Journal of Clinical Medicine
February 11, 2022
Chia‐ling Yu, Chih-Sung Liang, Fu-Chi Yang et al.
37 citations
A meta-analysis of ten studies found that one or two doses of psilocybin produce rapid and sustained antidepressant effects lasting up to six months. Depressive symptoms decreased substantially, with the largest effect at one week (standardized mean difference -1.74) and a still-large effect at six months (-1.12). Higher doses and two sessions were linked to greater improvement. Psilocybin raised systolic blood pressure by 19.00 mmHg and diastolic by 8.66 mmHg, but discontinuation rates and heart rate changes were similar to placebo. The findings suggest psilocybin has favorable cardiovascular safety and acceptability for treating depression.
Journal of Clinical Medicine
June 7, 2022
Mitchell Arnovitz, Andrew Spitzberg, Ashkhan J. Davani et al.
29 citations
Negative symptoms of schizophrenia, such as social withdrawal and lack of motivation, contribute heavily to the economic burden of the disease and have no FDA-approved treatments. This review argues that MDMA, a schedule I substance known to enhance social interaction and empathy, may offer a novel therapeutic approach. The authors examine literature on negative symptoms, existing treatments, and MDMA-assisted therapy, concluding that recent evidence suggests MDMA can be safe and potentially effective for treating negative symptoms. The review also discusses safety considerations and possible mechanisms of action, including MDMA's ability to induce metaplasticity in the brain.
Journal of Clinical Medicine
February 15, 2022
Lourdes Poyatos, A Acuna Torres, Esther Papaseit et al.
26 citations
Cathinone, mephedrone, methylone, and diethylpropion produce stimulant and euphorigenic effects similar to amphetamines and MDMA, with varying intensities that may correspond to different levels of abuse potential. This systematic review of 18 studies (5 on cathinone, 7 on mephedrone, 1 on methylone, 5 on diethylpropion) found that all four substances induce desirable and reinforcing effects that could lead to misuse and addiction. The authors conclude that further investigation is needed to minimize and prevent their impact on society and public health.
Journal of Clinical Medicine
March 17, 2024
Ane Larrea, Laura C Sánchez-sánchez, Eguzkiñe Diez-Martin et al.
21 citations
Mitochondrial dysfunction is central to the onset and progression of major depressive disorder (MDD), causing imbalances in energy production and oxidative stress. Identifying mitochondrial biomarkers could enable more objective and precise diagnosis than symptom-based methods. Traditional antidepressants have limits, but emerging pharmacological treatments such as ketamine/esketamine, psychedelics, and anti-inflammatories show potential for rapid antidepressant effects by modulating neuroplasticity and motor processing. Non-pharmacological approaches like transcranial magnetic stimulation and deep brain stimulation also offer alternatives by modulating neuronal activity. A SWOT analysis highlights key challenges for these approaches.
Journal of Clinical Medicine
April 24, 2025
Weronika Kisielewska, Michał Kościółek, Weronika Kowalczyk et al.
16 citations
About 80% of adult patients experience preoperative anxiety. This review describes pharmacological options such as benzodiazepines, ketamine, fentanyl, and antidepressants (which require four weeks to take effect) and nonpharmacological methods including supportive relationships with medical staff, informed consent forms, video materials, virtual reality, breathing techniques, music therapy, cognitive-behavioural therapy, and essential oils. Nonpharmacological interventions can be used across ages. Many researchers advocate for a holistic approach integrating less invasive, cost-effective interventions with conventional medicine. More research is needed to determine the most effective and feasible interventions for different patient populations.
Journal of Clinical Medicine
June 6, 2023
Maria Eduarda Sodré, Isabel Wießner, Muna Irfan et al.
15 citations
Sleep is increasingly understood as a local brain phenomenon, not just a whole-brain process, with different states of consciousness—wakefulness, sleep onset, light sleep, deep sleep, and REM sleep—able to occur simultaneously, leading to dissociative states. These are classified as physiological (daydreaming, lucid dreaming, false awakenings), pathological (sleep paralysis, sleepwalking, REM sleep behavior disorder), and altered (hypnosis, anesthesia, psychedelics). The article reviews the neurophysiology and phenomenology of these states, concluding that their study is important for understanding consciousness and treating neuropsychiatric diseases.
