Rucker James J
Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
South London and Maudsley NHS Foundation Trust, London, UK.
BJPsych Bull. 2024 Apr;48(2):110-117. doi: 10.1192/bjb.2023.28.
Although the development of psilocybin therapy has come as a surprise to many, modern research with the drug has been ongoing for 25 years. Psilocybin therapy is composed of psilocybin dosing sessions embedded within a wider process of psychoeducation, psychological support and integration. Early phase clinical trial evidence is promising, particularly for treatment-resistant depression. However, masking probably fails and expectancy effects may be a part of the mechanism of change. Disambiguating between drug and expectancy effects is a necessary part of the development process, yet this is difficult if masking fails. Hitherto, masking and expectancy have not been routinely measured in psilocybin or other medication trials. Doing so represents an opportunity for research and may influence psychiatry more widely. In this opinion piece I summarise the clinical development process of psilocybin therapy thus far, discussing the hope, the hype, the challenges and the opportunities along the way.
尽管裸盖菇素疗法的发展令许多人感到意外，但针对该药物的现代研究已经进行了25年。裸盖菇素疗法由在更广泛的心理教育、心理支持和整合过程中进行的裸盖菇素给药环节组成。早期临床试验证据很有前景，尤其是对于难治性抑郁症。然而，盲法可能无效，期望效应可能是改变机制的一部分。区分药物效应和期望效应是开发过程中的必要环节，但如果盲法失败，这将变得困难。迄今为止，在裸盖菇素或其他药物试验中，尚未常规测量盲法和期望效应。这样做是一个研究机会，可能会更广泛地影响精神病学。在这篇观点文章中，我总结了迄今为止裸盖菇素疗法的临床开发过程，讨论了其中的希望、炒作、挑战和机遇。
