2020 Articles

Volume 2 Issue 1

Psilocybin Assisted Psychotherapy Protocol

Gershom Hernandez, M.D.

Volume 2 Issue 1

Abstract: Psychotherapy protocols have been established for psychedelic-assisted therapy. No such protocol for psilocybin assisted psychotherapy is currently available. This paper aims to produce a protocol for psilocybin assisted psychotherapy for treatment-resistant depression that is in line with current methods and protocols, and one that includes an evidence-based treatment framework.

Methods: Pub med search for evidence-based therapies for depression and review of currently existing protocols for psychedelic-assisted therapies.

Results: A potential protocol for psilocybin assisted therapy to serve as a framework for future studies and to further discussion. More research is required to determine the most efficacious forms of therapy in combination with the potential of psychedelics.

Integrating Psychedelic Use: A Cautionary Note for Licensed Healthcare Providers

Rose Jade, LCSW

Volume 2 Issue 1

Viewpoint

Positive Response to Ketamine Administration in Treatment Resistant Psychosis: A Case Report

Joseph Pullara, M.D.

Volume 2 Issue 1

Abstract:

The pathophysiology underlying the schizophrenia spectrum of disorders has been a topic of research for decades. Ketamine has been used as a model for psychosis for over 20 years. Treatment of refractory cases of schizophrenia and similar disorders remains a challenging aspect of psychiatry. This case report describes the case of a 45-year-old woman with treatment-refractory schizoaffective disorder who was transitioned off of clozapine due to neutropenia. This resulted in psychotic destabilization and a complicated clinical course, ultimately resulting in a re-trial of clozapine after the failure of alternative psychotropic treatment. During this trial, an MRI brain was obtained, which required a sedating dose of intravenous ketamine due to patient agitation. After just a single dose of ketamine, resolution of behavioral activation and agitation was noted for a short period, something which had not been seen in over a month of hospitalization.

Selective Use of Ketamine in Patients with Psychotic Disorders

Tyler Kjorvestad, M.D.

Volume 2 Issue 1

Editorial

A Review of the Psychotherapeutic Effects of Ayahuasca

Adam Bertroche, D.O.

Volume 2 Issue 1

Abstract:

Objective: This paper aims to outline the background, pharmacology, subjective effects, and tolerability of the South American hallucinogenic tea, ayahuasca.

Methods: Literature Review

Discussion: Ayahuasca is a South American hallucinogenic tea that has been used in shamanistic practices for centuries and has become popularized globally through use by Brazilian churches and has potential implications for the treatment of psychiatric conditions due to its serotonergic activity. It relies on monoamine oxidase inhibition to prevent degradation of its psychoactive ingredient, DMT, allowing it to be absorbed into the systemic circulation and act centrally. Subjective effects acutely include perceptual, cognitive, affective, and somatic changes and is generally well tolerated with mild increased in cardiovascular parameters, possible gastrointestinal symptoms such as vomiting, and rarely prolonged psychosis

Volume 2 Issue 2

The Psychiatric Utility of MDMA

Mark Sundahl, M.D. Lisa Shenkman, M.D.

Volume 2 Issue 2

Abstract:

Objective: This paper aims to compile the history, available data, pharmacology, and notable studies of 3,4- Methylenedioxymethamphetamine (MDMA), more commonly referred to as ecstasy, order to assess any potential medical utility.
 

Methods: Literature Review

 

Discussion: MDMA, when combined with appropriate psychotherapy, appears to have a statistically significant and rather large effect on the reduction of PTSD symptoms. It has also been investigated for use in alcohol use disorder, autism spectrum disorder, and social anxiety disorder. Phase III clinical trials are underway, and MDMA assisted psychotherapy could be an FDA approved treatment for PTSD as early as 2021. Caution must be used to ensure there are no significant risks including addiction or long-term side effects from use, but early clinical trials suggest a reasonable safety profile.

Life After Attempted Death: A Case Report of Symptom Mitigation with the Use of LSD in Methamphetamine Use Disorder and Other Psychiatric Comorbidities

JP Martell, M.D.