Journal of Clinical Medicine
May 12, 2023
Severin Ableidinger, Brigitte Holzinger
13 citations
Sleep paralysis and lucid dreams are both connected to REM sleep but differ in emotional tone and perceived controllability. A review of 10 studies, mostly surveys plus a case study, a randomized trial, and an EEG study, found positive and significant correlations between sleep paralysis and lucid dreaming in most of the studies, indicating a connection between the two states. Research remains limited and methodologically diverse, and future work should develop standardized methods for examining both phenomena.
Journal of Clinical Medicine
February 21, 2022
Ľuboš Nižňanský, Žofia Nižnanská, Roman Kuruc et al.
11 citations
Ayahuasca is a decoction made from the liana Banisteriopsis caapi, which contains β-carbolines, often combined with Psychotria viridis leaves containing DMT. Over 100 plants can supply these active alkaloids, making precise compositional analysis crucial for pharmacological study. This review summarizes sensitive methods for analyzing the beverage and biological matrices, comparing pharmacokinetic parameters across studies with known composition and minimal adverse effects. Therapeutic benefits remain unclear, with side effects possibly linked to pre-existing psychiatric disorders. Toxicological risks and clinical benefits require accurate alkaloid concentrations for evaluation. No post-mortem study has suggested potential lethality from ayahuasca.
Journal of Clinical Medicine
February 20, 2026
Vassilis Martiadis, Fabiola Raffone, Serena Testa et al.
7 citations
Intranasal esketamine provides rapid symptom relief for treatment-resistant depression when standard antidepressants fail, but its real-world effectiveness depends on organizational and multidisciplinary factors beyond pharmacology. This narrative review synthesizes clinical and real-world evidence to propose a phase-based integration framework that specifies complementary roles for psychiatry, nursing, and psychotherapy across pre-treatment assessment, induction, session delivery, post-session integration, and maintenance phases. The framework emphasizes safety, continuity of care, and patient-centred monitoring, with measurable implementation indicators. While evidence supports esketamine's efficacy in reducing depressive symptoms, anhedonia, and suicidality, prospective implementation studies are needed to evaluate clinical effectiveness, feasibility, and cost-effectiveness of the proposed multidisciplinary approach.
Journal of Clinical Medicine
August 14, 2024
Lorenzo Moccia, Giovanni Bartolucci, Maria Pepe et al.
7 citations
In a small preliminary study of 18 patients with treatment-resistant depression given esketamine nasal spray for one month, those who responded to treatment (44.5% of the sample, defined by at least a 30% reduction in depression scores) had lower heart rate variability at baseline compared to non-responders. After one month of treatment, responders' heart rate variability increased. Baseline heart rate variability showed potential to discriminate between responders and non-responders. The findings suggest a link between esketamine treatment and changes in autonomic function measured by heart rate variability, but larger studies are needed to confirm heart rate variability as a predictor of treatment response.
Journal of Clinical Medicine
June 3, 2024
Malvika Godara, Tania Singer
5 citations
Two brief online mental interventions—attention-focused mindfulness and socio-emotional partner-based practice—were compared over 10 weeks in 253 participants. Both interventions led to week-to-week reductions in rumination and increases in psychological flexibility. Only attention-based practice reduced worry over time, and only the partner-based practice increased affective control. Mediation analyses found no significant indirect effects, but exploratory moderation showed that reductions in depression and anxiety and increases in resilience were predicted by weekly increases in acceptance and affective control in the partner-based group, and by weekly reductions in rumination and worry in the mindfulness group. The findings suggest distinct active ingredients for each practice.
Journal of Clinical Medicine
May 31, 2023
Karin Matko, Meike Burzynski, Maximilian Pilhatsch et al.
5 citations
An 8-week yoga-based mind-body intervention, Meditation-Based Lifestyle Modification (MBLM), reduced pain intensity and improved quality of life and pain self-efficacy in most of 17 women with chronic back pain, fibromyalgia, or migraines. The largest improvement was in pain self-efficacy, followed by average pain intensity and quality of life, with a smaller effect on most severe pain. Responses varied among participants, suggesting the intervention helps many but not all. The authors call for larger controlled trials and further exploration of yoga's ethical and philosophical aspects.
Journal of Clinical Medicine
September 15, 2024
Maria Margariti, Ilias I. Vlachos, Dimitra Mpourazana et al.
