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Article ; Online: Amphibious anti-depressants and other wonders.

Dakwar, Elias

The American journal of drug and alcohol abuse

2019 Volume 45, Issue 2, Page(s) 115–116

MeSH term(s)	Anxiety ; Depression ; Depressive Disorder ; Humans ; Methoxydimethyltryptamines ; N,N-Dimethyltryptamine
Chemical Substances	Methoxydimethyltryptamines ; N,N-Dimethyltryptamine (WUB601BHAA)
Language	English
Publishing date	2019-03-05
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	193086-2
ISSN	1097-9891 ; 0095-2990
ISSN (online)	1097-9891
ISSN	0095-2990
DOI	10.1080/00952990.2019.1580288
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Article ; Online: Middle meningeal artery embolization for chronic subdural hematoma- pathophysiology and radiological findings .

Bastianon Santiago, Raphael / Jastrzebski, Camille / Dakwar, Elias / Adada, Badih / Borghei-Razavi, Hamid / Obrzut, Michal

World neurosurgery: X

2024 Volume 23, Page(s) 100296

Language	English
Publishing date	2024-03-02
Publishing country	United States
Document type	Journal Article
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2024.100296
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Article ; Online: The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness.

Franco Corso, Silvia J / O'Malley, Kate Y / Subaiya, Saleena / Mayall, Danielle / Dakwar, Elias

Journal of affective disorders

2023 Volume 335, Page(s) 166–176

Abstract: Background: Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, ...

Abstract	Background: Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. Methods: We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. Results: A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and deliberate immersive experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. These experiences have also been correlated with short-term reductions in anxiety and depression, with increased motivation to change addictive behaviors, and with enhanced self-awareness and well-being. Limitations: Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. Conclusions: Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.
MeSH term(s)	Humans ; Consciousness ; Mental Health ; Mind-Body Therapies/methods ; Mind-Body Therapies/psychology ; Meditation/psychology ; Yoga ; Perception
Language	English
Publishing date	2023-05-06
Publishing country	Netherlands
Document type	Review ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.04.116
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Zs.A 1485: Show issues

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Article ; Online: Minding the brain: the role of pharmacotherapy in substance-use disorder treatment.

Elias, Dakwar / Kleber, Herbert D

Dialogues in clinical neuroscience

2018 Volume 19, Issue 3, Page(s) 289–297

Abstract: With its medicalization as a brain-based disease, addiction has come to be regarded as amenable to biomedical treatment approaches, most commonly pharmacotherapy. Various vulnerabilities are recognized to contribute to maladaptive substance use, and have ...

Abstract	With its medicalization as a brain-based disease, addiction has come to be regarded as amenable to biomedical treatment approaches, most commonly pharmacotherapy. Various vulnerabilities are recognized to contribute to maladaptive substance use, and have been linked to diverse neurobiological alterations that may be targeted with pharmacotherapy: withdrawal, craving and cue reactivity, and aberrant reward processing are the most significant. Here, we summarize current thinking regarding pharmacotherapy for substance-use disorders, grouping medications by the type of vulnerability they propose to address and providing insight into their neurobiological mechanisms. We also examine the limitations of the brain-based disease model in addiction treatment, especially as these shortcomings pertain to the place of pharmacotherapy in recovery. We conclude by sketching a framework whereby medications might be integrated fruitfully with other interventions, such as behavioral, existential, or peer-based treatments, targeting aspects of addiction beyond neurobiological deficits.
MeSH term(s)	Brain/drug effects ; Brain/physiology ; Drug Therapy/methods ; Humans ; Reward ; Substance-Related Disorders/pathology ; Substance-Related Disorders/therapy
Language	English
Publishing date	2018-02-09
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	2188781-0
ISSN	1958-5969 ; 1294-8322
ISSN (online)	1958-5969
ISSN	1294-8322
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Zs.A 6188: Show issues

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Article ; Online: Mystical-type experiences occasioned by ketamine mediate its impact on at-risk drinking: Results from a randomized, controlled trial.

Rothberg, Rebecca L / Azhari, Nour / Haug, Nancy A / Dakwar, Elias

Journal of psychopharmacology (Oxford, England)

2020 Volume 35, Issue 2, Page(s) 150–158

Abstract: Background: Sub-anesthetic ketamine administration may be helpful for substance use disorders. Converging evidence suggests that the efficacy of ketamine for certain conditions may implicate a subset of its psychoactive effects.: Aims: The aim of ... ...

