The Journal of Nervous and Mental Disease
May 17, 2018
Brian S. Barnett, Willie O. Siu, Harrison G. Pope
114 citations
A survey of American psychiatrists found that most perceive hallucinogens as potentially hazardous and appropriately illegal for recreational use, yet a large minority expressed optimism about their therapeutic potential for psychiatric disorders. Male and trainee psychiatrists, compared with female and attending psychiatrists, reported less concern about risks and greater optimism. Younger psychiatrists also appeared more optimistic, possibly due to greater exposure to recent positive publications and less awareness of negative past reports.
Journal of Psychoactive Drugs
August 19, 2021
Brian S. Barnett, Yvan Beaussant, Franklin King et al.
64 citations
Psychiatrists attending psychedelic didactic presentations at two national meetings largely believe psychedelics show treatment promise and strongly support federal funding for medicinal psychedelic research. The most common concerns were lack of trained providers, logistics of therapy delivery, administration for patients with contraindications, and diversion. Desired educational topics included potential benefits, how to conduct therapy, pharmacology, and side effects. Factors associated with increased belief in treatment potential included working primarily in research, higher psychedelic knowledge test scores, and less concern about addictive potential. Support for legalization of non-medicinal use was negatively associated with age and positively associated with support for medicinal legalization.
The International journal on drug policy
January 1, 2022
Brian S. Barnett, Sloane E Parker, Jeremy Weleff
57 citations
Despite a global resurgence in clinical trials of psychedelic-assisted therapies for mental health and addiction—mostly funded privately—the United States National Institutes of Health (NIH), the world's largest public biomedical funder, has not directly supported any such trial. A search of NIH grants from 2006 to 2020 for trials involving MDMA, 5-MeO-DMT, ayahuasca, DMT, ibogaine, LSD, mescaline, peyote, or psilocybin found zero grants directly funding psychedelic-assisted therapy clinical trials. Possible reasons include concerns about risks, a federal law barring promotion of Schedule 1 drug legalization, and prioritization of other psychedelic research.
Psychedelic Med (New Rochelle)
September 13, 2023
Jacob S. Aday, Brian S. Barnett, Dan Grossman et al.
56 citations
The psychedelic industry has grown into a multibillion dollar sector, with hundreds of companies formed in recent years to commercialize psychedelic-assisted therapies. Investment surged in the late 2010s and early 2020s, focusing on drug discovery, novel formulations, manufacturing, treatment centers, consumer goods, and adjunct technologies. Key challenges include regulatory barriers, high treatment costs, and intellectual property issues. Ethical concerns involve potential adverse effects, cost-cutting, ensuring access for marginalized communities, and reciprocity with Indigenous peoples. Lessons from the ketamine and cannabis industries offer guidance on regulatory approval, clinical implementation, and insurance reimbursement.
JAMA Network Open
June 3, 2024
Manish Kumar Jha, Samuel T. Wilkinson, Kamini Krishnan et al.
29 citations
In people with treatment-resistant depression who do not have psychosis, intravenous ketamine works as well as electroconvulsive therapy (ECT) overall. Among outpatients with moderately severe or severe depression, ketamine produced greater improvement in depressive symptoms than ECT. In contrast, inpatients with very severe depression improved more with ECT early in treatment, though by the end of the three-week course both treatments were similarly effective. Higher premorbid intelligence and a diagnosis of posttraumatic stress disorder were linked to greater improvement with ECT, but not with ketamine. These findings may help patients and clinicians decide between the two treatments.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2024
Brian S. Barnett, Miranda Arakelian, David Beebe et al.
28 citations
A repeat survey of American psychiatrists in 2022-23 found a striking increase in optimism about the therapeutic use of hallucinogens compared to 2016. Among 131 respondents (13.1% response rate), 80.9% moderately or strongly believed hallucinogens show promise for psychiatric conditions, and 60.8% for substance use disorders. Large majorities supported research into therapeutic potential (93.9% for psychiatric conditions, 88.6% for substance use disorders) and federal funding of clinical trials. Concern about risks decreased, and 50.4% reported moderate or strong intentions to incorporate hallucinogen-assisted therapy into their practice if regulatory approval is granted.
