Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
Mol Psychiatry. 2023 Sep;28(9):3595-3612. doi: 10.1038/s41380-023-02274-x. Epub 2023 Sep 27.
Psychedelics, also known as classical hallucinogens, have been investigated for decades due to their potential therapeutic effects in the treatment of neuropsychiatric and substance use disorders. The results from clinical trials have shown promise for the use of psychedelics to alleviate symptoms of depression and anxiety, as well as to promote substantial decreases in the use of nicotine and alcohol. While these studies provide compelling evidence for the powerful subjective experience and prolonged therapeutic adaptations, the underlying molecular reasons for these robust and clinically meaningful improvements are still poorly understood. Preclinical studies assessing the targets and circuitry of the post-acute effects of classical psychedelics are ongoing. Current literature is split between a serotonin 5-HT receptor (5-HTR)-dependent or -independent signaling pathway, as researchers are attempting to harness the mechanisms behind the sustained post-acute therapeutically relevant effects. A combination of molecular, behavioral, and genetic techniques in neuropharmacology has begun to show promise for elucidating these mechanisms. As the field progresses, increasing evidence points towards the importance of the subjective experience induced by psychedelic-assisted therapy, but without further cross validation between clinical and preclinical research, the why behind the experience and its translational validity may be lost.
迷幻剂,也被称为经典致幻剂,由于其在治疗神经精神和物质使用障碍方面的潜在治疗效果,已经被研究了几十年。临床试验的结果表明,迷幻剂在缓解抑郁和焦虑症状,以及促进尼古丁和酒精使用的大幅减少方面具有潜力。虽然这些研究为强烈的主观体验和长期治疗适应提供了有力的证据,但这些强大且具有临床意义的改善的潜在分子原因仍知之甚少。评估经典迷幻药急性后效应的靶点和回路的临床前研究正在进行中。目前的文献分为 5-羟色胺 5-HT 受体(5-HTR)依赖或非依赖的信号通路,因为研究人员试图利用持续急性后治疗相关效应背后的机制。神经药理学中的分子、行为和遗传技术的结合已经开始显示出阐明这些机制的希望。随着该领域的发展,越来越多的证据表明迷幻药辅助治疗引起的主观体验的重要性,但如果没有临床和临床前研究之间的进一步交叉验证,体验背后的原因及其转化的有效性可能会丢失。