PMID- 35788817
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2194-7511 (Print)
IS  - 2194-7511 (Electronic)
IS  - 2194-7511 (Linking)
VI  - 10
IP  - 1
DP  - 2022 Jul 5
TI  - Psychedelics in the treatment of unipolar and bipolar depression.
PG  - 18
LID - 10.1186/s40345-022-00265-5 [doi]
LID - 18
AB  - This is a narrative review about the role of classic and two atypical 
      psychedelics in the treatment of unipolar and bipolar depression. Since the 
      1990s, psychedelics experience a renaissance in biomedical research. The 
      so-called classic psychedelics include lysergic acid diethylamide (LSD), 
      psilocybin, mescaline and ayahuasca. Characteristic effects like alterations in 
      sensory perception, as well as emotion- and self-processing are induced by 
      stimulation of serotonin 2A receptors in cortical areas. The new paradigm of 
      psychedelic-assisted psychotherapy suggests a therapeutic framework in which a 
      safely conducted psychedelic experience is integrated into a continuous 
      psychotherapeutic process. First randomized, controlled trials with psilocybin 
      show promising efficacy, tolerability, and adherence in the treatment of unipolar 
      depression. On the other hand, classic psychedelics seem to be associated with 
      the induction of mania, which is an important issue to consider for the design of 
      research and clinical protocols. So called atypical psychedelics are a 
      heterogeneous group with overlapping subjective effects but different 
      neurobiological mechanisms. Two examples of therapeutic value in psychiatry are 
      3,4-methyl​enedioxy​methamphetamine (MDMA) and ketamine. Since 2020 the ketamine 
      enantiomer esketamine has been granted international approval for 
      treatment-resistant unipolar depression, and also first evidence exists for the 
      therapeutic efficacy of ketamine in bipolar depression. Whether psychedelics will 
      fulfil current expectations and find their way into broader clinical use will 
      depend on future rigorous clinical trials with larger sample sizes. A 
      well-considered therapeutic and legal framework will be crucial for these 
      substances to create new treatment settings and a potential paradigm shift.
CI  - (c) 2022. The Author(s).
FAU - Bosch, Oliver G
AU  - Bosch OG
AD  - Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric 
      University Hospital Zurich, University of Zurich, Lenggstrasse 31, PO Box 1931, 
      8032, Zurich, Switzerland. oliver.bosch@bli.uzh.ch.
FAU - Halm, Simon
AU  - Halm S
AD  - Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric 
      University Hospital Zurich, University of Zurich, Lenggstrasse 31, PO Box 1931, 
      8032, Zurich, Switzerland.
FAU - Seifritz, Erich
AU  - Seifritz E
AD  - Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric 
      University Hospital Zurich, University of Zurich, Lenggstrasse 31, PO Box 1931, 
      8032, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220705
PL  - Germany
TA  - Int J Bipolar Disord
JT  - International journal of bipolar disorders
JID - 101622983
PMC - PMC9256889
COIS- Dr. Bosch has received honoraria as a lecturer from Janssen-Cilag. He declares no 
      further conflict of interest. Dr. Halm declares no conflict of interest. Prof. 
      Dr. Seifritz has received honoraria as a lecturer from Janssen-Cilag. He declares 
      no further conflict of interest. Janssen-Cilag is manufacturing and marketing the 
      esketamine nasal spray Spravato for the treatment of therapy-resistant 
      depression. Dr. Bosch has received honoraria as a lecturer from Janssen-Cilag. He 
      declares no further conflict of interest. Dr. Halm declares no conflict of 
      interest. Prof. Dr. Seifritz has received honoraria as a lecturer from 
      Janssen-Cilag. He declares no further conflict of interest.
EDAT- 2022/07/06 06:00
MHDA- 2022/07/06 06:01
PMCR- 2022/07/05
CRDT- 2022/07/05 18:48
PHST- 2021/12/23 00:00 [received]
PHST- 2022/06/09 00:00 [accepted]
PHST- 2022/07/05 18:48 [entrez]
PHST- 2022/07/06 06:00 [pubmed]
PHST- 2022/07/06 06:01 [medline]
PHST- 2022/07/05 00:00 [pmc-release]
AID - 10.1186/s40345-022-00265-5 [pii]
AID - 265 [pii]
AID - 10.1186/s40345-022-00265-5 [doi]
PST - epublish
SO  - Int J Bipolar Disord. 2022 Jul 5;10(1):18. doi: 10.1186/s40345-022-00265-5.