Assessing the effects of methodological differences on outcomes in the use of psychedelics in the treatment of anxiety and depressive disorders: A systematic review and meta-analysis

2021 ◽  
pp. 026988112110446
Author(s):  
Robert F Leger ◽  
Ellen M Unterwald
Keyword(s):  
Clinical Trials ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Multiple Dosing ◽  
Positive Effects ◽  
Cohen’S D ◽  
Significant Difference ◽  
Cohen's D ◽  
Serotonin 2A ◽  
Positive Effect

Background: Classical psychedelics are a group of drugs which act as agonists on the serotonin-2A (5-HT2A) receptor. Evidence suggests they may have a uniquely rapid and enduring positive effect on mood. However, marked heterogeneity between methodological designs in this emerging field remains a significant concern. Aims: To determine how differences in the type of psychedelic agent used and the number of dosing sessions administered affect subjects’ depression and anxiety outcomes and adverse drug reactions (ADR). Methods: This review collected and screened 1591 records from the MEDLINE and Web of Science databases for clinical trials reporting objective data on mood for subjects with a known anxiety or depression. Results: After screening, nine clinical trials met inclusion criteria. Meta-analysis of these studies showed significant, large positive effect sizes for measures of anxiety (Cohen’s d = 1.26) and depression (Cohen’s d = 1.38) overall. These positive effects were also significant at acute (⩽1 week) and extended (>1 week) time points. No significant differences were observed between trials using different psychedelic agents (psilocybin, ayahuasca or lysergic acid diethylamide (LSD)), however, a significant difference was observed in favour of trials with multiple dosing sessions. No serious ADR were reported. Conclusion: Psilocybin, ayahuasca and LSD all appear to be effective and relatively safe agents capable of producing rapid and sustained improvements in anxiety and depression. Moreover, the findings of the present analysis suggest that they may show a greater efficacy when given to patients over multiple sessions as compared to the more common single session used in many of the existing trials.

scholarly journals The Safety and Efficacy of Stem Cell Therapy as an Emerging Therapy for ALS: A Systematic Review of Controlled Clinical Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Ammar Aljabri ◽  
Alhussain Halawani ◽  
Ghassan Bin Lajdam ◽  
Suhail Labban ◽  
Samah Alshehri ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Stem Cell ◽  
Control Group ◽  
Safety And Efficacy ◽  
Positive Effects ◽  
Significant Difference ◽  
Marrow Mesenchymal Stem Cells ◽  
New Treatments ◽  
Positive Effect ◽  
Emerging Therapy

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with a heterogeneous course that ultimately leads to death. Currently, there is no cure, and new treatments that can slow the progression of the disease are needed. Stem cell (SC) transplantation is an emerging therapy that has shown a lot of potential in recent clinical trials. This review is aimed to examine the results of various clinical trials on this topic, thus assessing the safety and efficacy of SC transplantation as a potential treatment for ALS. We identified 748 studies in our search, of which 134 full-text studies were assessed for eligibility. Six studies met the inclusion criteria and were included in this review. Although some of the included studies showed the positive effect of SC transplantation, other studies found that there was no significant difference compared to the control group. We observed more positive effects with bone marrow mesenchymal stem cells (BM-MSC) treatments than Granulocyte colony-stimulating factor (G-CSF) ones. However, other factors, such as route of administration, number of doses, and number of cells per dose, could also play a role in this discrepancy. Based on this information, we conclude that more properly conducted clinical trials are needed to appreciate the benefit of this treatment.

scholarly journals Effects of Paracetamol (Acetaminophen) Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis

Sports ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 126
Author(s):  
Jozo Grgic ◽  
Pavle Mikulic
Keyword(s):  
Subgroup Analysis ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Endurance Performance ◽  
Ergogenic Effect ◽  
Time To Exhaustion ◽  
Double Blind ◽  
Cohen’S D ◽  
Significant Difference ◽  
Cohen's D