4 citations
An emotional state called psychotic arousal (PA) may be a distinct feature of acute psychosis, involving abnormal experiential feelings that are often overlooked in schizophrenia research. In a study of 55 patients hospitalized for acute schizophrenia, a new Psychotic Arousal Scale showed good internal consistency (Cronbach's alpha reported for the scale). PA severity was linked to the strength of delusional beliefs and to other measures of anxiety and depression. The state also responded to antipsychotic medication within the first weeks of treatment. These findings suggest that emotional arousal with abnormal feelings is a measurable and clinically important component of acute psychosis.
Journal of Clinical Medicine
December 19, 2023
Hayley Smithers-Sheedy, Emma Waight, Katherine L Swinburn et al.
4 citations
A modified telehealth Mindfulness-Based Stress Reduction (MBSR) program for adults with cerebral palsy who had elevated anxiety or emotion regulation difficulties did not produce a statistically significant between-group difference in mindfulness scores compared with a wait-list group. However, within the MBSR group, participants showed improvements in depression, stress, and emotion regulation that were maintained eight weeks after the program ended. The program was successfully adapted for this population. The trial included 31 participants with no or mild intellectual impairment who attended 90-minute weekly sessions for nine weeks.
Journal of Clinical Medicine
February 20, 2025
Shakila Meshkat, Taha Malik, Jennifer Swainson et al.
3 citations
A systematic review examined whether psychedelic therapies can rapidly reduce suicide risk. Four randomized controlled trials reported significant reductions in suicidal ideation with psilocybin (three studies) and MDMA-assisted therapy (one study), with effect sizes (Cohen's d) ranging from 0.52 to 1.25 and no safety issues. Five additional randomized trials also showed reductions. Among 24 non-randomized and cross-sectional studies, results were mixed: psilocybin reduced suicidal ideation (odds ratios 0.40–0.75), MDMA-assisted therapy for PTSD showed a pooled effect of d = 0.61, while LSD was associated with increased odds of suicidality (odds ratios 1.15–2.08). DMT studies showed no significant effects. The evidence remains inconclusive, underscoring the need for further trials.
Journal of Clinical Medicine
December 29, 2025
Monika Dominiak, Adam Gędek, Szymon Modrzejewski et al.
2 citations
Psychedelic-assisted therapy shows short-term efficacy and safety for selected psychiatric disorders, particularly depression and PTSD. Psilocybin produced large effects in major depression (Hedges’ g ≈ 1.05), with some benefits lasting up to six months. MDMA showed very large reductions in PTSD symptoms (Hedges’ g ≈ 1.24) after 2–3 sessions. LSD yielded short-term benefits for alcohol use disorder (odds ratio ≈ 2.0), though effects declined over time. Adverse events were generally mild and transient, with no consistent signal for serious harm. However, considerable methodological variability, small and overlapping samples, risk of bias, and limited long-term data constrain the findings.
Journal of Clinical Medicine
June 16, 2025
Gisèle Pickering, Marion Voute, Marc Sorel et al.
2 citations
A one-year observational study of 585 chronic pain patients found no sex or age differences in how well ketamine relieved pain, anxiety, or depression. Women reported more adverse events than men (19% vs. 13%). Among 329 patients who received two or more doses, no sex or age differences appeared. A single ketamine dose may be more effective for men than women, particularly younger men.
Journal of Clinical Medicine
January 3, 2025
Adam Saloň, Karin Schmid-Zalaudek, Bianca Steuber et al.
2 citations
A pilot study of cardiac patients after heart surgery compared standard exercise therapy with groups that added 20 minutes of yoga or transcendental meditation twice daily during four weeks of rehabilitation. Retinal microcirculation—measured as central retinal artery equivalent, central retinal vein equivalent, and artery-to-vein ratio from non-mydriatic retinal images—showed no significant differences among the three groups over the course of rehabilitation. The authors conclude that neither yoga nor meditation produced measurable changes in retinal microcirculation in this setting, but suggest the findings provide preliminary information for future research on these underutilized approaches in cardiac rehabilitation.
