Department of Anesthesiology, St. Michael's Hospital, Toronto, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada.
Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada.
Anesthesiology. 2023 Oct 1;139(4):523-536. doi: 10.1097/ALN.0000000000004673.
Chronic pain is a public health concern that affects approximately 1.5 billion people globally. Conventional therapeutic agents including opioid and non-opioid analgesics have been associated with adverse side effects, issues with addiction, and ineffective analgesia. Novel agents repurposed to treat pain via different mechanisms are needed to fill the therapeutic gap in chronic pain management. Psychedelics such as lysergic acid diethylamide and psilocybin (the active ingredient in psychedelic mushrooms) are thought to alter pain perception through direct serotonin receptor agonism, anti-inflammatory effects, and synaptic remodeling. This scoping review was conducted to identify human studies in which psychedelic agents were used for the treatment of pain. Twenty-one articles that assessed the effects of psychedelics in treating various pain states were included. The present scarcity of clinical trials and small sample sizes limit their application for clinical use. Overall, psychedelics appear to show promise for analgesia in patients with certain headache disorders and cancer pain diagnoses. Future studies must aim to examine the combined effects of psychotherapy and psychedelics on chronic pain.
慢性疼痛是一个公共健康问题，全球约有 15 亿人受到影响。包括阿片类药物和非阿片类镇痛药在内的传统治疗药物与不良反应、成瘾问题和无效镇痛有关。需要通过不同机制重新用于治疗疼痛的新型药物来填补慢性疼痛管理中的治疗空白。迷幻剂，如麦角酸二乙酰胺和裸盖菇素（迷幻蘑菇中的有效成分），被认为通过直接血清素受体激动作用、抗炎作用和突触重塑来改变疼痛感知。这项范围界定综述旨在确定人类研究中使用迷幻剂治疗疼痛的研究。有 21 篇文章评估了迷幻剂治疗各种疼痛状态的效果。目前临床试验的匮乏和样本量小限制了它们的临床应用。总的来说，迷幻剂似乎在治疗某些头痛疾病和癌症疼痛诊断的患者的疼痛方面有一定效果。未来的研究必须旨在研究心理治疗和迷幻剂对慢性疼痛的综合影响。
