Hallucinogenic/psychedelic 5HT2A receptor agonists as rapid antidepressant therapeutics: Evidence and mechanisms of action

2021 ◽  
pp. 026988112098642
Author(s):  
Rafael Guimarães dos Santos ◽  
Jaime EC Hallak ◽  
Glen Baker ◽  
Serdar Dursun

Major depressive disorder (MDD) is among the most prevalent mental health disorders worldwide, and it is associated with a reduced quality of life and enormous costs to health care systems. Available drug treatments show low-to-moderate response in most patients, with almost a third of patients being non-responders (treatment-resistant). Furthermore, most currently available medications need several weeks to achieve therapeutic effects, and the long-term use of these drugs is often associated with significant unwanted side effects and resultant reductions in treatment compliance. Therefore, more effective, safer, and faster-acting antidepressants with enduring effects are needed. Together with ketamine, psychedelics (or classic or serotoninergic hallucinogens) such as lysergic acid diethylamide (LSD), psilocybin, and ayahuasca are among the few compounds with recent human evidence of fast-acting antidepressant effects. Several studies in the 1950s to 1970s reported antidepressive and anxiolytic effects of these drugs, which are being confirmed by modern trials (LSD, one trial; psilocybin, five trials; ayahuasca, two trials). The effects of these drugs appear to be produced primarily by their agonism at serotonin (5-hydroxytryptamine, 5-HT) receptors, especially the 5-HT2A receptor. Considering the overall burden of MDD and the necessity of new therapeutic options, the promising (but currently limited) evidence of safety and efficacy of psychedelics has encouraged the scientific community to explore more fully their beneficial effects in MDD.

2003 ◽  
Vol 33 (2) ◽  
pp. 325-356 ◽  
Author(s):  
Ross Coomber ◽  
Michael Oliver ◽  
Craig Morris

Thirty-three therapeutic cannabis users in England were interviewed about their experiences using an illegal drug for therapeutic purposes. Interviews were semi-structured, and responses highly qualitative. Particular issues included how and why cannabis was used therapeutically; what problems its illegality posed in terms of access, cost, reliability of supply, and quality of the product; the perceived beneficial effects of its use; and unwanted effects (problems in relation to family, friends, partners, the criminal justice system, and the health care system). The study did not seek to prove or disprove the efficacy of cannabis used as a therapeutic agent merely to report the experiences of those who use it in that way. It was found that users perceived cannabis to be highly effective in treating their symptoms, to complement existing medication, and to produce fewer unwanted effects. Smoking was the preferred method of administration, permitting greater control over dose and administration. Problems related to prescribed medication motivated many to use cannabis therapeutically. Few problems were experienced with friends, family, partners, and the criminal justice or health care systems, although other concerns about cannabis's illegality were reported. Although most were relatively unconcerned about the risk involved and were determined to continue use, many resented that they felt they were being forced to break the law. Problems relating to access to the drug (in an illegal context) and managing its administration were reported. A brief discussion of the continued prohibition of cannabis for this group is undertaken, and a harm reduction approach is suggested.


2002 ◽  
Vol 181 (6) ◽  
pp. 526-530 ◽  
Author(s):  
Nicola J. Dummett ◽  
Nicola J. Maughan ◽  
Anne Worrall-Davies

BackgroundEarly studies suggested that presentations with unexplained acute abdominal pain were associated with increased long-term rates of hospital attendance and self-harm, especially in women, but few studies were large enough for definitive findings.AimsTo test the hypothesis that such presentations are followed by higher long-term utilisation rates of secondary health care even excluding further abdominal symptoms, and particularly for self-harm, than presentations with acute appendicitis.MethodNew hospital attendance rates, liaison psychiatry attendances and self-harm attendances of patients with normal appendices at emergency appendicectomy were compared with those of appendicitis patients.ResultsAttendance rates of all kinds were significantly higher for normal appendix patients than for appendicitis patients, with equal strengths of finding for males and females.ConclusionsPeople with normal appendices at emergency appendicectomy show higher long-term rates of hospital attendance. This has implications for how these patients are best managed by health care systems.