Abstract	Background: Sub-anesthetic ketamine administration may be helpful for substance use disorders. Converging evidence suggests that the efficacy of ketamine for certain conditions may implicate a subset of its psychoactive effects. Aims: The aim of this analysis is to evaluate whether the mystical-type effects of ketamine are critical for clinical efficacy in alcohol-dependent individuals. In this secondary analysis, we determine if a subset of the psychoactive effects of ketamine, the so-called mystical-type experience, mediates the effect of ketamine, when combined with motivational enhancement therapy, on at-risk drinking behavior in alcohol-dependent individuals interested in treatment. Methods: Forty alcohol dependent adults were randomized to either a 52-minute infusion of ketamine or midazolam, which they received on a designated quit-day during the second week of a five-week motivational enhancement therapy regimen. Psychoactive effects were assessed following the infusion, and alcohol use was monitored for the subsequent 3 weeks at each twice-weekly visit. Results: We found that ketamine leads to significantly greater mystical-type effects (by Hood Mysticism Scale) and dissociation (by Clinician Administered Dissociative States Scale) compared to the active control. Ketamine also led to significant reduction in at-risk drinking. The Hood Mysticism Scale, but not Clinician Administered Dissociative States Scale score, was found to mediate the effect of ketamine on drinking behavior. Conclusions: This trial adds evidence to the literature on the importance of mystical-type experiences in addiction treatment. Future research should continue to investigate the relationship between the psychoactive effects of psychedelic therapeutics and clinical outcomes for other substance use and mental health disorders.
MeSH term(s)	Alcohol Drinking/drug therapy ; Alcohol Drinking/psychology ; Behavior, Addictive/drug therapy ; Behavior, Addictive/psychology ; Dissociative Disorders/drug therapy ; Dissociative Disorders/psychology ; Double-Blind Method ; Female ; Hallucinogens/therapeutic use ; Humans ; Ketamine/therapeutic use ; Male ; Midazolam/therapeutic use ; Middle Aged ; Mysticism/psychology ; Substance-Related Disorders/drug therapy ; Surveys and Questionnaires ; Treatment Outcome
Chemical Substances	Hallucinogens ; Ketamine (690G0D6V8H) ; Midazolam (R60L0SM5BC)
Language	English
Publishing date	2020-12-13
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639313-5
ISSN	1461-7285 ; 0269-8811
ISSN (online)	1461-7285
ISSN	0269-8811
DOI	10.1177/0269881120970879
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Zs.A 2311: Show issues

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Article ; Online: New Directions in Medication-Facilitated Behavioral Treatment for Substance Use Disorders.

Dakwar, Elias / Nunes, Edward V

Current psychiatry reports

2016 Volume 18, Issue 7, Page(s) 64

Abstract: A promising approach to addressing substance use disorders is to integrate pharmacotherapy with a behavioral treatment with which synergy is possible. In this review, we focus on recent research suggesting that this approach may be effective for cocaine ... ...

Abstract	A promising approach to addressing substance use disorders is to integrate pharmacotherapy with a behavioral treatment with which synergy is possible. In this review, we focus on recent research suggesting that this approach may be effective for cocaine and cannabis use disorders, both of which currently lack efficacious medications. We summarize potential targets of pharmacotherapy of particular relevance to combined medication-behavioral treatment and examine preliminary evidence of clinical efficacy. Common to these promising medications is a hypothesized mechanism of action predicated on reversing drug-related neural adaptations, such as high reactivity to stress or drug cues, that might undermine fruitful engagement with behavioral treatment. We also review emerging medications, such as certain glutamatergic and serotonergic agents, which may be feasibly integrated with existing treatments. We conclude with an outline of future directions for research.
MeSH term(s)	Behavior Therapy/methods ; Combined Modality Therapy ; Humans ; Psychotropic Drugs/pharmacology ; Substance-Related Disorders/therapy ; Treatment Outcome
Chemical Substances	Psychotropic Drugs
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055376-6
ISSN	1535-1645 ; 1523-3812
ISSN (online)	1535-1645
ISSN	1523-3812
DOI	10.1007/s11920-016-0703-4
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Zs.A 5520: Show issues

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Article ; Online: Naltrexone-facilitated buprenorphine discontinuation: a feasibility trial.

