Psychotic Reactions Research Articles

Potential therapeutics for effort-related motivational dysfunction: assessing novel atypical dopamine transport inhibitors.

People with depression and other neuropsychiatric disorders can experience motivational dysfunctions such as fatigue and anergia, which involve reduced exertion of effort in goal-directed activity. To model effort-related motivational dysfunction, effort-based choice tasks can be used, in which rats can select between obtaining a preferred reinforcer by high exertion of effort vs. a low effort/less preferred option. Preclinical data indicate that dopamine transport (DAT) inhibitors can reverse pharmacologically-induced low-effort biases and increase selection of high-effort options in effort-based choice tasks. Although classical DAT blockers like cocaine can produce undesirable effects such as liability for misuse and psychotic reactions, not all DAT inhibitors have the same neurochemical profile. The current study characterized the effort-related effects of novel DAT inhibitors that are modafinil analogs and have a range of binding profiles and neurochemical actions (JJC8-088, JJC8-089, RDS3-094, and JJC8-091) by using two different effort-related choice behavior tasks in male Sprague-Dawley rats. JJC8-088, JJC8-089, and RDS3-094 significantly reversed the low-effort bias induced by the VMAT-2 inhibitor tetrabenazine, increasing selection of high-effort fixed ratio 5 lever pressing vs. chow intake. In addition, JJC8-089 reversed the effects of tetrabenazine in female rats. JJC8-088 and JJC8-089 also increased selection of high-effort progressive ratio responding in a choice task. However, JJC8-091 failed to produce these outcomes, potentially due to its unique pharmacological profile (i.e., binding to an occluded conformation of DAT). Assessment of a broad range of DAT inhibitors with different neurochemical characteristics may lead to the identification of compounds that are useful for treating motivational dysfunction in humans.

Disulfiraminės psichozės atvejis

Introduction. Disulfiram is one of three medications approved by the Federal Drug Administration (FDA) to treat alcohol dependence. Patients tend to abstain from alcohol to avoid the unpleasant effects of alcohol toxicity. There may be some side effects, the most common of which are drowsiness, unusual tiredness, headache, metallic taste in mouth, skin rashes, decreased libido. Disulfiram induced psychosis is a psychiatric side effect that occurs very rarely.
 Case report. We report the case of a 33-year-old patient with nearly 15 years history of psychiatric personality disorder and alcohol dependence. Approximately 4 days of alcohol abstinence, as an inpatient he was administered disulfiram. After two weeks, the patient began to feel some side effects. He was admitted to hospital and was diagnosed with disulfiram induced psychosis.
 Discussion. The effect of disulfiram on alcohol metabolism was noticed in the 1940s. It should be used only by motivated patients who must be fully informed about the alcohol-disulfiram reaction. Disulfiram should only be started after about 10 days of sobriety, and the recommended dosage is 500 mg/day. The drug should be used with caution in people with a history of heart disease, diabetes mellitus, hypothyroidism, cerebral damage, nephritis, liver cirrhosis, epilepsy. Caution is recommended for patients who use benzodiazepines, some antibiotics, anticoagulants, tricyclic antidepressants. There may be some adverse effects, more serious ones include changes in vision, numbness, pain or weakness in the limbs, liver cell damage, peripheral neuropathy, seizures – but these are considered to be very rare. Psychiatric side effects may include mood changes, psychotic reactions, memory impairment. Reliable data is lacking, but cases of disulfiram induced psychosis are considered to be rare. Patients taking disulfiram should be monitored carefully.

Zolpidem-induced Brief Psychotic Reactions: A Case Series

Zolpidem-induced Brief Psychotic Reactions: A Case Series

Patient-GP-Pharmacist cooperation towards individualized tapering schemes for long term benzodiazepine users

