Journal article icon

Journal article : Review

A continuum hypothesis of psychotomimetic rapid antidepressants

Abstract:
Ketamine, classical psychedelics and sleep deprivation are associated with rapid effects on depression. Interestingly, these interventions also have common psychotomimetic actions, mirroring aspects of psychosis such as an altered sense of self, perceptual distortions and distorted thinking. This raises the question whether these interventions might be acute antidepressants through the same mechanisms that underlie some of their psychotomimetic effects. That is, perhaps some symptoms of depression can be understood as occupying the opposite end of a spectrum where elements of psychosis can be found on the other side. This review aims at reviewing the evidence underlying a proposed <i>continuum hypothesis of psychotomimetic rapid antidepressants</i>, suggesting that a range of psychotomimetic interventions are also acute antidepressants as well as trying to explain these common features in a hierarchical predictive coding framework, where we hypothesise that these interventions share a common mechanism by increasing the flexibility of prior expectations. Neurobiological mechanisms at play and the role of different neuromodulatory systems affected by these interventions and their role in controlling the precision of prior expectations and new sensory evidence will be reviewed. The proposed hypothesis will also be discussed in relation to other existing theories of antidepressants. We also suggest a number of novel experiments to test the hypothesis and highlight research areas that could provide further insights, in the hope to better understand the acute antidepressant properties of these interventions.
Publication status:
Published
Peer review status:
Peer reviewed

Actions

Access Document

Files:
Publisher copy:
10.1177/23982128211007772

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
More by this author
Role:
Author
ORCID:
0000-0001-5371-9631


Publisher:
SAGE Publications
Journal:
Brain and Neuroscience Advances More from this journal
Volume:
5
Article number:
23982128211007772
Publication date:
2021-05-03
Acceptance date:
2021-03-08
DOI:
EISSN:
2398-2128
ISSN:
2398-2128
Pmid:
34017922


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1178325
Local pid:
pubs:1178325
Deposit date:
2022-04-07
ARK identifier:

Terms of use


Views and Downloads






If you are the owner of this record, you can report an update to it here: Report update to this record

TO TOP