2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Widuri Widuri ◽  
Atik Badi’ah ◽  
Tomi Darmawan

Background: Improving the quality of life of children one of which isdetermined by plantingearly child health behavior. Behavior of school children are very varied. If not recognized early, these health problems will affect the learning achievements and future children. Health behavior is a person's response to stimuli or objects associated with illness and disease, health care systems, food, drinks and the environment. Many children do not wash their hands before eating, so it can result in bacteria that is in the hand will be brought in with the food through the mouth and throat to the digestive tract so that the occurrence of gastrointestinal disease.Objective: Knowing the effect of health education hand washing behavior of hand washing in TK Aisyiyah Bustanul Athfal Balong umbulharjo Cangkringan Sleman Yogyakarta.Research methods: This type  of research is one group pretest posttest.Research has been conducted kindergarten Aisyiyah Bustanul Athfal BalongUmbulharjo Cangkringan Sleman Yogyakarta for 2 days commencing on 26 April to 28 April 2014.Results: The results of paired samples correlation calculations indicate thatthere is significant influence effect of health education hand washing behavior of hand washing with sig. (Tailed).000Conclusion: A  significant difference between the effect of health educationhand washingbehavior of hand washing in TK Aisyiyah Bustanul Athfal Balong Umbulharjo Cangkringan Sleman Yogyakarta.


Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.


2014 ◽  
Vol 3 (2) ◽  
pp. 60-73
Author(s):  
Vahé A. Kazandjian

The past three decades have primarily focused on improving performance across health care providing organizations and even individual professionals. While their interest in performance improvement is global, the strategies across health care systems remain variable and the resulting methods of accountability to select audiences continue to be influenced by tradition and expectation. The purpose of this article is to review the key dimensions of the operationalization of performance measurement and the translation of its findings to statements about quality of care. While significant literature exists on the conceptual debates about the nature of quality, the deciding factor in demonstrating that better quality may have been achieved resides in the acceptability of the measurement tools to translate performance measures into profiles of quality. Fundamentally, the use of the tools is seen as only one component of a successful strategy – the education of various audiences as to what the measures mean not only is a necessary requisite for sound project design but also will determine how the accountability model is shaped in each environment based on the generic measurement tools results, local traditions of care and caring, and expectations about outcomes.


2020 ◽  
Vol 60 (5) ◽  
pp. 682-689 ◽  
Author(s):  
Allison E. White

Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed thousands of lives within the past few months; disrupted people’s participation in work, family, and school settings; and challenged economic and health care systems across the globe. In light of the countless challenges posed by COVID-19, a sense of purpose (i.e., a long-term life aim that guides behavior and contributes to the world beyond oneself) may be one important psychological resource for people of all ages to develop and/or recruit during this crisis. This article provides a brief overview of the purpose development literature, the argument that a growing or solidified sense of purpose can serve as an important internal resource during periods of adversity, and recommendations for practice during the COVID-19 pandemic.


Author(s):  
Paul Montgomery ◽  
Nicole Thurston ◽  
Michelle Betts ◽  
C. Scott Smith

The complexities of cancer treatment present a myriad of life-altering impacts for patients. These impacts can be addressed only if health care systems have been designed to detect and address all of these challenges. One significant, but often hidden, challenge is distress. This reaction to the myriad obstacles that cancer presents can impact the quality of life, and influence outcomes, of patients with cancer. Health systems have been slow to address these problems, and a prime example is the implementation of a distress screening and management system. This case study summarizes distress screening in a community oncology clinic compared to a Department of Veterans Affairs (VA) oncology clinic. The community clinic responded to accreditation and grant-driven initiatives, whereas the VA responded to mental health and integrated primary care initiatives. This case study explores the history and the ongoing challenges of distress screening in these community-based health care systems.


mBio ◽  
2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Adam T. Hilterbrand ◽  
Daniel R. Boutz ◽  
Edward M. Marcotte ◽  
Jason W. Upton

