Headache Center of Excellence, Neurology Service, Veterans Affairs Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA.
Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
Curr Pain Headache Rep. 2023 Sep;27(9):489-495. doi: 10.1007/s11916-023-01145-y. Epub 2023 Aug 4.
This review presents the existing literature of and a framework for how psychedelic drugs might be applied as therapeutic agents in episodic migraine.
The therapeutic effects of psychedelics in headache disorders have been reported for decades and controlled investigations are now beginning. In the first and only clinical trial of a psychedelic drug in migraine, the single administration of low-dose psilocybin reduced weekly migraine days and pain intensity for the following 2 weeks in episodic subjects. These transitional effects, along with abortive effects in two subjects and additional findings in cluster headache, offer insight into the potential medicinal use of this and other psychedelic drugs in episodic migraine. The existing evidence supports the continued investigation of psilocybin and other psychedelics as transitional treatments in episodic migraine. Acute and preventive effects also exist, but the risks may outweigh benefits with these applications. Future research of psychedelics in episodic migraine should be tailored for this condition and not modeled after protocols used in other medical or psychiatric conditions.
本篇综述介绍了现有文献,并为迷幻药物如何作为发作性偏头痛的治疗药物提供了一个框架。
几十年来,已有关于迷幻药物在头痛障碍中的治疗效果的报道,现在正在进行对照研究。在偏头痛中使用迷幻药物的首个也是唯一的临床试验中,低剂量裸盖菇素单次给药可减少发作性偏头痛患者接下来 2 周的每周偏头痛天数和疼痛强度。这些转归效应,以及在 2 名患者中的中止作用和集群性头痛的其他发现,为这种和其他迷幻药物在发作性偏头痛中的潜在药用用途提供了见解。现有证据支持继续研究裸盖菇素和其他迷幻药物作为发作性偏头痛的转归治疗。也存在急性和预防性作用,但这些应用的风险可能超过益处。发作性偏头痛中迷幻药物的未来研究应针对这种疾病进行,而不是仿照其他医学或精神疾病的方案进行。