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迷幻药物在未来精神健康护理中的潜在作用。

The Potential Role of Psychedelic Drugs in Mental Health Care of the Future.

机构信息

Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

OVID Health Systems GmbH, Berlin, Germany.

出版信息

Pharmacopsychiatry. 2021 Jul;54(4):191-199. doi: 10.1055/a-1486-7386. Epub 2021 May 12.

Abstract

Serotonergic psychedelics such as psilocybin, lysergic acid diethylamide (LSD), or dimethyltryptamine (DMT), as well as psychoactive drugs that trigger phenomenologically- related experiences like 3,4-methylenedioxymethamphetamine (MDMA) and ketamine, belong to the most promising treatment approaches in contemporary psychiatry. Psychedelic-assisted psychotherapy is not only a new treatment paradigm in psychopharmacology, but it also requires a redefinition of psychotherapeutic processes and the contextualization of psychopharmacological interventions within a new treatment infrastructure. Crucial for future practice and research in the field are (1) informed patient referral and co-treatment practices, (2) screening (e. g., choosing the right patients for these therapies), (3) the dosing preparation sessions, (4) the assisted dosing sessions as well as after-care procedures such as (5) psychological integration and (6) supporting the development of structured patient communities. Definition of future treatment delivery infrastructures and requirements for therapist training are further challenges for research and practice. Finally, the implementation of psychedelic-assisted psychotherapy in routine mental health care must be embedded into public communication about the potential and risks of these innovative therapeutic approaches. This paper provides a synopsis of challenges for practitioners, researchers, and regulators to be addressed in the approval processes of psychedelics.

摘要

血清素能致幻剂,如裸盖菇素、麦角酸二乙基酰胺(LSD)或二甲色胺(DMT),以及引发类似现象体验的精神活性药物,如 3,4-亚甲二氧基甲基苯丙胺(MDMA)和氯胺酮,都属于当代精神病学中最有前途的治疗方法之一。迷幻药辅助心理治疗不仅是精神药理学中的一种新的治疗模式,还需要重新定义心理治疗过程,并在新的治疗基础设施内对精神药理学干预进行情境化。对于该领域未来的实践和研究至关重要的是:(1)知情的患者转诊和共同治疗实践;(2)筛选(例如,为这些疗法选择合适的患者);(3)剂量准备阶段;(4)辅助给药阶段以及(5)心理整合等后续护理程序;(6)支持有组织的患者社区的发展。未来治疗提供基础设施的定义和治疗师培训的要求是研究和实践的进一步挑战。最后,迷幻药辅助心理治疗必须纳入常规精神保健中,同时向公众宣传这些创新治疗方法的潜力和风险。本文概述了从业者、研究人员和监管机构在批准迷幻药物的过程中需要解决的挑战。

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