氯胺酮和裸盖菇素诱导的主观效应对治疗结果影响的Meta相关性-动脉网

Meta-correlation of the effect of ketamine and psilocybin induced subjective effects on therapeutic outcome

Nature 等信源发布 2024-10-06 13:25

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AbstractThere is some evidence that the subjective effects of ketamine and other psychedelics like psilocybin are crucial for their therapeutic outcomes, such as treatment of depression or substance use disorder (SUD). We performed a meta-analysis and systematic review on the correlation of subjective symptoms and dissociation versus ketamine-induced therapeutic outcomes in patients with depression or SUD.

摘要有证据表明，氯胺酮和其他迷幻剂（如裸盖菇素）的主观作用对其治疗效果至关重要，例如治疗抑郁症或药物使用障碍（SUD）。我们对抑郁症或SUD患者的主观症状和解离与氯胺酮诱导的治疗结果的相关性进行了荟萃分析和系统评价。

A similar analysis was conducted for psilocybin-induced therapeutic improvement. We retrieved 23 papers studying ketamine (21 on depression, 2 on SUD) in 471 patients and 8 papers studying psilocybin (6 on depression, 2 on SUD) in 183 patients. Our study demonstrated a modest role for subjective effects mediating therapeutic outcomes, with R2-values ranging from 5–10% for ketamine and for psilocybine the R2 was 24%.

对psilocybin诱导的治疗改善进行了类似的分析。我们检索了23篇研究氯胺酮的论文（21篇关于抑郁症，2篇关于SUD），471例患者和8篇研究裸盖菇素的论文（6篇关于抑郁症，2篇关于SUD），183例患者。我们的研究表明，主观效应对介导治疗结果的作用不大，氯胺酮的R2值为5-10%，裸盖菇碱的R2值为24%。

A greater mediating effect for psilocybin compared to ketamine was detected, particularly when restricting the analysis to depression. Additionally there is a greater mediating effect in SUD than depression, irrespective of treatment..

与氯胺酮相比，裸盖菇素具有更大的介导作用，特别是在将分析限制在抑郁症时。此外，无论治疗如何，SUD的中介作用都比抑郁症更大。。

IntroductionPsychiatric conditions affect millions of people globally. Mainstream antidepressants remain the standard of care and first-line treatment despite limited and delayed efficacy. Consequently, there is a pressing need for alternative pharmaceutical options. Recently, various psychedelics demonstrated efficacy in treating several psychiatric illnesses.1 Psychedelics are a class of psychoactive substances that modulate consciousness, internal and external perception, mood, and various cognitive functions1.

。尽管疗效有限且延迟，但主流抗抑郁药仍然是护理和一线治疗的标准。因此，迫切需要替代药物选择。最近，各种迷幻剂在治疗几种精神疾病方面表现出疗效。迷幻剂是一类调节意识，内外知觉，情绪和各种认知功能的精神活性物质1。

They include a variety of pharmacological classes with different modes of action. “Classical psychedelics” act as agonists at serotonin receptors (psilocybin and lysergic acid diethylamide). “Non-classical psychedelics” include those that act on different targets, such as non-serotonergic opioidergic or adrenergic pathways.

。“经典迷幻剂”可作为血清素受体（裸盖菇素和麦角酸二乙酰胺）的激动剂。“非经典迷幻剂”包括那些作用于不同目标的药物，例如非5-羟色胺能阿片能或肾上腺素能途径。

The non-classical psychedelics include those that antagonize the N-methyl-D-aspartate (NMDA) receptor and include substances such as ketamine, esketamine and nitrous oxide, while others act at dopamine (MDMA) or opioid receptors in addition to serotonergic activity (ibogaine)1,2,3. What these drugs have in common is that they induce psychoplastogenic effects, i.e., they cause neurotrophic changes in the brain and promote rapid neural plasticity with rewiring of pathological neurocircuitry2.

