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药用迷幻剂在精神健康和成瘾领域的应用:推进新兴范式的研究。

Medicinal psychedelics for mental health and addiction: Advancing research of an emerging paradigm.

机构信息

School of Social and Political Science, The University of Melbourne, Parkville, VIC, Australia.

NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia.

出版信息

Aust N Z J Psychiatry. 2021 Dec;55(12):1127-1133. doi: 10.1177/0004867421998785. Epub 2021 Mar 21.

Abstract

The medical use of psychedelic substances (e.g. psilocybin, ayahuasca, lysergic acid diethylamide and 3,4-methylenedioxymethamphetamine) is attracting renewed interest, driven by a pressing need for research and development of novel therapies for psychiatric disorders, as well as promising results of contemporary studies. In this Viewpoint, we reflect upon the 'Clinical Memorandum on Psychedelics' recently released by the and note subsequent developments including the application for down-scheduling of psilocybin and 3,4-methylenedioxymethamphetamine presently being considered by the Therapeutic Goods Administration and approvals for access via the Special Access Scheme. We suggest that this field is worthy of rigorous research to assess potential benefits, address safety parameters and clarify therapeutic mechanisms. To this end, we outline recent research findings, provide an overview of current knowledge relating to mechanisms of action and discuss salient aspects of the psychedelic-assisted psychotherapy treatment model. The sum of this research points towards medicinal psychedelics as a potential new class of psychiatric treatments when used within a medically supervised framework with integrated psychotherapeutic support. However, before widespread translation into clinical use can occur, appropriately designed and sufficiently powered trials are required to detect both potential positive and negative outcomes. Unique safety and regulatory challenges also need to be addressed. As for any new medical therapy, psychedelic research needs to be conducted in a rigorous manner, through the dispassionate lens of scientific enquiry. Carte blanche availability to practitioners, without specific protocols and appropriate training, would be potentially harmful to individuals and detrimental to the field.

摘要

迷幻物质(例如裸盖菇素、死藤水、麦角酸二乙酰胺和 3,4-亚甲基二氧甲基苯丙胺)在医学上的应用重新引起了人们的兴趣,这是因为迫切需要研究和开发治疗精神疾病的新疗法,以及当代研究的有希望的结果。在本观点中,我们反思了最近由 发布的“迷幻药物临床备忘录”,并注意到随后的发展,包括向治疗商品管理局申请将裸盖菇素和 3,4-亚甲基二氧甲基苯丙胺降级,以及通过特殊准入计划获得准入的批准。我们认为,该领域值得进行严格的研究,以评估潜在的益处、解决安全参数问题,并阐明治疗机制。为此,我们概述了最近的研究结果,概述了与作用机制相关的当前知识,并讨论了迷幻辅助心理治疗模式的突出方面。总而言之,这些研究表明,药用迷幻物质在医学监督框架内与综合心理治疗支持结合使用时,可能成为一种新的潜在精神科治疗方法。然而,在广泛转化为临床应用之前,需要进行设计合理、足够有力的试验,以检测潜在的积极和消极结果。还需要解决独特的安全和监管挑战。与任何新的医疗疗法一样,迷幻物质研究需要通过科学探究的冷静视角进行严格的研究。如果没有具体的方案和适当的培训,就向从业者提供全权处理权,可能会对个人造成潜在的伤害,并对该领域造成损害。

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