ABSTRACT Maintaining control over inflammatory processes represents a paradox for viral pathogens. Although many viruses induce host inflammatory responses to facilitate infection, control is necessary to avoid overactivation. One way is through the manipulation of proinflammatory chemokine levels, both host and viral. Murine cytomegalovirus (MCMV), a model betaherpesvirus, encodes a viral C-C chemokine, MCK2, which promotes host inflammatory responses and incorporates into virions to facilitate viral dissemination. Here, we show that the activity of M48, the conserved MCMV deubiquitinating enzyme (DUB), regulates MCK2 levels during infection. Inactivation of M48 DUB activity results in viral attenuation and exacerbates virally induced, MCK2-dependent inflammatory responses. M48 DUB activity also influences MCK2 incorporation into virions. Importantly, attenuation of DUB-mutant virus acute replication in vitro and in vivo is largely ameliorated by targeted deletion of MCK2. Thus, uncontrolled MCK2 levels appear to mediate DUB-mutant virus attenuation in specific tissues or cell types. This demonstrates that MCMV M48 DUB activity plays a previously unappreciated role in controlling MCK2 levels, thereby managing MCK2-dependent processes. These findings reveal a novel intrinsic control mechanism of virally induced inflammation and support the identification of betaherpesvirus DUBs as possible new targets for antiviral therapies. IMPORTANCE Human cytomegalovirus infections represent a tremendous burden not only to those afflicted but also to health care systems worldwide. As cytomegalovirus infections are a leading cause of nongenetic sensory loss and neurodevelopmental delay, it is imperative that valuable model systems exist in order that we might understand what viral factors contribute to replication and pathogenesis. Currently, the only approved drug treatments against CMV infection are nucleoside analogues, to which some strains have become resistant. Understanding unique viral enzymatic contributions to infections will allow the development of novel pharmacological therapies. Here, we show that M48, the conserved MCMV deubiquitinase, is critical for MCMV replication in mice and demonstrate that attenuation is due to deregulated production of a viral proinflammatory chemokine. The deubiquitinases of both human and murine CMV represent structurally unique DUBs and are therefore attractive targets for pharmacological intervention. Continued research into the substrates of these DUBs will lend additional insight into their potential as targets. IMPORTANCE Human cytomegalovirus infections represent a tremendous burden not only to those afflicted but also to health care systems worldwide. As cytomegalovirus infections are a leading cause of nongenetic sensory loss and neurodevelopmental delay, it is imperative that valuable model systems exist in order that we might understand what viral factors contribute to replication and pathogenesis. Currently, the only approved drug treatments against CMV infection are nucleoside analogues, to which some strains have become resistant. Understanding unique viral enzymatic contributions to infections will allow the development of novel pharmacological therapies. Here, we show that M48, the conserved MCMV deubiquitinase, is critical for MCMV replication in mice and demonstrate that attenuation is due to deregulated production of a viral proinflammatory chemokine. The deubiquitinases of both human and murine CMV represent structurally unique DUBs and are therefore attractive targets for pharmacological intervention. Continued research into the substrates of these DUBs will lend additional insight into their potential as targets.


Author(s):  
Hugo Valenzuela-Garcia ◽  
José Luis Molina ◽  
Miranda J. Lubbers ◽  
Jorge Grau

This paper draws on research analyzing the emotional and relational impacts of poverty and exclusion on charities’ clients in Spain since the 2008–2009 economic crisis, including people experiencing multiple exclusion homelessness (MEH). The study adopts a mixed-methods approach in which twenty in-depth cases were collected in different geographical locations, including twelve cases experiencing MEH. Unlike other disadvantaged groups, those affected by MEH suffer material shortages, traumatic experiences, psychological disorders, physical illnesses, and a high degree of relational vulnerability, as reflected in the structure and composition of their personal networks, which tend to be smaller in size, with just a few weak and temporary contacts, and with care professionals playing an important role. These charity users often need long-term socio-sanitary care, which challenges public and private health-care systems. Therefore, our contribution to this Special Issue is directed toward improving understanding of the relational characteristics of severely excluded people, how social support affects their personal networks, and the challenges this assistance poses to care services.


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