Ragnhildstveit Anya, Khan Ryan, Seli Paul, Bass Lisa Claire, August River Jude, Kaiyo Miriam, Barr Nathaniel, Jackson Laura Kate, Gaffrey Michael Santo, Barsuglia Joseph Peter, Averill Lynnette Astrid
Integrated Research Literacy Group, Draper, UT, United States.
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
Front Psychiatry. 2023 Nov 23;14:1271152. doi: 10.3389/fpsyt.2023.1271152. eCollection 2023.
Psychedelic therapy is, arguably, the next frontier in psychiatry. It offers a radical alternative to longstanding, mainstays of treatment, while exciting a paradigm shift in translational science and drug discovery. There is particular interest in 5-methoxy--dimethyltryptamine (5-MeO-DMT)-a serotonergic psychedelic-as a novel, fast-acting therapeutic. Yet, few studies have directly examined 5-MeO-DMT for trauma- or stress-related psychopathology, including post-traumatic stress disorder (PTSD). Herein, we present the first longitudinal case study on 5-MeO-DMT for chronic refractory PTSD, in a 23-year-old female. A single dose of vaporized bufotoxin of the Sonoran Desert Toad (), containing an estimated 10-15 mg of 5-MeO-DMT, led to clinically significant improvements in PTSD, with next-day effects. This was accompanied by marked reductions in hopelessness and related suicide risk. Improvements, across all constructs, were sustained at 1-, 3-, 6-, and 12-months follow-up, as monitored by a supporting clinician. The subject further endorsed a complete mystical experience, hypothesized to underly 5-MeO-DMT's therapeutic activity. No drug-related, serious adverse events occurred. Together, results showed that 5-MeO-DMT was generally tolerable, safe to administer, and effective for PTSD; however, this was not without risk. The subject reported acute nausea, overwhelming subjective effects, and late onset of night terrors. Further research is warranted to replicate and extend these findings, which are inherently limited, non-generalizable, and rely on methods not clinically accepted.
可以说,迷幻疗法是精神病学的下一个前沿领域。它为长期以来的主要治疗方法提供了一种激进的替代方案,同时激发了转化科学和药物发现的范式转变。人们对5-甲氧基-N,N-二甲基色胺(5-MeO-DMT)——一种血清素能迷幻剂——作为一种新型的速效疗法特别感兴趣。然而,很少有研究直接考察5-MeO-DMT对创伤或应激相关精神病理学的影响,包括创伤后应激障碍(PTSD)。在此,我们报告了首例关于5-MeO-DMT治疗一名23岁女性慢性难治性PTSD的纵向病例研究。单剂量雾化的索诺兰沙漠蟾蜍的蟾毒素(含有估计10 - 15毫克的5-MeO-DMT)使PTSD在临床上有显著改善,且次日即有效果。这伴随着绝望感和相关自杀风险的显著降低。在一名支持性临床医生的监测下,所有指标的改善在1个月、3个月、6个月和12个月的随访中均得以维持。该受试者还认可了一次完整的神秘体验,推测这是5-MeO-DMT治疗活性的基础。未发生与药物相关的严重不良事件。总体而言,结果表明5-MeO-DMT通常耐受性良好、给药安全且对PTSD有效;然而,这并非毫无风险。该受试者报告了急性恶心、强烈的主观效应以及夜惊的延迟发作。有必要进行进一步研究以复制和扩展这些发现,因为这些发现本质上是有限的、不可推广的,且依赖于未被临床接受的方法。