抑郁症的psilocybin辅助疗法:人类研究的系统审查和剂量反应元分析
Natacha Perez1, Florent Langlest1, Luc Mallet2
1Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland.
概括
这项研究确定了抑郁症的最佳 псилоцибин剂量,为原发性,二次性和耐治疗性抑郁症找到特定的有效剂量 (ED95). 需要进行进一步的试验,以最大限度地提高疗效,并尽量减少副作用.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 神经科学是一个神经科学.
- 临床心理学 临床心理学
背景情况:
- 西作为抗抑郁药物表现有前途,但抑郁症的最佳剂量尚未确定.
- 系统性审查和元分析对于合成关于 пси洛西宾有效性和安全性的证据至关重要.
- 了解剂量反应关系是开发有效和安全的迷幻药辅助疗法的关键.
研究的目的:
- 进行系统性审查和剂量反应元分析,以确定降低抑郁症得分的最佳西宾剂量.
- 确定不同抑郁症亚型的特定有效剂量 (ED95),包括初级,二级和耐治疗抑郁症.
- 为了研究西的疗效和潜在副作用的剂量反应关联.
主要方法:
- 系统地搜索电子数据库 (开始至2023年2月) 双盲,随机,安慰剂对照试验 (RCT) 定剂量西在成人抑郁症.
- 包括7个RCT和489名参与者,分析了初级 (N=366) 和二级 (N=123) 抑郁症子组的数据.
- 应用一阶段剂量反应元分析,限制立方线和Cochrane偏差风险评估.
主要成果:
- 确定了每70公斤的95%有效剂量 (ED95):二次抑郁症8.92毫克,初级抑郁症24.68毫克,两者合并后36.08毫克.
- 观察到抑郁症得分的显著剂量反应关系,曲线在每个子组的不同水平上停滞不前.
- 发现了副作用的显著剂量反应关联,包括身体不适,血压升高,恶心,头痛和长期精神病的风险.
结论:
- 对二次性,初级性和耐治疗性抑郁症确定了西的特定ED95值,对耐治疗病例表示更高的剂量.
- 对于治疗结果和不良事件都注意到了显著的剂量反应效应.
- 对于每个特定的抑郁症人群,建议进行进一步的RCT,以优化 псилоцибин剂量,以获得最大的疗效和最小的副作用.
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