Lawrence David Wyndham
Dr. Lawrence is with the Faculty of Medicine, University of Toronto in Toronto, Canada; Mount Sinai Hospital, Sinai Health System in Toronto, Canada; and Faculty of Kinesiology & Physical Education, University of Toronto in Toronto, Canada.
Innov Clin Neurosci. 2023 Sep 1;20(7-9):37-39. eCollection 2023 Jul-Sep.
Migraine is a common neurovascular disorder with a pathophysiology related to the serotonin (5-hydroxytryptamine; 5-HT) system. Pharmacologic modulation of 5-HT receptors has demonstrated efficacy in the acute treatment of migraines. Psilocybin, a classic psychedelic with 5-HT receptor activity, has demonstrated therapeutic potential in the management of neuropsychiatric conditions. To date, no reports have investigated the effect of psilocybin administered acutely during a migraine episode.
The case of a 33-year-old male patient with a history of migraines with aura, who had acute administration of oral psilocybin (in the form of the dried fruiting body of mushrooms) at migraine onset is presented. Headache intensity was rated hourly using the Numerical Rating Scale (NRS) and compared to three previous migraines. Profound reductions in headache intensity and emetic episodes were reported during the migraine treated acutely with oral psilocybin administration, compared to three previous migraines.
The severe, disabling, and treatment-resistant nature of migraines warrants continued surveillance for novel pharmacologic interventions. The established congruous pathophysiology of migraine and pharmacology of psilocybin, via the 5-HT receptor system, positions psilocybin as a potential therapeutic target.
While this report highlights the potential role of psilocybin in the acute management of migraines, it is essential to note that it should not be considered a basis for guiding clinical practice at this point. Further research is necessary to establish the safety and efficacy of psilocybin as a treatment option for migraines.
偏头痛是一种常见的神经血管性疾病，其病理生理学与血清素（5-羟色胺；5-HT）系统有关。对5-HT受体的药物调节已证明在偏头痛的急性治疗中有效。裸盖菇素是一种具有5-HT受体活性的经典致幻剂，已证明在神经精神疾病的管理中具有治疗潜力。迄今为止，尚无报告研究在偏头痛发作期间急性给予裸盖菇素的效果。
本文介绍了一名33岁有先兆偏头痛病史的男性患者的病例，该患者在偏头痛发作时急性口服了裸盖菇素（以蘑菇干燥子实体的形式）。使用数字评分量表（NRS）每小时对头痛强度进行评分，并与之前的三次偏头痛进行比较。与之前的三次偏头痛相比，在急性口服裸盖菇素治疗的偏头痛期间，头痛强度和呕吐发作次数显著减少。
偏头痛的严重、致残和难治性需要持续监测新的药物干预措施。偏头痛既定的病理生理学与裸盖菇素通过5-HT受体系统的药理学相一致，使裸盖菇素成为一个潜在的治疗靶点。
虽然本报告强调了裸盖菇素在偏头痛急性管理中的潜在作用，但必须指出，目前不应将其视为指导临床实践的依据。需要进一步研究以确定裸盖菇素作为偏头痛治疗选择的安全性和有效性。
