Work in progress

The current state of research on ayahuasca: A systematic review of human studies assessing psychiatric symptoms, neuropsychological functioning, and neuroimaging

• "Neuropsychological studies have demonstrated impaired performance of working memory in AYA users under the influence of the substance"

• better performance in other executive functions such as planning and inhibitory control (after acute and long-term AYA intake) in experienced users compared to occasional users and non-users.

• Research with neuroimaging showed the activation of frontal and paralimbic brain regions.

• The controlled/ritualistic use of AYA has a good safety profile, and recent research has suggested that AYA can have therapeutic effects on the remission of some psychiatric disorders such as major depression and substance dependence."

U-shaped curve of psychosis according to cannabis use: New evidence from a snowball sample

CAPE (Community Assessment of Psychic Experiences ) for measuring psychotic-like experiences:

• Moderate smokers score lower on CAPE than non-users, and daily users score higher on CAPE than both users and non-users.

Serotonergic neurotransmission in emotional processing: New evidence from long-term recreational poly-drug ecstasy use

• "In the ecstasy users, SERT binding correlated negatively with amygdala activity"

• "accumulated lifetime intake of ecstasy tablets was associated with an increase in amygdala activity during angry face processing."

• "Conversely, time since the last ecstasy intake was associated with a trend toward a decrease in amygdala activity during angry and sad face processing"

Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences

Online challenging experience survey using Hallucinogen Rating Scale (HRS) and MEQ-30 - n=2000, mostly white men ~30yrs.

• (40% were daily cannabis users, 30% tobacco smokers)

The scary stuff. Of all reported bad trips,

• 10.7% reported putting themselves or others at risk of physical harm

  • correlated with: estimated dose, degree of difficulty, and duration of experience
  • anti-correlated: physical comfort, social support

• 2.6% reported behaving in a physically aggressive or violent manner towards themselves or others

• 2.7% reported getting help at a hospital or emergency department during the chosen occasion

• 20% of respondents sought treatment for enduring psychological symptoms like fear, anxiety, depression, paranoia and others, which lasted no longer than a week in 75% of respondents, but lasted over a year in 10%.

• Increased suicidality found in 5 of 2000 (0.25%)

Less scary stuff:

• Decreased suicidality in 6 of 2000

• "a population survey has indicated protective effects of lifetime psilocybin exposure and psychological distress and suicidality (Hendricks et al., 2015)."

• Personal meaning (and spiritual significance and subsequent well-being) correlated with the difficulty of the experience, but were anti-correlated with the length of the negative experience [i.e. best to shorten it when possible]

Reported conducive to positive experiences:

• emotional state (76%) before taking psilocybin

• physical comfort and safety of surroundings (75%)

• social support and trust for others physically present (65%)

Most effective strategies used to help stop challenging experience (from most to least effective):

• calming your mind [e.g. meditating]

• changing location, music, or social environment

• and asking for help from a friend

• smoking cannabis was reported to help ~50% the time [however the opposite may also be the case. why? High THC/CBD ratio or dose? Paranoia? CNS activity? Psychotic-like reaction? Predispositions? Setting?]

Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial

• Since the early 1990s, ~2000 doses of psilocybin have been safely administered to humans in the US and EU, in carefully controlled scientific settings

  • with no reports of any medical or psychiatric serious AEs, including no reported cases of prolonged psychosis or HPPD (Studerus et al., 2011).

• consistent with a US population (2001–2004 data from the National Survey on Drug Use and Health) based study that found no associations between lifetime use of any of the serotoninergic psychedelics and increased rates of mental illness (Krebs and Johansen, 2013).

• "It is important to monitor closely for the emergence of transient difficult psychological states (e.g. anxiety, paranoia) in these trials and to manage them. Difficult experiences are not necessarily pathological and can be understood as part of the therapeutic process (e.g. working through cancer-related psychological or existential distress through challenging encounters or emotionally charged confrontations with cancer-related fearful imagery or symbolism) (Carbonaro et al., 2016)."