Several studies explored the effects of paracetamol (acetaminophen) ingestion on endurance performance, but their findings are conflicting. Therefore, this review aimed to conduct a meta-analysis examining the effects of paracetamol ingestion on endurance performance. Five databases were searched to find relevant studies. The PEDro checklist was used to assess the methodological quality of the included studies. Data reported in the included studies were pooled in a random-effects meta-analysis. A total of ten studies with good or excellent methodological quality were included in the meta-analysis (pooled n = 141). All included studies had a randomized, double-blind, crossover design. In the main meta-analysis, there was no significant difference between the effects of placebo and paracetamol on endurance performance (Cohen’s d = 0.09; 95% confidence interval (CI): −0.04, 0.22; p = 0.172). However, an ergogenic effect was found when we considered only the studies that provided paracetamol 45 to 60 min before exercise (Cohen’s d = 0.14; 95% CI: 0.07, 0.21; p < 0.001). In a subgroup analysis that focused on time-to-exhaustion tests, there was a significant ergogenic effect of paracetamol ingestion (Cohen’s d = 0.19; 95% CI: 0.06, 0.33; p = 0.006). There was no significant difference between placebo and paracetamol in a subgroup analysis that focused on time trial tests (Cohen’s d = 0.05; 95% CI: −0.12, 0.21; p = 0.561). In conclusion, paracetamol ingestion appears to enhance performance (a) in time-to-exhaustion endurance tests and (b) when consumed 45 to 60 min before exercise.

scholarly journals Effects of n-3 Polyunsaturated Fatty Acid Supplementation in the Prevention and Treatment of Depressive Disorders—A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1070
Author(s):  
Maike Wolters ◽  
Annkathrin von der Haar ◽  
Ann-Kristin Baalmann ◽  
Maike Wellbrock ◽  
Thomas L. Heise ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Treatment Duration ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Pufa Supplementation ◽  
Depressive Symptomology ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Significant Difference

N-3 polyunsaturated fatty acids (PUFAs) have been suggested to affect depressive disorders. This review aims to determine the effect of n-3 PUFAs on depressive symptoms in people with or without diagnosed depression. Medline, PsycINFO, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) assessing the association between n-3 PUFAs and depressive symptoms or disorders as outcomes. A random-effects meta-analysis of standardized mean difference (SMD) with 95% confidence intervals (CI) was performed. Twenty-five studies (7682 participants) were included. Our meta-analysis (20 studies) indicated that n-3 PUFA supplementation lowered depressive symptomology as compared with placebo: SMD = −0.34, 95% CI: −0.55, −0.12, I2 = 86%, n = 5836, but a possible publication bias cannot be ruled out. Subgroup analyses indicated no statistically significant difference by treatment duration of <12 vs. ≥12 weeks, presence of comorbidity, or severity of depressive symptoms. Nevertheless, beneficial effects were seen in the subgroups of studies with longer treatment duration and with no depression and mild to moderate depression. Subgroup analysis by eicosapentaenoic acid (EPA) dosage revealed differences in favor of the lower EPA dosage. Sensitivity analysis including studies with low risk of bias seems to confirm the overall result. Supplementation of n-3 PUFA appears to have a modest beneficial effect on depressive symptomology, although the quality of evidence is still insufficient.

scholarly journals The Use of Green Coffee Extract as a Weight Loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Igho Onakpoya ◽  
Rohini Terry ◽  
Edzard Ernst
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Significant Heterogeneity ◽  
Green Coffee ◽  
Significant Difference ◽  
Using Data

The purpose of this paper is to assess the efficacy of green coffee extract (GCE) as a weight loss supplement, using data from human clinical trials. Electronic and nonelectronic searches were conducted to identify relevant articles, with no restrictions in time or language. Two independent reviewers extracted the data and assessed the methodological quality of included studies. Five eligible trials were identified, and three of these were included. All studies were associated with a high risk of bias. The meta-analytic result reveals a significant difference in body weight in GCE compared with placebo (mean difference: kg; 95%CI: , ). The magnitude of the effect is moderate, and there is significant heterogeneity amongst the studies. It is concluded that the results from these trials are promising, but the studies are all of poor methodological quality. More rigorous trials are needed to assess the usefulness of GCE as a weight loss tool.

scholarly journals Do You Get the Picture? A Meta-Analysis of the Effect of Graphics on Reading Comprehension

AERA Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 233285842090169 ◽  
Author(s):  
Daibao Guo ◽  
Shuai Zhang ◽  
Katherine Landau Wright ◽  
Erin M. McTigue
Keyword(s):  
Reading Comprehension ◽  
Grade Level ◽  
Text Comprehension ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Future Research ◽  
Significant Difference ◽  
Flow Diagrams ◽  
Positive Effect ◽  
Mixed Format