Psychopharmacology
January 1, 2025
Brian S. Barnett, M Frances Vest, Marcus S Delatte et al.
20 citations
Establishing psychedelic research programs at academic medical centers in the United States faces unique obstacles because psychedelics are intensely psychoactive, carry sociopolitical baggage, and most are Schedule I drugs. This article reviews academic literature and draws on the authors' experiences with regulatory agencies and conducting basic science, investigator-initiated, and industry-sponsored psychedelic trials. It recommends that investigators cultivate broad institutional support early and anticipate challenges in securing funding, obtaining FDA Investigational New Drug approval, sourcing clinical-grade drug, getting DEA Schedule I researcher registration and any required state license, preparing treatment and storage spaces, managing controlled substance inventory, and engaging the local community. With planning, persistence, and expert assistance, these hurdles are likely surmountable.
Psychedelic medicine (New Rochelle, N.Y.)
June 1, 2024
Brian S. Barnett, Akhil Anand, Elizabeth N. Dewey et al.
20 citations
From 2015 to 2019, the proportion of Americans who perceived 'great' risk in trying LSD fell from 70.5% to 64.8%, a statistically significant linear decline. Lower perceived risk was associated with later survey year, personal LSD use, younger age, higher education, male gender, identifying as a sexual minority, and past-year psychological distress. Higher perceived risk was linked to identifying as Black or Hispanic, past-year suicide attempt, and having children at home. Among respondents under 18, Hispanic identity showed no association, and male gender was linked to higher perceived risk. Most Americans still perceive great risk in trying LSD.
Palliative & Supportive Care
November 3, 2022
Lisa Reynolds, Brian S. Barnett, Jeremy Weleff et al.
19 citations
Cancer health-care practitioners in New Zealand and the USA perceive psychedelic-assisted therapy as potentially beneficial for cancer patients, especially those with advanced disease no longer receiving curative treatment. They consider research in this area important and express willingness to refer patients to trials, though they emphasize that work should incorporate spiritual and indigenous perspectives of health. US practitioners had greater awareness of psychedelics, while New Zealand practitioners more strongly believed that spiritual and indigenous factors should be considered. The findings suggest that practitioners may be more open to studies beginning in palliative and end-of-life contexts.
Journal of Psychopharmacology
August 16, 2022
Brian S. Barnett, Kathleen M Ziegler, Rick Doblin et al.
15 citations
An analysis of nationally representative survey data from 2015-2019 found no association between lifetime use of psychedelics and lifetime diagnosis of any cancer or hematologic cancer. Sub-analyses of specific classes of psychedelics—lysergamides, phenethylamines, and tryptamines—also showed no link to cancer diagnoses. These findings contrast with earlier laboratory studies and case reports from the 1960s and 1970s that raised concerns about psychedelics' carcinogenic potential. Limitations include lack of data on dosage, number of lifetime exposures, and timing of use relative to cancer diagnosis.
Journal of the Academy of Consultation-Liaison Psychiatry
January 21, 2021
Brian S. Barnett, George Greer
13 citations
Psychedelic compounds have a long and complex history with psychiatry, having been widely used in clinical settings a half century ago before being outlawed in the United States in 1970 due to concerns about abuse potential and their association with the counterculture movement. In recent years, a resurgence of research has revealed early evidence supporting psychedelic-assisted therapy for treating alcohol use disorder, nicotine use disorder, posttraumatic stress disorder, and depression. The literature indicates that psychedelic-assisted therapies may have treatment potential for mental illness and addiction, though adverse events from nonmedical use are rare. Current data suggest that, if administered thoughtfully by trained professionals in medical settings, psychedelic-assisted therapy could reduce suffering from mental illness and addiction.
Cleveland Clinic Journal of Medicine
March 1, 2025
Franklin King, Brian S. Barnett, Erin Mauney
11 citations
Psychedelic-assisted therapy, using substances like MDMA and psilocybin, shows preliminary efficacy for depression, PTSD, and substance use disorders. Psilocybin, MDMA, and LSD have been designated breakthrough therapies by the FDA. However, in August 2024, the FDA declined to approve MDMA and requested an additional phase 3 trial. Clinicians should prepare for the possible return of psychedelics to medicine.
