A single dose of psilocybin produces measurable positive changes in brain activity, providing mechanistic insight into its potential therapeutic effects for psychiatric conditions.
rTMS stimulation of the dorsolateral prefrontal cortex significantly reduces cigarette consumption, offering a non-pharmacologic precision-medicine option for smoking cessation.
The Minnesota House has approved a psilocybin therapy program within the state budget bill, marking a significant legislative step for the regulation and clinical implementation of this psychedelic treatment.
A UAB study indicates psilocybin shows promise as a treatment for cocaine use disorder, highlighting potential off-label or investigational applications of psychedelics in substance use disorder.
Emerging data suggests psilocybin may be a promising treatment for cocaine use disorder, highlighting potential off-label or investigational use of a psychedelic compound in substance use disorder.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from Oct 29 – May 09)
- Consider prescribing Auvelity (dextromethorphan/bupropion) as a pharmacologic option for agitation in Alzheimer's disease, but remain vigilant for its specific adverse effect profile.
- Regularly review and deprescribe antipsychotics in dementia patients to mitigate the significantly increased mortality risk associated with their use.
- Utilize direct comparative efficacy and tolerability data for the seven antipsychotics when making prescribing decisions for acutely ill schizophrenia patients.
- Monitor sleep architecture closely when initiating SSRIs or SNRIs, as these classes suppress REM sleep, whereas agomelatine and mirtazapine may preserve restorative stages.
- Prioritize patient preference over pharmacogenomic testing when selecting an initial antidepressant, as preference is a stronger driver of treatment success.
- Exercise extreme caution with ibogaine due to the risk of fatal ventricular arrhythmias; mandate cardiovascular monitoring and CYP2D6 genotyping before any clinical use.
- Target GABAergic pharmacotherapy for PTSD patients who present with elevated anxious arousal, as precision phenotyping may identify those most likely to respond.
- Anticipate lower retention rates for buprenorphine compared to methadone in pregnant women with opioid use disorder and implement targeted support strategies.
- Recognize that recent psychotropic medication use is a significant predictor of self-harm risk in patients with substance use disorders, warranting close monitoring.
- Apply caution when considering psychedelic-assisted therapies due to divergent clinical outcomes, ensuring careful patient selection and monitoring to prevent deterioration.
Mechanism of Action 4
A study demonstrates that lithium treatment alters brain electrical activity associated with impulsive decision-making in suicide attempt survivors, offering a potential neurophysiological mechanism for its protective effect.
Preclinical or early clinical research indicates psilocybin induces lasting anatomical changes in brain tracts and reduces neural rigidity, offering a mechanistic basis for its therapeutic effects in psychiatric conditions.
This article describes the mechanism of action of psilocybin, specifically its ability to promote neuroplasticity and rebuild synaptic connections, which is relevant to understanding its therapeutic potential in psychiatric conditions.
Preclinical research indicates psilocybin reduces aggression and attack behaviors, providing mechanistic insight into its potential for treating conditions characterized by impulsivity and aggression.
Substance Use 2
This retrospective cohort study highlights lower retention rates for buprenorphine compared to methadone in pregnant women with opioid use disorder, underscoring the need for targeted support as guidelines shift toward buprenorphine as first-line therapy.
Ibogaine, a psychedelic alkaloid with anti-addictive potential for opioid and cocaine dependence, carries a significant risk of QTc prolongation and fatal ventricular arrhythmias, necessitating cardiovascular monitoring and CYP2D6 genotyping in clinical settings.
Policy & Regulation 4
New Mexico is launching a medical psilocybin program, representing a significant policy shift in the regulation of psychedelic substances for psychiatric treatment.
The Minnesota House has approved legislation to legalize psychedelic mushrooms for therapeutic use, representing a significant state-level policy shift in the regulation of psychedelics.
FDA has approved the expanded use of Auvelity (dextromethorphan/bupropion) to treat agitation associated with Alzheimer's disease, providing a new pharmacologic option for behavioral symptoms in dementia.
Louisiana has passed a bill to establish a state-regulated psychedelic therapy program, marking a significant policy shift for the clinical use of psychedelics in the region.
Neuroscience 1
New evidence confirms psilocybin alters brain function after a single dose and identifies traditional use outside the Americas, supporting its potential as a psychiatric therapeutic agent.
Drug Development 1
Clinical Pearl 3
A randomized clinical trial demonstrates that a single dose of psilocybin reduces cocaine use, with Filament Health holding exclusive rights to the data.
This article discusses a clinical trial investigating psilocybin for the treatment of cocaine use disorder, highlighting the long-term research efforts by Peter Hendricks.
Clinical evidence suggests that patient preference is a more effective driver of antidepressant treatment success than pharmacogenomic testing, challenging the routine use of PGx in prescribing.
Pharmacogenomics 1
A study on genotype-guided SSRI prescribing yields mixed results, providing nuanced evidence for the clinical utility of pharmacogenomic testing in antidepressant treatment.
Diagnosis & Treatment 5
A clinical trial evaluating the adjunctive use of Ashwagandha with risperidone in schizophrenia patients, representing a study on herbal supplements in psychiatric treatment.
A large meta-analysis confirms that antipsychotic use in dementia patients is associated with a significantly increased mortality risk, reinforcing the need for cautious prescribing and regular medication reviews.
This review suggests that precision phenotyping of elevated anxious arousal in PTSD may identify a subgroup of patients who respond specifically to GABAergic pharmacotherapy, advocating for stratified clinical trials.
Research suggests lithium may reduce impulsive decision-making associated with suicide risk, reinforcing its clinical utility in mood disorders and suicide prevention.
Psychedelic-assisted therapy with psilocybin or LSD yields divergent clinical outcomes, with some patients experiencing therapeutic benefit while others deteriorate, highlighting the need for careful patient selection and monitoring in emerging psychiatric treatments.
Digital Health 1
A clinical trial is recruiting to evaluate transcranial direct current stimulation (tDCS) as an intervention for Major Depressive Disorder, representing a digital health/neuromodulation treatment approach rather than a pharmacologic one.
Journal Article 1
This article reports on a randomized, multicenter trial comparing the efficacy and tolerability of seven antipsychotic drugs in acutely ill patients with schizophrenia, providing direct comparative data for prescribing decisions.