Wilfrid Noel Raby, Ph.D., M.D.

Dr. Wilfrid Noel Raby Ph.D., M.D. is an assistant clinical professor of psychiatry at the College of Physicians and Surgeons, and a research psychiatrist at the New York State Psychiatric Institute. Dr Raby did his undergraduate studies at McGill University in Montreal, Que, Canada (1984). From 1984 to 1986, Dr. Raby traveled extensively in Europe, Africa and Asia. Following this, Dr. Raby returned to Canada, and completed his doctoral research also at McGill University in 1990 on the hypothalamic neural circuitry that controls the secretion of vasopressin and oxytocin, two neurohormones secreted from the posterior pituitary. He attended the School of Medicine at the University of Toronto, Ont. Canada from 1989 to 1993. He completed his training in psychiatry at Columbia University in 1997 during which he initiated research on the role of dopamine genetics in nicotine addiction. During the following year, he completed the fellowship in public psychiatry. He has extensive experience in the treatment of severe mental illness, and serves as a consultant for the New York State Office of Mental Health. His research interests include the phenomenology and treatment of the comorbidity of mental illness and addiction disorders, the role of the central and peripheral stress axes in maintaining drug addiction, the potential use of cannabinoids for medicinal purposes, and the impact of marijuana use on psychotic disorders.

email
rabywil@pi.cpmc.columbia.edu

telephone
(212) 740-3208

Substance Treatment and Research Service
513 West 166th street, 3rd floor
New York, NY, 10032

Current Research Activities:

Cocaine dependence and depression
With Dr. Edward V. Nunes, Dr. Raby is initiating a new clinical trial for the treatment of depression and cocaine dependence using the antidepressant mirtazapine. It is thought that the properties of antidepressant may improve the welfare of participants during the initial phase of the trial, as it is calming, sedating, and promotes the recovery of a good appetite. In addition, we hypothesize that this antidepressant may have a relapse preventing effect by inhibiting stress hormone secretion. We will couple the treatment with this antidepressant with measures to attempt to induce abstinence early in the trial, as we think this will enhance the efficacy of the antidepressant. This clinical trial also involves the participants in relapse-prevention therapy to acquire skills that will help maintain abstinence.

Perpetuation of cocaine dependence and stress hormones
Stressful life events promote continued use of cocaine in many cocaine-dependent individuals. Exposing cocaine-dependent individuals to pictures, objects, or active recollection of cocaine use also increases the secretion of stress hormones while eliciting a desire to use cocaine. Furthermore, injecting synthetic stress hormone intravenously in cocaine dependent individuals has been shown to provoke cravings for cocaine. Hence, it is possible that by manipulating the central and peripheral stress axes, relapse risk and frequency could be reduced. Dr. Raby is preparing a pilot study where the impact of inhibiting the stress axis on the frequency of cocaine use, length of abstinence will be investigated.

Schizophrenia, psychotic disorders, and marijuana
Dr Raby is also preparing studies to investigate further the relationship of cannabinoids in marijuana and the onset of psychotic symptoms. He is also preparing another study where he would investigate in patients with psychotic disorders what the effect of smoking marijuana is, and how it may affect ongoing symptoms. He is also developing treatment approaches to address the issue of cannabis dependence in individuals with psychotic disorders.

Cannabinoids and the control of intracranial hypertension
In collaboration with Dr. Patricia Modica of the State University of New York School of Optometry, Dr. Raby has been investigating how cannabinoids might be used to treat a condition called Idiopathic Intracranial Hypertension; a condition that affects women and that can lead to blindness. Drs Modica and Raby are planning a randomized trial to further investigate the role of synthetic cannabinoids like Marinol to treat this condition.

Recent Publications