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d-麦角酸二乙酰胺、裸盖菇素及其他经典致幻剂:作用机制及在情绪障碍中的潜在治疗应用

d-Lysergic acid diethylamide, psilocybin, and other classic hallucinogens: Mechanism of action and potential therapeutic applications in mood disorders.

作者信息

De Gregorio Danilo, Enns Justine P, Nuñez Nicolas A, Posa Luca, Gobbi Gabriella

机构信息

Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montréal, QC, Canada.

Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montréal, QC, Canada.

出版信息

Prog Brain Res. 2018;242:69-96. doi: 10.1016/bs.pbr.2018.07.008. Epub 2018 Aug 31.

Abstract

Depression and anxiety are psychiatric diagnoses commonly associated with low quality of life and low percentage of responsiveness by patients treated with currently available drugs. Thus, research into alternative compounds to treat these disorders is essential to guarantee a patient's remission. The last decade has witnessed a revamped interest for the application of psychedelic medicine for the treatment of mental disorders due to anecdotal reports and clinical studies which show that low doses of d-lysergic acid diethylamide (LSD) and psilocybin may have antidepressant effects. LSD and psilocybin have demonstrated mood-modulating properties likely due to their capacity to modulate serotonergic (5-HT), dopaminergic (DA) and glutamatergic systems. LSD, belonging to the category of "classic halluginogens," interacts with the 5-HT system through 5HT, and 5HT receptors, with the DA system through D receptors, and indirectly also the glutamatergic neurotransmission thought the recruitment of N-methyl-d-aspartate (NMDA) receptors. Randomized clinical studies have confirmed its antidepressant and anxiolytic effects in humans. Thus, in this chapter, we will review the pharmacology of psychedelic drugs, report the most striking clinical evidence which substantiate the therapeutic potentials of these fascinating compounds in mood disorders, and look into the horizon of where psychedelic medicine is heading.

摘要

抑郁症和焦虑症是常见的精神疾病诊断,通常与生活质量低下以及使用现有药物治疗的患者缓解率低有关。因此,研究用于治疗这些疾病的替代化合物对于确保患者缓解至关重要。过去十年见证了迷幻药在治疗精神疾病方面的应用重新受到关注,这是由于轶事报道和临床研究表明,低剂量的d-麦角酸二乙酰胺(LSD)和裸盖菇素可能具有抗抑郁作用。LSD和裸盖菇素已显示出情绪调节特性,这可能归因于它们调节血清素能(5-HT)、多巴胺能(DA)和谷氨酸能系统的能力。LSD属于“经典致幻剂”类别,它通过5HT和5HT受体与5-HT系统相互作用,通过D受体与DA系统相互作用,并且还通过募集N-甲基-D-天冬氨酸(NMDA)受体间接影响谷氨酸能神经传递。随机临床研究已证实其对人类的抗抑郁和抗焦虑作用。因此,在本章中,我们将回顾迷幻药的药理学,报告最显著的临床证据,这些证据证实了这些迷人化合物在情绪障碍中的治疗潜力,并展望迷幻药的发展前景。

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