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迷幻药物的治疗潜力:应对过高期望、有力宣称、薄弱证据和巨额资金

Therapeutic Potential of Psychedelic Drugs: Navigating High Hopes, Strong Claims, Weak Evidence, and Big Money.

作者信息

Humphreys Keith, Todd Korthuis P, Stjepanović Daniel, Hall Wayne

机构信息

Veterans Affairs and Stanford Medical Centers, Stanford University, Palo Alto, California, USA; email:

Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, Oregon, USA.

出版信息

Annu Rev Psychol. 2025 Jan;76(1):143-165. doi: 10.1146/annurev-psych-020124-023532. Epub 2024 Dec 3.

Abstract

Therapeutic claims about many psychedelic drugs have not been evaluated in any studies of even modest rigor. The science of psychedelic drugs is strengthening, however, making it easier to differentiate some promising findings amid the hype that suffuses this research area. Ketamine has risks of adverse side effects (e.g., addiction and cystitis), but multiple studies suggest it can benefit individuals with treatment-resistant depression. Other therapeutic signals from psychedelic drug research that merit rigorous replication studies include 3,4-Methylenedioxymethamphetamine (MDMA) for post-traumatic stress disorder (PTSD) and psilocybin for depression, end of life dysphoria, and alcohol use disorder. The precise mechanisms through which psychedelic drugs can produce benefit and harm are not fully understood. Rigorous research is the best path forward for evaluating the therapeutic potential and mechanisms of psychedelic drugs. Policies governing the clinical use of these drugs should be informed by evidence and prioritize the protection of public health over the profit motive.

摘要

许多迷幻药物的治疗效果尚未在任何哪怕只是适度严谨的研究中得到评估。然而,迷幻药物的科学研究正在不断加强,这使得在充斥着该研究领域的炒作中更容易区分一些有前景的发现。氯胺酮有不良副作用的风险(如成瘾和膀胱炎),但多项研究表明它对难治性抑郁症患者有益。迷幻药物研究中的其他值得进行严格重复研究的治疗信号包括用于创伤后应激障碍(PTSD)的3,4-亚甲基二氧甲基苯丙胺(摇头丸)以及用于治疗抑郁症、临终烦躁和酒精使用障碍的裸盖菇素。迷幻药物产生益处和危害的确切机制尚未完全明了。严谨的研究是评估迷幻药物治疗潜力和机制的最佳途径。管理这些药物临床使用的政策应以证据为依据,并将保护公众健康置于盈利动机之上。

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本文引用的文献

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Expectancy Effects Cannot Be Neglected in MDMA-Assisted Therapy Research.在摇头丸辅助治疗研究中,期望效应不容忽视。
ACS Chem Neurosci. 2023 Dec 6;14(23):4062-4063. doi: 10.1021/acschemneuro.3c00692. Epub 2023 Nov 15.
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A provisional evaluation of Australia's medical cannabis program.澳大利亚医用大麻计划的初步评估。
Int J Drug Policy. 2023 Dec;122:104210. doi: 10.1016/j.drugpo.2023.104210. Epub 2023 Oct 7.
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History repeating: guidelines to address common problems in psychedelic science.历史重演:解决迷幻科学常见问题的指南
Ther Adv Psychopharmacol. 2023 Sep 25;13:20451253231198466. doi: 10.1177/20451253231198466. eCollection 2023.

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