Journal of Psychopharmacology
September 8, 2010
Tibor M Brunt, Anneke Poortman, Raymond J.m. Niesink et al.
217 citations
The ecstasy market in the Netherlands became unstable in 2009, with more than a 50% drop in tablets containing MDMA. A new substance, mephedrone, partially replaced MDMA in tablets sold as ecstasy, at doses between 96 and 155 mg. Based on reports from 70 regular ecstasy users, mephedrone produced enjoyable effects similar to other amphetamine-type stimulants, including MDMA, but unlike MDMA it induced strong cravings in most users. If the unstable market continues, mephedrone may substantially substitute for MDMA, raising health concerns.
Regulatory toxicology and pharmacology : RTP
April 1, 2011
Jan Van Amsterdam, Antoon Opperhuizen, Wim van den Brink
208 citations
Magic mushroom use in the Netherlands declined from 6.3% last-year prevalence in 2000 to 2.9% in 2005, and further after possession and use became illegal in December 2008. A review by the Coordination point Assessment and Monitoring new drugs concluded that the physical and psychological dependence potential of magic mushrooms is low, acute toxicity moderate, chronic toxicity low, and public health and criminal aspects negligible. Combined use with alcohol and the quality of the setting deserve attention. Overall, magic mushroom use is relatively safe with few and mild adverse effects, though the low but unpredictable provocation of panic attacks and flash-backs remain a concern.
Archives of General Psychiatry
October 1, 2001
Liesbeth Reneman, Jules Lavalaye, Ben Schmand et al.
192 citations
MDMA may cause lasting memory problems even after its toxic effects on serotonin neurons in the brain's cortex reverse. The study suggests that damage to memory function from MDMA use can persist over the long term, while the neurotoxic effects on serotonin-producing neurons might be reversible.
Journal of Psychopharmacology
August 26, 2022
Joost J. Breeksema, Bouwe Kuin, Jeanine Kamphuis et al.
171 citations
A systematic review of 44 clinical studies (34 quantitative, 10 qualitative) involving 598 patients treated with MDMA or serotonergic psychedelics (psilocybin, LSD, ayahuasca) found that treatments were generally well tolerated, though adverse events were often not systematically assessed. Common acute adverse events across diagnoses and compounds included nausea, headaches, and anxiety. Late adverse events included headaches (psilocybin, MDMA), fatigue, low mood, and anxiety (MDMA). One serious adverse event occurred during MDMA administration (increased premature ventricular contractions requiring brief hospitalization); no other events required medical intervention. Qualitative studies suggested that psychologically challenging experiences may be therapeutically beneficial. The authors conclude that adverse events are poorly defined and likely underreported due to study design and sample selection.
Journal of Psychopharmacology
March 1, 2006
Liesbeth Reneman, Maartje M. L. de Win, Wim van den Brink et al.
85 citations
Heavy ecstasy (MDMA) use may cause injury to the brain's serotonin system. Neuroimaging techniques like SPECT, PET, and proton magnetic resonance spectroscopy have been used to study this potential neurotoxicity in living humans. The few available studies suggest that heavy users risk reductions in serotonin transporter (SERT) densities in subcortical and possibly cortical brain regions, a marker of serotonin neurotoxicity. These reductions appear dose-dependent and transient, with females possibly more vulnerable than males. Proton magnetic resonance spectroscopy seems less sensitive for detecting ecstasy's neurotoxic effects. Whether lower exposure also leads to SERT loss remains unknown. Most studies are retrospective, providing indirect evidence, so longitudinal studies are needed for definitive conclusions.
Expert Opinion on Drug Safety
February 26, 2022
Jan Van Amsterdam, Wim van den Brink
74 citations
Psilocybin, when combined with psychotherapy or psychotherapeutic support, shows promise as a treatment for various mental disorders, including treatment-resistant conditions. However, larger double-blind randomized controlled trials with objective long-term outcomes are needed to confirm these findings before standard clinical use can be considered.
Scientific Reports
February 5, 2024
Alistair Niemeijer, Erwin Krediet, Jeanine Kamphuis et al.
50 citations
Patients with treatment-resistant depression who received psilocybin in a clinical trial described challenges with trust-building and expectation management, the need to navigate intense experiences often guided by music, and a desire for a more comprehensive treatment including multiple psilocybin sessions and sustained therapy. Distrust in mental healthcare generally, but trust in study therapists, was a key subtheme. The findings suggest that optimizing psilocybin treatment for this population requires individualized preparation, investment in trust-building, additional sessions, and access to ongoing psychotherapy with trusted therapists.
Human Psychopharmacology Clinical and Experimental
December 1, 2001
Liesbeth Reneman, Jan Booij, Charles B.l.m. Majoie et al.
