Safety issues of psilocybin and LSD as potential rapid acting antidepressants and potential challenges.

INTRODUCTION: A limited number of preliminary open-label (n = 3) and placebo-controlled clinical trials (n = 5) have suggested psilocybin and LSD as potential rapid antidepressants. In this context, there is a growing need to verify and document their safety and tolerability as therapeutic agents, discuss the challenges associated with their administration, and develop safety protocols for their use as next-generation therapeutic agents. AREAS COVERED: We have analyzed all randomized, double-blind, and controlled trials that assessed the antidepressant effects of psilocybin and LSD in clinical populations to date, taking special attention to adverse events (AEs) related to their use. Prevalence, significance, and mechanisms of action related to AEs were systematically extracted, analyzed, and discussed. EXPERT OPINION: There were no serious AEs related to psilocybin and LSD administration. Most AEs were expected, manageable, and transient. Nevertheless, safety and tolerability concerns regarding some effects, such as dissociation, paranoia, and confusion, remain. Thus, randomized controlled trials with bigger samples are warranted to confirm their therapeutic effects and further investigate their safety and tolerability.

Uso de drogas de diseño en fiestas electrónicas: aspectos clínicos, neuropsiquiátricos, epidemiológicos y de intervención prehospitalaria / Use of designer drugs in electronic parties: clinical, neuropsychiatric, epidemiological and prehospital intervention aspects

Introducción: Las llamadas "fiestas electrónicas" permitieron la generalización del uso de drogas de diseño (DdD) para disminuir el cansancio, las inhibiciones y aumentar la empatía entre los asistentes. Objetivo: Presentar los resultados de prevalencia, aspectos neuropsiquiátricos, clínicos y epidemiológicos del uso de DdD en fiestas electrónicas. Material y método: Realizamos un estudio de campo, observacional y transversal, mediante encuesta estandarizada, normatizada y anónima para consignar parámetros clínicos y neuropsiquiátricos en 138 asistentes a fiestas electrónicas que mediante demanda espontánea o requerida por terceros fueron evaluados por médicos y refirieron consumo de DdD. Se aplicaron parámetros estadísticos y se cumplieron normas éticas. Resultados: Objetivamos un alto consumo de alcohol, con alta prevalencia de uso comórbido con otras sustancias de diseño como el éxtasis y GHB. Los consumidores de GHB presentaron disminución de parámetros clínicos con un síndrome inhibitorio, en contraste con los valores aumentados en usuarios de éxtasis. Conclusión: La diferencia en las manifestaciones clínico-neuropsiquiátricas tienen sustento en aspectos neurobiológicos del mecanismo de acción y condicionan el tratamiento prehospitalario.

Introduction: The so-called "electronic parties" allowed the widespread use of designer drugs (DOD) to reduce fatigue, inhibitions and increase empathy among participants. Objective: To present the results of prevalence, neuropsychiatric, clinical and epidemiological aspects of the use of DoD in electronic parties. Material and Methods: We conducted a field study, observational and transversal, through standardized, Normatized and anonymous survey to record clinical and neuropsychiatric parameters 138 attendees electronic parties that by spontaneous or required by third application were evaluated by physicians and reported consumption of DOD. Statistical parameters were applied and ethical standards were met. Results: We objectify a high consumption of alcohol, with high prevalence of comorbid use design with other substances like ecstasy and GHB. GHB consumers had decreased clinical parameters with an inhibitory syndrome, in contrast to the values increased in users of ecstasy. Conclusions The difference in clinical and neuropsychiatric manifestations have support in neurobiological aspects of the mechanism of action and determine the prehospital treatment.

Intoxicação por LSD em cão doméstico: relato de caso / LSD toxicosis in a domestic dog: case report

A intoxicação acidental ou intencional de animais de estimação por drogas ilícitas usadas de forma "recreativa" por pessoas com as quais convivem, é uma realidade, e os clínicos veterinários devem estar preparados para tal eventualidade. Este artigo relata um caso de intoxicação canina por LSD, em que o paciente apresentou sialorréia e sinais clínicos compatíveis com a sintomatologia humana, incluindo estado mental de alerta, taquicardia, taquipnéia, midríase, sialorréia, andar compulsivo e ataxia. O tratamento incluiu fluidoterapia parenteral e uso intravenoso de diazepam e furosemida,bem como repouso sob observação em local silencioso com iluminação suave. Os resultados foram satisfatórios, com plena recuperação do paciente em curto espaço de tempo, sem sequelas perceptíveis

The accidental or intentional intoxication of pets by illicit abuse "recreative" drugs used by owners or other people is a reality, and veterinary practitioners must be alert and prepared for these eventualities. This paper reports a clinical case of LSD toxicosis in a dog which presented sialorrhea and clinical signs compatible to human symptomatology, including mental alertness, tachycardia, tachypnea, mydriasis, compulsive walking, and ataxia. Treatment included IV fluids, diazepam, and furosemide, as well as resting in a calm and silent enclosure with diffuse light. The results were satisfactory, with full recovering in a short period of time, without sequelae

Intoxicação por LSD em cão doméstico: relato de caso / LSD toxicosis in a domestic dog: case report