Long-term use of benzodiazepines and Z-drugs is associated with multiple side effects, such as increased sedation, fall risk, and an elevated risk of dependency and abuse. Avoiding initiation of treatment, or stopping treatment after a few weeks, is definitely the best-case scenario. But for patients that are already using benzodiazepines for more than 3 months (up to 20 years or more), a deprescribing methodology should be deployed. Abrupt withdrawal, particularly if the individual has been taking the drug in high doses, can result in severe symptoms, including psychotic reactions. The recommendation is for slow withdrawal, tapering the dosage gradually over a period of several months.
 Pharmacy compounding of capsules has been a possibility for many years, and allows to prepare and dispense individualized dosages to patients. Medical practitioners such as GP’s have always had the possibility to prescribe dose reduction schemes for patients motivated to taper off. Unfortunately, as benzodiazepines are not reimbursed in Belgium, this came at a high cost for patients.
 In 2022, pharmacy associations together with health insurance funds and the National Institute for Health and Disability Insurance (NIHDI) worked on a reimbursement scheme that allowed tapering off benzodiazepines. The patient-GP-pharmacist triangle is at the core of the scheme:
 -Pharmacists raise awareness when dispensing prescribed benzodiazepines, and prepare and dispense individualized doses
 -GP’s motivate patients to consider tapering and prescribe the programme
 -Patients engage in a tapering path and are intensively followed by the GP and the pharmacist
 Apart from the roles and responsibilities of the 3 parties, there are some rules set out to increase the change of successful tapering whilst keeping expenditure under control. For instance, a maximum daily consumption of 3 DDD set out, there is choice between 3 tapering schemes (5, 7 or 10 steps), and the total duration of the programme should not exceed 360 days.
 Critical success factors of these programs are: intrinsic motivation of the patient, therapeutic contract with 3 parties concerned, absence of financial penalty for patients, and smooth communication between prescriber and preparer/dispenser.

Prediction of subjective cognitive decline after corpus callosum infarction by an interpretable machine learning-derived early warning strategy.

Corpus callosum (CC) infarction is an extremely rare subtype of cerebral ischemic stroke, however, the symptoms of cognitive impairment often fail to attract early attention of patients, which seriously affects the long-term prognosis, such as high mortality, personality changes, mood disorders, psychotic reactions, financial burden and so on. This study seeks to develop and validate models for early predicting the risk of subjective cognitive decline (SCD) after CC infarction by machine learning (ML) algorithms. This is a prospective study that enrolled 213 (only 3.7%) CC infarction patients from a nine-year cohort comprising 8,555 patients with acute ischemic stroke. Telephone follow-up surveys were carried out for the patients with definite diagnosis of CC infarction one-year after disease onset, and SCD was identified by Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. Based on the significant features selected by the least absolute shrinkage and selection operator (LASSO), seven ML models including Extreme Gradient Boosting (XGBoost), Logistic Regression (LR), Light Gradient Boosting Machine (LightGBM), Adaptive Boosting (AdaBoost), Gaussian Naïve Bayes (GNB), Complement Naïve Bayes (CNB), and Support vector machine (SVM) were established and their predictive performances were compared by different metrics. Importantly, the SHapley Additive exPlanations (SHAP) was also utilized to examine internal behavior of the highest-performance ML classifier. The Logistic Regression (LR)-model performed better than other six ML-models in SCD predictability after the CC infarction, with the area under the receiver characteristic operator curve (AUC) of 77.1% in the validation set. Using LASSO and SHAP analysis, we found that infarction subregions of CC infarction, female, 3-month modified Rankin Scale (mRS) score, age, homocysteine, location of angiostenosis, neutrophil to lymphocyte ratio, pure CC infarction, and number of angiostenosis were the top-nine significant predictors in the order of importance for the output of LR-model. Meanwhile, we identified that infarction subregion of CC, female, 3-month mRS score and pure CC infarction were the factors which independently associated with the cognitive outcome. Our study firstly demonstrated that the LR-model with 9 common variables has the best-performance to predict the risk of post-stroke SCD due to CC infarcton. Particularly, the combination of LR-model and SHAP-explainer could aid in achieving personalized risk prediction and be served as a decision-making tool for early intervention since its poor long-term outcome.

Acute Mescaline Intoxication Followed by Catatonia

The paper deals with a case report of a 41-year-old man who in search of the meaning of life in a so-called “shamanic ritual” drank tea made from the San Pedro cactus as well as paste made of the same plant. The hallucinations were post poned and started after 9.5 hours caracterised by a psychotic reaction with symptoms of catatonia. He was admitted to our Department of Psychiatry where he was administered a second generation antipsychotic. The clinical presentation disappeared about 60 hours after the ingestion of mescaline mainly because of the antagonistic effect the antipsychotic has on the serotoninergic 5-HT2A receptors.

