European Psychiatry
April 1, 2025
T. Fernandes, J. G. Freire, M. C. Pais et al.
Only nine studies, published between 1954 and 1967, have examined psychedelic-assisted therapy for functional neurological disorders (FND). Across 22 patients, 69% (18 individuals) showed at least some recovery, but the studies were low quality, often lacking control groups and valid outcome measures. There is insufficient evidence to support the efficacy of psychedelic-assisted therapy for FND. The discussion continues because abnormalities in default mode network activity have been reported in FND, and some proposed benefits of psychedelics may relate to their action on that network.
European Psychiatry
April 1, 2025
Kim P. C. Kuypers
Low doses of LSD (15 mcg over 2 weeks in healthy participants; 20 mcg over 6 weeks in participants with ADHD) were tested for lasting effects and potential to reduce ADHD symptoms. A follow-up study in 100 individuals with ADHD and emotion regulation or sleep problems is planned to identify treatment response markers. Additionally, high-ventilation breathwork, which can induce altered states of consciousness similar to psychedelics, is being investigated as a non-pharmacological alternative for social anxiety symptoms.
European Psychiatry
April 1, 2025
P. Andres-Olivera, Janis V. de la Iglesia, E. Dominguez-Alvarez et al.
Psilocybin, a psychedelic compound, shows promise for treating depression, particularly when standard treatments fail. This systematic review of studies published between 2019 and 2024 found that psilocybin leads to significant improvements in depressive symptoms compared to conventional therapies, with rapid and sustained symptom reduction and few adverse effects. The review concludes that psilocybin may be an effective and safe alternative, offering relief with fewer treatment sessions and a favorable safety profile, though more research is needed to understand its mechanisms and address current limitations.
European Psychiatry
April 1, 2025
Cristina Serritella, Federica Ferraiuolo, Mark Piccirillo et al.
Treatment with esketamine (Spravato) led to significant clinical improvement in most patients, as measured by the Clinical Global Impression and Dissociative Experience Scale II. Among 15 patients, dissociative symptoms decreased by an average of 14.65 points on the DES II (mean effect +0.98). CGI improvement showed an effect size of +56.57, with wide variability from +30.4 to +117.9. Two patients—a 31-year-old man and a 19-year-old woman—experienced clinical worsening with high dissociation, suggesting age and dissociative vulnerability may influence response. The scales proved complementary for monitoring change, and this work is the first attempt to differentiate traumatic from psychotic dissociation in esketamine-treated patients.
European Psychiatry
August 27, 2024
L. Carrión Expósito, G. Chauca Chauca, R. Galan Armenteros et al.
In a 62-year-old patient with treatment-resistant major depressive disorder, intranasal esketamine led to marked improvement. From the fifth administration onward, the patient showed clear progress. At three months, the MADRS depression scale score dropped from a baseline of 46 to 14, and at six months to 1, indicating euthymia. The only adverse effect was very mild dizziness after each dose. This case suggests that esketamine can be a fast, safe, and well-tolerated option for patients who do not respond to other treatments.
European Psychiatry
August 27, 2024
M. J. Gordillo Montaño, L. Rodriguez Rodriguez, C. Pérez Aparicio et al.
A 23-year-old man with a history of depression and recent use of Kambo and Salvia divinorum developed a manic episode with psychotic symptoms, including mystical delusions and auditory hallucinations. The episode took about a month to resolve with treatment. The authors suggest that these substances, sometimes used as alternative therapies, may trigger severe psychiatric episodes in vulnerable patients, and note that later similar episodes were linked to other natural medicinal substances rather than Kambo.
European Psychiatry
August 27, 2024
D. Zullino, L. Penzenstadler, S. Rothen et al.
Enhancement is the most common motive for using MDMA, followed by expansion motives—altering perceptions and increasing self-awareness—which reflects growing interest in MDMA-assisted therapy for conditions like PTSD. Social motives are third, coping fourth, and conformity least common. Compared to alcohol and cannabis, MDMA shows a distinct pattern of motives: social motives are less common for MDMA, and conformity motives are also less significant, possibly due to user maturity. These differences highlight the need for tailored harm reduction and intervention strategies. Data come from an online survey of 99 participants.