Dakwar, Elias / Kleber, Herbert D

Journal of substance abuse treatment

2015 Volume 53, Page(s) 60–63

Abstract: Rationale: Buprenorphine is an effective and popular treatment for opioid dependence. It remains unclear, however, when or how to transition stable buprenorphine-maintained individuals to complete abstinence. This trial investigates the feasibility of ... ...

Abstract	Rationale: Buprenorphine is an effective and popular treatment for opioid dependence. It remains unclear, however, when or how to transition stable buprenorphine-maintained individuals to complete abstinence. This trial investigates the feasibility of using naltrexone to facilitate buprenorphine discontinuation in stable individuals who had tolerated a taper to 2mg or less but were unable to terminate entirely due to withdrawal-related distress. Methods: The sample consisted of 6 buprenorphine-maintained individuals in sustained full remission, and who had tolerated a taper but were unable to discontinue altogether. A rapid induction procedure was performed, which included supervised buprenorphine discontinuation, oral naltrexone titration with a starting dose of 6.25mg, and administration of long-acting injectable naltrexone. Participants were followed weekly for 5weeks after the injection, with telephone follow-up occurring at 6months. Results: The rapid induction procedure was well tolerated. There was no observed or reported clinical worsening over the course of study participation. Notably, no participants experienced an increase in Subjective Opioid Withdrawal Scale (SOWS) scores after the first oral dose of NTX as compared to day 1 (24hours after last dose of buprenorphine); instead, SOWS scores decreased between days 1 and 7 (p=0.043). All participants were able to discontinue buprenorphine and to remain opioid free during the trial and at follow-up. Conclusions: This preliminary trial represented for all participants the first successful attempt at buprenorphine discontinuation. Further research is needed to better understand if naltrexone is effective at facilitating buprenorphine discontinuation, as well as the feasibility of a sequential approach (buprenorphine stabilization to naltrexone) for opioid use disorders.
MeSH term(s)	Administration, Oral ; Adult ; Buprenorphine/administration & dosage ; Drug Administration Schedule ; Feasibility Studies ; Female ; Humans ; Injections ; Male ; Naltrexone/administration & dosage ; Narcotic Antagonists/administration & dosage ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/rehabilitation ; Substance Withdrawal Syndrome/prevention & control ; Treatment Outcome
Chemical Substances	Narcotic Antagonists ; Buprenorphine (40D3SCR4GZ) ; Naltrexone (5S6W795CQM)
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	605923-5
ISSN	1873-6483 ; 0740-5472
ISSN (online)	1873-6483
ISSN	0740-5472
DOI	10.1016/j.jsat.2015.01.004
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Zs.A 2017: Show issues

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Article ; Online: Individual mindfulness-based psychotherapy for cannabis or cocaine dependence: a pilot feasibility trial.

Dakwar, Elias / Levin, Frances R

The American journal on addictions

2013 Volume 22, Issue 6, Page(s) 521–526

Abstract: Background: Mindfulness-based approaches may be effective treatments for substance use disorders (SUDs), but they have only been investigated for SUDs in the group setting.: Methods: A novel 10-week individual mindfulness-based psychotherapy was ... ...

Abstract	Background: Mindfulness-based approaches may be effective treatments for substance use disorders (SUDs), but they have only been investigated for SUDs in the group setting. Methods: A novel 10-week individual mindfulness-based psychotherapy was provided weekly to participants. Tolerability and therapeutic feasibility were assessed by retention rates, incidence of adverse events or clinical worsening, and abstinence rates at the end of the protocol. Results: Twenty-five patients were enrolled overall, and 19 completed (74% overall retention rate). Of the 14 cannabis dependent patients enrolled in the study, 11 completed (79%), and 8 achieved abstinence (57% by intent-to-treat analysis) at 10 weeks. Of the 11 cocaine dependent patients, 8 completed (73%), and 6 achieved abstinence (55% by ITT) at 10 weeks. Abstinence rates were substantially greater than those of historical comparison groups. Conclusions: These findings indicate that mindfulness training can be tolerably and feasibly extended to the individual psychotherapy setting for the treatment of cocaine or cannabis dependence.
MeSH term(s)	Adult ; Cocaine-Related Disorders/therapy ; Feasibility Studies ; Female ; Humans ; Male ; Marijuana Abuse/therapy ; Middle Aged ; Mindfulness/methods ; Pilot Projects ; Psychotherapy/methods ; Treatment Outcome
Language	English
Publishing date	2013-08-30
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1141440-6
ISSN	1521-0391 ; 1055-0496
ISSN (online)	1521-0391
ISSN	1055-0496
DOI	10.1111/j.1521-0391.2013.12036.x
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Zs.A 3594: Show issues

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Article ; Online: Ketamine-facilitated behavioral treatment for cannabis use disorder: A proof of concept study.

