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用于治疗精神疾病的迷幻药:解读并转化现有证据及为未来研究提供指导

Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research.

作者信息

McIntyre Roger S, Kwan Angela T H, Mansur Rodrigo B, Oliveira-Maia Albino J, Teopiz Kayla M, Maletic Vladimir, Suppes Trisha, Stahl Stephen M, Rosenblat Joshua D

机构信息

Department of Psychiatry (McIntyre, Mansur, Rosenblat) and Department of Pharmacology and Toxicology (McIntyre, Mansur, Rosenblat), University of Toronto, Toronto; Brain and Cognition Discovery Foundation, Toronto (Kwan, Teopiz); Faculty of Medicine, University of Ottawa, Ottawa (Kwan); Champalimaud Research and Clinical Center, Champalimaud Foundation, Lisbon (Oliveira-Maia); NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon (Oliveira-Maia); Department of Psychiatry and Behavioral Sciences, University of South Carolina School of Medicine, Greenville (Maletic); Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford (Suppes); Department of Psychiatry, University of California, San Diego (Stahl).

出版信息

Am J Psychiatry. 2025 Jan 1;182(1):21-32. doi: 10.1176/appi.ajp.20230902.

Abstract

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain psychedelics are effective and safe in the treatment of major depressive disorder, treatment-resistant depression, and posttraumatic stress disorder. Preliminary evidence also supports efficacy in other psychiatric disorders (e.g., tobacco and alcohol use disorders). Notwithstanding the interest and promise of psychedelics, concerns have arisen with respect to the interpretability and translatability of study results. For example, aspects related to short- and long-term safety, abuse liability, and the essentiality of the psychedelic "trip" and psychological support are, inter alia, insufficiently characterized with psychedelic agents. The overarching aims in this overview are 1) to review methodological aspects that affect inferences and interpretation of extant psychedelic studies in psychiatric disorders, and 2) to provide guidance for future research and development of psychedelic treatment in psychiatry, critical to study interpretation and clinical implementation.

摘要

在过去十年中,公众、媒体和医学研究对迷幻药产生了极大兴趣,将其视为治疗难治性精神疾病的有前景的疗法。短期对照试验数据表明,某些迷幻药在治疗重度抑郁症、难治性抑郁症和创伤后应激障碍方面是有效且安全的。初步证据也支持其在其他精神疾病(如烟草和酒精使用障碍)中的疗效。尽管迷幻药引起了人们的兴趣并展现出前景,但对于研究结果的可解释性和可转化性也出现了一些担忧。例如,与短期和长期安全性、滥用可能性以及迷幻药“体验”和心理支持的必要性等相关方面,尤其是在迷幻药制剂中,尚未得到充分描述。本综述的总体目标是:1)回顾影响现有迷幻药在精神疾病研究中的推断和解释的方法学方面;2)为未来精神科迷幻药治疗的研究和开发提供指导,这对研究解释和临床应用至关重要。

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