Disruptive Psychopharmacology

Description

Psychedelic therapies are gaining traction as potential treatments for a wide range of indications, but the structure and delivery of psychedelic therapies are a sharp departure from more traditional models of psychotherapy and pharmacotherapy for psychiatric and other medical disorders. This may be critical to their success. The current volume provides a comprehensive review of the state of the science of psychedelic therapies, including discussion of models and approaches to psychedelic therapies as well as the current status of safety and efficacy data for mood, substance use, trauma, obsessive-compulsive, neurodevelopmental, neurodegenerative disorders, neurological, and inflammatory disorders. Preface Contents Part I: Models and Approaches Dosing Psychedelics and MDMA 1 Introduction 2 Pharmaceutical Aspects 3 Psychedelic (Full) Doses 4 Personalized Dosing and Pharmacogenetics 5 Microdosing 6 Summary References Psychedelic Group Therapy 1 Introduction 2 Administration of Mind-Altering Substances in Groups 3 Groups in Psychotherapy 4 Psychedelic Group Therapy in Switzerland 4.1 Group Therapy in the Current Program for Limited Medical Use of Scheduled Substances 5 Discussion and Conclusion References Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature 1 Introduction 1.1 Setting, Aesthetics, and Health 1.2 Applications in Psychedelic Experiences and Psychedelic Therapies 1.3 Scoping Review 2 Methods 2.1 Design 2.2 Protocol Registration and Reporting 2.3 Definitions and Classifications 2.4 Inclusion and Exclusion Criteria 2.5 Literature Search 2.6 Data Collection and Analysis 2.7 Critical Appraisal 3 Results 3.1 Summary 3.2 Study Dates and Locations 3.3 Populations 3.4 Sample Sizes and Study Designs 3.5 Study Purposes 3.6 Psychedelics Under Study 3.7 Drug Comparators 3.8 Settings and Aesthetics Addressed 3.8.1 Comparators 3.9 Facilitators 3.10 Outcomes 3.10.1 Outcome Measures/Instruments 3.11 Associations Between Setting and Psychedelic Experiences 3.11.1 General Settings 3.11.2 Social/Cultural Settings 3.11.3 Ritual or Ceremonial Settings 3.11.4 Music as Setting 4 Discussion 4.1 Summary 4.2 Evidentiary Gaps 4.3 Evidentiary Opportunities 4.4 Reporting 4.5 Theory to Practice 5 Limitations 6 Conclusion References Psychedelic-Assisted Therapy for Social Adaptability in Autistic Adults 1 Autism and Psychedelics Research 1.1 Early Psychedelics Research with Autistic Minors (1950s-1970s) 1.2 Psychedelic Clinical Research with Autistic Adults 1.2.1 Qualitative Research 1.2.2 Recent and Current Clinical Trials with Autistic Adults 2 Establishing an Autism-Affirming Set and Setting for Psychedelic-Assisted Therapy 2.1 Considerations for Establishing a Neurodiversity-Affirming Set 2.2 Considerations for Establishing Neurodiversity-Affirming Settings 2.2.1 Attending to the Senses 2.2.2 Additional Features of Autism-Friendly Settings 3 Therapist Role in Psychedelic-Assisted Therapy with Autistic Adults 4 Risk Mitigation in Psychedelic-Assisted Therapies for Autistic Adults 5 Conclusion References Foundations for Training Psychedelic Therapists 1 Overview of the Psychedelic Healing Process 2 The Competencies of the Psychedelic Therapist 2.1 Competency 1: Ethical Integrity and Self-Reflection 2.2 Competency 2: Trust Enhancement 2.3 Competency 3: Knowledge of the Physical and Psychological Effects of Psychedelics 2.4 Competency 4: Proficiency in Complementary Techniques 2.5 Competency 5: Transpersonal Awareness 2.6 Competency 6: Empathetic Abiding Presence 3 Twelve Curricular Areas of Study for Psychedelic Therapy Training 4 Didactic Methods that Support Therapist Development 5 Flourishing Through Diversity: The Evolving Landscape of Training 6 Conclusion References Part II: Disruptive Psychopharmacology for Mood Disorders Ayahuasca for the Treatment of Depression 1 Ayahuasca 2 The Pharmacology of Ayahuasca 3 The Phenomenology of Ayahuasca 4 Ayahuasca and Depression 4.1 Evidence from Naturalistic Settings 4.2 Recent Evidence from the Laboratory 5 Potential Mechanisms of Action 6 Final Remarks References Psilocybin for the Treatment of Depression: A Promising New Pharmacotherapy Approach 1 An Essential Need to Help Ease Mental Suffering 2 Psilocybin Therapy for Depression 3 Psilocybin Therapy for People Diagnosed with Treatment-Resistant Depression 4 Psilocybin Therapy for the Treatment of Major Depressive Disorder 5 Direct Comparison of Psilocybin Therapy and Antidepressant Medication Therapy 6 Qualitative Reports from Depression Study Volunteers 7 Future Directions 8 Conclusion References Ketamine for Depression: Advances in Clinical Treatment, Rapid Antidepressant Mechanisms of Action, and a Contrast with Seroto... 