用于治疗精神疾病的迷幻剂及其他精神塑造剂

Psychedelics and Other Psychoplastogens for Treating Mental Illness.

作者信息

Vargas Maxemiliano V, Meyer Retsina, Avanes Arabo A, Rus Mark, Olson David E

机构信息

Neuroscience Graduate Program, University of California, Davis, Davis, CA, United States.

Delix Therapeutics, Inc., Concord, MA, United States.

出版信息

Front Psychiatry. 2021 Oct 4;12:727117. doi: 10.3389/fpsyt.2021.727117. eCollection 2021.

Abstract

Psychedelics have inspired new hope for treating brain disorders, as they seem to be unlike any treatments currently available. Not only do they produce sustained therapeutic effects following a single administration, they also appear to have broad therapeutic potential, demonstrating efficacy for treating depression, post-traumatic stress disorder (PTSD), anxiety disorders, substance abuse disorder, and alcohol use disorder, among others. Psychedelics belong to a more general class of compounds known as psychoplastogens, which robustly promote structural and functional neural plasticity in key circuits relevant to brain health. Here we discuss the importance of structural plasticity in the treatment of neuropsychiatric diseases, as well as the evidence demonstrating that psychedelics are among the most effective chemical modulators of neural plasticity studied to date. Furthermore, we provide a theoretical framework with the potential to explain why psychedelic compounds produce long-lasting therapeutic effects across a wide range of brain disorders. Despite their promise as broadly efficacious neurotherapeutics, there are several issues associated with psychedelic-based medicines that drastically limit their clinical scalability. We discuss these challenges and how they might be overcome through the development of non-hallucinogenic psychoplastogens. The clinical use of psychedelics and other psychoplastogenic compounds marks a paradigm shift in neuropsychiatry toward therapeutic approaches relying on the selective modulation of neural circuits with small molecule drugs. Psychoplastogen research brings us one step closer to actually curing mental illness by rectifying the underlying pathophysiology of disorders like depression, moving beyond simply treating disease symptoms. However, determining how to most effectively deploy psychoplastogenic medicines at scale will be an important consideration as the field moves forward.

摘要

迷幻药为治疗脑部疾病带来了新希望,因为它们似乎与目前可用的任何治疗方法都不同。它们不仅在单次给药后能产生持续的治疗效果,还似乎具有广泛的治疗潜力,已证明对治疗抑郁症、创伤后应激障碍(PTSD)、焦虑症、物质使用障碍和酒精使用障碍等有效。迷幻药属于一类更广泛的化合物,称为精神塑造剂,它们能有力地促进与大脑健康相关的关键神经回路中的结构和功能神经可塑性。在此,我们讨论结构可塑性在治疗神经精神疾病中的重要性,以及证明迷幻药是迄今为止研究的最有效的神经可塑性化学调节剂的证据。此外,我们提供了一个理论框架,有可能解释为什么迷幻化合物能在广泛的脑部疾病中产生持久的治疗效果。尽管它们有望成为广泛有效的神经治疗药物,但基于迷幻药的药物存在几个问题,严重限制了它们的临床可扩展性。我们讨论了这些挑战以及如何通过开发非致幻性精神塑造剂来克服它们。迷幻药和其他精神塑造性化合物的临床应用标志着神经精神病学向依赖小分子药物选择性调节神经回路的治疗方法的范式转变。精神塑造剂研究使我们更接近通过纠正抑郁症等疾病的潜在病理生理学来真正治愈精神疾病,而不仅仅是治疗疾病症状。然而,随着该领域的发展,确定如何最有效地大规模应用精神塑造性药物将是一个重要的考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5764/8520991/3085567253d8/fpsyt-12-727117-g0001.jpg

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