Therapeutic Advances in Psychopharmacology
January 1, 2024
Eduardo Ekman Schenberg
7 citations
A commentary responds to a call for greater methodological rigor in psychedelic research, agreeing that studies should adhere to principles of internal, external, and construct validity. The authors note that conclusions must not exceed what robust statistical inferences support. They find valuable the examples of past inadequacies and mistakes, including oversight by peer reviewers, and affirm that future research can benefit from increased rigor.
Therapeutic Advances in Psychopharmacology
September 1, 2025
Stanley Wong, Gray Meckling, Nicholas Fabiano et al.
6 citations
A systematic review and meta-analysis of nine randomized controlled trials involving 593 adults with psychiatric diagnoses found that psilocybin therapy led to a small but significant decrease in suicidal ideation compared to control conditions. No studies reported suicide attempts or deaths. The analysis showed low heterogeneity and no publication bias, though two studies had a high risk of bias. Current evidence is limited by small sample sizes, insufficient follow-up data, and inadequate assessment of blinding.
Therapeutic Advances in Psychopharmacology
September 1, 2025
Sally Meikle, Olivia Carter, Paul Liknaitzky et al.
2 citations
In an open-label pilot trial, two 25 mg doses of psilocybin combined with psychotherapy produced a clinically meaningful reduction in depressive symptoms at 3 weeks in people with treatment-resistant depression. The average improvement was sustained at 20 weeks, but individual responses varied: two participants showed lasting benefit, three relapsed, and two did not improve. Mindset before dosing, spiritual experiences, and perceptual changes during the session predicted treatment trajectory, whereas treatment expectations did not. No serious adverse events occurred. The findings support further research into tailoring psilocybin therapy to individual variability.
Therapeutic Advances in Psychopharmacology
March 1, 2026
Guillaume Thuery, Frank Crossen, Daniel Mc Loone et al.
1 citation
About 15% of pregnant women experience postpartum depression, and many remain impaired despite available antidepressants. Serotonergic psychedelics may offer a viable therapeutic approach for postpartum depression, though the benefit-risk ratio is unclear. This review summarizes immune, endocrine, and neural pathways underlying postpartum depression and explores how psychedelics interact with these pathways in relation to maternal motivation, bonding, and caregiving. Special considerations for psychedelic therapy in the postpartum period are outlined. Further research, especially longitudinal trials with adaptations for the postpartum context, is needed to determine efficacy and safety.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Alessandro Cuomo, Roger S McIntyre, Despoina Koukouna et al.
1 citation
Among 45 patients with treatment-resistant depression treated with intranasal esketamine alongside oral antidepressants in a routine clinic, depression severity scores dropped from an average of 40.0 to 22.9 at four weeks and to 9.70 at 52 weeks, with scores remaining near 9-10 at later follow-ups. Eight patients stopped treatment, mostly due to lack of efficacy or side effects. No manic symptoms emerged, and side-effect ratings were low. The findings suggest sustained symptom improvement and a favorable long-term safety profile for those who continued treatment, though the observational design, concurrent treatments, and survivor bias limit the conclusions.
Therapeutic Advances in Psychopharmacology
June 8, 2025
Nadav Liam Modlin, Victoria Williamson, Carolina Maggio et al.
1 citation
PTSD is a common and debilitating condition that current treatments only partially address. This review examines psilocybin, a classical psychedelic, as a potential therapeutic agent. It synthesizes recent literature on psychedelic therapies for trauma-related conditions, including treatment-resistant depression and end-of-life anxiety. The authors propose a conceptual framework viewing PTSD as a maladaptive interpretive framework that psilocybin may disrupt through its psychopharmacological properties and subjective effects. A clinical narrative illustrates this process. Recommendations emphasize rigorous, trauma-informed protocols for safe administration in medical research settings.
Therapeutic Advances in Psychopharmacology
July 1, 2026
Martin Krsak, David Sparrow, Bernard Rosner et al.
Clinical trials of psychedelic-assisted therapy face unique challenges beyond those of typical pharmacotherapeutics. The therapeutic container—including preparatory and integrative psychotherapy and supportive dosing sessions—likely affects outcomes, and the therapeutic relationship between subjects and therapists is more impactful than in drug-only trials. The most critical problem is the inability to maintain effective blinding in placebo-controlled settings; all attempted approaches have resulted in significant functional unblinding. This makes it difficult to separate the true therapeutic effect of the psychedelic plus psychotherapy from positive expectancy in active subjects and negative expectancy in placebo subjects. Functional unblinding may be deeply connected to the mechanism of therapeutic action itself. The manuscript discusses advantages and disadvantages of current approaches and proposes conceptual and methodological perspectives.
Therapeutic Advances in Psychopharmacology
July 1, 2026
Karthika Kasiviswanathan, Dinuli Nilaweera, M Morando et al.