Possible Therapeutics Effects of Ayahuasca, a Psychedelic Compound

IntroductionAyahuasca is an hallucinogenic tea prepared from the Amazonian vine Banisteriopsis caapi and the leaves of the plant Psychotria Viridis. Banisteriopsis caapi contains monoamine oxidase inhibitors (MAO) that render the N, N-dimethyltryptamine (DMT) of Psychotria Viridis active. This brew is being used as a sacrament in syncretic religions in urban areas of Brazil and worldwide with the purpose of enabling a spiritual experience as well as healing for a variety of conditions such as drug addiction, depression and anxiety disorders.ObjectivesThis work aims to provide an understanding on the potential benefits of ayahuasca in psychiatric symptoms, as well as its neuropsychological functioning, neuroimaging and adverse events.MethodsA non-systematic review was performed on PubMed database and Google Scholar, using the key words “Ayahuasca, Drug Addiction, Psychedelics, DMT, Neuroplasticity”. The review included experimental studies in humans, observational studies, systemic review articles and clinical trials.ResultsIn a randomized placebo-controlled trial, ayahuasca had a significant antidepressant effect when compared to the placebo group. Long term ayahuasca usage was associated with structural alterations in the medial parts of the brain with no evidence of increased psychopathology or worse neuropsychological functioning. According to reviewed studies the incident of prolonged psychotic reaction among ayahuasca users is rare and the causal relation with ayahuasca is sometimes difficult to establish.Conclusions Despite the promising results, more controlled double-blinded studies with larger populations are necessary to better understand the therapeutic potentials and side effects of ayahuasca.DisclosureNo significant relationships.

A pharmacogenomic assessment of psychiatric adverse drug reactions to levetiracetam.

ObjectiveLevetiracetam (LEV) is an effective antiseizure medicine, but 10%–20% of people treated with LEV report psychiatric side‐effects, and up to 1% may have psychotic episodes. Pharmacogenomic predictors of these adverse drug reactions (ADRs) have yet to be identified. We sought to determine the contribution of both common and rare genetic variation to psychiatric and behavioral ADRs associated with LEV.MethodsThis case‐control study compared cases of LEV‐associated behavioral disorder (n = 149) or psychotic reaction (n = 37) to LEV‐exposed people with no history of psychiatric ADRs (n = 920). All samples were of European ancestry. We performed genome‐wide association study (GWAS) analysis comparing those with LEV ADRs to controls. We estimated the polygenic risk scores (PRS) for schizophrenia and compared cases with LEV‐associated psychotic reaction to controls. Rare variant burden analysis was performed using exome sequence data of cases with psychotic reactions (n = 18) and controls (n = 122).ResultsUnivariate GWAS found no significant associations with either LEV‐associated behavioural disorder or LEV‐psychotic reaction. PRS analysis showed that cases of LEV‐associated psychotic reaction had an increased PRS for schizophrenia relative to contr ols (p = .0097, estimate = .4886). The rare‐variant analysis found no evidence of an increased burden of rare genetic variants in people who had experienced LEV‐associated psychotic reaction relative to controls.SignificanceThe polygenic burden for schizophrenia is a risk factor for LEV‐associated psychotic reaction. To assess the clinical utility of PRS as a predictor, it should be tested in an independent and ideally prospective cohort. Larger sample sizes are required for the identification of significant univariate common genetic signals or rare genetic signals associated with psychiatric LEV ADRs.

Culture and Psychopathology Revisited

The author presents examples of pathogenic influence of culture. He identifies specific pathogenic factors associated with rapid socio-cultural change affecting North American Indians and African populations and sketches the resulting typical psychopathological conditions: anomic depression in Amerindians, transient psychotic reactions (bouffée délirante) in Africans. Witchcraft and sorcery beliefs often characterize the clinical picture of psychotic reactions in “marginal” Africans and in transplanted South Europeans of tradition-directed background. Examples are provided which illustrate the emergence, metamorphosis and epidemic spreading of so-called “culture-bound syndromes” under changing socio-economic, cultural and political conditions. Ritualized possession and trance states, as well as religious rituals in general, are to be separated from psychopathological phenomena in order to avoid eurocentric and positivistic fallacies in psychiatric diagnosis.

Analysis of State Cannabis Laws and Dispensary Staff Recommendations to Adults Purchasing Medical Cannabis

