Abstract Ketamine is known to have anti-depressant effects and is suggested to reduce substance use. However, little is known about the mechanism of these effects. Given evidence from studies in depression of a greater therapeutic effect in those with a family history of AUD, this latter factor was also investigated as a moderating factor. We used data from the KARE trial, a randomised...
In the KARE trial, 96 adults with severe alcohol use disorder, abstinent following detoxification, were randomised in a 2×2 factorial design to 3 weekly infusions of ketamine (0.8 mg/kg) or saline, each combined with mindfulness-based psychological support (PS) or alcohol psychoeducation (PE). We re-expressed the trial data on endpoints acceptable to regulators and compared the most and least...
Setting up a psychedelic study can be a long, arduous, and Kafkaesque process. Researchers are faced with a host of challenges in this rapidly evolving field, necessitating a range of considerations that remain largely unstandardised. Many of the complexities inherent to psychedelic research also challenge existing assumptions around, for example, approaches to psychiatric prescribing, the...
Some investigational compounds exist in both regulated clinical pipelines and unregulated street or online markets. Ketamine, psychedelics and cannabis are all under active clinical investigation while remaining accessible, in unregulated form, through illicit channels without clinician oversight. We propose the term parallel-access compounds for this category and argue that it deserves...
While research on novel therapeutic applications of ketamine is expanding, particularly in controlled settings, there is limited exploration of its consumption related to self-treatment of psychiatric conditions. This study investigated the characteristics of people who use ketamine and psychedelics for self-treatment of psychiatric conditions, providing insight into patterns of use within this...
It is 60 years since ketamine was first tested in humans as an alternative but safer anaesthetic to PCP (phencyclidine) (Corssen and Domino 1966). It became widely used as the “buddy drug” for combatants in the Vietnam War: because of its great safety margin, it could be injected into wounded personnel by their buddies to relieve pain before the arrival of the medical team. Because of...
Safety and tolerability data from the first open-label feasibility study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for alcohol use disorder was recently published. This paper presents a Bayesian analysis of the impact of MDMA-assisted psychotherapy on treatment success, defined as 2-level reduction in the World Health Organization (WHO) drinking risk at the 3 months...
Abstract Background As the use of psychedelics increases in both therapeutic and non-clinical settings, reports of extended post-experience difficulties have also emerged. While many individuals integrate their experiences effectively, others face persistent challenges. Despite growing recognition of these issues, there is limited research on best practices for mitigating and addressing...
To report the symptoms and aetiology of ketamine use disorder (KUD), gauge the effectiveness of current treatment services and identify strategies to enhance patient access and outcomes. Mixed-methods, cross-sectional questionnaire. Electronic survey from November 2023 to April 2024. Participants were recruited through snowball sampling, social media and referrals from UK addiction treatment...
Abstract Psychedelic substances are increasingly recognized for their potential to catalyse transformative shifts in worldviews. Central to these transformations are states of awe, a self-transcendent, epistemic emotion. This mixed-methods study explored how awe during psychedelic trips relates to lasting changes in boundaries between self and world, and epistemic shifts that follow...
Setting up a psychedelic study can be a long, arduous, and kafkaesque process. This rapidly-developing field poses several unique challenges for researchers, necessitating a range of considerations that have not yet been standardised. Many of the complexities inherent to psychedelic research also challenge existing assumptions around, for example, approaches to psychiatric prescribing, the...
Methamphetamine use disorder is a significant public health concern. No pharmacological treatment options currently exist for methamphetamine use disorder, and psychotherapy is only moderately effective. Preliminary evidence suggests that ketamine-assisted psychotherapy produces sustained improvements in substance use and mental health symptomatology. In addition to direct antidepressant...
This Perspectives piece gives a brief overview on the last 70 years of psychedelic research in relation to the treatment of mental illness with a particular focus on addictions. We briefly precis the work in the 19650s/60s that started following the discovery of LSD. Then we overview research developments over the past twenty years driven by emerging neuroscience on these agents, the rise of...
Given the shifting public perception of psilocybin and associated legal changes, the increase in use observed by Keyes and Patrick is not surprising. The conclusion that this is a rising health concern is not justified by the data, particularly as in this sample non-lysergic acid diethylamide hallucinogen use seems to have increased in a white, educated, relatively higher socio-economic status...
Cannabis potency (concentration of Δ-9-Tetrahydrocannabinol) has been associated with risks of adverse mental health outcomes and addiction but no studies have triangulated evidence from self-report and objective measures of cannabis potency. We hypothesised that users of high potency cannabis would have higher levels of (a) anxiety, (b) depression and (c) psychosis-like symptoms (d) cannabis...
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OBJECTIVE: Early evidence suggests that ketamine may be an effective treatment to sustain abstinence from alcohol. The authors investigated the safety and efficacy of ketamine compared with placebo in increasing abstinence in patients with alcohol use disorder. An additional aim was to pilot ketamine combined with mindfulness-based relapse prevention therapy compared with ketamine and alcohol...
Background In the past two decades, subanaesthetic doses of ketamine have been demonstrated to have rapid and sustained antidepressant effects, and accumulating research has demonstrated ketamine's therapeutic effects for a range of psychiatric conditions. Aims In light of these findings surrounding ketamine's psychotherapeutic potential, we systematically review the extant evidence on...
Ayahuasca is a natural psychoactive brew, used in traditional ceremonies in the Amazon basin. Recent research has indicated that ayahuasca is pharmacologically safe and its use may be positively associated with improvements in psychiatric symptoms. The mechanistic effects of ayahuasca are yet to be fully established. In this prospective naturalistic study, 63 self-selected participants took...
BACKGROUND: While the acute effects of cannabis are relatively benign for most users, some individuals experience significant adverse effects. This study aimed to identify whether variation in schizotypal personality traits and frequency of cannabis use influence the acute effects of delta-9-tetrahydrocannabinol (THC). METHODS: Individual participant data from four double-blind, randomised,...
Background: The therapeutic benefits of ketamine have been demonstrated for a variety of psychiatric disorders. However, the role of ketamine induced psychoactive experiences in mediating the therapeutic effects is unclear. Despite the growing quantitative research on the efficacy of ketamine treatment, very few studies examined participant experiences of ketamine infusions in a treatment...
Esketamine was recently licensed by the US Food and Drug Administration (FDA) and European Drug Agency (EDA) for use in treatment resistant depression (TRD), and further research indicates ketamine as a possible treatment in other mental health conditions. While the underlying mechanisms remain unclear, it has been hypothesised that ketamine's acute psychoactive effects may be associated with...
BACKGROUND: Acute cannabis administration can produce transient psychotic-like effects in healthy individuals. However, the mechanisms through which this occurs and which factors predict vulnerability remain unclear. We investigate whether cannabis inhalation leads to psychotic-like symptoms and speech illusion; and whether cannabidiol (CBD) blunts such effects (study 1) and adolescence...
Background: 3,4-Methylenedioxymethamphetamine (MDMA) is widely known for its positive acute effects on social behaviour, such as increasing empathy, whilst also attenuating the negative impact of social exclusion. However there is a scarcity of research that investigates the long-term impact of recreational MDMA use on these fundamental social processes. Method: Sixty-seven individuals were...