Evens Ricarda, Schmidt Marianna Elisa, Majić Tomislav, Schmidt Timo Torsten
Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Ther Adv Psychopharmacol. 2023 May 29;13:20451253231172254. doi: 10.1177/20451253231172254. eCollection 2023.
Classic serotonergic psychedelics have anecdotally been reported to show a characteristic pattern of subacute effects that persist after the acute effects of the substance have subsided. These transient effects, sometimes labeled as the 'psychedelic afterglow', have been suggested to be associated with enhanced effectiveness of psychotherapeutic interventions in the subacute period.
This systematic review provides an overview of subacute effects of psychedelics.
Electronic databases (MEDLINE, Web of Science Core Collection) were searched for studies that assessed the effects of psychedelics (LSD, psilocybin, DMT, 5-MeO-DMT, mescaline, or ayahuasca) on psychological outcome measures and subacute adverse effects in human adults between 1950 and August 2021, occurring between 1 day and 1 month after drug use.
Forty-eight studies including a total number of 1,774 participants were eligible for review. Taken together, the following subacute effects were observed: reductions in different psychopathological symptoms; increases in wellbeing, mood, mindfulness, social measures, spirituality, and positive behavioral changes; mixed changes in personality/values/attitudes, and creativity/flexibility. Subacute adverse effects comprised a wide range of complaints, including headaches, sleep disturbances, and individual cases of increased psychological distress.
Results support narrative reports of a subacute psychedelic 'afterglow' phenomenon comprising potentially beneficial changes in the perception of self, others, and the environment. Subacute adverse events were mild to severe, and no serious adverse events were reported. Many studies, however, lacked a standardized assessment of adverse effects. Future studies are needed to investigate the role of possible moderator variables and to reveal if and how positive effects from the subacute window may consolidate into long-term mental health benefits.
据传闻，经典的血清素能致幻剂会呈现出一种亚急性效应的特征模式，这种效应在药物的急性作用消退后依然存在。这些短暂的效应，有时被称为“致幻余韵”，被认为与亚急性期心理治疗干预效果的增强有关。
本系统评价概述了致幻剂的亚急性效应。
检索电子数据库（MEDLINE、科学网核心合集），查找1950年至2021年8月间评估致幻剂（麦角酸二乙酰胺、裸盖菇素、二甲基色胺、5-甲氧基二甲基色胺、三甲氧苯乙胺或死藤水）对成年人类心理结局指标和亚急性不良反应影响的研究，这些影响发生在用药后1天至1个月之间。
48项研究共1774名参与者符合纳入综述的标准。综合来看，观察到以下亚急性效应：不同心理病理症状减轻；幸福感、情绪、正念、社交指标、灵性及积极行为改变增加；人格/价值观/态度及创造力/灵活性出现混合变化。亚急性不良反应包括多种不适，如头痛、睡眠障碍以及个别心理困扰增加的案例。
结果支持了关于亚急性致幻“余韵”现象的描述性报告，该现象包括在自我、他人及环境认知方面潜在的有益变化。亚急性不良事件从轻度到重度不等，未报告严重不良事件。然而，许多研究缺乏对不良反应的标准化评估。未来需要开展研究，以调查可能的调节变量的作用，并揭示亚急性窗口期的积极效应是否以及如何巩固为长期的心理健康益处。
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