Lancet Psychiatry
May 17, 2016
Robin Carhart-Harris, Mark Bolstridge, James Rucker et al.
1,546 citations
In an open-label trial, 12 patients with moderate-to-severe treatment-resistant depression received two doses of psilocybin (10 mg and 25 mg, one week apart) in a supportive setting. The psychedelic effects peaked 2-3 hours after dosing and subsided within 6 hours. No serious adverse events occurred; transient anxiety, confusion, nausea, and headache were noted. Depressive symptoms, measured with the Quick Inventory of Depressive Symptoms, were markedly reduced one week after the high dose (mean reduction of 11.8 points) and remained lower at three months (mean reduction of 9.2 points). Improvements in anxiety and anhedonia were also observed. The results provide preliminary support for psilocybin's safety and efficacy in treatment-resistant depression, warranting further controlled trials.
Lancet Psychiatry
January 1, 2018
Brooke L Short, J. Fong, V. Galvez et al.
551 citations
A systematic review of 60 studies on ketamine for depression found that after a single dose, psychiatric, psychotomimetic, cardiovascular, neurological, and other side effects were reported more often with ketamine than with placebo. The review identified a selective reporting bias: long-term safety and repeated-dose effects were poorly assessed in depression patients, even though such data exist for other groups (e.g., chronic pain patients and recreational users). The authors recommend large-scale trials with multiple doses and long-term follow-up to evaluate the safety of regular ketamine use.
Lancet Psychiatry
May 1, 2018
Michael C Mithoefer, Ann T Mithoefer, Allison A. Feduccia et al.
443 citations
A randomized, double-blind, phase 2 clinical trial tested MDMA-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers. Participants were randomly assigned to receive different doses of MDMA during psychotherapy sessions. The findings revealed that the active dose of MDMA led to significant and lasting reductions in PTSD symptoms compared to the lower dose, indicating that this innovative therapeutic approach can effectively treat this condition and provide significant relief for individuals with profound trauma.
Lancet Psychiatry
April 5, 2016
Michael C Mithoefer, Charles S. Grob, Timothy D Brewerton
237 citations
Psilocybin and MDMA, known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research over the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and anxiety in patients with advanced cancer. MDMA shows encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, not as stand-alone treatments. This model offers a possible alternative to existing pharmacological and psychological treatments, though further research is needed.
Lancet Psychiatry
November 1, 2022
S. Smith-Apeldoorn, J. Veraart, J. Spijker et al.
163 citations
Ketamine can quickly reduce depression in people who do not respond to other treatments, but the effect often fades. Maintenance ketamine treatment—repeated doses over time—may help sustain the antidepressant benefit. A review of three randomized trials, eight open-label studies, and 30 case series found that intravenous, intranasal, oral, and possibly intramuscular and subcutaneous maintenance ketamine are effective for sustaining antidepressant effects in treatment-resistant depression. Serious side effects such as tolerance, cognitive problems, addiction, and kidney or urinary issues appear uncommon. Despite limitations in the available studies, maintenance ketamine shows therapeutic potential. More controlled and naturalistic long-term research is needed to clarify its role in routine care.
Lancet Psychiatry
April 5, 2017
Ilina Singh, Celia J. A. Morgan, Valerie H. Curran et al.
158 citations
Based on current evidence, off-label ketamine use for severe, treatment-resistant depression does not violate ethical principles, but clinicians and professional bodies must establish guidelines for good practice, register all trial data, and continuously monitor risks. The analysis reviews evidence for ketamine's antidepressant effects and safety profile, concluding with recommendations for oversight bodies to support safe, effective, and ethical treatment.
Lancet Psychiatry
May 1, 2017
I. Anderson, A. Blamire, T. Branton et al.
106 citations
Adding a low dose of the drug ketamine to the anesthetic used during electroconvulsive therapy (ECT) does not improve memory or speed recovery in severely depressed patients. In a randomized trial of 79 patients, those who received ketamine scored no better on a test of delayed verbal recall after four ECT sessions than those who received a placebo (saline). The ketamine group actually scored slightly lower on average, and the results rule out any more than a small to moderate benefit. Patients receiving ketamine also reported more adverse events, including transient psychological effects. The findings do not support using ketamine as a routine addition to ECT.
Lancet Psychiatry
October 1, 2020
Brian T Anderson, Alicia Danforth, Charles S. Grob
99 citations
The text discusses safety and ethical concerns surrounding psychedelic medicine, emphasizing the need for stringent oversight, comprehensive patient screening, robust therapeutic support, and informed consent to mitigate risks such as psychological distress and misuse. It highlights the ethical imperative for equitable access and responsible medical use as these powerful medicines are integrated into clinical practice.
Lancet Psychiatry
September 1, 2016
Robin Carhart-Harris, David Nutt
1 citation
No Summary
Lancet Psychiatry
May 1, 2022
R. Ritunnano, Joshua J. Kleinman, Danniella Whyte Oshodi et al.
Delusions in psychosis are best understood as highly individual and complex phenomena arising from a dynamic interplay of biological, personal, social, and cultural processes. A systematic review and qualitative synthesis of 24 studies representing 373 help-seeking individuals with psychosis identified three key themes: a radical shift in the lived world dominated by intense emotions; a process of doubting, losing, and rediscovering oneself within delusional realities; and a search for meaning, belonging, and coherence beyond mere dysfunction. The findings propose an Emergence Model of Delusion, suggesting that effective clinical care should account for the subjective experience and meaning of delusions, which may also address power imbalances and epistemic injustices in mental health.