Over the last decade, cannabis has become more accessible through the proliferation of dispensaries in states that have legalized its use. Most patients using cannabis for medical purposes report getting advice from dispensaries, yet there has been little exploration of frontline dispensary staff practices. To describe the practices of frontline dispensary workers who interact with customers purchasing cannabis for medical purposes and assess whether dispensary practices are associated with medicalization of state cannabis laws (degree to which they resemble regulation of prescription or over-the-counter drugs) and statewide adult use. This nationwide cross-sectional survey study was conducted from February 13, 2020, to October 2, 2020, using an online survey tool. Potential respondents were eligible if they reported working in a dispensary that sells tetrahydrocannabinol-containing products and interacting with customers about cannabis purchases. Participant responses to questions about formulating customer recommendations and talking to customers about risks. The 434 survey responses from 351 unique dispensaries were most often completed by individuals who identified as budtenders (40%), managers (32%), and pharmacists (13%). Most respondents reported basing customer recommendations on the customer's medical condition (74%), the experiences of other customers (70%), the customer's prior experience with cannabis (67%), and the respondent's personal experience (63%); fewer respondents relied on clinician input (40%), cost (45%), or inventory (12%). Most respondents routinely advised customers about safe storage and common adverse effects, but few counseled customers about cannabis use disorder, withdrawal, motor vehicle collision risk, or psychotic reactions. A higher state medicalization score was significantly associated with using employer training (odds ratio, 1.41; 95% CI, 1.18-1.67) and physician or clinician input (odds ratio, 1.23; 95% CI, 1.05-1.43) as a basis for recommendation. Medicalization score was not associated with counseling about cannabis risks. This survey study provides insight into how frontline dispensary staff base cannabis recommendations and counsel about risks. The findings may have utility for clinicians to counsel patients who purchase cannabis, customers who want to be prepared for a dispensary visit, and policy makers whose decisions affect cannabis laws.

Five Years Ahead of My Time: Garage Rock from the 1950s to the Present by Seth Bovey

Reviewed by: Five Years Ahead of My Time: Garage Rock from the 1950s to the Present by Seth Bovey Marci Cohen Five Years Ahead of My Time: Garage Rock from the 1950s to the Present. By Seth Bovey. (Reverb Series.) London: Reaktion Books, 2019. [220 p. ISBN 9781789140651 (paperback), $16; ISBN 9781789140941 (e-book), $20.] Illustrations, bibliography, discography, index. Think of the salient elements in the lives of the American baby-boomer generation in the mid-twentieth century—a huge cohort of teenagers with disposable income and leisure time, living in bedroom communities as part of the growing suburbanization that provided more space for families and their activities. Then toss in the hand grenade of Beatlemania, and you have the makings of garage rock. Exemplified by guitar-based songs with few chords that teenagers could create with their friends in home spaces on inexpensive instruments, the genre took hold in 1960s with minor hits like "Psychotic Reaction" by the Count Five. The fad faded but never died out completely, instead finding pockets around the world and cyclical comebacks. With Five Years Ahead of My Time: Garage Rock from the 1950s to the Present, Seth Bovey provides a comprehensive overview of the genre across time and across the globe. Bovey opens after the original rock and roll explosion of the 1950s, when the charts had turned bland with whitebread crooners and teen idols late in the decade. This was offset by the rise of raucous rock instrumentals by the likes of guitarists Duane Eddy and Link Wray, aided by the increasing coverage of pop music on television. The mass media exposure and the relative simplicity of the tunes, coupled with an influx of cheap Japanese imports, inspired and enabled American teens to pick up guitars. They formed bands, supported by the infrastructure of a large peer audience and venues that hosted dances for the teen baby boomers. One of the first bands to make a name for themselves was Tacoma's the Wailers, a band with origins in jazz who set a template for rock and roll, then incorporated elements of rhythm and blues into their live act. The early 1960s laid the foundation for garage rock, fueled by teens' desire to dance. Dance clubs sprung up in large metropolitan areas. Those venues in the more isolated Pacific Northwest and Upper Midwest provided opportunities for local acts to thrive, since the big names were less likely to tour there than on the East Coast. Bovey covers the career arc of the Sonics as a standout for both their musicality and their impact; a great strength of the book is his concise but insightful histories of many bands in the genre and brief descriptions of many more. In Southern California, instrumental rock morphed into surf rock, and Bovey covers that evolution with plenty of detail on what made it sonically distinct. Then the Beatles blew up, creating a wake of imitators. Teen boys wanted [End Page 239] to emulate them, if only to attract teen girls. Bovey extracts the signature sounds, identifies their historic roots, and describes how they manifested in the repertoire of numerous Beatlesinfluenced bands. He also examines other branches of the mid-1960s heyday: the rhythm-and-blues strand of the British Invasion, folk rock, garage punk, and garage psych. After noting a common lyrical trope of antagonism towards women, which he attributes to the sexual insecurities of teenage boys, he devotes a section to all-girl garage groups, who are often overlooked in the genre. He singles out the Pleasure Seekers's story as indicative of the sexism of the era and for launching Suzi Quatro's career. In the wake of Beatlemania, garage rock became a global phenomenon. It took hold in Spain and throughout most of Latin America. In Argentina, a Uruguayan invasion accompanied the British one. Garage rock found footholds across continental Europe, aided by British pirate radio, and in Asia and Oceania. Bovey digs out great stories, such as the British groups that relocated to Sweden to escape stiff competition at home and to seek a rabid market abroad. The page he devotes to the Dandy Girls could spawn a movie: the Norwegian teenage...