MDMA-assisted psychotherapy (MDMA-AP) may help treat not only PTSD but also complex PTSD and borderline personality disorder. A systematic review of 24 studies involving 335 participants found that most reported reduced PTSD symptoms after MDMA-AP, with some noting decreased dissociative symptoms at higher doses. Although no studies directly assessed MDMA-AP for complex PTSD or borderline personality disorder, improvements in emotional regulation, interpersonal functioning, identity coherence, and abandonment concerns were reported. Adverse drug reactions were mild to moderate, though specific safety concerns remain. These findings offer preliminary insights for future research and clinical considerations.
Therapeutic Advances in Psychopharmacology
March 1, 2026
Ana Deutsch, Luis E. Contreras, Sarah Kratina et al.
Mystical-type experiences induced by psychedelic therapy are commonly linked to reductions in anxiety and depression symptoms, according to a scoping review of 13 clinical trials involving 410 participants. Among studies with life-threatening disease populations, 80% reported a positive relationship between mystical-type experiences and mood improvement, compared to 63% of studies with depressive populations. The review suggests this relationship may depend on factors like timing of symptom assessments and therapeutic context. Future research should examine variables affecting mystical-type experiences and other aspects of set and setting to optimize positive outcomes.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Zofia Kachlik, Wiesław Jerzy Cubała, Michał Walaszek et al.
Anhedonia, a core symptom of bipolar depression, often fails to improve with ketamine treatment in patients with treatment-resistant bipolar depression. In a retrospective analysis of 31 patients who received eight doses of ketamine, 45.2% did not achieve a 50% or greater reduction in anhedonia scores. Nonresponders tended to have higher body mass index, later illness onset, fewer hypomanic episodes, and lower employment rates. These metabolic, illness-course, and psychosocial factors may help predict which patients are less likely to benefit from ketamine's anti-anhedonic effects.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Manfred Klöbl, Thomas Liebe, Gregor Dörl et al.
Ketamine reduces sexual arousal in a sex-specific manner, which may explain why it is used recreationally in chemsex settings despite dampening sexual experience. In two placebo-controlled crossover studies with 67 healthy volunteers, subacute S-ketamine lowered arousal to heterosexual stimuli in women and to lesbian stimuli in men, while decreasing sexual aversion to gay stimuli in both sexes. Late racemic ketamine reduced arousal to heterosexual stimuli in men but increased aversion to gay stimuli in women. Ketamine also modulated calcarine gyrus activity differently in men and women. These sex-dependent effects on brain activity and sexual response may relate to ketamine's known sex-specific influences on stress resilience and psychosis-like symptoms.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Yujuan Liu, Xiaorong Liu, Sebastian Olbrich et al.
Ketamine, a rapid-acting antidepressant for treatment-resistant depression, may work by altering the brain's excitation-inhibition balance, measurable via the aperiodic exponent of EEG power spectra. In a placebo-controlled trial of 24 patients with major depressive disorder, ketamine infusion significantly reduced the aperiodic exponent across the scalp. Patients who responded to treatment had steeper pretreatment occipital aperiodic exponents, which predicted better outcomes. A meta-analysis within the study revealed substantial variability in ketamine's effect on this measure. The occipital aperiodic exponent may serve as a biomarker for predicting antidepressant response, but further large-scale studies are needed.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Kristian Beichmann, Polina Catzeflis, Helena Aicher et al.
In Switzerland, physicians provide psychedelic-assisted therapy (PAT) with psilocybin, LSD, or MDMA under case-by-case exemptions from the Federal Office of Public Health. An anonymous survey of 41 physicians found that PAT is used mainly for depression, anxiety, PTSD, and chronic pain. Most physicians work in private practices (82%) and use body-oriented (61%), psychodynamic (59%), and eclectic (54%) approaches. Psilocybin is the most used substance (85%), followed by MDMA (71%) and LSD (65.9%). Substance choice is linked to diagnosis: psilocybin for depression (54%) and substance use disorder (46%), MDMA for PTSD (86%) and anxiety (54%). Music is played in 90% of sessions. Group therapy is common; 42% provide both individual and group settings. Challenges include legal constraints, high patient expectations, and financial barriers.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Zofia Kachlik, Wiesław Jerzy Cubała, Michał Walaszek
Ketamine and esketamine offer rapid antidepressant and anti-suicidal effects for treatment-resistant depression and bipolar depression, but differ from conventional antidepressants in their acute subjective effects, physiological profile, delivery models, and misuse potential. This narrative review synthesizes evidence from regulatory guidance, clinical trials, observational studies, and qualitative research to identify key patient information needs and proposes practical psychoeducational strategies. Core elements include explanations of indications, mechanisms, and treatment algorithms; guidance on visit preparation, scheduling, and monitoring; management of acute adverse effects; counselling on suicidality and substance misuse; and tailored considerations for special populations such as older adults, women of reproductive potential, and medically complex patients. The review proposes a patient-centred framework for psychoeducation and identifies priorities for future research.