European Psychiatry
August 27, 2024
E. Kavakbasi, M. Yilmaz, Ö. Bulut et al.
In a retrospective chart review of 76 inpatients with treatment-resistant depression at a German university hospital, a series of esketamine nasal spray sessions (average 10.9) combined with usual care led to large reductions in depression severity and suicidal ideation. Scores on the Beck Depression Inventory (BDI-II) dropped by an average of 10.1 points, and Montgomery–Åsberg Depression Rating Scale (MADRS) scores fell by 10.0 points; suicidal ideation, measured by MADRS item 10, decreased by 0.9 points. All changes were statistically significant with large effect sizes. Treatment was generally well tolerated, though 5.3% of patients discontinued early due to dissociation.
European Psychiatry
April 1, 2024
V. Tsang
A small study tested whether a device called Apollo reduces anxiety compared to no intervention. Participants were matched by age, sex, and initial anxiety scores. The median anxiety reduction was larger in the Apollo group (a drop of 8.5 points on the GAD-7 scale) than in the control group, but the difference was not statistically significant. The authors conclude that the Apollo device did not produce a significant effect in this sample and suggest that future work should include more participants and balanced group sizes.
European Psychiatry
April 1, 2024
J. S. Seo
In Korea, debate over medical marijuana has preceded a similar discussion about psychedelics. Mescaline was first isolated from peyote in 1890, but psychedelics were prohibited in the US in 1970. Recent studies suggest psychedelic mushrooms may help with treatment-resistant depression, alcohol dependence, and anxiety in terminal cancer patients. This review catalogs wild hallucinogenic mushrooms in Korea. Psilocybin from magic mushrooms causes hallucinations and other symptoms lasting 2–4 hours. Of 114 psilocybin-containing Psilocybe species worldwide, only five grow in Korea: P. argentipes, P. coprophila, P. perdaria, and P. subcarulipes. Acute poisoning cases with GI symptoms occur, but abuse or dependence records are rare. The Korean government classifies psilocybin and psilocin as psychotropic drugs, and clinical trials require FDA approval.
European Psychiatry
April 1, 2024
V. Tsang
A program offering weekly virtual group therapy sessions combined with a single psilocybin session helped patients with terminal health conditions. Twenty-one of twenty-five participants (84%) completed the program. Feedback highlighted improved preparation, benefits such as perspective and peace, the group as a key source of connection, and the need for a curriculum focused on death and loss. Psilocybin was delivered safely in a group setting, and the virtual community of practice supported set, setting, and integration.
European Psychiatry
April 1, 2024
J. H. Shepherd, A. Hickman, C.t.m. Baten et al.
Acute ketamine administration alters neural activation in multiple cortical and subcortical regions in healthy people, as shown by a meta-analysis of 18 fMRI studies with 306 participants. The analysis used multilevel kernel density analysis and ensemble thresholding to minimize bias. These findings help map the functional neuroanatomical effects of ketamine, which may inform its therapeutic use for psychiatric and neurological conditions. Future research should examine both short- and long-term neural effects in clinical populations.
European Psychiatry
April 1, 2024
C. Zu Eulenburg, E. Papanastasiou, K. Schmid et al.
A novel oral prolonged-release ketamine formulation (KET01) produces a low and delayed peak concentration of ketamine, high hydroxynorketamine levels, and minimal dissociative effects. In a phase 2 trial in outpatients with treatment-resistant depression, 240 mg/day KET01 added to ongoing treatment reduced depressive symptoms within 7 hours, with a statistically significant separation from placebo on day 4 and day 7, though the difference was not significant at day 21. In a separate phase 1 trial in healthy volunteers, the mean maximum dissociative score was 0.7 for KET01 versus 29.6 for intranasal esketamine. The formulation appears to be a safe, take-at-home adjunct treatment with minimal dissociation.
