Mood Disorders Psychopharmacology Unit, University Health Network , Toronto, ON, Canada.
Institute of Medical Science, University of Toronto , Toronto, ON, Canada.
Expert Rev Neurother. 2020 Dec;20(12):1263-1273. doi: 10.1080/14737175.2020.1826931. Epub 2020 Sep 30.
Mental illness has a chronic course of illness with a number of clinical manifestations. Affected individuals experience significant functional, emotional, cognitive, and/or behavioral impairments. The growing prevalence of mental illness has been associated with significant social and economic costs. Indeed, the economic burden of mental illness is estimated to exceed $1.8 trillion USD over the next 30 years. A significant number of individuals affected by mental illness fail to respond to first-line treatment options. Therefore, there remains an unmet need for rapidly attenuating therapeutic options for mental health disorders with minimal social and economic burden.
The paucity of novel treatment options warrants a renewed investigation of psychedelic-based psychotherapy. Herein, the authors will evaluate the therapeutic potential of traditional psychedelics, psilocybin, and MDMA, in the treatment of mental illness with a narrative review of available literature.
Psychedelics, such as psilocybin and MDMA, offer an alternative avenue of therapy for many mental health disorders. Available evidence indicates that psychedelics may offer a single-dose, rapid effect model that have robust effects with treatment-resistant mental disorders and a unique advantage as a possible monotherapy for mental illness. Novel clinical trials that evaluate the safety, tolerability, and efficacy in clinically representative populations are warranted.
精神疾病具有多种临床表现,其病程呈慢性。受影响的个体经历明显的功能、情感、认知和/或行为障碍。精神疾病的发病率不断上升,与之相关的社会和经济成本也在不断增加。事实上,预计未来 30 年内,精神疾病的经济负担将超过 1.8 万亿美元。相当多的精神疾病患者对一线治疗方案没有反应。因此,对于精神障碍,仍需要快速减轻治疗方案的选择,同时尽量减少社会和经济负担。
新型治疗方案的缺乏使得基于迷幻剂的心理治疗需要重新研究。在此,作者将通过对现有文献的叙述性回顾,评估传统迷幻剂、裸盖菇素和 MDMA 在治疗精神疾病方面的治疗潜力。
迷幻剂,如裸盖菇素和 MDMA,为许多精神疾病提供了另一种治疗途径。现有证据表明,迷幻剂可能提供一种单剂量、快速作用的模式,对治疗抵抗性精神障碍有强大的疗效,并且作为一种可能的单一疗法治疗精神疾病具有独特的优势。有必要进行新的临床试验,以评估在具有临床代表性的人群中的安全性、耐受性和疗效。