A meta-analysis of five clinical trials found that psilocybin is superior to placebo for reducing end-of-life anxiety symptoms. Psilocybin reduced state anxiety at 1 day and 2 weeks after treatment, and trait anxiety at 1 day, 2 weeks, and 6 months after treatment. Psilocybin caused a temporary increase in systolic and diastolic blood pressure compared with placebo. There were no significant differences between psilocybin and placebo in rates of stopping treatment, serious adverse events, or heart rate. The authors conclude that psilocybin-assisted therapy can improve end-of-life anxiety without serious side effects, but note the small sample sizes and high heterogeneity in long-term outcomes.
A 62-year-old man with treatment-resistant bipolar II depression and hypertension showed improvement after adding esketamine nasal spray (ESK-NS) in October 2022, nearly remitting during the maintenance phase. However, depression recurred when ESK-NS frequency was reduced to once every 2 months, suggesting dosing frequency should be adjusted cautiously. Common side effects included dissociation, dizziness, and transient hypertension. Nifedipine was given when systolic blood pressure exceeded 160 mm Hg with headache or dizziness. Blood pressure monitoring was essential. This case highlights esketamine's potential for bipolar depression and calls for further studies on its cardiovascular effects and management.
People with schizophrenia spectrum disorders and those at ultra-high risk for psychosis both report elevated levels of disturbed self-experience, cognitive complaints, and schizotypy compared to healthy controls. Healthy controls scored significantly lower on the Examination of Anomalous Self-Experience (EASE), the Frankfurt Complaint Questionnaire (FBF), and the Chapman Psychosis Proneness Scales (CPPS). Differences between the ultra-high risk and schizophrenia groups on these measures were not statistically significant. Stronger associations among the three measures were observed in the schizophrenia group. The findings indicate a continuous spectrum of shared experiential anomalies and support integrated assessment approaches for early psychosis detection.
Mindfulness meditation works by blocking pathogenic thoughts and emotions from reaching the conscious mind, similar to how neurons use inhibitory and excitatory mechanisms. Meditation is a method for revealing unconscious content. Long-term, consistent practice may be more effective than short-term or interrupted practice.