European Psychiatry
April 1, 2024
A. M. Klassen, C.t.m. Baten, J. H. Shepherd et al.
Repeated-dose intravenous ketamine is an effective rapid-acting treatment for treatment-resistant depression. In a large-scale analysis of 1,182 participants across 51 primary studies, intravenous ketamine produced statistically significant reductions in depression symptoms compared to placebo and other control conditions, as measured by standardized clinician and self-report scales. The findings provide quantitative support for ketamine's effectiveness in treatment-resistant depression and highlight variations in treatment parameters across the literature.
European Psychiatry
April 1, 2024
Arun K. Iyer, W. Upadhyaya
Dreams in the Ayurvedic text Charaka Samhita are classified into seven types: those based on what was seen, heard, reflected upon, desired, imagined, prophetic dreams, and those caused by illnesses. Specific dreams in the prodromal stage predict the manifestation of specific illnesses, ranging from mild to fatal. Dream content analysis using the Hall Van de Castle system on 18 mentioned themes shows that categories of characters, objects, activities, and social interactions occur more frequently than others. Thus, like ancient Greek medicine, Ayurveda also had the practice of predicting illnesses based on dream contents.
European Psychiatry
November 17, 2023
M. I. Husain, D. M. Blumberger, D. J. Castle et al.
The antidepressant effects of psilocybin, the active compound in magic mushrooms, may not require its psychedelic effects. Psilocybin's psychedelic effects depend on activation of the serotonin 2A receptor, and blocking that receptor with drugs like risperidone or ketanserin eliminates the psychedelic experience in healthy volunteers. A mouse study showed that ketanserin did not reduce psilocybin's antidepressant effect. This proposed three-arm, double-blind, proof-of-concept randomized controlled trial in adults with treatment-resistant depression will test whether giving psilocybin with risperidone blocks psychedelic effects without reducing antidepressant effects. If so, psilocybin-assisted psychotherapy, which currently requires intensive therapist support, could become more scalable and accessible.
European Psychiatry
November 17, 2023
V. Gallese
Schizophrenia involves disturbances in the minimal, bodily self—the pre-reflective sense of one's own body as one's own. Anomalies in multisensory integration and in the differential processing of self-related versus other-related bodily information may blur the distinction between self and other. This imbalance in the embodied self's pre-reflective relationship to the social world could underlie the self-disturbances and social deficits characteristic of schizophrenia. Cognitive neuroscience can now correlate first-person experiential aspects of psychiatric diseases with their neurobiological roots, adding a new descriptive level to classic psychopathology.
European Psychiatry
November 17, 2023
J. Curto Ramos, H. Dolengevich, M.a. Morillas Romerosa et al.
A patient who used 2C-B during chemsex—intentional drug use before or during sex—arrived at an emergency room with psychotic symptoms and was diagnosed with stimulant acute intoxication and acute psychotic symptoms induced by stimulants. 2C-B increases dopamine, serotonin, and norepinephrine, producing both stimulating and hallucinogenic effects. Men who have sex with men (MSM) are especially vulnerable to problematic drug use in sexual contexts. Chemsex users face mental health problems including psychotic symptoms, suicidal ideation, encephalopathy, and delirium. Polysubstance use is common in chemsex, making identification of specific drugs during acute intoxication challenging, but psychiatrists should investigate use of drugs beyond classic chemsex substances like mephedrone, GHB, and methamphetamine, including 2C-B, cocaine, MDMA, ketamine, and other cathinones.
European Psychiatry
October 23, 2023
O. Martin-Santiago, G. Guerra-Valera, C. Alario-Ruiz et al.
A single dose of the hallucinogenic drug 25I-NBOMe can trigger psychosis lasting months, as shown in a case of a 30-year-old man who required psychiatric admission five months after use. He developed paranoid delusions, self-referential experiences, and intrusive flashbacks, becoming isolated and irritable. He previously worked and had a strong social network, with occasional adolescent use of alcohol, cannabis, and cocaine, and a family history of schizophrenia. Treatment with long-acting injectable aripiprazole reduced symptoms, allowing him to return to work within a year. The drug's expanding use may increase chronic psychosis cases, especially in vulnerable individuals, partly due to its phenylethylamine-like structure and the mistaken belief it is less dangerous.
