Lessons Learned at the Interface of Medicine and Psychiatry
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds repors that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Prim Care Companion CNS Disord 2024;26(3):23f03652
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References (35)
- Nichols DE. Psychedelics. Pharmacol Rev. 2016;68(2):264–355. PubMed CrossRef
- Galvão-Coelho NL, Marx W, Gonzalez M, et al. Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants. Psychopharmacology Berl. 2021;238(2):341–354. PubMed
- Grob CS, Danforth AL, Chopra GS, et al. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Arch Gen Psychiatry. 2011;68(1):71–78. PubMed CrossRef
- Ross S, Bossis A, Guss J, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol. 2016;30(12):1165–1180. PubMed CrossRef
- Ross S, Agin-Liebes G, Lo S, et al. Acute and sustained reductions in loss of meaning and suicidal ideation following psilocybin-assisted psychotherapy for psychiatric and existential distress in life-threatening cancer. ACS Pharmacol Transl Sci. 2021;4(2):553–562. PubMed CrossRef
- Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: a randomized double-blind trial. J Psychopharmacol. 2016;30(12):1181–1197. PubMed CrossRef
- Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of psilocybin versus escitalopram for depression. N Engl J Med. 2021;384:1402–1411. PubMed
- Davis AK, Barrett FS, May DG, et al. Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA Psychiatry. 2021;78(5):481–489. PubMed
- Raison CL, Sanacora G, Woolley J, et al. Single-dose psilocybin treatment for major depressive disorder: a randomized clinical trial. JAMA. 2023;330(9):843–853. PubMed CrossRef
- Voineskos D, Daskalakis ZJ, Blumberger DM. Management of treatment resistant depression: challenges and strategies. Neuropsychiatr Dis Treat. 2020;16:221–234. PubMed
- Carhart-Harris RL, Bolstridge M, Rucker J, et al. Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Lancet Psychiatry. 2016;3(7):619–627. PubMed CrossRef
- Goodwin GM, Aaronson ST, Alvarez O, et al. Single-dose psilocybin for a treatment-resistant episode of major depression: impact on patient-reported depression severity, anxiety, function, and quality of life. J Affect Disord. 2023; 327:120–127. PubMed CrossRef
- Johnson MW, Garcia-Romeu A, Cosimano MP, et al. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol. 2014;28(11):983–992. PubMed CrossRef
- Bogenschutz MP, Forcehimes AA, Pommy JA, et al. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. J Psychopharmacol. 2015; 29(3):289–299. PubMed CrossRef
- Bogenschutz MP, Ross S, Bhatt S, et al. Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: a randomized clinical trial. JAMA Psychiatry. 2022;79(10):953–962. PubMed CrossRef
- Moreno FA, Wiegand CB, Taitano EK, et al. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(11):1735–1740. PubMed CrossRef
- Ching THW, Grazioplene R, Bohner C, et al. Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive-compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial. Front Psychiatry. 2023;14:1178529. PubMed CrossRef
- Schindler EAD, Sewell RA, Gottschalk CH, et al. Exploratory investigation of a patient- informed low-dose psilocybin pulse regimen in the suppression of cluster headache: results from a randomized, double-blind, placebo-controlled trial. Headache. 2022;62(10):1383–1394. PubMed CrossRef
- Peck SK, Shao S, Gruen T, et al. Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study. Nat Med. 2023;29:1947–1953. PubMed CrossRef
- Koning E, Brietzke E. Psilocybin-assisted psychotherapy as a potential treatment for eating disorders: a narrative review of preliminary evidence. Trends Psychiatry Psychother. Published online May 1, 2023. doi: 10.47626/2237-6089-2022-0597. CrossRef
- Krediet E, Bostoen T, Breeksema J, et al. Reviewing the potential of psychedelics for the treatment of PTSD. Int J Neuropsychopharmacol. 2020;23(6):385–400. PubMed CrossRef
- Więckiewicz G, Stokłosa I, Stokłosa M, et al. Psychoactive substance use in patients diagnosed with attention-deficit/hyperactivity disorder: an exploratory study. Front Psychiatry. 2023;14:1184023. PubMed
- Reichelt A. Complexities of psychedelics for therapeutic use in obesity and eating disorders. J Psychiatry Neurosci. 2022;47(5):E366. PubMed CrossRef
- Lowe H, Toyang N, Steele B, et al. Psychedelics: alternative and potential therapeutic options for treating mood and anxiety disorders. Molecules. 2022; 27(8):2520. PubMed
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed text revised. American Psychiatric Association; 2000.
- Goodwin GM, Croal M, Feifel D, et al. Psilocybin for treatment resistant depression in patients taking a concomitant SSRI medication. Neuropsychopharmacology. 2023;48(10):1492–1499. PubMed CrossRef
- McIntyre RS. Serotonin 5-HT2B receptor agonism and valvular heart disease: implications for the development of psilocybin and related agents. Expert Opin Drug Saf. 2023;22(10):881–883. PubMed CrossRef
- Becker AM, Holze F, Grandinetti T, et al. Acute effects of psilocybin after escitalopram or placebo pretreatment in a randomized, double-blind, placebo controlled, crossover study in healthy subjects. Clin Pharmacol Ther. 2022;111(4):886–895. PubMed CrossRef
- Pokorny T, Preller KH, Kraehenmann R, et al. Modulatory effect of the 5-HT1A agonist buspirone and the mixed non-hallucinogenic 5-HT1A/2A agonist ergotamine on psilocybin-induced psychedelic experience. Eur Neuropsychopharmacol. 2016;26(4):756–766. PubMed CrossRef
- Keeler MH. Chlorpromazine antagonism of psilocybin effect. Int J Neuropsychiatry. 1967;3(1):66–71. PubMed CrossRef
- Quednow BB, Kometer M, Geyer MA, et al. Psilocybin-induced deficits in automatic and controlled inhibition are attenuated by ketanserin in healthy human volunteers. Neuropsychopharmacology. 2012;37(3):630–640. PubMed CrossRef
- Vollenweider FX, Vollenweider-Scherpenhuyzen MF, Bäbler A, et al. Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action. Neuroreport. 1998;9(17):3897–3902. PubMed CrossRef
- Goel DB, Zilate S. Potential therapeutic effects of psilocybin: a systematic review. Cureus. 2022;14(10):e30214. PubMed CrossRef
- MacCallum CA, Lo LA, Pistawka CA, et al. Therapeutic use of psilocybin: practical considerations for dosing and administration. Front Psychiatry. 2022;13:1040217. PubMed CrossRef
- Aaronson S, Miller T, Rudow S, et al. An open label study of synthetic psilocybin in bipolar type II depression. Biol Psychiatry. 2023;93(9):S132–S133.
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