Azhari, Nour / Hu, Helen / O'Malley, Kate Y / Blocker, Megan E / Levin, Frances R / Dakwar, Elias

The American journal of drug and alcohol abuse

2020 Volume 47, Issue 1, Page(s) 92–97

Abstract: Background: Sub-anesthetic ketamine infusions may benefit a range of psychiatric conditions, including alcohol and cocaine use disorders. Currently, there are no effective pharmacological treatments for cannabis use disorder.: Objectives: The ... ...

Abstract	Background: Sub-anesthetic ketamine infusions may benefit a range of psychiatric conditions, including alcohol and cocaine use disorders. Currently, there are no effective pharmacological treatments for cannabis use disorder. Objectives: The objective of this uncontrolled proof of concept trial was to test the feasibility, tolerability, and potential therapeutic effects of integrating ketamine infusions with a behavioral platform of motivational enhancement therapy and mindfulness-based relapse prevention in treating cannabis use disorder (CUD). Methods: Eight cannabis-dependent individuals (four female, four male) receiving motivational enhancement therapy and mindfulness-based relapse prevention behavioral treatments completed this single-blind outpatient 6-week study. Participants received either one or two infusions of ketamine (0.71 mg/kg [infusion 1]; 1.41 mg/kg [infusion 2] for non-responders) during the study. Participants self-reported cannabis use (Timeline Follow-Back) and underwent an assessment of confidence in abstaining from using cannabis (Drug-Taking Confidence Questionnaire) at predetermined time points throughout the study. Results: Ketamine infusions were well-tolerated and there were no adverse events. Frequency of cannabis use decreased significantly from baseline (B = 5.1, s.e = 0.7) to the week following the first infusion (B = 0.8, s.e = 0.412), and remained reduced at the end of the study (B = 0.5, s.e = 0.3). Participants' confidence in their ability to abstain from cannabis in potentially triggering situations increased significantly from baseline to the end of study. Conclusions: These findings suggest that combining ketamine with behavioral therapy is feasible,tolerable, and potentially helpful, in treating cannabis-dependent individuals.
MeSH term(s)	Adult ; Behavior Therapy/methods ; Excitatory Amino Acid Antagonists/therapeutic use ; Female ; Humans ; Ketamine/therapeutic use ; Male ; Marijuana Abuse/therapy ; Middle Aged ; Mindfulness ; Proof of Concept Study ; Single-Blind Method ; Treatment Outcome ; Young Adult
Chemical Substances	Excitatory Amino Acid Antagonists ; Ketamine (690G0D6V8H)
Language	English
Publishing date	2020-11-11
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	193086-2
ISSN	1097-9891 ; 0095-2990
ISSN (online)	1097-9891
ISSN	0095-2990
DOI	10.1080/00952990.2020.1808982
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Zs.A 1137: Show issues

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Article ; Online: Guanfacine extended-release for cannabis use disorder: a pilot feasibility trial.

Dakwar, Elias / Mahony, Amy / Choi, C Jean / Pavlicova, Martina / Brooks, Daniel / Mariani, John P / Levin, Frances R

The American journal of drug and alcohol abuse

2019 Volume 46, Issue 1, Page(s) 44–48

Abstract: ... ...

Abstract	Background
MeSH term(s)	Adrenergic alpha-2 Receptor Agonists/therapeutic use ; Adult ; Delayed-Action Preparations/therapeutic use ; Feasibility Studies ; Female ; Guanfacine/therapeutic use ; Humans ; Male ; Marijuana Abuse/drug therapy ; Middle Aged ; Pilot Projects ; United States/epidemiology
Chemical Substances	Adrenergic alpha-2 Receptor Agonists ; Delayed-Action Preparations ; Guanfacine (30OMY4G3MK)
Language	English
Publishing date	2019-07-24
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	193086-2
ISSN	1097-9891 ; 0095-2990
ISSN (online)	1097-9891
ISSN	0095-2990
DOI	10.1080/00952990.2019.1620259
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