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LSD 辅助治疗焦虑症患者:开放标签前瞻性 12 个月随访。

LSD-assisted therapy in patients with anxiety: open-label prospective 12-month follow-up.

机构信息

Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland.

Department of Pharmaceutical Sciences, University of Basel, Switzerland.

出版信息

Br J Psychiatry. 2024 Sep;225(3):362-370. doi: 10.1192/bjp.2024.99.

Abstract

BACKGROUND

Anxiety disorders are a major public health burden with limited treatment options.

AIMS

We investigated the long-term safety and efficacy of lysergic acid diethylamide (LSD)-assisted therapy in patients with anxiety with or without life-threatening illness.

METHOD

This study was an -planned long-term follow-up of an investigator-initiated, two-centre trial that used a double-blind, placebo-controlled, two-period, random-order, crossover design with two sessions with either oral LSD (200 μg) or placebo per period. Participants ( = 39) were followed up 1 year after the end-of-study visit to assess symptoms of anxiety, depression and long-term effects of psychedelics using Spielberger's State-Trait Anxiety Inventory-Global (STAI-G), the Beck Depression Inventory (BDI), the Persisting Effects Questionnaire and measures of personality traits using the NEOFive-Factor Inventory.

RESULTS

Participants reported a sustained reduction of STAI-G scores compared with baseline (least square means (95% CI) = -21.6 (-32.7, -10.4), = 1.04, < 0.001, for those who received LSD in the first period (94 weeks after the last LSD treatment) and -16.5 (-26.2, -6.8), = 1.02, < 0.05, for those who received LSD in the second period (68 weeks after the last LSD treatment)). Similar effects were observed for comorbid depression with change from baseline BDI scores of -8.1 (-13.2, -3.1), = 0.71, < 0.01, and -8.9 (-12.9, -4.9), = 1.21, < 0.01, for the LSD-first and placebo-first groups, respectively. Personality trait neuroticism decreased ( < 0.0001) and trait extraversion increased ( < 0.01) compared with study inclusion. Individuals attributed positive long-term effects to the psychedelic experience.

CONCLUSIONS

Patients reported sustained long-term effects of LSD-assisted therapy for anxiety.

摘要

背景

焦虑症是一种严重的公共健康负担,治疗选择有限。

目的

我们研究了麦角酸二乙酰胺(LSD)辅助治疗对伴有或不伴有生命威胁疾病的焦虑症患者的长期安全性和疗效。

方法

这是一项前瞻性的长期随访研究,是一项由研究者发起的、两中心试验的后续研究,该试验采用双盲、安慰剂对照、两期、随机、交叉设计,每期各有 2 次口服 LSD(200μg)或安慰剂。参与者(n=39)在研究结束后 1 年进行随访,使用斯皮尔伯格状态-特质焦虑量表-全球版(STAI-G)、贝克抑郁量表(BDI)、持久影响问卷和 NEO Five-Factor 量表评估焦虑、抑郁症状和致幻剂的长期影响。

结果

与基线相比,参与者报告 STAI-G 评分持续下降(最小二乘均值(95%置信区间)=-21.6(-32.7,-10.4), =1.04, <0.001,对于第一期接受 LSD 治疗的参与者(最后一次 LSD 治疗后 94 周)和-16.5(-26.2,-6.8), =1.02, <0.05,对于第二期接受 LSD 治疗的参与者(最后一次 LSD 治疗后 68 周))。对于共病抑郁,BDI 评分从基线的变化也观察到类似的效果,分别为-8.1(-13.2,-3.1), =0.71, <0.01,和-8.9(-12.9,-4.9), =1.21, <0.01,对于 LSD 优先组和安慰剂优先组。与纳入研究时相比,神经质人格特质降低( <0.0001),外向性人格特质增加( <0.01)。个体将积极的长期影响归因于致幻体验。

结论

患者报告 LSD 辅助治疗焦虑症的长期效果持续存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59c6/11536188/6032745cc441/S0007125024000990_fig1.jpg

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