Dermatological manifestations of psychic ailments

An increase in the number of patients with psychodermatological manifestations and the identification of a certain comorbidity during the course of diseases in patients with a dermatological profile makes us take a fresh look at this problem. Psychodermatology is one of the relevant and, at the same time, the least studied areas of modern medicine, which is at the junction of psychiatry and dermatovenereology. Psychiatry and psychotherapy studies the inner world of a person; Dermatovenerology deals with the diagnosis and treatment of diseases of the human skin and its appendages, and psychodermatology combines these two sections of medicine. In the modern world, as a result of increasing the amount of incoming sensory information, accelerating the rhythm of life, the action of harmful environmental factors, a person can be subjected to excessive psycho-emotional stress, leading to the development of mental disorders. Often it is skin rashes that are an objective manifestation of such disorders. Early diagnosis of psychodermatosis and signs of obsessive-compulsive pathology in sick people contributes to the timely identification of the category of people at risk of psychotic reactions and mental illness. This is especially true for young patients. Against the background of hormonal changes in the body, the crisis of adolescence, the increased educational load on them at school, the destroyed institute of family and marriage, an overabundance of sensory information and physical inactivity, the incidence of psychodermatosis throughout the world, including in our country, is increasing.

Развитие социально-психологической адаптированности личности детей из замещающих семей в условиях техникума

The research featured various means of psychological and pedagogical support of college students from foster families aimed at developing their socio-psychological adaptation. The authors identified the key characteristics of the socio-psychological adaptability of underage orphan students. Students that spent less than a year in foster families combined adaptation with behavioral regulation and demonstrated communicative potential, long-term goals, interest in life, and a sense of purpose. They were active, strong, and satisfied with their self-realization and self-image. Their maladaptation disorders, as well as asthenic and psychotic reactions, were minimal. The key characteristics of the socio-psychological adaptation of minor students from foster families were manifested in the inverse relationship of maladaptation with the life process, locus of self-control, behavioral regulation, communicative potential, moral norms and maladaptation disorders. In underage students from orphanages, adaptation was associated with the locus of control – life, behavioral regulation and minimized asthenic reactions. The authors designed and tested a set of means of psychological and pedagogical support that improve the socio-psychological adaptation of students from foster families. The experiment demonstrated a positive dynamics in the level of adaptation, emotional comfort, sense of purpose, internality and personal adaptive potential, as well as a decrease in the level of maladaptation.

Cannabis points to the synaptic pathology of mental disorders: how aberrant synaptic components disrupt the highest psychological functions .

Cannabis can elicit an acute psychotic reaction, and its long-term use is a risk factor for schizophrenia. The main active psychoactive ingredient ∆9-tetrahydrocannabinol (Δ9-THC) activates cannabinoid 1 (CB1) receptors, which are localized to the terminals of glutamate and GABA neurons in the brain. The endogenous cannabinoids are involved in information processing and plasticity at synapses in the hippocampus, basal ganglia, and cerebral cortex. Exogenously applied CB1 receptor agonists disrupt neuronal dynamics and synaptic plasticity, resulting in cognitive deficits and impairment of the highest psychological functions. Various other pro-psychotic drugs, such as ketamine and methamphetamine, exert their effects in the same microdomain of synaptic spines as Δ9-THC. Additionally, many of the most robust findings in psychiatric genetics include components that localize to dendritic spines and have important roles in information processing and plasticity.

