Buprenorphine extends ketamine's anti-suicide effects for 4 weeks in depression trial
This week brought major advances in psychedelic medicine—from the largest brain imaging study of psilocybin ever conducted to breakthrough combinations that could make ketamine's life-saving effects last longer.
🎯 Buprenorphine extends ketamine's anti-suicide effects
- 50 adults with major depression and suicidal thoughts received ketamine infusions, then were randomized to receive either low-dose buprenorphine (0.2-0.8 mg/day) or placebo for 4 weeks
- The buprenorphine group showed much greater reductions in suicidal ideation scores (-11.6 points) compared to placebo (-6.3 points)
- No serious treatment-related adverse events occurred, suggesting this combination could be both effective and safe
Why it matters: Ketamine rapidly reduces suicidal thoughts but the effects fade quickly. This study provides the first evidence that a follow-up medication can significantly sustain ketamine's life-saving benefits—potentially offering a scalable solution for people at highest risk.
Key Findings
🧠 Largest psilocybin brain imaging study launches
- PsiConnect enrolled 62 participants for comprehensive brain scans before and after 19 mg psilocybin doses
- The study combines multiple brain imaging techniques (fMRI, structural MRI, diffusion MRI, and EEG) with three different contexts: meditation, music, and movies
- Half the participants completed 8 weeks of meditation training, allowing researchers to study how meditation and psilocybin interact in the brain
- Follow-ups continue for one year post-treatment, with data made publicly available for other researchers
🍄 Mescaline shows unique brain signature in rats
- Awake rats given mescaline showed selective suppression of brain activity in the cerebellum, unlike LSD and psilocybin
- Despite cerebellar suppression, the brain showed global hyperconnectivity, with the cerebellum forming new connections to the hippocampus, thalamus, and sensory areas
- Mescaline enhanced acoustic filtering at certain frequencies (+27.6% at 4 kHz, +27.3% at 20 kHz) but impaired it at others (-16.4% at 12 kHz)
🌿 Psychedelics show promise for eating disorders
- A meta-analysis of 8 studies identified how psychedelic experiences may help with eating disorder recovery through improved emotion processing and enhanced body connection
- Researchers found that people with eating disorders need specialized safety considerations during psychedelic therapy due to physical vulnerabilities from low weight
- The analysis suggests therapists need dual expertise in both psychedelic treatment and eating disorder psychology for optimal outcomes
🏥 Most palliative care providers skeptical of psilocybin therapy
- Survey of 121 palliative care stakeholders found 61% had unfavorable attitudes toward psilocybin-assisted therapy for end-of-life distress
- However, 95% of physicians reported favorable attitudes, showing a stark divide between clinical and non-clinical staff
- Lack of trained healthcare providers was identified as the primary barrier to implementation, with 68% endorsing early-stage illness intervention
💊 Oral ketamine proves effective for depression
- Meta-analysis of 8 studies with 414 participants found oral ketamine significantly reduced depression scores compared to placebo
- Patients were 2.38 times more likely to achieve remission with oral ketamine versus placebo
- Oral ketamine showed similar effectiveness to other forms of ketamine (IV, nasal) with no serious adverse events reported
🎵 Setting specific intentions enhances psychedelic benefits
- Study of recreational psychedelic users found those with mental health and self-discovery intentions experienced greater mystical experiences and improved well-being
- Recreational intentions were unrelated to well-being improvements and negatively correlated with positive outcomes
- Specific, relevant intentions that were integrated after the experience correlated with the best outcomes, while flexible intentions led to worse results
Implications
These studies reveal psychedelic medicine is rapidly maturing from experimental treatments to practical therapies. The combination approaches—like buprenorphine extending ketamine's effects—suggest the future may involve strategic drug pairings rather than single interventions. Meanwhile, the emphasis on context, intentions, and specialized training highlights that successful psychedelic therapy requires much more than just the drugs themselves.
Studies in this issue
Primary sources used for this newsletter.
- Low-dose buprenorphine after ketamine for suicidal thoughts in major depression: a controlled clinical trialmain storyThe American journal of psychiatry2026-05-19PMID 42151794
- Brain and behavior changes with psilocybin in different situations using multiple brain imaging methodskey findingScientific data2026-05-21PMID 42168232
- How People Experience Psychedelic Treatments for Eating Disorders: A Summary of Qualitative Studieskey findingBMC medicine2026-05-20PMID 42157199
- How Setting Intentions Affects Immediate Experiences and Well-Being in Recreational Psychedelic Userskey findingJournal of psychoactive drugs2026-05-22PMID 42172091
- Mescaline Changes Movement System Activity, Overall Brain Connections, and Sound Filtering in Awake Ratskey findingNeuroscience bulletin2026-05-21PMID 42168715
- Short-term effects of oral ketamine on depression symptoms: A review and analysis of clinical trialskey findingAsian journal of psychiatry2026-05-19PMID 42155204
- Using psilocybin therapy in end-of-life care: views from patients and providerskey findingPalliative medicine2026-05-19PMID 42154482
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