PMID- 38518266
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240405
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 31
IP  - 2
DP  - 2024 Mar-Apr 01
TI  - Psychedelic Therapy: A Primer for Primary Care Clinicians-Historical Perspective 
      and Overview.
PG  - e97-e103
LID - 10.1097/MJT.0000000000001727 [doi]
AB  - BACKGROUND: Psychedelic drugs have recently emerged as plausibly effective 
      pharmacological agents for the management of depression, anxiety, and other 
      neuropsychiatric conditions, including those that are treatment-resistent. The 
      latter half of the 20th century marked a revolution in the treatment of mental 
      illnesses, exemplified by the introduction of selective serotonin reuptake 
      inhibitors and other pharmacological agents. Nevertheless, mental illness remains 
      a major public health crisis, affecting nearly one billion individuals worldwide. 
      AREAS OF UNCERTAINTY: Because of the decades-long status of several psychedelics 
      as Schedule I drugs, there have not been very many large, double-blind, 
      randomized controlled trials of psychedelics. Owing to small sample sizes, there 
      may be rare yet serious adverse events that have not been reported in the 
      clinical trials thus far. THERAPEUTIC ADVANCES: Esketamine, a dissociative 
      hallucinogen drug, was approved for the management of major depressive disorder 
      by the Food and Drug Administration in 2019. As of January 2024, two Phase III 
      trials of 3,4-methylenedioxymethamphetamine (MDMA), a synthetic drug that 
      inhibits the serotonin transporter, have been completed; the results indicate 
      that MDMA is superior to existing pharmacological treatments for post-traumatic 
      stress disorder. A phase III trial of psilocybin, a naturally occurring serotonin 
      receptor partial agonist, is currently underway. The following series details the 
      current state of research in psychedelic therapeutics, including lysergic acid 
      diethylamide (LSD), N-N-dimethyltryptamine (DMT) and ayahuasca, psilocybin, 
      ibogaine, MDMA, and ketamine. LIMITATIONS: While initial clinical trials of 
      psychedelics for depression were very promising, trials of psilocybin with larger 
      sample sizes (100+ participants) suggest that its remission rate is 25%-29%. This 
      is about the same as the remission rate of antidepressants, which is roughly 30% 
      according to the landmark STAR*D trial. CONCLUSIONS: Psychedelic drugs and 
      structural derivatives offer a great deal of promise for the management of a wide 
      range of psychiatric morbidities. It is imperative that clinicians become 
      familiar with these novel agents and learn how to integrate psychedelic therapy 
      with the rest of their care through open communication and referral.
CI  - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Tabaac, Burton J
AU  - Tabaac BJ
AD  - University of Nevada, Reno School of Medicine, Reno, NV.
AD  - Department of Neurology, Carson Tahoe Health, Carson City, NV.
FAU - Shinozuka, Kenneth
AU  - Shinozuka K
AUID- ORCID: 0000-0002-2859-9161
AD  - Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, United 
      Kingdom.
AD  - Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
FAU - Arenas, Alejandro
AU  - Arenas A
AD  - Department of Anesthesiology, University of Washington School of Medicine, 
      Seattle, WA.
FAU - Beutler, Bryce D
AU  - Beutler BD
AD  - University of Southern California, Keck School of Medicine, Los Angeles, CA.
FAU - Cherian, Kirsten
AU  - Cherian K
AD  - Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, 
      CA.
FAU - Evans, Viviana D
AU  - Evans VD
AD  - Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Fasano, Chelsey
AU  - Fasano C
AD  - Teachers College, Columbia University, New York, NY.
FAU - Muir, Owen S
AU  - Muir OS
AD  - Fermata Health, Brooklyn, NY; and.
AD  - Acacia Clinics, Sunnyvale, CA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
RN  - 2RV7212BP0 (Psilocybin)
SB  - IM
MH  - Humans
MH  - *Depressive Disorder, Major/drug therapy
MH  - *Hallucinogens/pharmacology/therapeutic use
MH  - N-Methyl-3,4-methylenedioxyamphetamine/pharmacology/therapeutic use
MH  - Primary Health Care
MH  - Psilocybin/pharmacology/therapeutic use
MH  - Randomized Controlled Trials as Topic
COIS- The authors have no conflicts of interest to declare.
EDAT- 2024/03/22 18:44
MHDA- 2024/03/25 06:43
CRDT- 2024/03/22 17:50
PHST- 2024/03/25 06:43 [medline]
PHST- 2024/03/22 18:44 [pubmed]
PHST- 2024/03/22 17:50 [entrez]
AID - 00045391-202404000-00001 [pii]
AID - 10.1097/MJT.0000000000001727 [doi]
PST - ppublish
SO  - Am J Ther. 2024 Mar-Apr 01;31(2):e97-e103. doi: 10.1097/MJT.0000000000001727.