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迷幻剂:我们现在在哪里,我们为什么会在这里,我们必须做什么。

Psychedelics: Where we are now, why we got here, what we must do.

机构信息

Captain (CAPT), United States Public Health Service (USPHS), 11307 Church Bend Court, Germantown, MD 20876, United States.

Professor, Behavioral Biology, Adjunct, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, United States; Vice President, Research, Health Policy and Abuse Liability, Pinney Associates, 4800 Montgomery Lane, Suite 400, Bethesda, MD 20814, United States.

出版信息

Neuropharmacology. 2018 Nov;142:7-19. doi: 10.1016/j.neuropharm.2018.02.018. Epub 2018 Feb 21.

Abstract

The purpose of this commentary is to provide an introduction to this special issue of Neuropharmacology with a historical perspective of psychedelic drug research, their use in psychiatric disorders, research-restricting regulatory controls, and their recent emergence as potential breakthrough therapies for several brain-related disorders. It begins with the discovery of lysergic acid diethylamide (LSD) and its promising development as a treatment for several types of mental illnesses during the 1940s. This was followed by its abuse and stigmatization in the 1960s that ultimately led to the placement of LSD and other psychedelic drugs into the most restrictively regulated drug schedule of the United States Controlled Substances Act (Schedule I) in 1970 and its international counterparts. These regulatory controls severely constrained development of psychedelic substances and their potential for clinical research in psychiatric disorders. Despite the limitations, there was continued research into brain mechanisms of action for psychedelic drugs with potential clinical applications which began during the 1990s and early 2000s. Finding pathways to accelerate clinical research in psychedelic drug development is supported by the growing body of research findings that are documented throughout this special issue of Neuropharmacology. Accumulated research to date suggests psychedelic drug assisted psychotherapy may emerge as a potential breakthrough treatment for several types of mental illnesses including depression, anxiety, post-traumatic stress disorder, and addiction that are refractory to current evidenced based therapies. This research equally shows promise in advancing the understanding of the brain, brain related functioning, and the consequential effects of untreated brain related diseases that have been implicated in causing and/or exacerbating numerous physical disease state conditions. The authors conclude that more must be done to effectively address mental illnesses and brain related diseases which have become so pervasive, destructive, and whose treatments are becoming increasingly resistant to current evidenced based therapies. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.

摘要

本文旨在通过回顾迷幻药物研究的历史,包括其在精神疾病中的应用、限制其研究的监管控制,以及最近作为几种与大脑相关疾病的潜在突破性治疗方法的出现,为本期《神经药理学》特刊提供介绍。本文从麦角酸二乙酰胺(LSD)的发现及其在 20 世纪 40 年代作为几种类型精神疾病的治疗方法的有前途的发展开始。随后,在 20 世纪 60 年代,它被滥用和污名化,最终导致 LSD 和其他迷幻药物于 1970 年被列入美国《管制物质法》(附表 I)和国际管制药物中最受限制的药物类别。这些监管控制严重限制了迷幻物质的发展及其在精神疾病临床研究中的潜力。尽管存在这些限制,但对迷幻药物的大脑作用机制仍在继续研究,以期在 20 世纪 90 年代和 21 世纪初将其应用于临床。支持加速迷幻药物开发临床研究的是越来越多的研究结果,这些结果在本期《神经药理学》特刊中都有记录。迄今为止的研究积累表明,迷幻药物辅助心理治疗可能成为几种类型精神疾病的潜在突破性治疗方法,包括抑郁症、焦虑症、创伤后应激障碍和成瘾,这些疾病对目前基于证据的治疗方法有抵抗力。这项研究同样有希望增进对大脑、大脑相关功能的理解,以及未治疗的大脑相关疾病的后果,这些疾病与许多身体疾病状态的发生和/或恶化有关。作者得出结论,必须采取更多措施来有效治疗这些如此普遍、破坏性的精神疾病和大脑相关疾病,而目前基于证据的治疗方法对这些疾病的治疗效果越来越差。本文是特刊《迷幻剂:新视角,新认识》的一部分。

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