Molecular Psychiatry Lab, Faculty of Science and Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland.
Faculty of Pharmacy, Saarland University, Saarbuecken, Germany.
J Psychopharmacol. 2024 Oct;38(10):873-886. doi: 10.1177/02698811241278873. Epub 2024 Sep 20.
Psychedelic-assisted therapy (PAT) is permitted in Switzerland under its limited medical use program. Data from patients in this program represent a unique opportunity to analyze the real-world practice of PAT.
This study compared the subjective effects of lysergic acid diethylamide (LSD) and psilocybin between patients undergoing PAT and healthy volunteers. For the patients, it also investigated the relationship between antidepressant effects and six measures of acute drug effects.
We compared data on acute psychedelic drug effects between 28 PAT patients with data from 28 healthy participants who participated in a randomized, double-blind crossover trial. All participants received varying doses of psilocybin and LSD. Subjective effects were assessed on an hourly basis during the acute drug effects, and the Mystical Experience Questionnaire (MEQ) was completed retrospectively. For patients, depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS).
Ratings of overall drug effect and mystical experience were similar across groups. Compared with healthy controls, patients reported lower ratings of ego dissolution. Patients showed a significant decrease in MADRS scores, and the greatest predictor of antidepressant outcome was relaxation during the PAT session. We did not observe a relationship between mystical-type experiences and antidepressant effects. Most patients experienced mild adverse effects which resolved within 48 h.
PAT reduced depressive symptoms in this heterogeneous patient group. Patients may experience more challenging psychedelic effects and reduced ego dissolution. Hourly assessment of drug effects may predict clinical outcomes better than retrospectively assessed mystical experiences, and the impact of relaxation during PAT should be investigated further.
迷幻辅助治疗（PAT）在瑞士被允许在其有限的医疗用途计划下使用。该计划中的患者数据代表了分析 PAT 真实实践的独特机会。
本研究比较了接受 PAT 的患者和健康志愿者之间 LSD 和裸盖菇素的主观效果。对于患者，还调查了抗抑郁效果与急性药物效果的六个衡量标准之间的关系。
我们将 28 名接受 PAT 的患者的急性迷幻药物效果数据与 28 名参加随机、双盲交叉试验的健康参与者的数据进行了比较。所有参与者都接受了不同剂量的裸盖菇素和 LSD。在急性药物作用期间，每小时评估一次主观效果，并完成回溯性神秘体验问卷（MEQ）。对于患者，使用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评估抑郁症状。
总体药物效果和神秘体验的评分在两组之间相似。与健康对照组相比，患者报告的自我解体评分较低。患者的 MADRS 评分显著下降，抗抑郁治疗效果的最大预测因素是 PAT 治疗期间的放松。我们没有观察到神秘体验与抗抑郁效果之间的关系。大多数患者经历了轻微的不良反应，这些不良反应在 48 小时内得到解决。
PAT 降低了这一异质患者群体的抑郁症状。患者可能会经历更具挑战性的迷幻效果和降低的自我解体。药物效果的每小时评估可能比回溯性评估的神秘体验更好地预测临床结果，并且应该进一步研究 PAT 期间放松的影响。