非经典迷幻剂包括拮抗N-甲基-D-天冬氨酸（NMDA）受体的迷幻剂，包括氯胺酮，氯胺酮和一氧化二氮等物质，而其他迷幻剂除5-羟色胺能活性外还作用于多巴胺（MDMA）或阿片受体（伊博加因）1,2,3。这些药物的共同之处在于它们诱导心理塑性作用，即它们引起大脑的神经营养变化，并通过重新连接病理性神经回路来促进快速的神经可塑性2。

Still, despite these shared pathways, each of these psychedelics exert unique effects on subjective conscious experience that differ markedly in nature among compounds4. These subjective effects are perceived as meaningful and significant by some users and have been implicates as potential mechanism of therapeutic effect.5In recent years, there has been a growing interest in the use of psychedelics in clinical practice, particularly within psychiatry and.

尽管有这些共同的途径，但这些迷幻药中的每一种都对主观意识体验产生了独特的影响，这些主观意识体验在化合物之间存在明显的性质差异4。这些主观影响被一些用户认为是有意义和重要的，并被认为是潜在的治疗效果机制。5近年来，人们越来越关注在临床实践中使用迷幻药，特别是在精神病学和精神病学中。

Data availability

数据可用性

The data that has been generated are available from the authors depending on the request and nature of the protocol.

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C. DahanUSC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles, CA, USADavid DadiomovLos Angeles General Medical Center, Los Angeles, CA, USADavid DadiomovARQ National Psychotrauma Center, Diemen, the NetherlandsTijmen BostoenDepartment of Psychiatry, Leiden University Medical Center, Leiden, the NetherlandsTijmen BostoenLeiden University Medical Center, Leiden, the NetherlandsAlbert DahanPainLess Foundation, Leiden, the NetherlandsAlbert DahanOutcomes Research Consortium, Cleveland, OH, USAAlbert DahanAuthorsJack D.

C、加利福尼亚州洛杉矶DahanUSC Alfred E.Mann药学院，美国加利福尼亚州洛杉矶David DadiomovLos Angeles General Medical Center，美国加利福尼亚州洛杉矶，美国David DadiomovARQ National Psychorauma Center，Diemen，NetherlandsTijmen BostoenDepartment of Psychiatry，Leiden University Medical Center，Leiden，NetherlandsTijmen BostoenLeiden University Medical Center，Leiden，NetherlandsAlbert Dahanless Foundation，Leiden，NetherlandsAlbert DahanOutcomes Research Consortium，Cleveland，OH，USAAlbert DahanAuthorsJack D。

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PubMed Google ScholarContributionsJ.D.C.D. had the idea of the study, retrieved the studies and red all studies. He performed the data analyses and wrote a large part of the paper and approved the final version of the study. D.D. was involved in the writing of the paper and the revision and approved the final version.

PubMed谷歌学术贡献。D、 C.D.有了这项研究的想法，检索了这些研究，并公布了所有研究。他进行了数据分析，写了大部分论文，并批准了研究的最终版本。D、 D.参与了论文的撰写和修订，并批准了最终版本。

T.B. was involved in the writing of the paper and approved the final version. A.D. wrote the protocol, retrieved papers/red papers together with J.D.C.D., performed the data analyses and wrote the paper and the revision. he approved the final version of the paper.Corresponding authorCorrespondence to.

T、 B.参与了论文的撰写并批准了最终版本。A、 D.撰写协议，与J.D.C.D.一起检索论文/红文，进行数据分析，撰写论文和修订。他批准了论文的最终版本。对应作者对应。

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Reprints and permissionsAbout this articleCite this articleDahan, J.D.C., Dadiomov, D., Bostoen, T. et al. Meta-correlation of the effect of ketamine and psilocybin induced subjective effects on therapeutic outcome.

转载和许可本文引用本文Dahan，J.D.C.，Dadiomov，D.，Bostoen，T。等人。氯胺酮和裸盖菇素对治疗结果的主观影响的元相关性。

npj Mental Health Res 3, 45 (2024). https://doi.org/10.1038/s44184-024-00091-wDownload citationReceived: 18 July 2024Accepted: 30 September 2024Published: 06 October 2024DOI: https://doi.org/10.1038/s44184-024-00091-wShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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