Jevotovsky David S, Chopra Harman, Pak Daniel J, Durbhakula Shravani, Shustorovich Alexander, Juneja Tanya, Broachwala Mustafa Y, AlFarra Tariq, Silver Caroline, Kreitzer Greg, Oreoluwa Philip, Weissman Braden B, AlFarra Abraham, Mayrsohn Brian G, Orhurhu Vwaire, Emerick Trent, Furnish Timothy, Castellanos Joel P
Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, New York, USA.
Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Reg Anesth Pain Med. 2024 Aug 8. doi: 10.1136/rapm-2024-105532.
BACKGROUND/IMPORTANCE: Chronic pain affects many people globally, requiring alternative management strategies. Psilocybin is gaining attention for its potential in chronic pain management despite being classified as Schedule I.
This systematic review critically evaluates the evidence for psilocybin, a Schedule I substance, in the treatment of chronic pain. The exact purpose of the review is to assess the impact of psilocybin on chronic pain relief, focusing on dosing protocols, treated conditions, and patient outcomes.
A comprehensive review of PubMed, CINAHL, Web of Science, Cochrane Library, and EMBASE was conducted up to January 2024. Eligibility criteria included studies evaluating psilocybin for chronic pain management. The risk of bias was assessed using the MASTER (MethodologicAl STandards for Epidemiological Research) scale, and the strength of evidence was graded using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).
The review identified 28 relevant studies focusing on dosing, treated conditions, and outcomes. The majority of the included studies (76.2%) were of low or very low quality. Several studies with moderate-to-low-quality evidence utilized a 0.14 mg/kg dosing protocol. The findings suggest promise for the use of psilocybin in chronic pain relief, though the quality of evidence is generally low.
The current research shows potential for psilocybin as a treatment option for chronic pain relief. However, methodological issues and a lack of high-quality evidence underscore the need for further investigations with standardized protocols. Despite these limitations, the potential for psilocybin in chronic pain management is encouraging.
CRD42023493823.
背景/重要性：慢性疼痛在全球影响着众多人群，需要替代性管理策略。尽管裸盖菇素被列为一类管制药物，但其在慢性疼痛管理方面的潜力正受到关注。
本系统评价批判性地评估了一类管制物质裸盖菇素治疗慢性疼痛的证据。该评价的确切目的是评估裸盖菇素对缓解慢性疼痛的影响，重点关注给药方案、治疗的病症和患者结局。
截至2024年1月，对PubMed、CINAHL、科学网、考克兰图书馆和EMBASE进行了全面检索。纳入标准包括评估裸盖菇素用于慢性疼痛管理的研究。使用MASTER（流行病学研究方法标准）量表评估偏倚风险，使用GRADE（推荐分级、评估、制定和评价）对证据强度进行分级。
该评价确定了28项关注给药、治疗病症和结局的相关研究。纳入的研究大多（76.2%）质量低或非常低。几项证据质量为中到低的研究采用了0.14mg/kg的给药方案。研究结果表明裸盖菇素在缓解慢性疼痛方面有应用前景，尽管证据质量总体较低。
当前研究表明裸盖菇素作为缓解慢性疼痛的治疗选择具有潜力。然而，方法学问题和高质量证据的缺乏凸显了采用标准化方案进行进一步研究的必要性。尽管存在这些局限性，裸盖菇素在慢性疼痛管理中的潜力令人鼓舞。
PROSPERO注册号：CRD42023493823。
