Kim Vivian, Wilson Scott M, Woesner Mary E
From the Albert Einstein College of Medicine, Bronx, NY.
J Clin Psychopharmacol. 2025;45(1):37-45. doi: 10.1097/JCP.0000000000001941. Epub 2024 Nov 22.
Following a decades-long decline in psychedelic research resulting from social, political, and legislative factors, there has been greatly renewed interest in these compounds' ability to treat psychiatric disorders. Classic psychedelics, encompassing both natural and synthetic psychoactive compounds, are characterized by their action as agonists or partial agonists of serotonin 5-hydroxytryptamine 2A receptors. In this comprehensive review, we summarize the latest clinical trials of classic psychedelics on depression and anxiety, attending to the patient demographics and methodology of each study. Overall, studies published since 2020 affirm the potential for classic psychedelics to treat major depressive disorder, treatment-resistant depression, bipolar II, and anxiety-spectrum disorders. However, findings are limited by short follow-up durations and nonstandard dosing and study designs. Given that many of the studies identified were post hoc analyses or follow-up studies from a select few parent studies, it is recommended that more original research be undertaken, with more diverse and larger sample sizes, standardized methodologies including blinding assessment, and long-term follow-up to identify duration of benefits and adverse reactions. It is also important to consider the role of psychological support and the therapeutic alliance in the psychedelic treatment of psychiatric disorders.
由于社会、政治和立法因素，迷幻药研究在经历了数十年的衰退之后，人们对这些化合物治疗精神疾病的能力重新产生了浓厚兴趣。经典迷幻药包括天然和合成的精神活性化合物，其特点是作为血清素5-羟色胺2A受体的激动剂或部分激动剂发挥作用。在这篇全面综述中，我们总结了经典迷幻药治疗抑郁症和焦虑症的最新临床试验，关注每项研究的患者人口统计学和方法。总体而言，自2020年以来发表的研究证实了经典迷幻药治疗重度抑郁症、难治性抑郁症、双相II型障碍和焦虑谱系障碍的潜力。然而，研究结果受到随访时间短、给药和研究设计不规范的限制。鉴于所确定的许多研究是少数几个母研究的事后分析或随访研究，建议开展更多原创研究，采用更多样化、更大的样本量、包括盲法评估在内的标准化方法以及长期随访，以确定益处持续时间和不良反应。考虑心理支持和治疗联盟在迷幻药治疗精神疾病中的作用也很重要。