50 citations
Human users of MDMA (Ecstasy) may be at risk of developing MDMA-induced neuronal injury. Previously, no methods were available for directly evaluating neurotoxic effects in the living human brain, but the development of in vivo neuroimaging tools has begun to provide insights. This review highlights contributions of brain imaging studies on the potential neurotoxic effects of MDMA and functional consequences. An overview of PET, SPECT, and MR spectroscopy studies shows evidence of neuronal injury in MDMA users. Different neuroimaging tools have investigated potential functional consequences of MDMA-induced 5-HT neurotoxic lesions. Brain imaging will play a crucial role in understanding MDMA's short- and long-term effects in the human brain.
Frontiers in Psychiatry
January 1, 2022
Joost J. Breeksema, Alistair Niemeijer, Bouwe Kuin et al.
41 citations
Patients with treatment-resistant depression undergoing oral esketamine treatment often find the experience overwhelming and struggle with whether to let go or maintain control. Their ability to let go is influenced by preparation, emotional support, and the treatment setting. Better preparation, an optimized environment, and psychological support during sessions may improve patients' experiences and outcomes. The study provides recommendations for improving quality of care, including training for nurses and support staff.
Psychopharmacology
July 1, 2023
Joost J. Breeksema, Alistair Niemeijer, Bouwe Kuin et al.
26 citations
The effects of oral esketamine for treatment-resistant depression are highly variable, and psychological distress is common. Patients report perceptual changes, detachment from body and emotions, stillness, mystical-type experiences, and fear. After sessions, many feel hungover and fatigued, while depressive mood is neutralized. Some effects, such as increased openness and detachment, may hold psychotherapeutic potential, but the frequent distress calls for additional patient support throughout treatment.
Drug Science Policy and Law
January 1, 2022
Plinio Ferreira, Adam Winstock, Anne Katrin Schlag et al.
9 citations
Nitrous oxide (laughing gas) and alkyl nitrites (poppers) rank among the least harmful recreational drugs when assessed on 16 criteria including dependence, injury, and economic cost. An expert panel using Multi-Criteria Decision Analysis scored nitrous oxide at 6 and poppers at 5 on a 0–100 overall harm scale, placing them just above magic mushrooms (psilocybin). Nitrous oxide scored higher for dependence, environmental damage, mental impairment, and family adversities; poppers scored higher for injury, drug-related damage, economic cost, and mortality. The findings aim to inform UK policy decisions, as nitrous oxide possession is not currently controlled under the Misuse of Drugs Act.
Journal of Behavioral Addictions
March 26, 2024
Pedro Romero, Andrea Czakó, Wim van den Brink et al.
7 citations
Gambling disorder is a severe mental health and behavioral problem with harmful financial, relationship, and mental health consequences. This paper initiates discussion on using psychedelics combined with psychotherapeutic support as a potential treatment option. Recent studies have shown promising results with psychedelic-assisted therapy (PAT) for anxiety, depression, post-traumatic stress disorder, and various substance use disorders. Given similarities in underlying psychosocial and neurobiological mechanisms between gambling disorder and other addictions, the authors suggest PAT could be effective for gambling disorder. The paper underscores the need for further research into its viability and effectiveness.
Drugs Education Prevention and Policy
September 10, 2020
Jan Van Amsterdam, Johannes G. Ramaekers, Ton Nabben et al.
4 citations
Ecstasy (MDMA) is a popular recreational drug with low abuse and dependence liability compared to several other illicit drugs and alcohol, and there is little evidence of long-term harm. A potential health risk is acute hyperthermia, which occurs at an unknown incidence rate and is more prevalent when ecstasy is consumed with heavy exercise at high ambient temperatures or with other substances including alcohol. However, illegal production and trade in the Netherlands have developed into a serious public order and ecological problem, with organized crime related to production and trafficking growing. This review provides a science-based summary to assist debate on future Dutch ecstasy policy to reduce organized crime while maintaining harm reduction.
Psychopharmacology
January 1, 2022
Nina Schimmers, Joost J. Breeksema, Sanne Y Smith-Apeldoorn et al.
Both classical psychedelics (DPT, LSD, psilocybin) and atypical psychedelics (MDMA, ketamine) show promise for reducing anxiety, depression, and existential distress in terminally ill patients, with recent controlled trials indicating positive effects on existential and spiritual well-being, quality of life, and acceptance while causing few adverse and no serious adverse effects. Early studies had serious methodological flaws, but newer trials are of higher quality. Larger high-quality studies are still needed for classical psychedelics and MDMA, and ketamine research should better address existential well-being and psychotherapeutic context.