Journal of Psychoactive Drugs
October 11, 2022
Jeremy Weleff, Teddy J. Akiki, Brian S. Barnett
11 citations
After decades of limited research, interest in using psychedelics as psychiatric treatments has revived. A bibliometric analysis of 394 clinical studies on 5-MeO-DMT, ayahuasca, DMT, LSD, ibogaine, mescaline, MDMA, and psilocybin published from 1965 to 2021 found that publications resurged after a lull from the 1970s to the 1990s. MDMA was the most frequently studied substance (49%), followed by LSD (19%), psilocybin (18%), and ayahuasca (7%). Comparing studies from 1965-2009 with those from 2010-2021, the recent cohort had a higher proportion of studies on therapeutic applications and a lower proportion on effects in non-research settings. Psilocybin studies increased proportionally, while DMT and mescaline studies decreased. Researchers in the United Kingdom had the most diverse international collaborations.
Journal of Psychopharmacology
September 16, 2022
Brian S. Barnett
10 citations
As regulatory and financial barriers to clinical psychedelic research recede, a clearer understanding of naturalistic psychedelic use and its epidemiology is needed, since such use is growing and will likely always exceed clinical use. Psychedelics' effects vary by setting, so research findings may differ depending on context. Improving data collection on real-world psychedelic use should be a higher public health priority. Expanding data collection in the U.S. National Survey on Drug Use and Health could address this need, ensuring high-quality information for the public, scientists, and regulators as psychedelics' role in medicine and society is reevaluated.
Journal of Psychoactive Drugs
June 21, 2024
Peter Kenneth Gillman, Brian S. Barnett, Curtis J. Koons et al.
9 citations
A 42-year-old man with treatment-resistant depression experienced a hypertensive emergency with chest pain, palpitations, headache, and ST-elevation on electrocardiogram about half an hour after taking 1 g of Psilocybe cubensis mushrooms while on tranylcypromine, extended-release dextroamphetamine-amphetamine, and other medications. He was diagnosed with a myocardial infarction, treated with lorazepam, nitroglycerin, and aspirin, and underwent cardiac catheterization that showed no significant abnormalities. He was discharged after overnight hospitalization with no lasting physical effects. The authors suspect phenylethylamine in the mushrooms interacted with the MAOI and amphetamine to cause the event, noting past studies suggest classic serotonergic psychedelics alone with MAOIs should not produce such emergencies.
Psychedelic medicine (New Rochelle, N.Y.)
September 1, 2023
Zachary Herrmann, Adam W. Levin, Steven P Cole et al.
9 citations
Among 228 healthcare providers who treat psychiatric disorders with medications and reported at least one lifetime psychedelic use, retrospective measures showed improvements in depression, anxiety, and well-being after psychedelic exposure. Suicidality decreased and resilience increased. A factor analysis indicated that a cluster of mystical, interpersonal, and personal experiences predicted these improvements. The preferred psychedelic agent did not affect outcomes, and frequency of use was not associated with outcomes, though effect sizes varied. Harm was reported by 13.2% (n = 30), consistent with general population rates. Pre-exposure alcohol use, aggressive impulses, and desire to die by suicide improved most often, while marijuana use most often worsened or did not change.
Journal of Psychedelic Studies
February 1, 2024
Jeremy Weleff, Akhil Anand, Elizabeth N. Dewey et al.
8 citations
Lysergic acid diethylamide (LSD) use in the United States increased by 47% from 2015 to 2019, rising from 0.59% to 0.87% of the population. Among people with past-year hallucinogen use disorder, the proportion of LSD users did not significantly increase. Factors associated with LSD use included easier access to LSD, lower perceived risk of trying it, low income, fewer children in the home, recent contact with drug sellers, and, among adults 18 and older, a past-year suicide attempt. No associations were found with unemployment, arrest history, or psychological distress. Over the study period, LSD users became more likely to be ages 26–34 and married, and lifetime methamphetamine users also increased their LSD use. LSD remains uncommon and does not appear to be a major public health burden.