Therapeutic Advances in Psychopharmacology
January 1, 2026
Veronika Andrashko, Tomáš Novák, Miloslav Kopecek et al.
Higher blood pressure during ketamine infusion was associated with better antidepressant response in people with depression. Among 39 patients who received a single intravenous dose of ketamine, those who responded at day 7 had significantly higher systolic and diastolic blood pressure during the infusion than nonresponders. Dissociation and psychotomimetic symptoms did not differ between responders and nonresponders. Concomitant antipsychotic medication was linked to worse antidepressant outcome and lower infusion-related blood pressure. Plasma levels of ketamine or norketamine did not correlate with blood pressure, dissociative symptoms, or psychotomimetic effects.
Therapeutic Advances in Psychopharmacology
December 1, 2025
Tiago Machado, Ana Rodrigues, João G. Costa
Psilocybin, a hallucinogen known for its therapeutic potential in psychiatry, has shown remarkable promise in reducing depression. In a sample of 200 participants, 70% reported significant improvements in mood after treatment. Additionally, psilocybin was associated with a 50% decrease in suicidal thoughts among those with severe depression. This medicine not only offers hope for pain management but also raises intriguing questions about the placebo effect and its implications for mental health economics. Enhanced understanding could reshape approaches to suicide prevention and psychological well-being.
Therapeutic Advances in Psychopharmacology
October 1, 2025
Luke Flynn, Martin Krsak, Mary Rondeau et al.
A group ketamine-assisted psychotherapy program for frontline healthcare workers and first responders reduced symptoms of anxiety, depression, trauma, and burnout. Median scores on the GAD-7 (anxiety) dropped from 9.5 to 6, PHQ-9 (depression) from 12 to 5, and PCL-5 (trauma) from 27 to 10, all with statistically significant improvements. The Maslach Burnout Inventory also improved across all subcomponents. The seven-week program included three ketamine sessions and four group psychotherapy sessions. Adverse events were rare, suggesting this model may be a viable intervention for job-related stress, though larger controlled studies are needed.
Therapeutic Advances in Psychopharmacology
January 1, 2025
Diana McHerron, Michaela Barber, Rachel Ham et al.
Physical touch is often used as a supportive tool in psychedelic-assisted therapy, but participants under the influence of psychedelics have reduced capacity to consent and are more suggestible. Interviews with 16 researchers revealed three themes: flexible frameworks, therapeutic alliance, and boundary management. Researchers noted that consent to therapeutic touch should be established before dosing sessions and continually managed. Flexibility in consent protocols helped build therapeutic alliance but also created challenges in boundary management. Researchers emphasized the need for clearer ethical guidelines for handling changing preferences during dosing sessions and limits on expanding consent after drug administration.
Therapeutic Advances in Psychopharmacology
January 1, 2025
Aleksander Kwaśny, Wiesław Jerzy Cubała, Alina Wilkowska
Intravenous ketamine is effective for treatment-resistant bipolar depression, with dosing typically based on actual body weight. In a retrospective analysis of 22 inpatients, doses recalculated using formulas for lean body mass, ideal body weight, and body surface area were compared between responders and nonresponders. Body surface area-normalized doses ranged from 17.63 to 23.09 mg/m² in nonresponders and 15.73 to 23.89 mg/m² in responders. Lean body mass and ideal body weight recalculations at 0.5 mg/kg yielded lower relative doses, especially among nonresponders, suggesting potential underdosing. These preliminary findings do not support alternative dosing formulas over actual body weight, but replication in larger controlled studies is warranted.
Therapeutic Advances in Psychopharmacology
January 1, 2024
correction
No Summary
Therapeutic Advances in Psychopharmacology
January 1, 2024
correction
This is a correction notice for a previously published article. It provides no new findings, arguments, or data.
Therapeutic Advances in Psychopharmacology
January 1, 2025
correction
No Summary
Therapeutic Advances in Psychopharmacology
January 1, 2021
D. O’Shaughnessy, I. Berlowitz, Robin Rodd et al.
A residential addiction treatment center in Tarapoto, Peru that combines Western and traditional Amazonian methods showed significant and clinically positive changes across all repeated psychological measures in 36 male inpatients. Improvements appeared early and were maintained over time, with significant gains also in neuropsychological functioning. The sample was 58% South American, 28% European, and 14% North American. The authors conclude the results provide evidence for treatment safety and suggest positive therapeutic effects.
Therapeutic Advances in Psychopharmacology
October 1, 2012
Leo Hermle, Melanie Simon, Martin Ruchsow et al.
A woman who abused LSD for a year at age 18 developed hallucinogen-persisting perception disorder (HPPD) with after images, peripheral movement perception, blurring, halos, and size distortions. Antidepressants and risperidone did not help, but lamotrigine almost completely resolved the visual disturbances. The authors suggest lamotrigine, an antiepileptic with neuroprotective and mood-stabilizing effects, may be a promising new treatment for HPPD.