Meinhardt Marcus W, Güngör Cansu, Skorodumov Ivan, Mertens Lea J, Spanagel Rainer
Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
Neuropsychopharmacology. 2020 Jul;45(8):1316-1322. doi: 10.1038/s41386-020-0694-z. Epub 2020 May 5.
For most psychiatric disorders, including alcohol use disorder (AUD), approved pharmacological treatments are limited in their effectiveness, and new drugs that can easily be translated into the clinic are needed. Currently, great hope lies in the potential of psychedelics to effectively treat AUD. The primary hypothesis is that a single session of psychedelic-guided psychotherapy can restore normal brain function in AUD individuals and thereby reduce the risk of relapse in the long run. Here we applied three different treatment schedules with psilocybin/LSD in order to investigate relapse-like drinking in the alcohol deprivation effect (ADE) model. In contrast to the primary hypothesis, psychedelics had no long-lasting effects on the ADE in male and female rats, neither when administered in a high dosage regime that is comparable to the one used in clinical studies, nor in a chronic microdosing scheme. Only sub-chronic treatment with psilocybin produced a short-lasting anti-relapse effect. However, it is not a translatable treatment option to give psychedelics sub-chronically for relapse prevention. In conclusion, our results in the ADE model do not support the hypothesis that microdosing or high doses of psychedelic reduce relapse behavior. This conclusion has to be confirmed by applying other animal models of AUD. It could also well be that animal models of AUD might be unable to fully capture the therapeutic potential of psychedelic drugs and that only future large-scale clinical trials will be able to demonstrate the efficacy of psychedelics as a new treatment option for AUD.
对于大多数精神疾病,包括酒精使用障碍(AUD),已获批的药物治疗效果有限,因此需要能够轻易转化应用于临床的新药。目前,人们对迷幻药有效治疗AUD的潜力寄予厚望。主要假设是,单次迷幻剂引导的心理治疗可以恢复AUD患者的正常脑功能,从而从长远来看降低复发风险。在此,我们应用了三种不同的裸盖菇素/麦角酸二乙酰胺(LSD)治疗方案,以研究酒精剥夺效应(ADE)模型中的类似复发饮酒情况。与主要假设相反,迷幻药对雄性和雌性大鼠的ADE没有长期影响,无论是在与临床研究中使用的剂量相当的高剂量方案下给药,还是在慢性微剂量方案下给药。只有裸盖菇素的亚慢性治疗产生了短期的抗复发效果。然而,亚慢性给予迷幻药以预防复发并非一种可转化应用于临床的治疗选择。总之,我们在ADE模型中的结果不支持微剂量或高剂量迷幻药可减少复发行为这一假设。这一结论必须通过应用其他AUD动物模型来证实。也很有可能AUD动物模型无法完全捕捉迷幻药的治疗潜力,只有未来的大规模临床试验才能证明迷幻药作为AUD新治疗选择的疗效。