JAMA Psychiatry
February 12, 2025
Brian S. Barnett, Roger D Weiss, Gerard Sanacora
7 citations
Ketamine's use in psychiatry presents safety challenges, including risks of misuse, adverse effects, and lack of standardized protocols. Recommendations to optimize patient safety include careful patient selection, monitoring during and after administration, and establishing guidelines for appropriate use in clinical settings.
Psychoactives
February 5, 2025
Brian S. Barnett
7 citations
A survey of researchers who submitted NIH grant applications for therapeutic psychedelic research found that only 16.7% of 24 applications were funded, below the NIH's average 23.4% funding rate for R01-equivalent grants from 1998 to 2023. No applications submitted before 2006–2010 received funding, but the rate since then (19.05–22.2%) aligns with the NIH's annual average of 20.6 ± 1.9% from 2006 to 2023. Respondents perceived funding as more difficult to obtain than for other areas, though recent improvements were noted. The small sample and lack of public data on unfunded applications limit generalizability.
Journal of Psychoactive Drugs
August 31, 2023
Alexsandra Kovacevich, Jeremy Weleff, Benjamin Claytor et al.
6 citations
Three individuals with smell loss—one from a respiratory infection, one from childhood, and one from COVID-19—reported improved olfactory function after using psychedelics: 6 g of psilocybin mushrooms, 100 µg of LSD, or microdosing 0.1 g of psilocybin mushrooms three times. These are the first such cases recorded in academic literature. Possible mechanisms include serotonergic effects, increased neuroplasticity, and anti-inflammatory actions. The authors suggest that the potential therapeutic benefits of psychedelics for olfactory impairment warrant further investigation.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2023
Brian S. Barnett, Andrey Ostrovsky
6 citations
Psychedelic therapies are approaching regulatory approval in the United States, but a major barrier to equitable patient access is the lack of specific medical billing codes for their delivery. The authors argue that developing new billing codes through the American Medical Association's Current Procedural Terminology (CPT) Editorial Panel is the best approach, but note challenges: no similar existing services to guide development, the potential need for multiple providers during dosing sessions, limited mental health care representation on the panel, and misconceptions about psychedelic therapy. An industry-sponsored application for new CPT codes for "psychedelic drug monitoring services" is under review, but questions remain about flexibility and provider qualifications. The effort marks a critical step toward creating a robust billing strategy.
Drug Science Policy and Law
January 1, 2023
Brian S. Barnett, Noah Wiles Sweat, Peter S. Hendricks
6 citations
A person with red-green color blindness (mild deuteranomalia) self-administered the Ishihara color vision test before and after taking 5 grams of dried psilocybin mushrooms. Partial improvement in color vision peaked at 8 days and lasted at least 16 days after taking psilocybin, though later observations were confounded by additional substance use. The improvement extended beyond the acute drug effect, even though color blindness is typically a genetic condition. The authors call for systematic research to confirm these findings and understand the mechanism.
Psychiatric Annals
September 1, 2022
Brian S. Barnett, Jeremy Weleff
6 citations
Psychedelics such as LSD, MDMA, and psilocybin may hold treatment potential for alcohol, opioid, tobacco, and other substance use disorders, based on growing evidence from observational studies and clinical trials. The mechanisms are not fully understood, but the subjective psychedelic experience appears necessary for therapeutic effects, possibly serving as a turning point that elicits lasting behavioral change. Randomized, placebo-controlled trials are needed and some are underway. Even with compelling evidence, these substances may face challenges to integration into current treatment paradigms due to clinician concerns about addictive potential and philosophical objections from 12-step facilitation programs.
The British Journal of Psychiatry
January 1, 1968
Brian S. Barnett
6 citations
No Summary
Journal of Psychiatric Practice
March 1, 2024
Brian S. Barnett
5 citations
Intravenous ketamine has rapid antidepressant effects but is rarely covered by insurance because it lacks FDA approval for depression, while intranasal esketamine, which is FDA-approved and still patented, is widely covered. A review of 2023 Ohio Health Insurance Marketplace and Medicaid plans found that no Marketplace or Medicaid plan covered intravenous ketamine for depression, whereas intranasal esketamine was on 72.7% of Marketplace formularies and 100% of Medicaid formularies. This means patients can more easily access esketamine even though intravenous ketamine is more cost-effective and possibly more efficacious.