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Navegando por Autor "Riba, Jordi"

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    Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report
    (2015) Osório, Flávia de L.; Sanches, Rafael F.; Macedo, Ligia R.; Santos, Rafael G. dos; Maia-de-Oliveira, João P.; Wichert-Ana, Lauro; Araújo, Dráulio Barros de; Riba, Jordi; Crippa, José A.; Hallak, Jaime E.
    Objectives: Ayahuasca (AYA), a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT) and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode. Methods: Open-label trial conducted in an inpatient psychiatric unit. Results: Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS). AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS) scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement. Conclusions: These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.
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    Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study
    (2016) Sanches, Rafael Faria; Osório, Flávia de Lima; Santos, Rafael G. dos; Macedo, Ligia R.H.; Maia-de-Oliveira, João Paulo; Wichert-Ana, Lauro; Araújo, Dráulio Barros de; Riba, Jordi; Crippa, José Alexandre S.; Hallak, Jaime E.C.
    Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.
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    Assessing the psychedelic "after-glow" in ayahuasca users: post-acute neurometabolic and functional connectivity changes are associated with enhanced mindfulness capacities
    (2017-06-13) Sampedro, Frederic; de la Fuente Revenga, Mario; Valle, Marta; Roberto, Natalia; Domínguez-Clavé, Elisabet; Elices, Matilde; Luna, Luís Eduardo; Crippa, José Alexandre S; Hallak, Jaime E C; Araújo, Dráulio Barros de; Friedlander, Pablo; Barker, Steven A; Álvarez, Enrique; Soler, Joaquim; Pascual, Juan C; Feilding, Amanda; Riba, Jordi
    BACKGROUND: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network, purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here, we investigated in an open-label uncontrolled study in 16 healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications and their association with mindfulness measures. METHODS: Using 1H-magnetic resonance spectroscopy and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior and anterior cingulate cortex after a single ayahuasca dose. RESULTS: Magnetic resonance spectroscopy showed post-acute reductions in glutamate+glutamine, creatine, and N-acetylaspartate+N-acetylaspartylglutamate in the posterior cingulate cortex. Connectivity was increased between the posterior cingulate cortex and the anterior cingulate cortex, and between the anterior cingulate cortex and limbic structures in the right medial temporal lobe. Glutamate+glutamine reductions correlated with increases in the "nonjudging" subscale of the Five Facets Mindfulness Questionnaire. Increased anterior cingulate cortex-medial temporal lobe connectivity correlated with increased scores on the self-compassion questionnaire. Post-acute neural changes predicted sustained elevations in nonjudging 2 months later. CONCLUSIONS: These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the posterior cingulate cortex, a key region within the default mode network, and increased connectivity between the anterior cingulate cortex and medial temporal lobe structures involved in emotion and memory potentially underlie the post-acute psychological effects of ayahuasca.
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    Assessing the psychedelic "after-glow" in ayahuasca users: post-acute neurometabolic and functional connectivity changes are associated with enhanced mindfulness capacities
    (2017-06-13) Sampedro, Frederic; de la Fuente Revenga, Mario; Valle, Marta; Roberto, Natalia; Domínguez-Clavé, Elisabet; Elices, Matilde; Luna, Luís Eduardo; Crippa, José Alexandre S.; Hallak, Jaime E. C.; Araújo, Dráulio Barros de; Friedlander, Pablo; Barker, Steven A.; Álvarez, Enrique; Soler, Joaquim; Pascual, Juan C.; Feilding, Amanda; Riba, Jordi
    BACKGROUND: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network (DMN), purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers, and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here we investigated in an open-label uncontrolled study in sixteen healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications, and their association with mindfulness measures. METHODS: Using 1H-magnetic resonance spectroscopy (MRS) and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior (PCC) and anterior (ACC) cingulate cortex after a single ayahuasca dose. RESULTS: MRS showed post-acute reductions in Glx (glutamate+glutamine), creatine and NAA-NAAG (N-acetylaspartate+N-acetylaspartylglutamate) in the PCC. Connectivity was increased between the PCC and the ACC, and between the ACC and limbic structures in the right medial temporal lobe (MTL). Glx reductions correlated with increases in the "Non-Judging" subscale of the Five Facets Mindfulness Questionnaire. Increased ACC-MTL connectivity correlated with increased scores on the Self-Compassion questionnaire. Post-acute neural changes predicted sustained elevations in "Non-Judging" two months later. CONCLUSIONS: These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the PCC, a key region within the DMN, and increased connectivity between the ACC and MTL structures involved in emotion and memory, potentially underlie the post-acute psychological effects of ayahuasca.