Although convergent research demonstrates that well-designed graphics can facilitate readers’ understanding of text, there are select situations where graphics have been shown to have no effect on learners’ overall text comprehension. Therefore, the current meta-analytic study examined 39 experimental studies published between 1985 and 2018 measuring graphics’ effects on readers’ comprehension. We first quantified the overall effect on reading comprehension. Then, we considered interactions with learners’ characteristics, graphic types, and assessment formats. Our analysis revealed that the inclusion of graphics had a moderate overall positive effect (Hedges’s g = 0.39) on students’ reading comprehension, regardless of grade level. Regarding graphic type, we did not find a significant difference among pictures, pictorial diagrams, and flow diagrams. Only when compared to mixed graphics, pictures had a greater effect on comprehension. Additionally, compared with true and false assessments, graphics differentially benefited students’ comprehension on open-ended comprehension assessments and mixed format assessments. Implications for future research are presented.

scholarly journals Factors Influencing Risk of Premature Mortality in Community Cases of Depression: A Meta-Analytic Review

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Amanda J. Baxter ◽  
Andrew Page ◽  
Harvey A. Whiteford
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Excess Mortality ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Premature Mortality ◽  
Population Based ◽  
Clinical Depression ◽  
Risk Estimates ◽  
Significant Difference

Background. Depressive disorders are associated with substantial risk of premature mortality. A number of factors may contribute to reported risk estimates, making it difficult to determine actual risk of excess mortality in community cases of depression. The aim of this study is to conduct a systematic review and meta-analysis of excess mortality in population-based studies of clinically defined depression. Methods. Population-based studies reporting all-cause mortality associated with a clinically defined depressive disorder were included in the systematic review. Estimates of relative risk for excess mortality in population-representative cases of clinical depressive disorders were extracted. A meta-analysis was conducted using Stata to pool estimates of excess mortality and identify sources of heterogeneity within the data. Results. Twenty-one studies reporting risk of excess mortality in clinical depression were identified. A significantly higher risk of mortality was found for major depression (RR 1.92 95% CI 1.65–2.23), but no significant difference was found for dysthymia (RR 1.37 95% CI 0.93–2.00). Relative risk of excess mortality was not significantly different following the adjustment of reported risk estimates. Conclusion. A mortality gradient was identified with increasing severity of clinical depression. Recognition of depressive symptoms in general practice and appropriate referral for evidence-based treatment may help improve outcomes, particularly in patients with comorbid physical disorders.

scholarly journals Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e96905 ◽  
Author(s):  
Giuseppe Grosso ◽  
Andrzej Pajak ◽  
Stefano Marventano ◽  
Sabrina Castellano ◽  
Fabio Galvano ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Clinical Trials ◽  
Depressive Disorders ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Omega 3 Fatty Acids ◽  
Omega 3

scholarly journals Carbon dioxide versus air insufflation enteroscopy: a systematic review and meta-analysis based on randomized controlled trials

2018 ◽  
Vol 06 (06) ◽  
pp. E637-E645 ◽  
Author(s):  
Julio Aquino ◽  
Wanderley Bernardo ◽  
Diogo de Moura ◽  
Flávio Morita ◽  
Rodrigo Rocha ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Ambient Air ◽  
Quality Analysis ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Co2 Insufflation ◽  
Significant Difference

Abstract Objectives To compare the insufflation of CO2 and ambient air in enteroscopy. Search sources The investigators researched the electronic databases MedLine, Cochrane Library, Central, LILACS, BVS, Scopus and Cinahl. The grey search was conducted in the base of theses of the University of São Paulo, books of digestive endoscopy and references of selected articles and in previous systematic revisions. Study eligibility criteria The evaluation of eligibility was performed independently, in a non-blind manner, by two reviewers, firstly by title and abstract, followed by complete text. Disagreements between the reviewers were resolved by consensus. Data collection and analysis method Through the spreadsheet of data extraction, where one author extracted the data and a second author checked the extraction. Disagreements were resolved by debate between the two reviewers. The quality analysis of the studies was performed using the Jadad score. The software RevMan 5 version 5.3 was used for the meta-analysis. Results Four randomized clinical trials were identified, totaling 473 patients submitted to enteroscopy and comparing insufflation of CO2 and ambient air. There was no statistical difference in the intubation depth between the two groups. When CO2 insufflation was reduced, there was a significant difference in pain levels 1 hour after the procedure (95 % IC, –2.49 [–4.72, –0.26], P: 0.03, I2: 20%) and 3 hours after the procedure (95% IC, –3.05 [–5.92, –0.18], P: 0.04, I2: 0 %). There was a usage of lower propofol dosage in the CO2 insufflation group, with significant difference (95 % IC, –67.68 [–115.53, –19.84], P: 0.006, I2: 0 %). There was no significant difference between the groups in relation to the use of pethidine and to the oxygen saturation. Limitations Restricted number of randomized clinical trials and nonuniformity of data were limitations to the analysis of the outcomes. Conclusion The use of CO2 as insufflation gas in enteroscopy reduces the pain levels 1 hour and 3 hours after the procedure, in addition to the reduction of the sedation (propofol) dosage used.

