagerty, Charles S. Grob et al.
1,220 citations
In a double-blind, placebo-controlled study, twelve adults with advanced-stage cancer and anxiety received a moderate dose (0.2 mg/kg) of psilocybin. Safe physiological and psychological responses were documented, with no clinically significant adverse events. The State-Trait Anxiety Inventory trait anxiety subscale showed a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory indicated improved mood that reached significance at 6 months; the Profile of Mood States showed mood improvement that approached but did not reach significance. The results support the need for more research into psilocybin for cancer-related anxiety.
The Journal of Nervous and Mental Disease
February 1, 1996
Charles S. Grob, Dennis J. Mckenna, J. C. Callaway et al.
333 citations
Long-term members of a Brazilian church who regularly consume hoasca (ayahuasca) as a legal sacrament show remission of psychopathology after starting use, with no evidence of personality or cognitive deterioration. Psychological assessments of 15 long-term users and 15 matched controls with no hoasca history included psychiatric interviews, personality tests, and neuropsychological evaluation. Users reported high functional status. The study suggests hoasca may have therapeutic potential, though further investigation is needed.
Psychopharmacology
November 1, 2018
Alicia Danforth, Charles S. Grob, Christopher M Struble et al.
284 citations
Autistic adults with severe social anxiety who received MDMA-assisted psychotherapy showed significantly greater improvement in social anxiety symptoms compared to those given an inactive placebo. The improvement was rapid and durable, with effects still present at a six-month follow-up. The study used two eight-hour psychotherapy sessions with either MDMA (75–125 mg) or placebo, plus three non-drug sessions after each. The effect size was very large at the primary endpoint and remained large at follow-up. Social anxiety stayed the same or continued to improve for most in the MDMA group after treatment ended. Initial safety and efficacy support larger studies.
Lancet Psychiatry
April 5, 2016
Michael C Mithoefer, Charles S. Grob, Timothy D Brewerton
237 citations
Psilocybin and MDMA, known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research over the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and anxiety in patients with advanced cancer. MDMA shows encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, not as stand-alone treatments. This model offers a possible alternative to existing pharmacological and psychological treatments, though further research is needed.
Journal of Analytical Toxicology
October 1, 1996
J. C. Callaway, Lionel P. Raymon, William Lee Hearn et al.
158 citations
After ritual ingestion of ayahuasca, the highest plasma concentrations in 15 healthy male volunteers were 222.3 ng/mL for harmine, 134.5 ng/mL for tetrahydroharmine, and 9.4 ng/mL for harmaline, with N,N-dimethyltryptamine (DMT) also quantitated. Harmala alkaloids were measured by high-performance liquid chromatography with fluorescence detection, achieving limits of quantitation below 2 ng/mL; DMT was measured by gas chromatography with nitrogen-phosphorus detection. Recovery was quantitative for all analytes. These are the first reported measurements of DMT and harmala alkaloids in human plasma following ritual ayahuasca ingestion. The methods may apply to other biological matrices.
Journal of Psychoactive Drugs
December 1, 1998
James C. Callaway, Charles S. Grob
134 citations
The Amazonian psychoactive beverage ayahuasca may dangerously interact with SSRI antidepressants. Its harmala alkaloids inhibit monoamine oxidase, and combining them with selective serotonin reuptake inhibitors can trigger serotonin syndrome, a potentially life-threatening condition. Caution is advised when using ayahuasca alongside certain pharmaceutical drugs.
The Journal of Nervous and Mental Disease
June 1, 1992
Mitchell B. Liester, Charles S. Grob, Gary Bravo et al.
130 citations
Twenty psychiatrists who had previously taken MDMA were interviewed about their subjective experiences during the drug's effects and its short- and long-term aftereffects. The study retrospectively examined side effects, insight gained, pleasure, intensity of the experience, and the influence of set, setting, and dosage. The authors discuss the methodological limitations of this type of retrospective self-report study.
Journal of Psychoactive Drugs
June 1, 2005
Evelyn Doering-Silveira, Charles S. Grob, Marlene Dobkin De Rios et al.
122 citations
Adolescents who use ayahuasca in a religious setting show similar lifetime drug use compared to those who never use it, but they consume significantly less alcohol. In the previous year, 46.31% of ayahuasca-using adolescents drank alcohol versus 74.4% of the comparison group; recent alcohol use was 32.5% versus 65.1%. The findings suggest religious affiliation may protect against alcohol use, and that early exposure to ayahuasca in a controlled ritual context does not lead to broader drug misuse.
Journal of Psychoactive Drugs
June 1, 2005
Dartiu Xavier Da Silveira, Charles S. Grob, Marlene Dobkin De Rios et al.
111 citations
Adolescents who consume ayahuasca in a religious setting show lower rates of anxiety, body dysmorphic concerns, and attentional problems compared to matched controls, despite similar overall psychiatric profiles. The study compared 40 adolescents from a Brazilian ayahuasca sect with 40 controls matched on sex, age, and education. Screening scales for depression, anxiety, alcohol abuse, attentional problems, and body dysmorphic disorders found considerably lower positive scores for anxiety, body dysmorphism, and attentional problems among ayahuasca-using adolescents. These low frequencies may reflect a protective effect of religious affiliation, though further research on other variables is needed.
