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Monday, October 14, 2019

Vacuum energy

From Wikipedia, the free encyclopedia

Vacuum energy is an underlying background energy that exists in space throughout the entire Universe. This behavior is codified in Heisenberg's energy–time uncertainty principle. Still, the exact effect of such fleeting bits of energy is difficult to quantify. The vacuum energy is a special case of zero-point energy that relates to the quantum vacuum.

The effects of vacuum energy can be experimentally observed in various phenomena such as spontaneous emission, the Casimir effect and the Lamb shift, and are thought to influence the behavior of the Universe on cosmological scales. Using the upper limit of the cosmological constant, the vacuum energy of free space has been estimated to be 10−9 joules (10−2 ergs) per cubic meter. However, in both quantum electrodynamics (QED) and stochastic electrodynamics (SED), consistency with the principle of Lorentz covariance and with the magnitude of the Planck constant suggest a much larger value of 10113 joules per cubic meter. This huge discrepancy is known as the cosmological constant problem.

Origin

Quantum field theory states that all fundamental fields, such as the electromagnetic field, must be quantized at each and every point in space. A field in physics may be envisioned as if space were filled with interconnected vibrating balls and springs, and the strength of the field is like the displacement of a ball from its rest position. The theory requires "vibrations" in, or more accurately changes in the strength of, such a field to propagate as per the appropriate wave equation for the particular field in question. The second quantization of quantum field theory requires that each such ball–spring combination be quantized, that is, that the strength of the field be quantized at each point in space. Canonically, if the field at each point in space is a simple harmonic oscillator, its quantization places a quantum harmonic oscillator at each point. Excitations of the field correspond to the elementary particles of particle physics. Thus, according to the theory, even the vacuum has a vastly complex structure and all calculations of quantum field theory must be made in relation to this model of the vacuum. 

The theory considers vacuum to implicitly have the same properties as a particle, such as spin or polarization in the case of light, energy, and so on. According to the theory, most of these properties cancel out on average leaving the vacuum empty in the literal sense of the word. One important exception, however, is the vacuum energy or the vacuum expectation value of the energy. The quantization of a simple harmonic oscillator requires the lowest possible energy, or zero-point energy of such an oscillator to be: 


Summing over all possible oscillators at all points in space gives an infinite quantity. To remove this infinity, one may argue that only differences in energy are physically measurable, much as the concept of potential energy has been treated in classical mechanics for centuries. This argument is the underpinning of the theory of renormalization. In all practical calculations, this is how the infinity is handled. 

Vacuum energy can also be thought of in terms of virtual particles (also known as vacuum fluctuations) which are created and destroyed out of the vacuum. These particles are always created out of the vacuum in particle–antiparticle pairs, which in most cases shortly annihilate each other and disappear. However, these particles and antiparticles may interact with others before disappearing, a process which can be mapped using Feynman diagrams. Note that this method of computing vacuum energy is mathematically equivalent to having a quantum harmonic oscillator at each point and, therefore, suffers the same renormalization problems. 

Additional contributions to the vacuum energy come from spontaneous symmetry breaking in quantum field theory.

Implications

Vacuum energy has a number of consequences. In 1948, Dutch physicists Hendrik B. G. Casimir and Dirk Polder predicted the existence of a tiny attractive force between closely placed metal plates due to resonances in the vacuum energy in the space between them. This is now known as the Casimir effect and has since been extensively experimentally verified. It is therefore believed that the vacuum energy is "real" in the same sense that more familiar conceptual objects such as electrons, magnetic fields, etc., are real. However, alternative explanations for the Casimir effect have since been proposed.

