Dos Santos Rafael G, Osório Flávia L, Crippa José Alexandre S, Riba Jordi, Zuardi Antônio W, Hallak Jaime E C
Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Hospital das Clínicas, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, Brazil.
Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
Ther Adv Psychopharmacol. 2016 Jun;6(3):193-213. doi: 10.1177/2045125316638008. Epub 2016 Mar 18.
To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.
迄今为止,用于治疗情绪和焦虑障碍以及药物依赖的药物治疗效果有限,导致大量患者遭受严重且持续的症状困扰。动物和人体的初步研究表明,死藤水、裸盖菇素和麦角酸二乙酰胺(LSD)可能具有抗抑郁、抗焦虑和抗成瘾特性。因此,我们对1990年至2015年发表的临床试验进行了系统综述,评估这些治疗特性。使用PubMed、LILACS和SciELO数据库进行电子检索。仅纳入发表在同行评审期刊上的临床试验。其中,共识别出151项研究,其中六项符合既定标准。综述研究表明,对于难治性抑郁症、与危及生命疾病相关的焦虑和抑郁以及烟草和酒精依赖具有有益效果。所有药物耐受性良好。总之,死藤水、裸盖菇素和LSD可能是治疗药物依赖、焦虑和情绪障碍的有用药物工具,尤其是对于难治性患者。这些药物也可能是理解精神疾病和开发新治疗药物的有用药物工具。然而,所有综述研究的样本量都很小,其中一半是开放标签的概念验证研究。需要更多患者参与的随机、双盲、安慰剂对照研究来重复这些初步发现。