Volume 2 Issue 2

Abstract:

The use of psychedelics, such as LSD, in the treatment of psychiatric conditions, remains controversial. Early LSD studies showed positive results in the treatment of psychiatric disorders, but critics point to questionable methodologies and poor data analysis as an alternative explanation for these results. As a result of the society backlash against psychedelics, LSD was included in the Convention of Psychotropic Substances of 1971 as a schedule 1 substance, further limiting its inclusions in research efforts. More recent interest in the use of psychedelics as potential treatments for psychiatric conditions including substance, mood trauma, and anxiety related disorders, will prompt researches towards exploring new, and promising avenues in neuroscience. Additional research into the therapeutic uses of LSD is necessary to determine its role in the treatment of psychiatric and substance use disorders.

Holotropic Breathwork: A Review

John Jacobs, M.D.

Volume 2 Issue 2

Abstract:

Holotropic Breathwork is a method of psychotherapy that was developed by Stanislav and Christina Grof in the mid-1970s. It is a therapeutic practice utilizing breathwork, music, and bodywork that is designed to produce an altered state of consciousness, similar to psychedelic experiences. This paper presents a review of the literature on the topic of holotropic breathwork, the components of holotropic breathwork, and the potential implications for use.

 

Methods: Literature Review
 

Results: Holotropic breathing, which uses non-ordinary states of consciousness as a therapeutic tool, deserves further consideration.

Psychedelic-Assisted Psychotherapy Prior to Euthanasia or Physician-Assisted Suicide: Potential Implications for Future Practice

Tyler Kjorvestad, M.D.

Volume 2 Issue 2

Editorial

Case Report: Hallucinogen Persisting Perceptual Disorder

Gershom Hernandez

Volume 2 Issue 2

Abstract:

A 20-year-old male reported symptoms of persisting perceptual disturbances the failed to remit completely. The patient met DSM-V criteria for Hallucinogen Persisting Perceptual Disorder and reported visualizations, perception of movement in still images, and fractal patterns. The patient responded to treatment with Risperdal initially, followed by Zoloft over the course of two years.

Volume 2 Issue 3

The PSIP Model: An Introduction to a Novel Method of Therapy: Psychedelic Somatic Interactional Psychotherapy

Saj Razvi, LPC, Steven Elfrink, Research Associate

Volume 2 Issue 3

Viewpoint

A Case Report of an Individual’s Experience Participating in a Traditional Costa Rican Ayahuasca Ceremony

George T. Naratadam, BS; Jason Narikkattu, MS; Safeer Shah MD

Volume 2 Issue 3

Abstract:

Historical evidence has shown the potential efficacy of psychedelic drugs in the treatment of psychiatric diseases. Reporting psychedelic drug experiences in biomedical academic literature is critical to the progress of psychedelic psychiatry research and the potential implementation of psychedelics as therapeutics. Ayahuasca is a plant-based compound with hallucinogenic properties used by South American shamans to treat various psychological ailments. This report describes the case of a 25-year-old male’s experience participating in a traditional Costa Rican ayahuasca ceremony and the immediate and long-term effects of the therapy on the participant.

Medicalization, Decriminalization, Legalization and the Path Forward for Psychedelics

Tyler Kjorvestad, M.D.

Volume 2 Issue 3

Editorial

Volume 2 Issue 4

A Critical Review Investigating whether there are similarities in EEG band waves between Schizophrenic patients and participants given DMT or Ayahuasca Tea

Medusa Warrior, BSc (Hons), MSc

Volume 2 Issue 4

Abstract:

Early research suggests that the endogenous neurobiological chemical Dimethyltryptamine (DMT) may be responsible for schizophrenic symptoms [1].  This article investigates EEG band waves between participants given Dimethyltryptamine (DMT) or Ayahuasca Tea and schizophrenic patients.  Evaluation of articles on EEG band wave monitoring of DMT or Ayahuasca participants was compared to articles on EEG band wave monitoring in schizophrenic patients. It is hypothesized that adult DMT and Ayahuasca participants and adult schizophrenic patients would have similar EEG oscillation-band waves.  Ranlund et al. [2] found that schizophrenic patients produced lower band waves, and this review supported the findings that there were similarities, especially in lower band waves between the two groups.  Although the reviewed Ayahuasca articles produced higher EEG wave band oscillations, the additional plant compounds added to Ayahuasca Tea may account for the resulting discrepancy in this review. The similarities in EEG band wave oscillations between the pure DMT injection and the schizophrenic patients did support the hypothesis, although, the EEG band waves only show neuron activity and not specific DMT brain chemicals.  There may be a connection between the symptoms reflected in schizophrenic patients, suggestive of endogenous DMT, due to the similarities when DMT is administered

