Ketamine is a well-known and widely available general anesthetic from the 1960s that, in sub-anesthetic doses, has been adopted in a limited manner for the treatment of acute suicidality and treatment-resistant depression. Its short onset time and short duration of action make it feasible for use at outpatient clinics. In the US, it has a long history of off-label use and was officially approved for depression treatment in 2019. In Finland, it has been administered to selected hospitalized patients in (...) the public healthcare system since 2010 and became available at a private outpatient clinic very recently. In Norway, it has been administered off-label at a private clinic for approximately 500 patients since mid-2010s and at a public clinic for approximately 300 patients since 2020, with plans on opening more clinics in 2024. In the US, the treatment has been administered to hundreds of thousands of patients. -/- The retrospective ethnographic inquiry part of this study features a Finnish woman in her twenties who suffered from treatment-resistant depression, rooted in her insecure childhood and having been bullied at school, as well as income insecurity and excessive workload in adulthood. Eventually, she was violently raped, which induced an obvious post-traumatic stress disorder and exacerbated her depression, incapacitating her. In the course of approximately five years, she was prescribed ten different anti-depressive medications and seventeen other medications, including various antipsychotic medications and lithium. These failed to provide an anti-depressive effect but resulted in 'massive' adverse effects instead, including 60% weight gain and psychotic hallucinations. Eventually, esketamine spray treatment at a private outpatient clinic resolved her depression in a single session. A weekly re-administration process was ongoing. -/- In this case, repeated esketamine administration alleviated depression by producing accumulating corrective emotional experiences without the need to re-experience previous traumatizing events. In a few months to a year, the transient but accumulating anti-depressive effect typically leads to the resolution of depression in most cases, if the patients' living conditions no longer constantly re-traumatize them. It is necessary to adopt ketamine more widely as an emergency measure while more effective, non-addictive alternatives and complements are prepared for adoption. The cost of this specific pilot program implementation was unscalable, but costs can be reduced by approximately 90% by modifying the implementation details. Ketamine and its more effective alternative, 5-MeO-DMT, can serve a major role in facilitating a rebirth of public and private mental healthcare systems, with treatment efficacy multiplied and treatment costs simultaneously reduced. (shrink)

Currently, documentation on the effects of psychedelics on psychosis appears scarce. In the present case, a higher-dose LSD experience during acute paranoid psychosis before the initiation of antipsychotics induced feelings of love, which resolved the majority of the symptoms of the paranoid psychosis in one session, leading the person to reconnect with his family and seek treatment in a psychiatric hospital. The session did not resolve schizoaffective disorder, however. More than a decade later, while using the antipsychotic aripiprazole, concurrent self-administration (...) of ketamine induced psychedelic effects that appeared to allow for practicing 'grounding' of psychotic thoughts. Immediately afterwards, daily self-administration of psycholytic doses of LSD for four weeks caused a mood-enhancing effect that enabled the patient to successfully discontinue aripiprazole without the return of psychotic symptoms. No psychotic or other noticeable symptoms could be observed during two interviews conducted in the two months following the discontinuation of the antipsychotic. -/- The mechanisms of action remain unexplored, and their possible generalizability to other cases remains unclear, but the observations may serve as a basis for further research. It may, for example, be that chronic use of LSD induces a tolerance to its psychedelic effects but not to its anti-inflammatory or other possibly unknown effects, which may be related to the observed mood-enhancing effect. A preclinical study from 1971 appeared consistent with the claimed effect. -/- In the present case, paranoia, i.e., the hypersensitivity to potential threats, was partly due to childhood trauma, partly intentionally induced by military training, and partly accentuated by war experiences. It could not be 'turned off'. Fear related to the uncertainty of survival formed the core of psychosis; without the fear, psychosis would likely not have existed. Paranoid psychosis presented itself as a biased estimation of probabilities of possible adverse outcomes, as a mismatch between the past and the present. (shrink)