Other predictions are harder to verify. Vacuum fluctuations are always created as particle–antiparticle pairs. The creation of these virtual particles near the event horizon of a black hole has been hypothesized by physicist Stephen Hawking to be a mechanism for the eventual "evaporation" of black holes. If one of the pair is pulled into the black hole before this, then the other particle becomes "real" and energy/mass is essentially radiated into space from the black hole. This loss is cumulative and could result in the black hole's disappearance over time. The time required is dependent on the mass of the black hole (the equations indicate that the smaller the black hole, the more rapidly it evaporates) but could be on the order of 10100 years for large solar-mass black holes.

The vacuum energy also has important consequences for physical cosmology. General relativity predicts that energy is equivalent to mass, and therefore, if the vacuum energy is "really there", it should exert a gravitational force. Essentially, a non-zero vacuum energy is expected to contribute to the cosmological constant, which affects the expansion of the universe. In the special case of vacuum energy, general relativity stipulates that the gravitational field is proportional to ρ + 3p (where ρ is the mass–energy density, and p is the pressure). Quantum theory of the vacuum further stipulates that the pressure of the zero-state vacuum energy is always negative and equal in magnitude to ρ. Thus, the total is ρ + 3p = ρ − 3ρ = −2ρ, a negative value. If indeed the vacuum ground state has non-zero energy, the calculation implies a repulsive gravitational field, giving rise to acceleration of the expansion of the universe. However, the vacuum energy is mathematically infinite without renormalization, which is based on the assumption that we can only measure energy in a relative sense, which is not true if we can observe it indirectly via the cosmological constant.

The existence of vacuum energy is also sometimes used as theoretical justification for the possibility of free-energy machines. It has been argued that due to the broken symmetry (in QED), free energy does not violate conservation of energy, since the laws of thermodynamics only apply to equilibrium systems. However, consensus amongst physicists is that this is unknown as the nature of vacuum energy remains an unsolved problem. In particular, the second law of thermodynamics is unaffected by the existence of vacuum energy. However, in Stochastic Electrodynamics, the energy density is taken to be a classical random noise wave field which consists of real electromagnetic noise waves propagating isotropically in all directions. The energy in such a wave field would seem to be accessible, e.g., with nothing more complicated than a directional coupler. The most obvious difficulty appears to be the spectral distribution of the energy, which compatibility with Lorentz invariance requires to take the form Kf3, where K is a constant and f denotes frequency. It follows that the energy and momentum flux in this wave field only becomes significant at extremely short wavelengths where directional coupler technology is currently lacking.

History

In 1934, Georges Lemaître used an unusual perfect-fluidequation of state to interpret the cosmological constant as due to vacuum energy. In 1948, the Casimir effect provided an experimental method for a verification of the existence of vacuum energy; in 1955, however, Evgeny Lifshitz offered a different origin for the Casimir effect. In 1957, Lee and Yang proved the concepts of broken symmetry and parity violation, for which they won the Nobel prize. In 1973, Edward Tryon proposed the zero-energy universe hypothesis: that the Universe may be a large-scale quantum-mechanical vacuum fluctuation where positive mass–energy is balanced by negative gravitational potential energy. During the 1980s, there were many attempts to relate the fields that generate the vacuum energy to specific fields that were predicted by attempts at a Grand unification theory and to use observations of the Universe to confirm one or another version. However, the exact nature of the particles (or fields) that generate vacuum energy, with a density such as that required by inflation theory, remains a mystery.

Esketamine

From Wikipedia, the free encyclopedia
 
Esketamine
Esketamine2DCSD.svg
S-ketamine-from-HCl-xtal-3D-balls.png
Clinical data
Trade namesKetanest, Ketanest S, Spravato, others
SynonymsEsketamine hydrochloride; (S)-Ketamine; S(+)-Ketamine; JNJ-54135419
AHFS/Drugs.comInternational Drug Names
License data
Addiction
liability
Low–moderate
Routes of
administration
Intranasal; Intravenous infusion
Drug classNMDA receptor antagonists; Antidepressants; General anesthetics; Dissociative hallucinogens; Analgesics
ATC code
Legal status
Legal status
  • AU: S8 (Controlled)
  • US: Schedule III
  • In general: ℞ (Prescription only)
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.242.065 Edit this at Wikidata
Chemical and physical data
FormulaC13H16ClNO
Molar mass237.725 g/mol g·mol−1
3D model (JSmol)

Esketamine, sold under the brand names Ketanest and Spravato, among others, is a medication used as a general anesthetic and for treatment-resistant depression. Esketamine is used as a nasal spray or by injection into a vein.

