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精神科治疗中迷幻药的周期性复兴。

The cyclical revival of psychedelics in psychiatric treatment.

机构信息

Bioethics Committee, Hospital de Clínicas José de San Martín, Facultad de Ciencias Médicas, Universidad de Buenos Aires, Buenos Aires, Argentina.

Departamento de Psiquiatría y Salud Mental, Facultad de Ciencias Médicas, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Curr Med Res Opin. 2024 Aug;40(8):1389-1396. doi: 10.1080/03007995.2024.2368725. Epub 2024 Jun 20.

Abstract

There is an increasing demand for effective treatments for depression, particularly for individuals grappling with treatment-resistant depression. Over recent years, a surge of interest has focused on exploring the safety and efficacy of psilocybin as a potential treatment for depression. However, preliminary findings from phase 2 studies have been inconclusive, prompting critical examination of issues such as maintaining blinding and the role of adjunctive psychotherapy. The maintenance of double-blinding and the role of adjunctive psychotherapy introduce biases that complicate the attainment of conclusive results in clinical research. Examining historical data reveals a recurrent pattern linked to the use of psychoactive substances, which starts with an excess of optimism and ends with general addictive behaviors and a heightened risk of serious public health problems. Considering these findings, a cautious and measured approach is imperative, given that the efficacy and safety of psilocybin treatment have yet to be unequivocally established. The potential for excessive optimism among researchers is a notable concern, as unwarranted enthusiasm may inadvertently facilitate the widespread adoption of this treatment without sufficient empirical support. In navigating the complexities of depression treatment, it is necessary to strike a balance between innovation and prudence to ensure evidence-based advancement of therapeutic approaches.

摘要

对于抑郁症的有效治疗方法,特别是对于那些正在与治疗抵抗性抑郁症作斗争的人,需求正在不断增加。近年来,人们对探索迷幻蘑菇作为一种潜在的抑郁症治疗方法的安全性和有效性产生了浓厚的兴趣。然而,来自 2 期研究的初步结果并不明确,这促使人们对保持双盲和辅助心理治疗的作用等问题进行了批判性的审视。双盲的维持和辅助心理治疗的作用引入了偏见,使临床研究难以得出确凿的结果。对历史数据的研究揭示了一种与使用精神活性物质相关的反复出现的模式,这种模式始于过度乐观,最终导致普遍的成瘾行为和严重的公共卫生问题风险增加。考虑到这些发现,鉴于迷幻蘑菇治疗的疗效和安全性尚未得到明确确立,谨慎和慎重的方法是必要的。研究人员过度乐观的可能性是一个值得关注的问题,因为不必要的热情可能会无意中促进这种治疗方法的广泛采用,而没有足够的经验支持。在应对抑郁症治疗的复杂性时,需要在创新和谨慎之间取得平衡,以确保基于证据的治疗方法的推进。

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