Clinical considerations of sleep related amnestic behaviours associated with zolpidem

Objective. Zolpidem is a non-benzodiazepine agonist of GABA-A receptor indicated for the short-term insomnia treatment. Over the years, there have been reports in literature on zolpidem abuse complications and neuropsychiatric side effects involving headache, dizziness, nightmares, confusion, depression, sleepiness, memory deficits as well as hallucinations, sensory distortions, delirium and sleep-related complex behaviours with anterograde amnesia. The aim of this work is to review and highlight the most serious adverse reactions to zolpidem with emphasis on sleep-related amnestic behaviours. We also focus our attention on common traits, patterns and predisposing factors. This paper refers to zolpidem side effects or complex amnestic behaviours, or sleep related amnestic behaviours presented in literature. Literature review. A comprehensive search of PubMed and Google Scholar was conducted to find relevant studies, case reports and literature reviews addressing the zolpidem use in insomniac patients. Conclusions. Zolpidem may pose a risk for serious adverse reactions most common dose-dependent and associated with age, gender, concurrent use of medications and concomitant comorbidities. If severe adverse reactions occur, the drug should be immediately discontinued or switched to another hypnotic. This review indicates an association between psychotic reactions and complex sleep related behavioural abnormalities in patients using zolpidem alone or in combination with other psychotropic medications. Clinicians should adopt a cautious approach prescribing zolpidem and be alert to possible unusual adverse effects of the drug.

Una historia de la vida en la Universidad Metropolitana como universidad inclusiva

In the present article about the pedagogical foundations of educational inclusion and the aspects that highlight the work developed by the UMET as Inclusive University, is shown a pedagogical experience that highlights the attention to diversity and special educational needs, developed in the career of Graphic design of the headquarters of Quito, with a student who at the beginning of the career and after three years of psychiatric treatment does not bring a definitive diagnosis of the disease he suffers, pointing to an acute psychotic reaction, with fears, phobias and social difficulties, who demand professional pedagogical help from the University so that they can study their career and insert themselves into society.

Psychotic Reaction Associated with Clomiphene-Induced Ovulation

Clomiphene citrate belongs to the selective estrogen receptor modulator (SERM) and has been used as an ovulation inducer for decades [1,2].

Topical Triamcinolone-Induced Psychosis

Topical Triamcinolone-Induced Psychosis

Adverse Neuropsychiatric Events and Recreational Use of Efavirenz and Other HIV-1 Antiretroviral Drugs.

Efavirenz is a highly effective HIV-1 antiretroviral; however, it is also frequently associated with neuropsychiatric adverse events (NPAE) that include abnormal dreams, sleep disturbances, nervousness, anxiety, depression, and dizziness. The incidence of NPAEs upon initiation of treatment with efavirenz-containing medications is high, exceeding 50% in most studies. Although the NPAEs tend to decrease after the first month in many patients, they persist for long periods of time in others. Efavirenz-based treatment is generally well-tolerated in children, although some experience persistent concentration problems, as well as sleep disturbances, psychotic reactions, and seizures. In an effort to link basic with clinical research, parameters associated with efavirenz brain exposure are discussed, and factors that increase efavirenz levels are explored in depth as they are expected to contribute to NPAE risk. These include the role of modifiable and nonmodifiable risk factors such as diet, weight, and drug-drug interactions and sex, age, and ethnicity/pharmacogenetics. In addition to NPAEs, this review explores what is known about antiretroviral (ARV) drugs being used for recreational purposes. Although multiple ARV drugs are covered, special attention is devoted to efavirenz given that the majority of reports of NPAEs and illicit use of ARV drugs concern efavirenz. The evolving molecular mechanistic basis of NPAEs and abuse of efavirenz point to a complex and polymodal receptor pharmacology. Animal studies to date primarily point to a serotonergic mechanism of action. Recently emerging associations between HIV-associated neurocognitive disorder and efavirenz use, and possible contributions of the mitochondrial-immune-inflammatory-redox cascade are explored in the context of the signaling mechanisms that appear to be involved.

Ayahuasca: what mental health professionals need to know

Abstract Background Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes. In the last two decades, it is being used worldwide in evolving practices. Ayahuasca seem to therapeutic effects, but controlled studies are lacking. Moreover, its safety and toxicity are not completely understood. Objectives To present an overview of the effects of ayahuasca based on the most recent human studies. Methods Narrative review. Results Ayahuasca administration in controlled settings appears to be safe from a subjective and physiological perspective, with few adverse reactions being reported. More frequent adverse reactions occur in non-controlled settings. Prolonged psychotic reactions are rare and seem to occur especially in susceptible individuals. Ayahuasca showed antidepressive, anxiolytic, and antiaddictive effects in animal models, observational studies, and in open-label and controlled studies. Discussion Ayahuasca administration in controlled settings appear to be safe. Moreover, ayahuasca seem to have therapeutic effects for treatment-resistant psychiatric disorders that should be further investigated in randomized controlled clinical trials. However, medical complications and cases of prolonged psychotic reactions have been reported, and people with personal or family history of psychotic disorders should avoid ayahuasca intake.