Esketamine acts primarily as a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist. It also acts to some extent as a dopamine reuptake inhibitor but, unlike ketamine, does not interact with the sigma receptors. The compound is the S(+) enantiomer of ketamine, which is an anesthetic and dissociative similarly. It is unknown whether its antidepressant action is superior, inferior or equal to racemic ketamine and its opposite enantiomer, arketamine, which are both being investigated for the treatment of depression.

Esketamine was introduced for medical use in 1997. In 2019, it was approved for use with other antidepressants, for the treatment of depression in adults in the United States. The cost of the nasal spray as of 2019 will be US$4,700 to $6,800 for the first month.

Medical uses

Anesthesia

Esketamine is a general anesthetic and is used for similar indications as ketamine. Such uses include induction of anesthesia in high-risk patients such as those with hemorrhagic shock, anaphylactic shock, septic shock, severe bronchospasm, severe hepatic insufficiency, cardiac tamponade, and constrictive pericarditis; anesthesia in caesarian section; use of multiple anesthetics in burns; and as a supplement to regional anesthesia with incomplete nerve blocks.

Depression

Similarly to ketamine, esketamine appears to be a rapid-acting antidepressant. It received a breakthrough designation from the FDA for treatment-resistant depression (TRD) in 2013 and major depressive disorder (MDD) with accompanying suicidal ideation in 2016. The drug was studied specifically for use in combination with an oral antidepressant in people with TRD who had been unresponsive to treatment; six phase III clinical trials for this indication were conducted in 2017. It is available as a nasal spray.

In February 2019, an outside panel of experts recommended that the FDA approve the nasal spray version of esketamine, provided that it be administered in a clinical setting, with patients remaining on site for at least two hours after administration. The reasoning for this requirement is that drug trial participants temporarily experienced sedation, visual disturbances, trouble speaking, confusion, numbness, and feelings of dizziness/faintness during the period immediately after administration.

Pharmacology

Esketamine is approximately twice as potent as an anesthetic as racemic ketamine. It is eliminated from the human body more quickly than arketamine (R(–)-ketamine) or racemic ketamine, although arketamine slows its elimination.

A number of studies have suggested that esketamine has a more medically useful pharmacological action than arketamine or racemic ketamine. However, in mice found that the rapid antidepressant effect of arketamine was greater and lasted longer than that of esketamine. As such, as an antidepressant, the contrary has been stated ("R ketamine appears to be a potent and safe antidepressant relative to S ketamine", "(2R,6R)-HNK (hydroxynorketamine), a major metabolite of (R)-ketamine", "R-ketamine as a longer-lasting antidepressant compared with rapastinel").

Esketamine inhibits dopamine transporters eight times more than arketamine. This increases dopamine activity in the brain. At doses causing the same intensity of effects, esketamine is generally considered to be more pleasant by patients. Patients also generally recover mental function more quickly after being treated with pure esketamine, which may be a result of the fact that it is cleared from their system more quickly. This is however in contradiction with R-ketamine being devoid of psychotomimetic side effects.

Esketamine has an affinity for the PCP binding site of the NMDA receptor 3 to 4 times higher than that of arketamine. Unlike arketamine, esketamine does not bind significantly to sigma receptors. Esketamine increases glucose metabolism in frontal cortex, while arketamine decreases glucose metabolism in the brain. This difference may be responsible for the fact that esketamine generally has a more dissociative or hallucinogenic effect while arketamine is reportedly more relaxing. However, another study found no difference between racemic and (S)-ketamine on the patient's level of vigilance. Interpretation of this finding is complicated by the fact that racemic ketamine comprises 50% (S)-ketamine.