Lilly was one of the greatest scientists and pioneers on the limits of human possibility but after his death a collective amnesia has descended and he is now almost forgotten. His Wiki is good but inevitably incomplete so here are a few missing details and viewpoints. Lilly was a generation (or more) ahead of his time. He is almost single-handedly responsible for the great interest in dolphins (which led to the Marine Mammal Protection Act in the USA and helped to (...) found the animal rights movement). In 1958 he noted that the brains of elephants and cetaceans were larger than ours, that we should not abuse them and that it was one our most important projects to communicate with them. He invented sensory isolation tanks (at NIMH in 1954) and used them extensively with and without powerful psychoactive drugs at a time when it was thought that either the brain would shut down or one would go insane if external stimuli were eliminated. He created methods for implanting electrodes in mammal brains and was planning to do it to himself. He was one of the first to make serious use of computers in bioscience research and created the hardware and software to make the first attempts to communicate with dolphins. He self experimented with dangerous physiological investigations in high altitude medicine for the military during WW2, took LSD with dolphins and movie stars, submitted himself to the rigors of various forms of yoga and of Arica training, and taught classes at Esalen. He was a computer pioneer who forsaw the rapid advances in A.I. and it's inevitable clash with humans. He was the first one to investigate the bizarre psychedelic ketamine (" vitamin K "), and his results (published in the two last chapters of his book `The Scientist`) are still the best data on the dose/effect relation of any psychedelic on one person. It cured his lifelong daily migraine headaches (see http://www.conspiracyarchive.com/UFOs/Gorightly.htm). And all this happened before most of us were born! He had courage, honesty and integrity that is rare anywhere and almost nonexistent in science. His goal was to find the ultimate truth about everything and he went about as far as anyone ever has. He had little patience with the stupid and hypocritical games one has to play to fit into monkey society. Of course the reaction of the establishment was predictable. He left the NIMH and was never given any government or academic support for the last 35 years of his life. His paper and comments at a conference on sensory deprivation were removed from the published version. He was not invited to government sponsored symposia on dolphins (he had refused to help develop them as weapons), though he clearly knew more about them than anyone in the world. He liked to live and work on the edge and few could keep up with him, as his books make clear. If you have read some of his other books it will be much easier going. He was a pioneer in consciousness research and pushed the boundaries of our understanding of who we are and what we might become. Among other things he catalogs the various states reached by drugs, meditation, and isolation, tries to determine their significance, and suggests how to use them. I very briefly review and comment on his life and work. -/- Those interested in all my writings in their most recent versions may download from this site my e-book ‘Philosophy, Human Nature and the Collapse of Civilization Michael Starks (2016)- Articles and Reviews 2006-2016’ by Michael Starks First Ed. 662p (2016). -/- All of my papers and books have now been published in revised versions both in ebooks and in printed books. -/- Talking Monkeys: Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B071HVC7YP. -/- The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle--Articles and Reviews 2006-2016 (2017) https://www.amazon.com/dp/B071P1RP1B. -/- Suicidal Utopian Delusions in the 21st century: Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B0711R5LGX -/- . (shrink)

Recent evidence shows significant potential for therapies involving psychedelic substances such as psilocybin and MDMA to improve clinical outcomes for patients experiencing various mental disorders. However, research to date focuses almost exclusively on adults. I argue that adolescents should be included in research into psychedelic therapies. First, I demonstrate the pressing need for novel interventions to address the growing mental health burden of adolescents, and I draw on empirical evidence to show that research into psychedelic therapies presents an opportunity to (...) address this shortfall. Secondly, I argue that psychedelics pose low risk to young patients, particularly relative to existing psychiatric medications. I then address two major concerns specific to adolescent contexts. First, I address the risks of using psychedelic substances at earlier stages of physiological and cognitive development. I note that the lack of understanding of the risks underscores the need for including adolescents in research. I then address the added complexity of consent in the adolescent context. I highlight some additional concerns that should be addressed in an “enhanced” informed consent process for adolescents and defend the view that capable adolescents should be able to consent to psychedelic interventions. I ultimately hold that including adolescents in emerging psychedelic research has the potential to substantiate innovative treatments that could improve their clinical outcomes, long-term mental health and quality of life. (shrink)