Progress in neuro-psychopharmacology & biological psychiatry
January 4, 2016
Alicia Danforth, Christopher M Struble, Berra Yazar-Klosinski et al.
110 citations
A clinical trial of MDMA-assisted therapy for social anxiety in autistic adults began in spring 2014. MDMA has been administered to over 1133 individuals in research without unexpected serious adverse events requiring expedited FDA reporting. The authors argue that established safety parameters justify developing MDMA-assisted interventions to help autistic adults improve social adaptability. MDMA, like classic psychedelics, can catalyze lasting openness and introspection without ongoing administration, reducing adverse event frequency and improving the risk/benefit ratio compared to daily medications. Clinicians could employ new treatment models using one to several MDMA sessions within supportive psychotherapy for social anxiety or similar distress.
Journal of Magnetic Resonance Imaging
October 1, 1999
L. Chang, Thomas Ernst, Charles S. Grob et al.
109 citations
Recreational use of MDMA does not cause significant neuronal injury, as indicated by normal levels of N-acetyl compounds in the brain. However, in the parietal white matter, the concentration of myo-inositol was 16.3% higher and the ratio of myo-inositol to creatine was 14.1% higher in MDMA users compared to non-users. These increases, which were related to the cumulative lifetime dose of MDMA, suggest that even recreational doses may lead to increased glial content in the brain. The study involved 22 MDMA users and 37 normal subjects, using magnetic resonance imaging and spectroscopy to assess neurochemical abnormalities.
Lancet Psychiatry
October 1, 2020
Brian T Anderson, Alicia Danforth, Charles S. Grob
99 citations
The text discusses safety and ethical concerns surrounding psychedelic medicine, emphasizing the need for stringent oversight, comprehensive patient screening, robust therapeutic support, and informed consent to mitigate risks such as psychological distress and misuse. It highlights the ethical imperative for equitable access and responsible medical use as these powerful medicines are integrated into clinical practice.
Forensic Science International
March 1, 2018
David E Nichols, Charles S. Grob
86 citations
LSD is physiologically non-toxic and medically safe at standard doses (50-200 μg). Five sudden deaths previously attributed to LSD toxicity were actually caused by other factors: two from massive overdoses, two from fatal cardiovascular collapse after agitated individuals were placed in maximal physical restraint positions (hog-tying) by police, and one from extreme hyperthermia likely due to a substituted drug (e.g., 25i-NBOMe) that affects central nervous system temperature regulation. Accurate understanding of these fatalities is important given renewed therapeutic interest in LSD and other psychedelics.
Addiction Research
January 1, 2000
Charles S. Grob
79 citations
The text defines ecstasy as an intense state of overpowering emotion or rapture, tracing its etymology to the ancient Greek ekstasis, meaning flight of the soul from the body. Drawing on Mircea Eliade's work on shamanism, it describes how select individuals among aboriginal peoples become shamans, specialists who induce ecstatic trance states where the soul is believed to leave the body. Shamans undergo initiation through isolation, suffering, and the imminence of death, and are considered technicians of the sacred, serving as intermediaries between everyday life and sacred alternative realities.
Psychopharmacology
November 1, 1994
J. C. Callaway, Mauno M. Airaksinen, Dennis J. Mckenna et al.
79 citations
Healthy male drinkers of ayahuasca, a psychoactive Amazonian sacrament, showed an increased number of binding sites for [3H]citalopram on platelet serotonin transporters compared to healthy male controls, while the dissociation constant remained unchanged. If these platelet measures reflect neuronal serotonin uptake activity, the findings suggest either a decreased concentration of extracellular serotonin or a compensatory response to increased serotonin production and release. The authors caution that such changes in serotonin synaptic activity should not be misinterpreted as signs of developing neurological or psychiatric illness.
Journal of Psychoactive Drugs
June 1, 2005
Evelyn Doering-Silveira, Enrique Lopez, Charles S. Grob et al.
70 citations
Adolescents who use ayahuasca in a religious context show no significant differences in neuropsychological performance compared to matched controls. A battery of tests measuring speeded attention, visual search, sequencing, psychomotor speed, verbal and visual abilities, memory, and mental flexibility found no impairment among ayahuasca users. The groups were matched for sex, age, and education. Statistical comparisons using independent t-tests indicated no significant differences on any measure. The authors suggest further studies are needed to confirm these findings.
Journal of Psychoactive Drugs
January 1, 2002
Marlene Dobkin De Rios, Charles S. Grob, John R. Baker
58 citations
Drug substitution using hallucinogens such as ayahuasca, ibogaine, peyote, and LSD can help people recover from addiction to substances like alcohol and opiates. A redemptive model, drawing on data from the U.S., Brazil, Peru, and West Africa, proposes that using one psychoactive substance in a spiritual or clinical setting frees individuals from addiction and restores them as functioning community members. Two mechanisms are proposed: psychological suggestibility aids in achieving abstinence, and neurophysiological and neurochemical changes support substitution efficacy. Research with the Uñaio do Vegetal Church in Brazil illustrates this model.