Randomized Trial of PMTO in Foster Care: Six-Month Child Well-Being Outcomes

2016 ◽  
Vol 29 (2) ◽  
pp. 206-222 ◽  
Author(s):  
Becci A. Akin ◽  
Kyle Lang ◽  
Thomas P. McDonald ◽  
Yueqi Yan ◽  
Todd Little
Keyword(s):  
Foster Care ◽  
Well Being ◽  
Analysis Of Covariance ◽  
High Risk Population ◽  
Social Emotional ◽  
Prosocial Skills ◽  
Positive Effects ◽  
Cohen’S D ◽  
Children In Foster Care ◽  
Cohen's D

Objective: This study tested the effectiveness of Parent Management Training, Oregon (PMTO) model on child social–emotional well-being. Methods: Using a randomized controlled design and three measures of social–emotional well-being, the study investigated effectiveness of PMTO with families of children in foster care with serious emotional disturbance (SED). Participants included children (3–16 years) and parents who were randomly assigned to PMTO ( n = 461) or services as usual ( n = 457). Study condition was known to participants and assessors. Six months after baseline, analysis of covariance models examined the intervention’s overall effect and time interactions using intent-to-treat analysis. Follow-up analyses identified salient predictors of well-being. Results: PMTO demonstrated small but significant positive effects on three primary outcomes: social–emotional functioning (Cohen’s d = .31), problem behaviors (Cohen’s d = .09), and prosocial skills (Cohen’s d = .09). Conclusion: Results suggest that PMTO was effective at improving short-term social–emotional well-being in a high-risk population of children with SED.

scholarly journals Safety of Human Papillomavirus 9-Valent Vaccine: A Meta-Analysis of Randomized Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ana Paula Ferreira Costa ◽  
Ricardo Ney Oliveira Cobucci ◽  
Janine Medeiros da Silva ◽  
Paulo Henrique da Costa Lima ◽  
Paulo César Giraldo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Human Papillomavirus ◽  
Adverse Effects ◽  
Randomized Trials ◽  
Web Of Science ◽  
Meta Analysis ◽  
Developed Countries ◽  
Electronic Data ◽  
Tetravalent Vaccine ◽  
Significant Difference

Vaccination against human papillomavirus (HPV) has been progressively implemented in most developed countries for approximately 10 years. In order to increase the protection of the vaccines, a 9-valent vaccine (HPV9) was developed, which provides protection against nine types of the virus. Studies evaluating its safety are rare. Thus, we performed a meta-analysis of three clinical trials assessing adverse effects on women randomly vaccinated with HPV9 or tetravalent vaccine (HPV4), with the objective of analyzing whether the HPV9 is as safe as HPV4. An electronic data search was performed through the PubMed, Embase, Scopus, Web of Science, and SciELO databases. The studies selected 27,465 women who received one of the two vaccines. Pain (OR 1.72; 95% CI 1.62–1.82) and erythema (OR 1.29; 95% CI 1.21–1.36) occurred significantly more in the HPV9 group. However, there was no significant difference between the groups for the following adverse effects: headache (OR 1.07; 95% CI 0.99–1.15), dizziness (OR 1.09; 95% CI 0.93–1.27), and fatigue (OR 1.09; 95% CI 0.91–1.30), and the occurrence of serious events related to vaccination was similarly rare among those vaccinated. Therefore, our findings demonstrate that HPV9 in female patients is as safe as the tetravalent vaccine.

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