псилоцибин:从精神病学外来者到被认为是万能药
Gregory A Fonzo1, Aaron S Wolfgang1, Bryan R Barksdale1
1Department of Psychiatry and Behavioral Sciences (Fonzo, Barksdale, Nemeroff) and Center for Psychedelic Research and Therapy (Fonzo, Nemeroff), University of Texas at Austin Dell Medical School, Austin; Institute for Early Life Adversity Research, University of Texas at Austin, Austin (Fonzo, Nemeroff); Department of Behavioral Health, Walter Reed National Military Medical Center, Bethesda, MD (Wolfgang); Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD (Wolfgang); Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Wolfgang, Krystal); Butler Hospital, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI (Carpenter); Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles (Grzenda); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA (Rodriguez); Veterans Affairs Palo Alto Health Care System, Palo Alto, CA (Rodriguez).
松素辅助疗法对严重抑郁症有很大的前景,但需要更多的研究. 由于有效性问题和有限的数据,目前的证据不足以推psilocybin用于精神病治疗.
科学领域:
- 心理药理学 心理药理学
- 临床心理学 临床心理学
- 神经科学是一个神经科学.
背景情况:
- 一种迷幻化合物psilocybin正在研究其在精神疾病中的治疗潜力.
- 心理支持/治疗 (PST) 经常与 псилоцибин一起使用,以提高治疗结果.
研究的目的:
- 批判性地评估现有的证据,用于治疗精神疾病时的西辅助疗法 (PST).
- 为这个新兴领域的未来研究提供建议.
主要方法:
- 在PubMed上对1998年1月至2023年11月期间发表的英语文章进行了全面的文献搜索,使用关键字"psilocybin".
- 对1449篇文章的查确定了21项独特的开放标签或随机对照试验 (RCT),涉及各种精神疾病,包括严重抑郁症 (MDD),焦虑/抑郁症,物质使用障碍等.
- 分析的重点是证据的质量,研究设计和确定限制.
主要成果:
- 对于主要抑郁症 (MDD) 存在最强有力的证据,有三个双盲RCT表明了积极的结果.
- 然而,这些发现的有效性受到诸如不完善的失明,小样本大小,治疗方案的可变性,参与者的多样性有限以及潜在的预期效应等问题的挑战.
- 研究人员对西的作用机制和治疗反应的预测因素的理解有限.
结论:
- 目前的证据不足以支持将psilocybin与PST作为标准精神病治疗.
- 进一步严格设计的临床试验至关重要,以确认在更大,多样化的群体中有效性,优化剂量,改善研究盲目化,阐明作用机制.
- 需要对已确定的治疗方法进行比较研究,以确定西辅助疗法的未来作用.
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