Psilocybin在姑息治疗中的应用:最新进展。

IF 1.1 Q4 GERIATRICS & GERONTOLOGY Current Geriatrics Reports Pub Date : 2023-01-01 Epub Date: 2023-04-14 DOI:10.1007/s13670-023-00383-7
Emily Whinkin, Moira Opalka, Conor Watters, Atara Jaffe, Sunil Aggarwal
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引用次数: 1

摘要

综述目的:这篇综述文章总结了过去五年来经典色胺类迷幻物质裸盖菇素治疗应用的临床和社会相关进展,以及姑息治疗患者及其护理团队面临的常见挑战。Psilocybin有完整的真菌和分离形式,但尚未在美国被批准用于治疗。通过有针对性的数据库、灰色文献检索和作者回忆,确定、回顾和综合了裸盖菇素在姑息治疗中的安全性和有效性的关键来源。最近的发现:姑息治疗患者所面临的威胁生命或限制生命的疾病与情绪和精神痛苦共病。综述的研究和现场报告表明,裸盖菇素具有显著的、在某些情况下持续的抗焦虑、抗抑郁、抗炎和促热作用,具有良好的安全性。该研究的局限性包括对健康、白人、经济上有特权的个人的选择偏见的风险,以及总体而言,随访时间太短,无法适当评估精神心理益处和生活质量结果的持久性。摘要:虽然还需要对姑息治疗人群进行更多的研究,但裸盖菇素的抗焦虑、抗抑郁、抗炎和促热作用对姑息治疗患者的潜在益处可以做出合理的推断。然而,普通民众在获取信息方面存在重大的法律、道德和财政障碍;对于老年和姑息治疗患者来说,这些障碍可能会恶化。应对裸盖菇素进行经验性治疗和大规模对照试验,以进一步调查在不同人群中进行的小型研究的结果,更好地了解治疗益处和临床相关安全标准,并支持深思熟虑的合法化和医疗途径。
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Psilocybin in Palliative Care: An Update.

Purpose of review: This review article summarizes clinically and socially relevant developments over the past five years in the therapeutic use of the classical tryptamine psychedelic substance psilocybin, with respect to the common challenges faced by palliative care patients and their care teams. Psilocybin is available in whole fungal and isolated forms but is not yet approved for therapeutic use in the United States. Using targeted database and gray literature searches, and author recall, key sources were identified, reviewed, and synthesized as to the safety and efficacy of psilocybin in palliative care.

Recent findings: Life-threatening or life-limiting illnesses and faced by palliative care patients are comorbid with emotional and spiritual distress. Research and field reports reviewed suggest that psilocybin has significant and in some cases, sustained anxiolytic, antidepressant, anti-inflammatory and entheogenic effects with a favorable safety profile. Limitations of the research include the risk for selection bias toward healthy, white, financially privileged individuals, and in general, follow-up timelines too short to appropriately evaluate durability of outcomes in psychospiritual benefits and quality of life.

Summary: While more research is needed for palliative care populations specifically, reasonable inferences can be made regarding the potential for benefit to palliative care patients from psilocybin's demonstrated anxiolytic, antidepressant, anti-inflammatory and entheogenic effects. However, major legal, ethical and financial barriers to access exist for the general population; obstacles which are likely worsened for geriatric and palliative care patients. Empiric treatment and large-scale controlled trials of psilocybin should be conducted to further investigate the findings of the smaller studies reviewed here across a variety of populations, for a greater understanding of therapeutic benefit and clinically relevant safety criteria, and to support thoughtful legalization and medical access.

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来源期刊
Current Geriatrics Reports
Current Geriatrics Reports Medicine-Geriatrics and Gerontology
CiteScore
2.20
自引率
0.00%
发文量
4
期刊介绍: This journal aims to offer in-depth review articles on the most recent innovative publications in geriatrics and gerontology. By providing clear, insightful contributions by international experts, the journal intends to serve clinicians and researchers involved in the diagnosis, management, treatment, prevention, and study of patients affected by age-related conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as the age-related change in cognitive function, the influence of genetics on neurodegenerative disorders, and traumatic brain injury and dementia. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board of more than 20 members reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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