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    Long-term use of psychedelic drugs is associated with differences in brain structure and personality in humans
    (2015) Bouso, José Carlos; Palhano-Fontes, Fernanda; Rodríguez-Fornells, Antoni; Ribeiro, Sidarta Tollendal Gomes; Sanches, Rafael; Crippa, José Alexandre S.; Hallak, Jaime E.C.; Araújo, Dráulio Barros de; Riba, Jordi
    Psychedelic agents have a long history of use by humans for their capacity to induce profound modifications in perception, emotion and cognitive processes. Despite increasing knowledge of the neural mechanisms involved in the acute effects of these drugs, the impact of sustained psychedelic use on the human brain remains largely unknown. Molecular pharmacology studies have shown that psychedelic 5-hydroxytryptamine (5HT)2A agonists stimulate neurotrophic and transcription factors associated with synaptic plasticity. These data suggest that psychedelics could potentially induce structural changes in brain tissue. Here we looked for differences in cortical thickness (CT) in regular users of psychedelics. We obtained magnetic resonance imaging (MRI) images of the brains of 22 regular users of ayahuasca (a preparation whose active principle is the psychedelic 5HT2A agonist N,N-dimethyltryptamine (DMT)) and 22 controls matched for age, sex, years of education, verbal IQ and fluid IQ. Ayahuasca users showed significant CT differences in midline structures of the brain, with thinning in the posterior cingulate cortex (PCC), a key node of the default mode network. CT values in the PCC were inversely correlated with the intensity and duration of prior use of ayahuasca and with scores on self-transcendence, a personality trait measuring religiousness, transpersonal feelings and spirituality. Although direct causation cannot be established, these data suggest that regular use of psychedelic drugs could potentially lead to structural changes in brain areas supporting attentional processes, self-referential thought, and internal mentation. These changes could underlie the previously reported personality changes in long-term users and highlight the involvement of the PCC in the effects of psychedelics.
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    Preliminary evidence of links between ayahuasca use and the corpus callosum
    (Frontiers Media SA, 2022-10) Simonsson, Otto; Bouso, José Carlos; Kurth, Florian; Araujo, Draulio Barros de; Gaser, Christian; Riba, Jordi; Luders, Eileen
    Background: Recent research suggests that ayahuasca and its alkaloid-containing ingredients may be helpful in the treatment and prevention of certain movement and neurodegenerative disorders. However, such research is still in its infancy and more studies in normative samples seem necessary to explore effects of ayahuasca on clinically relevant brain structures, such as the corpus callosum. Aims: The purpose of the present study was to investigate links between ayahuasca use and callosal structure in a normative sample. Methods: Using structural imaging data from 22 ayahuasca users and 22 matched controls we compared the thickness of the corpus callosum between both groups at 100 equidistant points across the entire midsagittal surface. In addition, we investigated point-wise correlations between callosal thickness and the number of past ayahuasca sessions. Results: The corpus callosum was significantly thicker within the isthmus in the ayahuasca group than in the control group. There was also a significant positive correlation between callosal thickness and the number of past ayahuasca sessions within the rostral body, albeit none of these effects survived corrections for multiple comparisons. No region was significantly thicker in the control than in the ayahuasca group, and no callosal region was negatively linked to ayahuasca use, even at uncorrected significance thresholds. Conclusion: This study provides preliminary evidence of links between ayahuasca use and the corpus callosum. However, future studies need to replicate these findings, preferably using larger sample sizes and ideally also utilizing longitudinal research designs, to draw any practical conclusion and offer implications for follow-up clinical research
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    Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial
    (2018-06-15) Palhano-Fontes, Fernanda; Barreto, Dayanna; Onias, Heloisa; Andrade, Katia C.; Novaes, Morgana M.; Pessoa, Jessica A.; Mota-Rolim, Sergio A.; Osório, Flávia L.; Sanches, Rafael; Santos, Rafael G. dos; Tófoli, Luís Fernando; Silveira, Gabriela de Oliveira; Yonamine, Mauricio; Riba, Jordi; Santos, Francisco R.; Silva-Junior, Antonio A.; Alchieri, João C.; Galvão-Coelho, Nicole L.; Lobão-Soares, Bruno; Hallak, Jaime E. C.; Arcoverde, Emerson; Maia-de-Oliveira, João P.; Araújo, Dráulio Barros de
    Background Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. Methods To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing. Results We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054). Conclusions To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769).
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