Averill has a joint appointment at Yale and the Baylor College of Medicine in Houston, and has served as an expert consultant in Texas’s House Bill 1802.
Wonderful interview: I especially love her descriptions of SSRI's
"take it every day for at least four weeks, maybe eight to twelve weeks, and you may or may not feel any better during that time. In fact, you might feel worse. And you'll also potentially lose or gain 20 to 30 pounds, experience cognitive impairment, and you might not be able to perform sexually. But don't fret! If you get to the end of that three month period and it hasn’t worked, you will start over at ground zero."
Interesting the use MDMA and Psilocybin ......and NOT considering Ketamine. My wife is a KAP, and I'm an MD interested in End of Life. We've found the Psycholytic approach combining low dose Ketamine (100mg lozenge) with good intention/therapy/integration very powerful. I wonder if a three arm study would be even better? Thanks for the sharing/interview and work!
Hi David! Thanks for your feedback and comment. Excellent question/comment! We did consider ketamine as well - the initial bill actually included all three. Aside from funding limitations, we've limited to MDMA and psilocybin as the evidence for MDMA as a treatment for PTSD is generally all positive and the evidence for ketamine is quite mixed, including a study my colleagues and I recently published from a large ketamine trial for Veterans and active duty personnel with PTSD that did not find ketamine was really superior to placebo. I have some thoughts as to why this finding may be divergent from some of the studies like Adriana Feder's group at Mount Sinai. Would love to do some comparative trials with ketamine though and hope to in the near future. I think your comment re: intention/therapy/integration is also a critical piece missing from the ketamine literature and I'm delighted to see that some work is happening here now - and excited a colleague here in Houston is hoping to work on a treatment protocol as well. Thanks! :)
Thank you for this interview and the work you're doing in behalf of Veterans and hopefully for many people with PTSD from other sources than military involvements. I'm a psychiatrist with almost 50 years of experience and have been an advocate for psychotherapy with guided use of psychotropic medications as an adjunct to therapy and not the full therapy. There are many instances of psychotropic limitations, side effects, and even adverse reactions. However, there have been times when the psychotropics are significant in helping change lives for the better and profoundly so, especially with a psychotherapy component. I fully agree we need other ways to approach the severity of PTSD than just one form of pharmacological approach but especially ones that can help make changes in our experiences with reality and understandings about life. It's critical we acknowledge the various paths that bring us to a deeper appreciation of life, our own adversities during our lives, and a way to achieve a better future. With thanks for your work and dedication, Barry Ostrow MD
Great post! I love the idea of comparing MDMA and psilocybin in the same study, I was wondering when that was going to become a research question. I’ve also been reading as much as I can about Texas’s approach because they’re kind of uniquely positioned as the territory that contains most of the habitat of Peyote and other mescaline-producing cacti. I’m really interested to find out how the state plans to reconcile the new wave of psychedelic interest with the well-being of it’s Indigenous community. Thanks!
Wonderful interview: I especially love her descriptions of SSRI's
"take it every day for at least four weeks, maybe eight to twelve weeks, and you may or may not feel any better during that time. In fact, you might feel worse. And you'll also potentially lose or gain 20 to 30 pounds, experience cognitive impairment, and you might not be able to perform sexually. But don't fret! If you get to the end of that three month period and it hasn’t worked, you will start over at ground zero."
Interesting the use MDMA and Psilocybin ......and NOT considering Ketamine. My wife is a KAP, and I'm an MD interested in End of Life. We've found the Psycholytic approach combining low dose Ketamine (100mg lozenge) with good intention/therapy/integration very powerful. I wonder if a three arm study would be even better? Thanks for the sharing/interview and work!
Hi David! Thanks for your feedback and comment. Excellent question/comment! We did consider ketamine as well - the initial bill actually included all three. Aside from funding limitations, we've limited to MDMA and psilocybin as the evidence for MDMA as a treatment for PTSD is generally all positive and the evidence for ketamine is quite mixed, including a study my colleagues and I recently published from a large ketamine trial for Veterans and active duty personnel with PTSD that did not find ketamine was really superior to placebo. I have some thoughts as to why this finding may be divergent from some of the studies like Adriana Feder's group at Mount Sinai. Would love to do some comparative trials with ketamine though and hope to in the near future. I think your comment re: intention/therapy/integration is also a critical piece missing from the ketamine literature and I'm delighted to see that some work is happening here now - and excited a colleague here in Houston is hoping to work on a treatment protocol as well. Thanks! :)
-Nette Averill, BCM
Thank you for this interview and the work you're doing in behalf of Veterans and hopefully for many people with PTSD from other sources than military involvements. I'm a psychiatrist with almost 50 years of experience and have been an advocate for psychotherapy with guided use of psychotropic medications as an adjunct to therapy and not the full therapy. There are many instances of psychotropic limitations, side effects, and even adverse reactions. However, there have been times when the psychotropics are significant in helping change lives for the better and profoundly so, especially with a psychotherapy component. I fully agree we need other ways to approach the severity of PTSD than just one form of pharmacological approach but especially ones that can help make changes in our experiences with reality and understandings about life. It's critical we acknowledge the various paths that bring us to a deeper appreciation of life, our own adversities during our lives, and a way to achieve a better future. With thanks for your work and dedication, Barry Ostrow MD
Great post! I love the idea of comparing MDMA and psilocybin in the same study, I was wondering when that was going to become a research question. I’ve also been reading as much as I can about Texas’s approach because they’re kind of uniquely positioned as the territory that contains most of the habitat of Peyote and other mescaline-producing cacti. I’m really interested to find out how the state plans to reconcile the new wave of psychedelic interest with the well-being of it’s Indigenous community. Thanks!