The Clinical neuropsychologist
November 1, 2003
Carla Back-Madruga, Kyle B. Boone, Linda Chang et al.
57 citations
Recreational MDMA (ecstasy) users show no overall cognitive deficits compared to non-users, but heavy users perform worse on tests of nonverbal (visual) memory. In a study comparing 22 recreational MDMA users with 28 matched controls, no significant differences in general cognitive functioning emerged. However, greater lifetime MDMA use correlated with poorer scores on several nonverbal memory measures. Users who had taken MDMA 50 or more times scored significantly lower on two of three nonverbal memory tests than less frequent users. Other cognitive areas appeared unaffected. The findings suggest that only heavy, frequent MDMA use is associated with specific declines in visual memory.
November 3, 2012
Charles S. Grob, Anthony P. Bossis, Roland R. Griffiths
52 citations
Psilocybin, a hallucinogen, shows promise in alleviating distress in patients with mental health issues. In a study involving 200 participants, 60% reported significant reductions in anxiety and depression after treatment sessions with a trained psychotherapist. This suggests that psilocybin could serve as a valuable tool in psychiatry, offering an alternative to traditional medications. The findings highlight the potential of psychedelics in enhancing psychological well-being and support their inclusion in complementary and alternative medicine studies for better mental health outcomes.
Neuropharmacology
August 13, 2022
Ingrid Donato, Veronica Magar, Sean J Belouin et al.
49 citations
Psychedelic and entactogen medicines like psilocybin and MDMA, when combined with psychosocial support, show potential for safe, rapid, and durable clinical improvements. Both have received Breakthrough Therapy designation from the US FDA and may gain full approval, with similar regulatory steps in other countries. Regulatory changes are also increasing access to legal or decriminalized psychedelic use outside medical settings. This review covers historical use, current evidence, and policy considerations around standards of practice, consumer protection, community engagement, equitable access, and data standards. It suggests a public-private partnership involving diverse stakeholders to co-create best practices and public policies supporting responsible, ethical use.
Journal of Drug Issues
January 1, 1992
Charles S. Grob, Marlene Dobkin De Rios
49 citations
In three tribal societies—Australian Aboriginal males, Tshogana Tsonga females, and Chumash youth—adolescents ingest hallucinogenic plants during initiation rituals as part of a managed, short-term socialization process led by elders for religious and pedagogical purposes. This contrasts with abusive drug patterns among American adolescents. The analysis highlights hypersuggestibility as a cultural technique used to normalize youth in these societies, in contrast to the pathological drug ingestion patterns seen among American adolescents.
Sci Am
December 1, 2010
Roland R. Griffiths, Charles S. Grob
46 citations
The text briefly notes that hallucinogens are being used as medicine, indicating a shift toward therapeutic applications of these substances. It does not provide details about specific conditions, outcomes, or evidence.
JAMA Network Open
June 3, 2024
Amy L. Mcguire, I Glenn Cohen, Dominic Sisti et al.
41 citations
A consensus statement from a 2023 meeting of 27 experts identifies 20 points of consensus across five ethical issues for integrating psychedelic medicines into mainstream medical practice: reparations and reciprocity, equity, and respect; informed consent; professional boundaries and physical touch; personal experience; and gatekeeping. The meeting included clinicians, researchers, Indigenous groups, industry, philanthropy, veterans, retreat facilitators, training programs, and bioethicists. The statement focuses on government-approved medical use in the US and abroad, emphasizing that policymakers must address challenges ahead while acknowledging the hopeful moment.
Journal of Psychoactive Drugs
January 1, 1989
Gary Bravo, Charles S. Grob
38 citations
Psychedelic drugs have declined in psychiatric research because social reactions led to their classification as controlled substances. Three historical paradigms for their use are reviewed: the psychotomimetic approach, which aimed to temporarily induce psychoses but proved limited for understanding or treating mental illness; the psycholytic approach, using low doses to reduce defenses and release unconscious material, rooted in psychoanalysis; and the high-dose psychedelic paradigm, which often produced mystical or spiritual experiences and recast the psychiatrist as a modern shaman, alienating many in the profession. Future sanctioned clinical research should learn from traditional shamanic models to assess efficacy and safety.
J Palliat Med
April 13, 2021
Yvan Beaussant, James A. Tulsky, Benjamin Guérin et al.
34 citations
Researchers from palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies identified seven key opportunities for advancing research on psychedelic-assisted therapy for people with serious illness. Four opportunities relate to science and design: clarifying which conditions the therapy is indicated for, developing and refining therapeutic protocols, investigating how set and setting affect outcomes, and understanding mechanisms of action. Three opportunities concern institutional and societal drivers: education and certification for therapists, regulations and funding, and diversity and inclusion. Participants also noted epistemological limitations of the medical model for understanding psychedelics' therapeutic value.