As government agencies around the globe contemplate approval of the first psychedelic medicines, many questions remain about their ethical integration into mainstream medical practice. To identify key ethics and policy issues related to the eventual integration of psychedelic therapies into clinical practice. From June 9 to 12, 2023, 27 individuals representing the perspectives of clinicians,...
The ELEKT-D: Electroconvulsive Therapy (ECT) vs Ketamine in Patients With Treatment Resistant Depression (TRD) (ELEKT-D) trial demonstrated noninferiority of intravenous ketamine vs ECT for nonpsychotic TRD. Clinical features that can guide selection of ketamine vs ECT may inform shared decision-making for patients with TRD. To evaluate whether selected clinical features were associated with...
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), recently identified internet gaming disorder (IGD) as a condition warranting more research, and few empirically validated treatments exist. Mindfulness meditation (MM) has multiple health benefits; however, its efficacy in treating IGD and potential neural mechanisms underlying MM treatment of...
Importance Psilocybin has been studied in the treatment of depression and anxiety disorders. Clinical studies have mainly focused on efficacy, with systematic reviews showing favorable efficacy; however, none have primarily focused on psilocybin safety. Objective To evaluate the acute adverse effects of psilocybin at therapeutic doses in the treatment of depression and anxiety. Data Sources...
Importance Postpartum depression (PPD) is one of the most common mental health conditions during the perinatal and postpartum periods, which can have adverse effects on both mother and infant. Objective To investigate the efficacy of perioperative adjunctive esketamine administration after cesarean deliveries in the prevention of PPD. Design, Setting, and Participants A single-center,...
Physicians are exposed to high stress and strain that results in burnout, which affects them, their families, their patients, and the entire health care system; thus, there is an urgent need to develop methods to increase the resiliency of physicians. Sudarshan Kriya Yoga (SKY) is a comprehensive yoga breathing and meditation-based program that is a potential approach to mitigate physician...
JAMA Network OpenOctober 2, 2023William G Mantyh, Adam D Block, Madelyn R Castro et al.
Visual hallucinations are a core feature of dementia with Lewy bodies and primary psychiatric disease, yet identification of a hallucination vs normal spiritual experience depends on cultural context. Almost no information exists in the medical literature regarding normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. To assess the...
JAMA Network OpenAugust 1, 2023Chunfeng Xiao, Jia Zhou, Anning Li et al.
Importance: Loss of a previously effective response while still using adequate antidepressant treatment occurs in a relatively high proportion of patients with major depressive disorder (MDD); therefore, there is a need to develop novel effective treatment strategies. Objective: To assess the efficacy and safety of a single subanesthetic dose of esketamine in boosting the efficacy of oral...
Nonpharmacological interventions are a potential strategy to maintain or promote cognitive functioning in older adults. To investigate the effects of 18 months' meditation training and 18 months' non-native language training on cognition in older adults. This study was a secondary analysis of the Age-Well trial, an 18-month, observer-masked, randomized clinical trial with 3 parallel arms....
This secondary analysis of a randomized clinical trial examines whether automated self-association training can prolong the antidepressant effect of a single infusion of ketamine beyond 1 month in patients with treatment-resistant depression.
Controlled clinical laboratory studies have shown that cannabidiol (CBD) can sometimes attenuate or exacerbate the effects of Δ9-tetrahydrocannabinol (Δ9-THC). No studies have evaluated differences in pharmacokinetics (PK) of Δ9-THC and pharmacodynamics (PD) between orally administered cannabis extracts that vary with respect to Δ9-THC and CBD concentrations. To compare the PK and PD of orally...
Importance Psychosis is a hypothesized consequence of cannabis use. Legalization of cannabis could therefore be associated with an increase in rates of health care utilization for psychosis. Objective To evaluate the association of state medical and recreational cannabis laws and commercialization with rates of psychosis-related health care utilization. Design, Setting, and Participants...
JAMA Network OpenSeptember 1, 2022Sangeeta P Joshi, An-Kwok Ian Wong, Amanda Brucker et al.
Health care workers (HCWs) have been experiencing substantial stress and burnout, and evidence-based mitigation strategies are needed. Transcendental Meditation (TM) is a mantra meditation practice with potential efficacy in reducing stress. To assess the efficacy of TM practice in reducing stress among HCWs over a 3-month period. This single-center open-label randomized clinical trial was...
Key Points Question Is group loving-kindness meditation noninferior to group cognitive processing therapy for treatment of posttraumatic stress disorder (PTSD) among veterans? Findings In this randomized clinical trial, 184 veterans with PTSD were assigned to group loving-kindness meditation or group cognitive processing therapy; the differences in the decrease from baseline to 6-month...
Importance: Caregivers of people with mental illness are at increased risk of developing depression, anxiety, and stress. Objective: To investigate the effect of a compassion cultivation training (CCT) program on decreasing caregiver psychological distress. Design, setting, and participants: This waitlist-controlled randomized clinical trial was conducted in 2 different community settings in...
Importance: A single subanesthetic dose of ketamine produces an antidepressant response in patients with major depressive disorder (MDD) within hours, but the mechanism of antidepressant effect is uncertain. Objective: To evaluate whether ketamine dose and brain glutamate and glutamine (Glx) and γ-aminobutyric acid (GABA) level responses to ketamine are related to antidepressant benefit and...
JAMA Network OpenAugust 1, 2020Sapna Oberoi, Jiayu Yang, R. Woodgate et al.
Key Points Question Are mindfulness-based interventions associated with decreased anxiety in adults with cancer? Findings In this systematic review and meta-analysis of 28 randomized clinical trials with 3053 participants, mindfulness-based interventions were associated with reductions in the severity of anxiety in adults with cancer up to 6 months after delivery of mindfulness sessions...
This meta-analysis assesses the psychopathological outcomes in healthy volunteers and patients with schizophrenia treated with ketamine and the experimental factors associated with these findings.