Neuroimage
February 15, 2016
Christopher G. Davey, Jesus Pujol, Ben J. Harrison
576 citations
The brain's default mode network (DMN) is linked to self-referential thought during rest, but it also serves other functions, and self-reference involves regions outside the DMN. In 88 participants, self-referential and resting-state brain activity were compared to identify DMN areas common to both conditions that also show specialization for self-reference. The 'core-self' DMN regions—medial prefrontal cortex, posterior cingulate cortex, and inferior parietal lobule—were analyzed with dynamic causal modeling. The optimal model indicated that self-related processes are driven by posterior cingulate activity and moderated by the medial prefrontal cortex. This confirms these regions' importance for self-reference and clarifies their specialized roles.
Australian & New Zealand Journal of Psychiatry
March 21, 2021
Daniel Perkins, Jerome Sarris, Susan L. Rossell et al.
53 citations
Psychedelic substances such as psilocybin, ayahuasca, LSD, and MDMA are gaining renewed medical interest due to the need for new psychiatric treatments and promising study results. This viewpoint reflects on the Royal Australian and New Zealand College of Psychiatrists' Clinical Memorandum on Psychedelics and notes regulatory developments, including applications for down-scheduling and access approvals. The authors argue that rigorous research is needed to assess benefits, safety, and therapeutic mechanisms. They summarize recent findings on mechanisms of action and the psychedelic-assisted psychotherapy model, suggesting medicinal psychedelics could become a new class of psychiatric treatments when used under medical supervision with psychotherapeutic support. However, sufficiently powered trials and safety protocols are required before clinical use, and untrained practitioner access could be harmful.
The Australian and New Zealand journal of psychiatry
April 1, 2025
Alene Sze Jing Yong, Suzie Bratuskins, Musa Samir Sultani et al.
16 citations
An umbrella review of 14 systematic reviews (20 primary studies, up to 353 participants) evaluating MDMA-assisted psychotherapy for post-traumatic stress disorder found that meta-analyses reported substantial benefits in symptom improvement, response, and remission compared to psychotherapy alone. However, when reviews assessed certainty of evidence, it was rated low to very low due to high risk of bias, indirectness, and imprecision. Moderate-quality evidence linked MDMA-assisted therapy to increased odds of transient adverse events, but reviews noted reliance on spontaneous rather than systematic reporting, discrepancies between published and registry data, and a lack of long-term safety information. The four high-quality reviews indicate low to very low certainty for efficacy and moderate to very low for safety.
The Australian and New Zealand journal of psychiatry
February 1, 2024
Anthony Rodgers, Dilara Bahceci, Christopher G. Davey et al.
8 citations
The repurposing of generic racemic ketamine for severe depression has been delayed and uncoordinated for over 20 years due to insufficient commercial incentives, while a patented intranasal formulation (Spravato) gained widespread registration through substantial commercial investment. Spravato costs $600-$900 per dose compared to about $5 per dose for generic ketamine, and an annual government investment of approximately AUD$100 million in Australia was rejected twice, leaving the treatment largely inaccessible. Emerging evidence suggests generic ketamine is at least as effective as Spravato, but no comparative trials have been conducted. Without systemic reforms—including commercial incentives, public funding, reduced regulatory barriers, and coordinated international support—this pattern will repeat with new psychedelic treatments.
The International Journal of Neuropsychopharmacology
February 4, 2025
Yingliang Dai, Ben J. Harrison, Christopher G. Davey et al.
6 citations
Ketamine, a fast-acting antidepressant, works by blocking N-methyl-D-aspartate receptors. While its molecular mechanisms are known, its large-scale neurocognitive effects are less clear. This synthesis links ketamine treatment to changes in brain systems for reward processing, interoception, and self-related cognition. The authors suggest that ketamine's antidepressant effects arise from dynamic, multi-level influences across these functional domains.
Early Intervention in Psychiatry
July 2, 2023
Marija Krcmar, Cassandra Wannan, Suzie Lavoie et al.
6 citations
Basic self-disturbance is a potential core vulnerability marker for schizophrenia spectrum disorders. The Self, Neuroscience and Psychosis (SNAP) study tests a neurophenomenological model of psychosis by examining clinical, neurocognitive, and neurophysiological variables in individuals at ultra-high risk (UHR) for psychosis. It includes 400 UHR individuals, 100 clinical controls without attenuated psychotic symptoms, and 50 healthy controls. Participants complete baseline assessments and electroencephalography; UHR participants are followed for 24 months with clinical assessments every 6 months. The protocol aims to develop a prediction model for persistence or worsening of UHR symptoms at 12 months and to determine how specific these disturbances are to attenuated psychotic symptoms.