Journal of Clinical Medicine
December 18, 2024
Kathleen Kendall-Tackett
2 citations
Several innovative, mostly non-invasive treatments for depression during pregnancy and postpartum are emerging. Integrative approaches such as vitamin D, infant massage, mindfulness-based cognitive therapy, acupuncture, and repetitive transcranial magnetic stimulation show promise for perinatal women without medication side effects, and can be used alongside standard care. Two new medications, brexanolone and esketamine, quickly treat severe depression by targeting GABA and glutamate receptors rather than serotonin or norepinephrine, though their effectiveness diminishes after 30 days and they can be combined with SSRIs. Pregnant and postpartum women now have more options beyond psychotherapy and antidepressants.
Journal of Clinical Medicine
December 25, 2025
Michał Walaszek, Wiesław Jerzy Cubała, Zofia Kachlik
1 citation
Patients with treatment-resistant depression report a range of experiences with ketamine therapy that go beyond symptom scores. Motivations, expectations, the subjective treatment experience, post-treatment changes, side effects, reasons for stopping, and the importance of the treatment setting and relationship with clinicians all shape how patients perceive the value and acceptability of ketamine. These findings highlight the need for patient-centered service design that aligns with what matters most to those receiving the treatment.
Journal of Clinical Medicine
January 28, 2024
Gniewko Więckiewicz, Iga Florczyk, Maciej Stokłosa et al.
1 citation
Among 703 users of illegal psychoactive substances surveyed online, intensity of substance use correlated positively with the risk and severity of prodromal psychosis symptoms. Early exposure to psychoactive substances increased the risk of heavy use in adulthood and more frequent prodromal states. The most popular drugs were tetrahydrocannabinol-containing products, MDMA, amphetamines, and LSD. 39.8% of respondents had been treated by a psychiatrist. A significant correlation was found between the Drug Use Disorders Identification Test and the Prodromal Questionnaire Brief Version scores.
Journal of Clinical Medicine
February 28, 2026
Chisato Tanaka, Yuta Shinohara, Saki Takaoka et al.
In a group of 33 adults with chronic pain who took part in an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program, mood improved markedly both during individual sessions and across the entire program. Vigor increased, while depression, tension-anxiety, and confusion decreased. Participants who started with higher tension-anxiety showed the greatest gains in anger, depression, tension, and confusion. The findings suggest that MBCT can enhance emotional well-being in chronic pain patients, especially those with elevated anxiety.
Journal of Clinical Medicine
December 29, 2025
Matteo Leonardi, Alice Frediani, Mauro Angeletti et al.
Intranasal esketamine rapidly reduces suicidal ideation and depressive symptoms in patients with treatment-resistant depression. Suicidal ideation scores dropped from 1.56 at baseline to 0.78 after one week and to 0.12 after six months. Depressive symptoms improved from a mean Montgomery-Åsberg Depression Rating Scale score of 30.9 at baseline to 17.5 after one week and 9.8 after six months. Male gender was a negative predictor of response; no other baseline variable predicted outcomes. The findings suggest intranasal esketamine is effective for rapid reduction and resolution of suicidal ideation in this population, and gender differences should be considered in treatment planning.
Journal of Clinical Medicine
October 24, 2025
Adriano Dos-Santos, Lucas Porto Fernandes Dos Santos, Gabriela Da Silva-Santos et al.
Chronic ketamine exposure in rats elevates systolic blood pressure and impairs baroreflex sensitivity and heart rate variability. Six weeks of treadmill-based aerobic training, performed three times per week alongside ketamine administration (10 mg/kg, intraperitoneal), attenuated these cardiovascular impairments. Trained rats receiving ketamine showed improved baroreflex sensitivity (bradycardic reflex: -1.3 ± 0.1) and preserved heart rate variability (total power: 38.9 ± 8.4) compared to sedentary ketamine-treated rats (bradycardic reflex: -0.7 ± 0.1; total power: 18.3 ± 2.1). The findings suggest aerobic exercise may serve as a non-pharmacological strategy to counteract ketamine-induced cardiotoxicity.
Journal of Clinical Medicine
September 19, 2025
Ana Flavia Burlec, Cornelia Mircea, Irina Macovei et al.
Psilocybin clinical trials are advancing more rapidly in the United States than in the European Union, driven by stronger research infrastructure, greater financial investment, and more favorable regulatory and cultural attitudes. The EU has fewer trials and slower progress, reflecting a cautious approach focused on patient safety and therapeutic efficacy. Harmonizing policies and fostering international collaboration are essential to ensure scientific rigor and patient protection as psilocybin-assisted therapies are integrated into psychiatric care.