Kozak Zofia, Miller Christopher W T
Department of Psychiatry, Sheppard Pratt Health System, Baltimore, MD, USA.
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
Int Rev Psychiatry. 2024 Dec;36(8):833-840. doi: 10.1080/09540261.2024.2419662. Epub 2024 Nov 13.
Psychedelic compounds continue gaining scientific and regulatory traction as potential new treatments for psychiatric disorders. While most psychiatrists will likely not work directly with these compounds, psychedelic research practices provide insights that may improve conventional psychiatric care. Through its emphasis on 'set and setting' (mindset and environment, respectively), psychedelic research highlights the importance of non-pharmacologic factors maximizing therapeutic outcomes. While psychedelics and serotonergic antidepressants are distinctly different in their subjective experience, new findings suggest mechanistic overlap between them. Both have been found to modulate neurotrophins, enhance neuroplasticity, and reopen critical periods of learning, molded by the environmental context in which they are administered. This paper will argue that by integrating insights from psychedelic research (particularly set and setting), depression treatment outcomes in traditional psychiatric settings can improve by optimizing non-pharmacological factors in treatment, including the provision of high-quality psychotherapy.
迷幻化合物作为精神疾病潜在的新治疗方法,在科学和监管方面的关注度持续上升。虽然大多数精神科医生可能不会直接使用这些化合物,但迷幻药物研究实践提供了一些见解,可能会改善传统的精神科护理。通过强调“心境和环境”(分别指心态和环境),迷幻药物研究突出了非药物因素对最大化治疗效果的重要性。虽然迷幻药物和血清素能抗抑郁药在主观体验上有明显差异,但新的研究结果表明它们在作用机制上存在重叠。两者都被发现可以调节神经营养因子,增强神经可塑性,并重新开启关键的学习期,这受到给药时所处环境背景的影响。本文将论证,通过整合迷幻药物研究的见解(特别是心境和环境),在传统精神科环境中,通过优化治疗中的非药物因素,包括提供高质量的心理治疗,可以改善抑郁症的治疗效果。