History

Esketamine was introduced for medical use as an anesthetic in Germany in 1997, and was subsequently marketed in other countries. In addition to its anesthetic effects, the medication showed properties of being a rapid-acting antidepressant, and was subsequently investigated for use as such. In November 2017, it completed phase III clinical trials for treatment-resistant depression in the United States. Johnson & Johnson filed a Food and Drug Administration (FDA) New Drug Application (NDA) for approval on September 4, 2018; the application was endorsed by an FDA advisory panel on February 12, 2019, and on March 5, 2019, the FDA approved esketamine, in conjunction with an oral antidepressant, for the treatment of depression in adults.

Society and culture

Names

Esketamine is the generic name of the drug and its INN and BAN, while esketamine hydrochloride is its BANM. It is also known as S(+)-ketamine, (S)-ketamine, or (–)-ketamine, as well as by its developmental code name JNJ-54135419.

Esketamine is marketed under the brand names Spravato for use as an antidepressant and Ketanest, Ketanest S, Ketanest-S, Keta-S for use as an anesthetic (veterinary), among others.

Availability

Esketamine is marketed as an antidepressant in the United States; and as an anesthetic in Europe, including in Austria, Denmark, Estonia, Finland, Germany, the Netherlands, Norway, Slovenia, Sweden, and Switzerland.

Legality

Varenicline (Chantix)

From Wikipedia, the free encyclopedia
 
Varenicline
Varenicline.svg
Varenicline ball-and-stick model.png
Clinical data
Trade namesChampix, Chantix, others
AHFS/Drugs.comMonograph
MedlinePlusa606024
License data
Pregnancy
category
  • AU: B3
  • US: C (Risk not ruled out)
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Protein binding<20 span="">
MetabolismLimited (<10 span="">
Elimination half-life24 hours
ExcretionRenal (81–92%)
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
FormulaC13H13N3
Molar mass211.267 g·mol−1
3D model (JSmol)

Varenicline (trade name Chantix and Champix) is a prescription medication used to treat nicotine addiction. It reduces both craving for and decreases the pleasurable effects of cigarettes and other tobacco products.

It is a high-affinity partial agonist for the α4β2 nicotinic acetylcholine receptor subtype (nACh) that leads to the release of dopamine in the nucleus accumbens when activated, and therefore, has the capacity to reduce the feelings of craving and withdrawal caused by smoking cessation. In this respect it is similar to cytisine and different from the nicotinic antagonist bupropion and nicotine replacement therapies (NRTs) like nicotine patches and nicotine gum. It is estimated that varenicline successfully helps one of every 11 people who smoke remain abstinent from tobacco at six months.

Medical uses

Varenicline is used to help people stop smoking tobacco (smoking cessation). A meta-analysis found that less than 20% of people treated with varenicline remain abstinent from smoking at one year. In a 2009 meta-analysis varenicline was found to be more effective than bupropion (odds ratio 1.40) and nicotine replacement therapies (NRT) (odds ratio 1.56).

A 2013 Cochrane overview and network meta-analysis concluded that varenicline is the most effective medication for tobacco cessation and that smokers were nearly three times more likely to quit on varenicline than with placebo treatment. Varenicline was more efficacious than bupropion or NRT and as effective as combination NRT for tobacco smoking cessation.

The United States' Food and Drug Administration (US FDA) has approved the use of varenicline for up to twelve weeks. If smoking cessation has been achieved it may be continued for another twelve weeks.

Varenicline has not been tested in those under 18 years old or pregnant women and therefore is not recommended for use by these groups. Varenicline is considered a class C pregnancy drug, as animal studies have shown no increased risk of congenital anomalies; however, no data from human studies is available. An observational study is currently being conducted assessing for malformations related to varenicline exposure, but has no results yet. An alternate drug is preferred for smoking cessation during breastfeeding due to lack of information and based on the animal studies on nicotine.

