Tudorancea Ivona-Maria, Stanciu Gabriela-Dumitrita, Torrent Carla, Madero Santiago, Hritcu Lucian, Tamba Bogdan-Ionel
Advanced Research and Development Center for Experimental Medicine "Prof. Ostin C. Mungiu" CEMEX, "Grigore T. Popa" University of Medicine and Pharmacy of Iasi, Iasi, Romania.
Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
Dialogues Clin Neurosci. 2025 Dec;27(1):98-111. doi: 10.1080/19585969.2025.2499458. Epub 2025 May 6.
The global population is ageing rapidly, with the number of individuals aged 60 and older reaching 1 billion in 2019 and expected to double by 2050. As people age, neuropsychological health often deteriorates, leading to a higher prevalence of age-related depression. Symptoms may include anxiety, apathy, mood instability, sadness, and, in severe cases, suicidal thoughts. Depression in the elderly is a widespread concern, and conventional treatments such as antidepressants are often limited by side effects, reduced efficacy, and complications arising from polypharmacy. In response, novel therapeutic approaches are being explored, including psychedelic interventions. Recent clinical and preclinical studies suggest that psychedelics could offer a promising treatment for major depressive disorder (MDD) in older adults. These compounds, known for their profound neurobiological effects, have gained attention for their potential to address depression where traditional therapies fall short. This review aims to examine the therapeutic promise of psychedelic substances, focusing on those that show potential for treating MDD in the elderly. We also explore the underlying mechanisms through which psychedelics may exert their effects and highlight the preclinical models that support their use. Finally, we address safety considerations and propose strategies to enhance the effectiveness and safety of psychedelics in future clinical trials, offering new hope for treating age-related depressive disorders.
全球人口正在迅速老龄化，2019年60岁及以上的人口数量达到10亿，预计到2050年将翻一番。随着人们年龄的增长，神经心理健康往往会恶化，导致与年龄相关的抑郁症患病率更高。症状可能包括焦虑、冷漠、情绪不稳定、悲伤，严重时还会出现自杀念头。老年人的抑郁症是一个广泛关注的问题，而抗抑郁药等传统治疗方法往往受到副作用、疗效降低以及多重用药引起的并发症的限制。作为回应，人们正在探索新的治疗方法，包括迷幻剂干预。最近的临床和临床前研究表明，迷幻剂可能为老年人的重度抑郁症（MDD）提供一种有前景的治疗方法。这些化合物以其深刻的神经生物学效应而闻名，因其在传统疗法不足时解决抑郁症的潜力而受到关注。这篇综述旨在研究迷幻物质的治疗前景，重点关注那些显示出治疗老年人MDD潜力的物质。我们还探讨了迷幻剂可能发挥作用的潜在机制，并强调了支持其使用的临床前模型。最后，我们讨论了安全问题，并提出了在未来临床试验中提高迷幻剂有效性和安全性的策略，为治疗与年龄相关的抑郁症提供了新的希望。
