| Popis: |
Classical psychedelics as a treatment for depression: where are we today? Over the past few years, psychedelics have made an exciting comeback in the field of psychiatric and neuroscientific research. Scientists are inspired by early work from the 1960s and find themselves supported by new entrepreneurial interest in this potentially lucrative market. The term ‘classical psychedelics’ is reserved for a number of molecules that are structurally similar to the neurotransmitter serotonin (5-HT). A central part in their mechanism of action consists of agonism of the 5-HT2A receptor. This receptor is found in different regions of the brain and - when activated - induces pharmacological, neurocognitive and psychological alterations. In this review, the research on classical psychedelics as a treatment for depression is evaluated. Particularly studies involving psilocybin (1 open-label study (n = 12) and 2 randomised, controlled trials (RCTs) (n = 27 and n = 59)) show encouraging results and suggest a significant antidepressant effect of this molecule. Furthermore, there is some evidence regarding antidepressant properties of Ayahuasca (1 open-label study (n = 17) and 1 RCT (n = 29)). Yet, these studies rely on small sample sizes and have to face with methodological challenges. Research populations lack diversity and achieving adequate blinding remains difficult. Amidst the global interest that psychedelic science is currently experiencing, independent and transparent scientific research remains indispensable to more fully identify the risks and benefits involved in any presumptive clinical application of these molecules. Future research can focus on including larger and more diverse groups of patients, developing long-term and longitudinal study designs, and mitigating blinding challenges, for instance by using active control conditions. In addition, standardizing the context (‘set’ and ‘setting’) in which psychedelic research takes place, can contribute to a higher validity of the data. |