Side effects

Mild nausea is the most common side effect and is seen in approximately 30% of people taking varenicline though this rarely (<3 a="" common="" discontinuation="" effects="" href="https://en.wikipedia.org/wiki/Headache" in="" include="" less="" medication.="" of="" other="" results="" side="" the="" title="Headache">headache
, difficulty sleeping, and nightmares. Rare side effects reported by people taking varenicline compared to placebo include change in taste, vomiting, abdominal pain, flatulence, and constipation. It has been estimated that for every five subjects taking varenicline at maintenance doses, there will be an event of nausea, and for every 24 and 35 treated subjects, there will be an event of constipation and flatulence, respectively. Gastrointestinal side-effects lead to discontinuation of the drug in 2% to 8% of people using varenicline. Incidence of nausea is dose-dependent: incidence of nausea was higher in people taking a larger dose (30%) versus placebo (10%) as compared to people taking a smaller dose (16%) versus placebo (11%).

Depression and suicide

In 2007, the US FDA had announced it had received post-marketing reports of thoughts of suicide and occasional suicidal behavior, erratic behavior, and drowsiness among people using varenicline for smoking cessation. In 2009, the US FDA required varenicline to carry a boxed warning that the drug should be stopped if any of these symptoms are experienced.

A 2014 systematic review did not find evidence of an increased suicide risk. Other analyses have reached the same conclusion and found no increased risk of neuropsychiatric side effects with varenicline. No evidence for increased risks of cardiovascular events, depression, or self-harm with varenicline versus nicotine replacement therapy has been found in one post-marketing surveillance study.

In 2016 the FDA removed the black box warning. People are still advised to stop the medication if they "notice any side effects on mood, behavior, or thinking."

Cardiovascular disease

In June 2011, the US FDA issued a safety announcement that varenicline may be associated with "a small, increased risk of certain cardiovascular adverse events in people who have cardiovascular disease."

A prior 2011 review had found increased risk of cardiovascular events compared with placebo. Expert commentary in the same journal raised doubts about the methodology of the review, concerns which were echoed by the European Medicines Agency and subsequent reviews. Of specific concern were "the low number of events seen, the types of events counted, the higher drop-out rate in people receiving placebo, the lack of information on the timing of events, and the exclusion of studies in which no-one had an event." 

In contrast, multiple recent systematic reviews and meta-analyses have found no increase in overall or serious adverse cardiovascular events (including for individuals at risk of developing cardiovascular disease) associated with varenicline use.

Alcohol

It is recommended that people reduce the amount of alcohol they drink when on Varenicline.

Mechanism of action

Varenicline displays full agonism on α7 nicotinic acetylcholine receptors and is a partial agonist on the α4β2, α3β4, and α6β2 subtypes. In addition, it is a weak agonist on the α3β2 containing receptors. 

Varenicline's partial agonism on the α4β2 receptors rather than nicotine's full agonism produces less effect of dopamine release than nicotine's. This α4β2 competitive binding reduces the ability of nicotine to bind and stimulate the mesolimbic dopamine system - similar to the method of action of buprenorphine in the treatment of opioid addiction.

Pharmacokinetics

Most of the active compound is excreted by the kidneys (92–93%). A small proportion is glucuronidated, oxidised, N-formylated or conjugated to a hexose. The elimination half-life is about 24 hours.

History

Use of Cytisus plant as a smoking substitute during World War II led to use as a cessation aid in eastern Europe and extraction of cytisine. Cytisine analogs led to varenicline at Pfizer.

