Creo que nuestro programa inspirará a otros médicos e investigadores a iniciar un programa de este tipo en su país, dijo Gr. Estoy seguro de que dentro de 12 meses, tendremos varios programas más de este tipo en Europa.

Hay un enemigo silencioso que retrasa la investigación de los tratamientos con psilocibina.
El uso del principio activo de la psilocibina en el tratamiento de la salud mental ya existe y se brinda desde hace mucho tiempo en Uruguay.

Los psicodélicos son sustancias capaces de alterar la conciencia, a través de su efecto sobre la transmisión serotoninérgica en el sistema nervioso central. En sus formas de ingesta tradicional son utilizados en rituales, con fines espirituales y medicinales. En el campo científico, dichas sustancias fueron estudiadas para posibles aplicaciones psicoterapéuticas en el período 1950-1970, y luego fueron excluidas de la investigación clínica durante las posteriores décadas. Sin embargo, desde 1990 asistimos a un «renacimiento de los estudios sobre psicodélicos», donde estas sustancias están siendo estudiadas en su potencial clínico para el tratamiento de distintos trastornos mentales. El presente artículo describe y reflexiona sobre la historia de estas investigaciones en Uruguay y en el mundo, tanto en su primera etapa (1950-1970) como en su renacimiento posterior (1990-actualidad), dejando planteado un escenario en el que sea posible avanzar en el campo de las investigaciones clínicas con psicodélicos en nuestro país.

"Estos resultados coinciden con investigaciones anteriores de otros tipos de estudios y otros países. Los participantes reconocieron aspectos desafiantes y místicos como parte de sus experiencias psicodélicas, y una gran mayoría, el 94%, informó de mejoras vitales positivas. Factores como un motivo de crecimiento personal y redes sociales de apoyo se asociaron con un mayor bienestar. A pesar de las muchas limitaciones del estudio, incluida la muestra autoseleccionada, las medidas autoinformadas y el diseño transversal, los resultados subrayan el impacto que las experiencias psicodélicas pueden tener en la vida de las personas."

40 research articles were included for review: 26 studies on EBPI for PTSD, and 14 studies on PT. EBPI studied were CBT, EMDR, CPT and PE. Psychedelic compounds studied were psilocybin, ibogaine, LSD, MDMA and ketamine, for treatment of substance use disorders, anxiety relating to physical illness, depression, and PTSD. Core themes from patient experiences of EBPI: 1) patient burden in PTSD treatment; 2) readiness; 3) key mechanisms of change; 4) psychological safety and trust. Themes identified in the review of PT: 1) indirect trauma processing; 2) reorganisation of self-narratives via processes of relatedness and identification; 3) key treatment characteristics.

Conclusion: This study suggests overlap between patients' experience of EBPI and PT in terms of key mechanisms of change, the importance of psychological safety and readiness to engage in treatment. Trauma-informed care paradigms and practices may improve safety and acceptability of PT research.

Ketamine-assisted psychotherapy, facilitated remotely, with ongoing support and a sober sitter with you during the acute effects of the medicine, taken by mouth is a possibility for some clients. For others, they may need a higher level of medical intervention during the acute medicine stage, and go on to work with the psychotherapist in person or via telehealth in the days following the medicine administration.

This paper introduces a new construct, the ‘pivotal mental state’, which is defined as a hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation. We believe this new construct bears relevance to a broad range of psychological and psychiatric phenomena. We argue that pivotal mental states serve an important evolutionary function, that is, to aid psychological transformation when actual or perceived environmental pressures demand this. We cite evidence that chronic stress and neurotic traits are primers for a pivotal mental state, whereas acute stress can be a trigger. Inspired by research with serotonin 2A receptor agonist psychedelics, we highlight how activity at this particular receptor can robustly and reliably induce pivotal mental states, but we argue that the capacity for pivotal mental states is an inherent property of the human brain itself. Moreover, we hypothesize that serotonergic psychedelics hijack a system that has evolved to mediate rapid and deep learning when its need is sensed. We cite a breadth of evidences linking stress via a variety of inducers, with an upregulated serotonin 2A receptor system (e.g. upregulated availability of and/or binding to the receptor) and acute stress with 5-HT release, which we argue can activate this primed system to induce a pivotal mental state. The pivotal mental state model is multi-level, linking a specific molecular gateway (increased serotonin 2A receptor signaling) with the inception of a hyper-plastic brain and mind state, enhanced rate of associative learning and the potential mediation of a psychological transformation.

Many authors assert that those who provide psychedelic-assisted therapy (PAT) likely benefit from having personal experiences with psychedelics (PEP) as part of their training. Meta-analytic results confirm advantages of experiential learning in other forms of training as well. Potential PAT clients, especially those who identify as members of underrepresented groups, report that PEP is important to them in their choice of guides. Establishing PAT's efficacy will require more trained professionals for generating appropriately powered clinical trials. Despite these rationales for PEP for trainees, prevalent legal prohibitions limit access to psychedelics, preventing trainees from obtaining experiences that many potential clients deem important. A randomized clinical trial comparing outcomes in those trained with PEP to those trained without the experience has intuitive appeal. Nevertheless, a close look at challenges related to design suggests that a definitive experiment would require more resources than almost every previous study of PAT or therapist effects. (Based on effect size estimates from other therapist effects, power analyses reveal that an experiment with 80–160 participants could offer meaningful data. An ideal design would require 80 therapists treating 30 clients each.) Underpowered designs, however, could lead to serious misinterpretations that would suggest that PEP fails to provide advantages. Given the severity of symptoms targeted by PAT, the current need for treatment providers (especially members of underrepresented groups), the rarity of serious negative consequences in supervised drug administration trials, and the low potential for PEP-induced symptoms of dependence, permitting trainees access likely would create more positives than harms.

Psychedelics in Psychiatry, the Nursing Influence, and the Future of Psychedelic Therapies (Spotswood, 2024) "Nurses have been involved with psychedelic-assisted therapies in the past and are fully capable of providing a wide range of roles upon the anticipated approval as a treatment modality." #psychedelics #psychedelicnursing #psychedelicresearch #nurses #psychedelicassistedtherapies #psychiatry #painmanagement #mentalhealth #palliativecare #neuroscience #psychiatry