Psychopharmacology
March 7, 2022
Aryan Sarparast, Kelan Thomas, Benjamin Malcolm et al.
85 citations
As MDMA and psilocybin progress through FDA drug development, this systematic review compiles existing research on psychiatric drug-drug interactions with these substances. It identifies which medications may alter the effects or safety of MDMA- and psilocybin-assisted therapy, providing a resource for clinicians and researchers. The review suggests that certain psychiatric drugs, such as SSRIs and other serotonergic agents, can diminish or alter the subjective and physiological responses to MDMA and psilocybin, while others may increase risks. The authors indicate that careful medication management is necessary during psychedelic-assisted therapy to optimize outcomes and minimize adverse events.
Journal of Psychoactive Drugs
May 8, 2017
Kelan Thomas, Benjamin Malcolm, Dan Lastra
77 citations
A review of seven clinical trials found that psilocybin-assisted therapy reduced symptoms of anxiety, depression, and substance use, with large effect sizes for improved depression and anxiety. Reductions in alcohol or tobacco use and increased abstinence rates in addiction were less clear due to open-label designs without statistical analysis. The therapy appears promising, but more robust trials are needed for FDA approval.
Journal of Psychoactive Drugs
January 1, 2018
Benjamin Malcolm, Martin Polanco, Joseph P Barsuglia
64 citations
Ibogaine, a plant-derived compound, reduces opioid withdrawal and craving during detoxification. In 50 participants with opioid use disorder undergoing a week-long ibogaine treatment protocol, withdrawal and craving scores were significantly lower 48 hours after administration compared to baseline. At that point, 78% showed no objective clinical signs of opioid withdrawal, 79% reported minimal cravings, and 68% reported only mild subjective withdrawal symptoms. The findings suggest ibogaine can facilitate opioid detoxification by easing withdrawal and craving, but controlled trials are needed to confirm these results.
Progress in Brain Research
January 1, 2018
Joseph P Barsuglia, Martin Polanco, Robert Palmer et al.
37 citations
A 31-year-old male military veteran with moderate alcohol use disorder received sequential treatment with ibogaine hydrochloride (1550mg, 17.9mg/kg) on day 1 and vaporized 5-MeO-DMT (bufotoxin source 50mg, estimated 5-7mg) on day 3 at an inpatient clinic in Mexico. SPECT neuroimaging before and 3 days after treatment showed increased brain perfusion in bilateral caudate nuclei, left putamen, right insula, and temporal, occipital, and cerebellar regions. The patient reported improved mood, cessation of alcohol use, and reduced cravings at 5 days, sustained at 1 month, with partial return to mild alcohol use at 2 months. The findings suggest short-term therapeutic outcomes and warrant further investigation.
Mental Health Clinician
January 1, 2017
Benjamin Malcolm, Kelly C. Lee
26 citations
Ayahuasca, a traditional psychoactive sacrament used for centuries in Amazonian shamanic rituals, produces its psychedelic effects through the combination of monoamine oxidase inhibitors (MAOIs) from the Banisteriopsis caapi vine and N-N-dimethyltryptamine from Psychotria viridis or Diplopterys cabrerana. Its ritual use has recently increased, drawing attention for potential treatment of mental illnesses like substance use and depressive disorders. However, its MAOI properties raise concerns about serious drug interactions in patients. This paper describes ayahuasca's pharmacology, potential drug interactions, and clinical data on its therapeutic potential in psychiatric illness.
Journal of Psychoactive Drugs
November 26, 2020
Heba Diab, Benjamin Malcolm
1 citation
A 39-year-old man with past polysubstance use disorder and depression developed tinnitus after inhaling DMT, though he was also microdosing LSD weekly. The ringing caused distress and anxiety, leading him to seek help from an audiologist, primary care doctor, and psychopharmacologist. Tinnitus lasted several months, but its intensity and his ability to cope improved over time. Taking psilocybin mushrooms worsened the tinnitus on two occasions, after which he stopped using psychedelics. While psychedelics are known to cause acute auditory changes, this is the first probable case linking DMT to persistent tinnitus. The report reviews possible mechanisms connecting psychedelics and tinnitus.