Andrade Filipe Reis Teodoro, Buchborn Tobias, Thalheimer Gabriel, Meinhardt Marcus W, Joca Samia, de Almeida Rosa Maria Martins
Department of Psychopharmacology, Central Institute of Mental Health (ZI), Mannheim, Germany.
Department of Developmental and Personality Psychology, Laboratory of Experimental Psychology, Neuroscience and Behavior (LPNeC), Universidade Federal of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Acta Neuropsychiatr. 2025 Sep 3;37:e86. doi: 10.1017/neu.2025.10039.
Major depressive disorder (MDD) is a significant public health concern, and current treatments often have limitations in effectiveness and adherence. Psilocybin, a psychedelic compound found in certain mushrooms, is being explored as a potential treatment for depression. It primarily acts through the serotonin 5-HT2A receptor but interacts with 5-HT1A and 5-HT2C receptors. Its precise mechanisms remain under investigation.
(1) To consolidate evidence on psilocybin’s efficacy and safety for depression and the role of 5HT2a, (2) to identify limitations in the literature, and (3) to highlight areas needing further research.
This systematic review follows PRISMA guidelines and analyses 22 studies, including randomised controlled trials (RCTs) and open-label studies. The studies cover various populations, including individuals with treatment-resistant depression, different dosing regimens, and adjunctive therapies.
Psilocybin therapy shows substantial and rapid antidepressant effects, often after one or two sessions with psychological support. Improvements are sustained for weeks or months in many cases. Psilocybin is generally well-tolerated, with mild adverse effects such as anxiety during administration and transient headaches, which are manageable in controlled settings.
Psilocybin demonstrates promise as a novel treatment for depression, especially for individuals unresponsive to conventional antidepressants. Further research is needed to refine dosing, explore long-term effects, and understand its mechanisms of action.
重度抑郁症（MDD）是一个重大的公共卫生问题，目前的治疗方法在有效性和依从性方面往往存在局限性。裸盖菇素是一种在某些蘑菇中发现的致幻化合物，正被探索作为抑郁症的一种潜在治疗方法。它主要通过5-羟色胺2A（5-HT2A）受体起作用，但也与5-HT1A和5-HT2C受体相互作用。其确切机制仍在研究中。
（1）巩固关于裸盖菇素治疗抑郁症的疗效和安全性以及5-HT2A作用的证据；（2）识别文献中的局限性；（3）突出需要进一步研究的领域。
本系统评价遵循PRISMA指南，分析了22项研究，包括随机对照试验（RCT）和开放标签研究。这些研究涵盖了不同人群，包括难治性抑郁症患者、不同给药方案以及辅助治疗。
裸盖菇素疗法显示出显著且快速的抗抑郁作用，通常在接受一两次心理支持治疗后即可出现。在许多情况下，改善可持续数周或数月。裸盖菇素一般耐受性良好，不良反应轻微，如给药期间的焦虑和短暂头痛，在可控环境中这些不良反应是可管理的。
裸盖菇素作为一种新型抑郁症治疗方法显示出前景，尤其是对于对传统抗抑郁药无反应的个体。需要进一步研究以优化给药方案、探索长期效果并了解其作用机制。