European Psychiatry
October 23, 2023
I. B. Nita, O. D. Ilie, A. S. Ciobica et al.
A review of 246 studies from 2010 to 2022 examined how various substances induce schizophrenia-like symptoms in zebrafish. The compounds included NMDA inhibitors (MK-801, ketamine, phencyclidine), psychedelics (mescaline, LSD), amphetamine, and amino acids (proline, methionine). Most research focused on MK-801, ketamine, amphetamine, proline, methionine, and phencyclidine, with fewer studies on mescaline and LSD. Findings were inconsistent, showing both increases and decreases in behaviors such as locomotion, aggression, sociability, circling, and memory. The authors conclude that additional studies are needed to clarify these effects and guide future research on pharmacodynamics and kinetics.
European Psychiatry
March 1, 2023
R. Sousa, Luís Costa, J. Brás et al.
Substance use disorders (SUDs) remain a major health concern, with about 50–60% of patients relapsing within 6–12 months after treatment. Hallucinogens such as lysergic acid diethylamide (LSD) and psilocybin have shown potential anti-craving properties and may reduce substance use. Psilocybin has been found to increase trait openness, cognitive and behavioral flexibility, and positive attitudes and mood, with some studies reporting persistent positive changes. These effects suggest psilocybin could help treat SUDs and prevent relapse, possibly by improving negative emotional states and stress or by reducing cognitive inflexibility and compulsivity. However, research is still limited to a handful of studies, and many questions about its mechanisms and use alongside current treatments remain unanswered.
European Psychiatry
March 1, 2023
J. H. Shepherd, C.t.m. Baten, A. C. Klassen et al.
Serotonergic psychedelics such as LSD, psilocybin, and MDMA significantly alter neural activation in several regions of the cerebral cortex and basal ganglia. Some effects are common across these drugs, while others are unique to each substance. This meta-analysis combined functional MRI studies of both clinical and healthy participants, using multilevel kernel density analysis with ensemble thresholding. The findings clarify the functional neuroanatomy associated with these drugs and may guide future research into their therapeutic and adverse effects, particularly for emerging psychiatric treatments.
European Psychiatry
March 1, 2023
J. Ramírez González, I. Fernández Márquez, Serafín González et al.
Psilocybin microdoses (10–25 mg) combined with psychotherapy improve depressive symptoms in patients with drug-resistant depressive disorder, with benefits lasting at least six months. A review of 19 recent studies found that one or two such doses produce statistically significant improvement. These findings offer optimism for new mental health treatments.
European Psychiatry
March 1, 2023
René Zeiss
Psilocybin, a classical psychedelic, is being studied as an alternative treatment for mental disorders. A narrative review of recent studies found no serious side effects under controlled conditions. Common adverse drug reactions include headache, nausea, vomiting, diarrhea, rapid heart rate, and high blood pressure. The lethal dose is many times higher than the therapeutic dose, with no overdose deaths identified. Hallucinogen persisting perception disorder did not occur in the studies reviewed and is more associated with recreational use. Results are preliminary because risk populations were mostly excluded. Risks like delusional experiences and bad trips are more likely in uncontrolled recreational use. The authors caution that high expectations and fame surrounding psilocybin could blur the line between therapeutic and abusive use.
European Psychiatry
June 1, 2022
L. Silva, L. Bravo
Ayahuasca, a hallucinogenic tea containing monoamine oxidase inhibitors and DMT, shows potential benefits for psychiatric symptoms such as depression, anxiety, and drug addiction. In a randomized placebo-controlled trial, ayahuasca had a significant antidepressant effect compared to placebo. Long-term use was associated with structural brain alterations in medial regions, with no evidence of increased psychopathology or impaired neuropsychological functioning. Prolonged psychotic reactions among users are rare, and causal links to ayahuasca are difficult to establish. More controlled double-blinded studies with larger populations are needed to clarify therapeutic potentials and side effects.