Psychedelics Research April 2020

April has been a slow month (probably related to COVID-19). There are many ongoing trials with ketamine and researchers should note them and not only look at finished studies to determine their research direction. Microdosing psychedelics remains interesting, yet not studied in a very controlled way.

Registered clinical trials investigating ketamine for psychiatric disorders

Authors: Bahareh Peyrovian, RogerS. McIntyre, Lee Phan, Leanna M.W. Lui, Hartej Gill, Amna Majeed, David Chen-Li, Flora Nasri & Joshua D. Rosenblat

Published: 9 Apr 2020

One sentence summary: There are currently 140 registered ketamine trials, mostly for mood disorders, mostly via intravenous administration, mostly phase I and II.

As interest has grown in the potential psychiatric applications of ketamine, the number of registered clinical trials has grown substantially. Herein, we summarize and analyze clinical trials registered with ClinicalTrials.gov that assess the treatment of any psychiatric disorder with ketamine or ketamine enantiomers (e.g., S-ketamine, R-ketamine), with a focus on ongoing clinical trials. A ClinicalTrials.gov search on February 21, 2020 returned 140 registered trials. Frequency data was analyzed to determine the distribution of study designs. The majority of trials (70%) investigated the therapeutic effect of ketamine in mood disorders (unipolar: 60%, bipolar: 0.7%, both: 5.7%). Suicidal ideation (13.1%), post-traumatic stress disorder (5.4%), and obsessive-compulsive disorder (3.6%) were also investigated. Intravenous (IV) administration was the most common route with 87% of the studies using IV ketamine. Single-dose studies represented 50% of IV ketamine studies. Few studies were assessing maintenance treatment. Most studies were phase I or II with few definitive phase III trials registered. Given the large number of ongoing studies assessing psychiatric application of ketamine, researchers and relevant stakeholders should consider not only completed, published studies, but also ongoing registered studies in adjudicating the most relevant research questions. More definitive phase III trials and maintenance studies of IV ketamine for mood disorders are required, as numerous completed and ongoing studies have already assessed and demonstrated the proof-of-concept of acute antidepressant effects in phase I and II trials.

Microdosing Psychedelics: Subjective Benefits and Challenges, Substance Testing Behavior, and the Relevance of Intention

Authors: Rotem Petranker, Thomas Anderson, Larissa Maier, Monica Barratt, Jason Ferris & Adam Winstock

Published: 14 Apr 2020 (pre-print linked)

One sentence summary: Microdosing had fewer side-effects than previously found, this was measured with the Global Drug Survey 2019.

Background: Microdosing psychedelics – the practice of taking small, sub-hallucinogenic doses of substances like LSD or psilocybin-containing mushrooms – is becoming increasingly popular. Despite its surging popularity, little is known about the effects of this practice. Aims: This research had two main aims. First, we attempted to replicate previous findings in the literature regarding the subjective benefits and challenges reported for microdosing. Second, we measured whether people who microdose test their substances for purity before consumption and whether having an approach-intention to microdosing was predictive of more reported benefits. Methods: The Global Drug Survey (GDS) runs the world’s largest drug survey. Participants responding to GDS2019 who reported last year use of LSD or psilocybin were offered the opportunity to answer a specialist sub-section on microdosing. Results: Data from 6,753 people who reported microdosing at least once in the last 12 months were used for analyses. Our results suggest a partial replication of previous benefits and challenges with the present sample often reporting enhanced mood, creativity, focus, and sociability. Against our prediction and quite remarkably, the most common challenge participants associated with microdosing was “none”. As predicted, most participants reported not testing their substances. Counter to our hypothesis, approach-intention predicted less rather than more benefits when microdosing. We discuss alternate theoretical frameworks that may better capture the reasons people microdose. Conclusion: Our results suggest that the benefits associated with microdosing greatly outweigh the challenges. Microdosing may have utility for a variety of uses while having minimal side-effects. However, double-blind, placebo-controlled experiments are still required in order to substantiate these reports.”

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