Varenicline received a "priority review" by the US FDA in February 2006, shortening the usual 10-month review period to 6 months because of its demonstrated effectiveness in clinical trials and perceived lack of safety issues. The agency's approval of the drug came on May 11, 2006. On August 1, 2006, varenicline was made available for sale in the United States and on September 29, 2006, was approved for sale in the European Union.

Psilocybin therapy

From Wikipedia, the free encyclopedia
Psilocybin therapy describes the controversial use of psilocybin to treat anxiety and depression. Psilocybin is the active substance found in "magic" mushrooms. Due to the absence of medical evidence for efficacy and safety, and legal concerns, psilocybin therapy is not used in conventional medical practice.

Research

Anxiety

Potential anxiolytic and antidepressant mechanisms of psilocybin include serotonergic and psychedelic effects in the brain.

Depression

In vitro research indicates that mechanisms of psilocybin pharmacological action are mediated by binding to 5-HT2 receptors.

Ethical concerns

A debate has been going on about whether psilocybin is an ethical, or even safe, treatment for depression and other mental illnesses such as anxiety. In comparison to other drugs, psychedelics in general are relatively harmless physiologically. Many of the currently known psychedelics, including psilocybin, are classified as having no accepted medical use in the US.

In the past, research with psychedelics has been conducted in the absence of rigorous guidelines. Especially during the 1950s and 1960s, lack of informed consent led to substantial and long-lasting harm to some subjects, averting the public away from use of psychedelics in medical practice. Further, unsupported claims led to drug abuse in the absence of a formal and supervised setting. This undoubtedly raised ethical concerns. Since then, research regarding the effectiveness of psilocybin therapy has been conducted under strict ethical guidelines, with fully informed consent and a prescreening to avoid people with psychosis taking part. Additionally, the experimenters conducting it are trained to properly administer the drug, and suggestions for experiments have to comply with the APA's ethical guidelines as well as pass expert reviews before they can be carried out.

Furthermore, potential harms of psilocybin, such as psychosis and hallucinations, have only been linked to recreational and unsupervised nonmedical use of the drug. Experts agree that the drug treatment is still under development and they do not recommend to the public to try and self-medicate their mental states. Acute effects, such as anxiety, fear states, and increases in heart rate and blood pressure, can occur during the time of drug action, and without supervision dangerous behaviors can emerge. However, trained specialists can readily manage this and usually no negative long-term effects are reported.

History

The first use of "magic mushrooms" is believed to have taken place in around 9,000 B.C in North Africa, where they were consumed by indigenous cultures. Different rock paintings depicting what seemed to be mushrooms have been found originating in this time. Additionally, statues and other forms of representations of mushrooms or mushroom-like figures have been discovered in Mayan and Aztec ruins in Central America. The mushrooms were most likely used by indigenous cultures to produce visions, induce a state of trance and to 'talk to the gods'.

First experiments

In October 1799, the first experiment investigating mushrooms and their psychedelic effects took place in London. It was conducted by Dr. Everdad Brande, who visited and observed families whose members were seized with visions and laughter following consumption of wild mushrooms. Later, these mushrooms were examined and classified as Agaricus Glutinosus and reclassified as Psilocybe Semilanceata at a later point in time.

As European travelers, traders and missionaries arrived in these areas where mushroom consumption was common, they attempted to ban mushroom consumption and possession, arguing they were unhallowed, indulgent and dangerous.

In 1959, Albert Hofmann, as Swiss chemist, was the first person to ever extract pure psilocybin from the mushrooms that commonly contain it (Psilocybe mexicana). Sandoz, the company that Hofmann worked for at that time, then began to sell the active compound to clinicians and physicians all across the world, which then used the drug as an aiding substance in psychedelic psychotherapy

In August 1960, Timothy Leary, a psychology professor from Harvard University, traveled to Mexico to conduct a self-experiment using psilocybin mushrooms. After trying pure, extracted psilocybin he decided to experiment even more with the substance, even administering it to his students. In conducting his experiment, he was assisted by his colleague, prof. Dr. Richard Alpert. One of their experiments consisted of administering psilocybin to prisoners, attempting to find out whether it could help reduce recidivism rate and constitute an effective psychotherapy aid. In fact, the results showed a recidivism rate that was 40% lower than expected. In another experiment, Leary and Alpert gave psilocybin to divinity graduate students with the aims of observing the effects of the drug on spiritually predisposed subjects. Students confirmed afterwards that their experience had made positive, lasting changes in their lives.

