Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
J Affect Disord. 2023 Feb 1;322:194-204. doi: 10.1016/j.jad.2022.09.168. Epub 2022 Oct 7.
Psychedelic therapy shows promise for Major Depressive Disorder, especially when treatment-resistant, as well as life-threatening illness distress. The objective of this systematic review, inclusive of meta-analysis, is to examine recent clinical research on the therapeutic effects of classic psychedelics on depressive symptoms.
Fourteen psychedelic therapy studies, utilising psilocybin, ayahuasca, or LSD, were systematically reviewed. For the meta-analysis, standardised mean differences were calculated for seven randomised controlled trials.
The systematic review indicated significant short- and long-term reduction of depressive symptoms in all conditions studied after administration of psilocybin, ayahuasca, or LSD, with psychological support. In the meta-analysis, symptom reduction was significantly indicated in three timepoints out of four, including 1-day, 1-week, and 3-5 weeks, supporting the results of the systematic review, with the exception of the 6-8 weeks follow-up point which was less conclusive.
The absence of required data for 2 studies necessitated the less precise use of graphical extraction and imputation. The small sample size in all but one study negatively affected the statistical power. None of the studies had long-term follow-up without also utilising the cross-over method, which did not allow for long-term results to be included in the meta-review.
This review indicates an association between psychedelic therapy and significant reduction of depressive symptoms at several time points. However, the small number of studies, and low sample sizes, calls for careful interpretation of results. This suggests the need for more randomised clinical trials of psychedelic therapy, with larger and more diverse samples.
迷幻疗法在治疗重度抑郁症方面具有潜力，尤其是对于那些治疗抵抗或危及生命的疾病痛苦。本系统综述的目的，包括荟萃分析，是检查经典迷幻剂治疗抑郁症状的最新临床研究。
系统综述共纳入了 14 项迷幻疗法研究，使用了裸盖菇素、死藤水或 LSD。对于荟萃分析，计算了七个随机对照试验的标准化均数差值。
系统综述表明，在给予裸盖菇素、死藤水或 LSD 并辅以心理支持的情况下，所有研究条件下的抑郁症状在短期和长期内都有显著减轻。荟萃分析表明，在四个时间点中的三个，包括 1 天、1 周和 3-5 周，症状都有明显减轻，这支持了系统综述的结果，但 6-8 周的随访时间点则不那么确定。
由于 2 项研究缺乏所需数据，因此需要更精确地使用图形提取和插补。除了一项研究外，所有研究的样本量都很小，这对统计效力产生了负面影响。由于没有长期随访而没有使用交叉方法，因此没有将长期结果纳入荟萃综述，这使得所有研究都没有长期随访。
本综述表明，迷幻疗法与抑郁症状在几个时间点的显著减轻之间存在关联。然而，研究数量少、样本量小，要求对结果进行仔细解释。这表明需要更多的随机临床试验来评估迷幻疗法，需要更大和更多样化的样本。