A intoxicação acidental ou intencional de animais de estimação por drogas ilícitas usadas de forma "recreativa" por pessoas com as quais convivem, é uma realidade, e os clínicos veterinários devem estar preparados para tal eventualidade. Este artigo relata um caso de intoxicação canina por LSD, em que o paciente apresentou sialorréia e sinais clínicos compatíveis com a sintomatologia humana, incluindo estado mental de alerta, taquicardia, taquipnéia, midríase, sialorréia, andar compulsivo e ataxia. O tratamento incluiu fluidoterapia parenteral e uso intravenoso de diazepam e furosemida,bem como repouso sob observação em local silencioso com iluminação suave. Os resultados foram satisfatórios, com plena recuperação do paciente em curto espaço de tempo, sem sequelas perceptíveis(AU)

The accidental or intentional intoxication of pets by illicit abuse "recreative" drugs used by owners or other people is a reality, and veterinary practitioners must be alert and prepared for these eventualities. This paper reports a clinical case of LSD toxicosis in a dog which presented sialorrhea and clinical signs compatible to human symptomatology, including mental alertness, tachycardia, tachypnea, mydriasis, compulsive walking, and ataxia. Treatment included IV fluids, diazepam, and furosemide, as well as resting in a calm and silent enclosure with diffuse light. The results were satisfactory, with full recovering in a short period of time, without sequelae(AU)

Uso y abuso de drogas durante el embarazo: [revisión] / Illicit drug use and abuse during pregnancy: [review]

El consumo y dependencia de sustancias, es un serio problema social con alta morbilidad materno-fetal. El aumento de la oferta y el contexto social favorecedor, permitió que la difusión del consumo sustancias tóxicas ilícitas, conlleve una incidencia creciente en gestantes consumidoras de sustancias y aumento de recién nacidos afectados por las prácticas tóxicas de sus madres. La evaluación del riesgo cuando la gestación es expuesta a las drogas es difícil, los resultados pueden estar sesgados por el consumo concomitante de otros tóxicos o por factores sociológicos y socio-sanitarios desfavorables. Aunque tampoco se definió un patrón específico de anomalías congénitas, se considera que el abuso de drogas, en general, comporta mayor riego de desenlace anómalo del embarazo, por un incremento del riesgo de malformaciones congénitas, debido a la probable teratogenicidad de algunas sustancias o de la morbilidad perinatal afectando el crecimiento fetal o el normal desarrollo del embarazo. También existen posibles repercusiones a largo plazo en la capacidad de aprendizaje y comportamiento delos niños expuestos intraútero, aunque no demostró efectivamente. Por lo tanto, todo embarazo en el que se detecto un hábito tóxico se debe considerar de mayor riesgo, tomando las medidas oportunas para lograr que las pacientes se alejen de éstas prácticas, apoyadas por un equipo multidisciplinario, idealmente antes del inicio del embarazo, lo que implica la adopción de medidas profilácticas de información y concienciación de las mujeres en edad fértil y de apoyo durante el embarazo y la lactancia para el abandono de la dependencia.

Illicit drug use and dependence is a serious social problem with high maternal and fetal morbidity. Supply increase and propitious social context allowed that the diffusion of theuse of illicit toxic substances entails a growing incidence in pregnant women who use illicit drugs and an increase of newborns affected by the practices of their mothers. Risk evaluation is difficult when gestation is exposed to illicit drugs because the results could be biased by the concomitant consumption of others toxic substances or by psychological and socio-sanitary unfavorable factors. Though a specific pattern of congenital anomalies has not been defined, in general it is considered that drug abuse has an increased risk ofanomalous outcomes in pregnancies. This risk is caused by an increase in the risk of congenital malformations due to the probable teratogenicity of some substances or the perinatal morbility affecting the fetal growth or normal pregnancy development. Although it has not been demonstrated effectively, there are also possible long-term repercussions in the learning capacity and behavior of the children exposed intra uterus. In conclusion, all pregnancies exposed to illicit drugs must be considered high risk pregnancies and measures should be taken so that the patients avoid these practices supported by a multidisciplinary team. Ideally, this team should start working before pregnancy implying the adoption of preventive measures such as information and public awareness of women in fertile age and support during pregnancy and maternal lactation.

Hallucinogens and redemption.

This article examines drug substitution with regard to hallucinogens (ayahuasca, ibogaine, peyote and LSD) set within the concept of redemption. The model examines both religious and secular approaches to the contemporary use of hallucinogens in drug substitution, both by scientists and in religious settings worldwide. The redemptive model posits that the proper use of one psychoactive substance within a spiritual or clinical context helps to free an individual from the adverse effects of their addiction to another substance and thus restores them as functioning members of their community or group. Data is drawn from the U.S., Brazil, Peru, and West Africa. Two principle mechanisms for this are proposed: the psychological mechanism of suggestibility is examined in terms of the individual reaching abstinence goals from addictive substances such as alcohol and opiates. Neurophysiological and neurochemical mechanisms to understand the efficacy of such substitution are highlighted from ongoing research on hallucinogens. Research by two of the authors with the Uñaio do Vegetal (UDV) Church in Brazil is examined in terms of the model.

Drogas ilicitas e esquizofrenia em adolescentes / Use of illicit drugs and schizophrenia in adolescents

Este trabalho trata da investigacao dos registros medicos de todos os adolescentes hospitalizados no Departamento de Psiquiatria infantil e de adolescentes com o diagnostico de esquizofrenia ou psicose esquizoafetiva (DSM-IV) associado ao uso e abuso de drogas ilicitas...