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迷幻辅助疗法:心理健康治疗中的潜在益处与挑战

Psychedelic-Assisted Therapy: Potential Benefits and Challenges in Mental Health Treatment.

作者信息

Silczuk Andrzej, Madejek Robert J, Koweszko Tytus, Mularczyk-Tomczewska Paulina, Adamska Ewelina, Gujski Mariusz, Szulc Agata

机构信息

Department of Environmental Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

出版信息

Med Sci Monit. 2025 Aug 9;31:e948302. doi: 10.12659/MSM.948302.

Abstract

Psychedelics, derived from the Greek words "psyche" (soul) and "deloun" (revealing), are substances historically and currently considered "soul-revealing". Also termed hallucinogens due to their impact on sensory perception, they are further categorized into hallucinogens, such as lysergic acid diethylamide (LSD), psilocybin, and mescaline; entactogens or empathogens, such as 3,4-methylenedioxymethamphetamine (MDMA); and dissociatives, such as phencyclidine (PCP) and ketamine. The concept of using these substances to enhance psychotherapy emerged in the 1940s, leading to the first wave of psychedelic research, which yielded promising initial results. Following a period of restricted research, modern investigations began anew around 20 years ago. In this review, we analyze the last 10 years of research, exploring the potential of psychedelics in psychotherapy. Current evidence reveals that psychedelic-assisted psychotherapy remains an experimental approach. While preliminary studies suggest potential therapeutic benefits in treating various conditions, including depression, post-traumatic stress disorder, obsessive-compulsive disorder, and substance use disorders, a definitive assessment of efficacy and safety is hampered by the scarcity of large-scale, rigorous clinical trials. Psychedilics should rather be viewed as integral components of broader therapeutic frameworks than as standalone treatment. The unique mechanisms of psychedelics, notably their effect on neuroplasticity, hint at the potential to address treatment gaps in patients unresponsive to conventional methods. However, this potential requires validation through larger, more rigorously designed studies. Future research must prioritize high-quality, randomized, double-blind, placebo-controlled trials encompassing diverse populations to produce reliable, generalizable findings and ensure responsible clinical implementation. The aim of this article is to review the current status of psychedelic-assisted psychotherapy.

摘要

迷幻剂一词源于希腊语“psyche”(灵魂)和“deloun”(揭示),在历史上及当下都被视为“揭示灵魂”的物质。因其对感官知觉的影响,它们也被称为致幻剂,进一步可分为致幻剂,如麦角酸二乙酰胺(LSD)、裸盖菇素和三甲氧苯乙胺;触觉致幻剂或共情致幻剂,如3,4-亚甲基二氧甲基苯丙胺(摇头丸);以及分离性药物,如苯环己哌啶(PCP)和氯胺酮。利用这些物质来加强心理治疗的概念在20世纪40年代出现,引发了第一轮迷幻剂研究,初步结果很有前景。经过一段研究受限的时期后,大约20年前现代研究重新开始。在本综述中,我们分析了过去10年的研究,探讨迷幻剂在心理治疗中的潜力。目前的证据表明,迷幻剂辅助心理治疗仍是一种实验性方法。虽然初步研究表明在治疗各种病症(包括抑郁症、创伤后应激障碍、强迫症和物质使用障碍)方面有潜在的治疗益处,但由于缺乏大规模、严格的临床试验,对疗效和安全性的明确评估受到阻碍。迷幻剂应被视为更广泛治疗框架的组成部分,而不是独立的治疗方法。迷幻剂的独特机制,尤其是它们对神经可塑性的影响,暗示了弥补对传统方法无反应患者治疗缺口的潜力。然而,这种潜力需要通过更大规模、设计更严谨的研究来验证。未来的研究必须优先进行高质量、随机、双盲、安慰剂对照试验,涵盖不同人群,以产生可靠、可推广的结果,并确保负责任的临床应用。本文旨在综述迷幻剂辅助心理治疗的现状。

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