Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
Tallaght University Hospital, Dublin, Ireland.
Ir J Psychol Med. 2021 Jun;38(2):93-98. doi: 10.1017/ipm.2020.94. Epub 2020 Aug 19.
The medium- to long-term consequences of COVID-19 are not yet known, though an increase in mental health problems are predicted. Multidisciplinary strategies across socio-economic and psychological levels may be needed to mitigate the mental health burden of COVID-19. Preliminary evidence from the rapidly progressing field of psychedelic science shows that psilocybin therapy offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and maladaptive habitual patterns of cognition and behaviour, notably depression, addiction and obsessive compulsive disorder. The COMPASS Pathways (COMPASS) phase 2b double-blind trial of psilocybin therapy in antidepressant-free, treatment-resistant depression (TRD) is underway to determine the safety, efficacy and optimal dose of psilocybin. Results from the Imperial College London Psilodep-RCT comparing the efficacy and mechanisms of action of psilocybin therapy to the selective serotonin reuptake inhibitor (SSRI) escitalopram will soon be published. However, the efficacy and safety of psilocybin therapy in conjunction with SSRIs in TRD is not yet known. An additional COMPASS study, with a centre in Dublin, will begin to address this question, with potential implications for the future delivery of psilocybin therapy. While at a relatively early stage of clinical development, and notwithstanding the immense challenges of COVID-19, psilocybin therapy has the potential to play an important therapeutic role for various psychiatric disorders in post-COVID-19 clinical psychiatry.
虽然预测 COVID-19 会导致更多的心理健康问题，但 COVID-19 的中长期后果尚不清楚。可能需要在社会经济和心理层面采取多学科策略来减轻 COVID-19 对心理健康的负担。快速发展的迷幻科学领域的初步证据表明，迷幻药治疗为一系列以受限和适应不良的认知和行为模式为特征的障碍（尤其是抑郁症、成瘾和强迫症）提供了一种有前途的跨诊断治疗策略。正在进行的 COMPASS 途径（COMPASS）二期双盲试验，旨在确定无抗抑郁药、治疗抵抗性抑郁症（TRD）中迷幻药治疗的安全性、疗效和最佳剂量。伦敦帝国理工学院比较迷幻药治疗与选择性 5-羟色胺再摄取抑制剂（SSRI）依地普仑疗效和作用机制的 Psilodep-RCT 研究结果即将公布。然而，迷幻药治疗与 TRD 中 SSRI 联合使用的疗效和安全性尚不清楚。都柏林的另一个 COMPASS 研究将开始解决这个问题，这可能对未来迷幻药治疗的实施产生影响。尽管迷幻药治疗仍处于临床开发的早期阶段，而且 COVID-19 带来了巨大挑战，但它有可能在 COVID-19 后精神病学中为各种精神障碍发挥重要的治疗作用。
