The dose-response profile of racemic ketamine in internalizing disorders is poorly characterized. This was a secondary analysis of outcome responses in patients with treatment-resistant depression, post-traumatic stress disorder, generalized and/or social anxiety, or obsessive-compulsive disorder. For each disorder, they received single intramuscular doses of racemic ketamine (0.5 and 1.0...
Expanded use of buprenorphine-naloxone use, particularly for marginalized communities, such as the unhoused, is an established priority. Unfortunately, due to fear of the precipitation of opioid withdrawal, this goal remains unmet. In response, microdosing methods during the initial week of treatment do not require opioid abstinence and do not precipitate withdrawal. This review establishes the...
Ketamine is a non-competitive antagonist at the N-methyl-D-aspartate (NMDA) glutamate receptor. It was approved by the US Food and Drug Administration for anesthesia in 1970. The only other related US regulatory approval since then has been for esketamine nasal spray for depression in 2019. Over this time ketamine has been repurposed by mainly academic researchers, reporting clinical activity...
Abstract This article discusses current literature on the use of 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy in the treatment of posttraumatic stress disorder (PTSD). MDMA, the intended active ingredient in illicit Ecstasy or Molly products, is a psychedelic that causes an elevated mood, feeling of bonding, and increased energy. In MDMA‐assisted psychotherapy, patients are...
Abstract Hallucinogens constitute a unique class of substances that cause changes in the user's thoughts, perceptions, and mood through various mechanisms of action. Although the serotonergic hallucinogens such as lysergic acid diethylamide, psilocybin, and N,N‐ dimethyltryptamine have been termed the classical hallucinogens , many hallucinogens elicit their actions through other mechanisms...
Parenteral ketamine has fast‐onset antidepressant and antianxiety effects; however, it causes dissociation, hypertension, and tachycardia shortly after dosing. Ketamine's antidepressant effects may be due to active metabolites rather than to ketamine itself. We hypothesized that oral controlled‐release ketamine tablets would improve safety and tolerability compared with injected ketamine by...
Conversion of ibogaine to its active metabolite noribogaine appears to be mediated primarily by CYP2D6. We compared 168 hours pharmacokinetic profiles of both analytes after a single oral 20 mg dose of ibogaine in 21 healthy subjects who had been pretreated for 6 days with placebo or the CYP2D6 inhibitor paroxetine. In placebo-pretreated subjects, ibogaine was rapidly converted to noribogaine....
Noribogaine is the active metabolite of the naturally occurring psychoactive substance ibogaine, and may help suppress withdrawal symptoms in opioid-dependent subjects. The objectives of this Phase I study were to assess the safety, tolerability, pharmacokinetic, and pharmacodynamic profiles of noribogaine. In this ascending single-dose, placebo-controlled, randomized, double-blind,...
Abstract 3,4‐Methylenedioxymethamphetamine (MDMA) is an agent of abuse that has been used by over 16 million Americans. Increased energy, elevated mood, bonding with others, and psychedelic effects are desired effects while liver damage, extended depressed mood, sexual assault, rhabdomyolysis, serotonin syndrome, multiorgan failure, cardiovascular events, arrhythmias, and death are possible...
The authors evaluated the contribution of the SLCO2B1 polymorphism to the pharmacokinetics of celiprolol at a microdose (MD) and therapeutic dose (TD) and compared pharmacokinetic proportionality between the 2 dose forms in 30 SLCO2B1 genotype-matched healthy volunteers. Three drugs (celiprolol, fexofenadine, and atenolol) were orally administered as a cassette dosing following the MD (totally...
This article presents data from two avenues of marijuana research. First, the author shows that daily marijuana smoking in healthy individuals produces dependence, as demonstrated by withdrawal symptoms such as increased irritability and depression and decreased food intake. In addition, two antidepressant medications were evaluated to assess their potential effectiveness in the treatment of...
Two neuroleptics, haloperidol and chlorpromazine, have been reported to be effective in the treatment of phencyclidine (PCP) psychosis. Both neuroleptics are thought to exert their antipsychotic PCP effects by blockade of central dopamine receptors. They have been studied extensively in animal populations and less extensively in human populations. There has, however, been no comparison of their...
The effects of single oral doses of nabilone, a synthetic cannabinoid, were studied in eight anxious volunteer subjects. Each subject had two exposures to placebo and three dose levels of nabilone at one-week intervals in a single-blind balanced Latin-square design after the nabilone dose range was determined by each subject's response to a test dose. Heart rate and blood pressure were...
Psychoactive drugs are often widely used before tolerance and dependence is fully appreciated. Tolerance to cannabis-induced cardiovascular and autonomic changes, decreased intraocular pressure, sleep and sleep EEG, mood and behavioral changes is acquired and, to a great degree, lost rapidly with optimal conditions. Mechanisms appear more functional than metabolic. Acquisition rate depends on...
Cannabinoids (or presumed synonyms such as cannabinols or cannabis-like agents) have been variously defined in botanical, chemical, or pharmacological terms, with unfortunate consequences. Botanical definitions include inactive substances such as cannabigerol, as well as alkaloids and other secondary constituents of Cannabis sativa, but exclude synthetics such as levonantradol and nabilone....
Detal-9-tetrahydrocannabinol and pentobarbital both interfered with visual tracking performance. Of these, delta9THC had a statistically significant effect (P less than 0.04) when the first 12 responses for each subject were analyzed at each half-hourly period.