In 1963, however Dr. Leary and Dr. Alpert were faced with disapproval from other colleagues at Harvard University, eventually leading to their suspension from their jobs at the University. Academics criticized their experiments and their project, describing it as irresponsible and dangerous.

First medical use

Around the years 1960-1977, psilocybin was first studied as a psychotherapeutic drug. Research on humans in this field was approved by the Food and Drug Administration (FDA), but after a while it was ended and did not continue until the late 1990s, when research on the medical use of psilocybin was finally picked up again.

In 2011, a study conducted at Johns Hopkins School of Medicine showed that about 60% of the subjects that were given psilocybin under controlled conditions underwent significantly positive personality changes concerning traits like openness, imagination or feelings. On the basis of these findings, researchers have since been working on studies of psilocybin treatments in patients with cancer, who frequently experience depression, anxiety or ache.

Society and culture

Legal status

Psilocybin is listed as a Schedule I drug under the United Nations 1971 Convention on Psychotropic Substances.Therefore, the legal status of psilocybin varies internationally. In Jamaica, any kind of psilocybin is legal and openly sold. Psilocybin is partially legal in the Netherlands. Possessions of 0.5g dried or 5g fresh psychoactive mushrooms is allowed, but everything whereas major amount will lead to a penalty. In Australia, Bulgaria, Belgium, Canada, Denmark, Finland, France, Germany, Hong Kong, Indonesia, Ireland, Japan, New Zealand, Poland, Russia, South Africa, Sweden, Taiwan, Turkey, the UK and the US psilocybin is illegal and therefore possession, use or cultivation will usually lead to significant punishment. Psilocybin is not legal worldwide, but psilocybists argue that it is very important to have research on the positive consequences on mental illnesses. Thus, there is a bureaucracy to follow for the permission of psilocybin as use for researches.

Therapy

In Germany, psilocybin therapy is not illegal per se but the usage of psychedelic drugs like LSD or psilocybin while therapy generally is unlawful. Furthermore, the German Medical Association stated in 2010 an explicit warning about the application of drugs as part of therapy after two patients died during a poly-drug therapy session that year. The drugs used, although including psilocybin and LSD which are known to be reasonably safe, also included more dangerous drugs such as MDMA, heroin and amphetamine.

In the United States it is only possible to receive a psilocybin therapy in context of a study to the effects of this therapy form on different psychological illnesses. The same is true for the United Kingdom and the Netherlands. All three countries are pioneers in studying psilocybin therapy. In 2006 for example people with Obsessive-compulsive Disorder were able to apply for a study at the University of Arizona which observed the effects of psilocybin therapy on OCD.

Since 2014 the Swiss authorities give permission for the usage of psilocybin in some individual cases.

The usage of psilocybin holds a low but unpredictable chance of eliciting panic attacks, lasting flashbacks of the drug experience or even a psychosis, which serves as one of the reasons why psilocybin is illegal in many countries and not used in therapy. Another reason was formulated by the president of the German Medical Association in 2010 appealing to official psychotherapies as aiming to support a patient's self-organization instead of a drug-based therapy. On the other hand, there is increasing evidence for the medical practicality of psilocybin. Also, different studies showed that it is not likely that psilocybin induces dependence and the therapeutic index for psilocybin is about 1000, contrasting, for example 10 in alcohol.

Degenerative disc disease

From Wikipedia, the free encyclopedia https://en.wikipedia.org/wiki/Deg...