1 Introduction 1.1 Clinical Studies Leading to the Approval of Esketamine as an Antidepressant: A Historical Overview 1.2 The Need for Rapid-Acting Antidepressants 1.3 Safety of Ketamine as an Antidepressant 2 Pharmacodynamics of Ketamine as Antidepressant 2.1 Central Mechanisms of Action 2.2 Ketamine´s Central and Peripheral Actions Beyond Glutamate 2.3 Common Downstream Mechanisms Engaged by Rapid-Acting Antidepressants 2.3.1 Rapid Restoration of Synaptic Deficits Due to Stress 2.3.2 Rapid Glutamate Release 2.3.3 Rapid Stimulation of AMPA Throughput 2.3.4 Release of Neurotrophins 2.3.5 Stimulation of Intracellular Neuroplasticity Cascades 3 Conclusion References The Potential of Psychedelics for End of Life and Palliative Care 1 Contemporary End of Life and Palliative Care 2 Classic Psychedelics 3 Psychedelics in Palliative Care and End of Life Contexts 4 Clinical Considerations for Psychedelics in End of Life and Palliative Care 5 Conclusion References Part III: Disruptive Psychopharmacology for Other Disorders Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action 1 Introduction 2 Potential Mechanisms of Action of Psychedelic Substances in the Treatment of Substance Use Disorders 2.1 Induced Neuroplasticity 2.2 Alterations in Brain Networks Connectivity 2.3 Alterations in Emotion Processing 2.4 Alterations in Reward and Stress Processing 2.5 Increased Social Connectedness 2.6 Subjective Experiences and Personal Meaning of the Experiences 3 Therapeutic Implications 3.1 Implications of Induced Neuroplasticity 3.2 Implications of Alterations in Brain Network Connectivity 3.3 Implications of Alterations in Emotion, Stress, and Reward Processing 3.4 Implications of Social Connectedness 3.5 Implications of Subjective Experiences and Personal Meaning 3.6 Implications for Dose-Finding and Dosing Regimen 4 Conclusion References Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation 1 Historical Research 2 Resurgence of Modern-Day Research 3 Anthropological Evidence 4 Epidemiological Research 5 Modern Research in Alcohol Use Disorder 6 Psychedelics in Tobacco Smoking Cessation 7 Future Directions References Psychedelics and Anti-inflammatory Activity in Animal Models 1 Introduction 2 History of Psychedelics as Anti-Inflammatories 3 5-HT2A Receptor Activation in Allergic Asthma Models 4 5-HT2A Activation by Psychedelics in Models of Cardiovascular Disease 5 Conclusion References Psilocybin for the Treatment of Obsessive-Compulsive Disorders 1 OCD Defined 2 OCD Hypothesized Mechanisms of Disease 2.1 Psychological Theories 2.2 Biological Theories 2.3 Brain Basis of OCD 3 OCD Treatments 3.1 Pharmacotherapy 3.2 Psychotherapy 3.3 Treatment Strategies for Poor Responders 4 Background of Psilocybin in OCD 4.1 Incidental Findings 4.2 Rationale for Psilocybin Use in OCD 5 Previous and Prospective Research 5.1 Initial Study Design and Participants Characteristics 5.2 Study Findings 5.3 Important Implications 6 Conclusion References Psychedelics in the Treatment of Headache and Chronic Pain Disorders 1 Introduction 2 Background 2.1 Pain and Chronic Pain 2.2 Techniques in Pain Management 3 Headache Disorders 3.1 Migraine Headache 3.2 Cluster Headache 3.3 Source of Psychedelics´ Effects in Headache Disorders 4 Chronic Pain Disorders (Non-headache) 4.1 Cancer Pain 4.2 Phantom Limb Syndrome 4.3 Source of Psychedelics´ Effects in Pain Disorders 5 Safety 5.1 Safety of Infrequent Use 5.2 Safety of Chronic (Daily or Frequent) Use 6 Conclusions References Psychedelics as Novel Therapeutics in Alzheimer´s Disease: Rationale and Potential Mechanisms 1 Introduction 2 Pathophysiology and Etiology of Alzheimer´s Disease 2.1 Decreased Serotonergic Neurotransmission in AD 2.2 Loss of Synaptic Function in AD 2.3 Key Signaling Pathways in AD 2.4 Inflammation in AD 2.5 Changes in Brain Metabolism and Functional Connectivity in AD 2.6 Neuropsychiatric Comorbidities in AD 3 Neurobiology of Psychedelics 3.1 Data on the Role of 5-HT2AR in Learning and Memory 3.2 Psychoplastogenic Effects of Psychedelics and Related Signaling Pathways 3.3 Psychedelics as Anti-inflammatory Agents 3.4 Psychedelics´ Effects in Humans 4 Rationale and Approaches for Researching Psychedelics in Patients with AD 5 Conclusion References Psilocybin for Trauma-Related Disorders 1 Introduction 2 PTSD and Trauma-Related Disorders 3 Brief Review of Psilocybin 4 Review of the Empirical Literature of Psilocybin for Treating PTSD 5 Review of the Empirical Literature of Other Classic Psychedelics for Treating PTSD 6 Considerations for Other Trauma-Related Disorders 6.1 Complicated Grief 6.2 Borderline Personality Disorder 7 Precautions and Possible Contraindications 8 Conclusions References