Ghaznavi Sharmin, Ruskin Jeremy N, Haggerty Stephen J, King Franklin, Rosenbaum Jerrold F
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).
Am J Psychiatry. 2025 Jan 1;182(1):47-53. doi: 10.1176/appi.ajp.20230914.
The last few years have seen exponential growth in interest, investment, advocacy, and research into psychedelics as therapeutics. This reflects an optimism about the potential promise of psychedelics as therapeutics. As with all therapeutic interventions, research is needed not only into their benefits but also potential risks. Indeed, when substances with therapeutic potential are scrutinized over time, especially in broad populations with psychiatric and medical comorbidities typically excluded from clinical trials, and applied in less well-regulated or controlled settings, a greater understanding of the cautions emerges. Here, we review the literature on the known and potential harms, including enduring perceptual disturbances; triggering or enhancing the risk for onset of mania or psychosis; overuse, misuse, and dependence; challenging experiences or "bad trips"; risks associated with increased neuroplastic potential; and acute and cumulative cardiovascular effects. Each of these issues is addressed in this review, along with the call for continued research, including recommendations for further research and monitoring.
在过去几年中，人们对迷幻剂作为治疗药物的兴趣、投资、宣传和研究呈指数级增长。这反映出人们对迷幻剂作为治疗药物的潜在前景持乐观态度。与所有治疗干预措施一样，不仅需要研究它们的益处，还需要研究潜在风险。事实上，随着时间的推移，当对具有治疗潜力的物质进行审查时，尤其是在通常被排除在临床试验之外的患有精神疾病和内科合并症的广泛人群中，并在监管或控制较少的环境中应用时，人们对注意事项有了更深入的了解。在此，我们回顾了关于已知和潜在危害的文献，包括持久的感知障碍；引发或增加躁狂或精神病发作的风险；过度使用、滥用和依赖；具有挑战性的体验或“糟糕的旅程”；与神经可塑性潜力增加相关的风险；以及急性和累积性心血管影响。本综述讨论了上述每个问题，并呼吁继续开展研究，包括进一步研究和监测的建议。