A Ketamine-Induced Episode of Insight: A Case Report

Benjamin J. Nissen, MD; Kelly A. Bisel, DO

Volume 2 Issue 4

Abstract:

Schizophrenia is a chronic mental illness characterized by a constellation of symptoms, often including hallucinations, delusional thinking, and disorganization in thought and or speech, resulting in significant social or occupational dysfunction. One key factor that impairs a patient with schizophrenia to achieve and maintain wellness involves a profound lack of insight into the disease. With an improvement in insight, patients with schizophrenia are more likely to remain compliant with medication interventions and engage in active treatment modalities, including cognitive-behavioral models of change [1]. Given the predominant lack of efficacy in available long-term treatments for schizophrenia, novel mechanisms of intervention, including the use of psychedelics such as ketamine, may result in lasting improvements in insight and provide additional means of helping those with schizophrenia better understand their illness. In time it may be possible for improvements in insight to reduce the likelihood that patients with schizophrenia fail to remain compliant with medication and therapy and ultimately result in shorter and less frequent hospitalizations. The case below describes a 33-year-old male with schizophrenia who benefited from a brief and temporary improvement in insight after receiving a one-time dose of IM ketamine during a period of acute agitation shortly after being hospitalized for active psychosis

Ethical Guidelines for Ketamine Clinicians and Commentary

Raquel Bennett, PsyD

Commentary by Wesley C Ryan, MD

Volume 2 Issue 4

Viewpoint

Ketamine-Hypnosis Package (KHP): A Clinical Case Study for the treatment of depression and addiction administering Ketamine with Hypnotherapy

Sophie-Charlotte Adler, M.Sc., Mario Schieb, MD

Volume 2 Issue 4

Abstract

Background. There are few studies on ketamine and its properties to work with addiction (alcohol, opioid, cannabis, and cocaine use disorder). The studies show that ketamine treatment can help reduce craving and support abstinence [14]. Hypnotherapy is an evidence-based treatment gaining popularity for treating addiction, but not everybody can be hypnotized due to different levels of suggestibility. Our clinical practice has observed that people who are not highly hypnotizable, such as patients with obsessive-compulsive disorders, become more suggestible accompanied by our newly developed method called “Ketamine-Hypnosis package” (KHP). In this case report and study, we want to explore and evaluate the potential of KHP in working with addiction. Diagnostic and a qualitative content analysis should give profound insights into the treatment process and method.

Case Report. The subject is a 48-year-old male German Social Worker with treatment-resistant depression, suicidal thoughts, obsessive behavior, and several forms of addiction. The patient received a 10-day treatment at Instituto Dr. Scheib, with Diagnostic, rTMS, neurofeedback, and four sessions of KHP. Every Ketamine infusion remained with a standard dose of 0.5 mg/kg R-Ketamine for about 45 minutes. 

Results. Primary outcome measures included change in depression as measured by the BDI-II with a reduction from 44, highly depressed, to a score of 3, no depression, and change of symptoms measured by the SCL-90 R that showed a clear reduction in almost every factor vs. baseline. The qualitative content analysis of the KHP sessions identified nine categories; Setting, Intervention, Body, Control, Feelings, Insights/Realizations, Addiction, Depression and Imagery. QEEG measurements before and after treatment showed a pattern of over-representation of slow brain activity with closed eyes, which can be observed in fluctuating concentration and volatile impulse control. Follow-Up Data with BDI-II one week after treatment showed factor 3 and 5 weeks after treatment factor 15.

Conclusions. The 10-day-treatment program improved numerous important treatment outcomes in one substance-dependent adult engaged in hypnotherapeutic modification, including promoting less substance abuse, diminishing craving, and reducing the risk of relapse. Further research is needed to replicate these promising results in a larger sample.