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Psilocybin as a treatment for psychiatric disorders : a systematic review
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O renaissance dos psicadélicos na investigação está atualmente em curso e o estudo dos efeitos terapêuticos da psilocibina está a crescer como nunca. Neste artigo, faço uma revisão dos estudos realizados até ao momento relativamente aos efeitos terapêuticos da psilocibina em distúrbios psiquiátricos. Foram utilizados critérios de inclusão muito amplos tendo em conta a reduzida investigação relativamente a esta questão. Doze estudos foram incluídos: três ensaios aleatorizados com controlo, seis ensaios open-label e três estudos de caso. Os efeitos da psilocibina estudados focaram-se em três patologias: depressão, perturbação obsessivo-compulsiva e transtornos relacionados com substâncias (nomeadamente tabaco e álcool). Todos os estudos demonstraram um perfil relativamente seguro por parte da psilocibina assim como resultados promissores com reduções observadas na maior parte das escalas psiquiátricas de classificação utilizadas. Os estudos relativos à depressão apresentam maior solidez em termos de resultados sendo que os três ensaios aleatorizados com controlo encontrados exploram os efeitos da psilocibina nesta desordem. Os estudos relativos à perturbação obsessivo-compulsiva e aos transtornos relacionados com substâncias apresentam mais limitações devido ao design open-label ou de estudo de caso. Contudo, os resultados observados nestas patologias são igualmente promissores. Os mecanismos subjacentes aos efeitos da psilocibina são ainda pouco compreendidos, mas várias hipóteses foram propostas. Em suma, os resultados dos estudos incluídos nesta revisão sugerem um substancial potencial efeito terapêutico da psilocibina, que requer mais ensaios aleatorizados, com amostras maiores de modo a confirmar os resultados observados até agora e clarificar os mecanismos subjacentes a esses resultados.
A psychedelic renaissance is currently ongoing and investigation on psilocybin’s therapeutic effects is expanding more than ever. In this paper, I review the research conducted so far on the therapeutic effects of psilocybin on psychiatric disorders. The inclusion criteria used were very broad given the scarce research on the matter. Twelve studies were included: three randomized controlled trials, six open-label trials and three case-reports. The psilocybin’s effects studied focused on three disorders: depression, obsessive-compulsive disorder and substance use disorder (namely tobacco and alcohol). All studies showed that psilocybin has a relatively safe profile and reported very promising results with reductions observed on most of the psychiatric rating scale scores used. Research on depression had the most solid evidence and the three randomized controlled trials included have addressed psilocybin’s effects on this disorder. Studies on obsessive-compulsive disorder and substance use disorder show more limitations due to their open-label or case report designs. Nonetheless, the results reported in regard to these disorders are equally promising. The mechanisms underlying psilocybin’s effects are poorly understood; however, several hypotheses have been proposed. Altogether, the results from the studies reviewed in this paper suggest a substantial therapeutic potential from psilocybin. This calls for further research with more randomized controlled trials, with larger samples to confirm the results observed so far and further explain the underlying mechanisms.
A psychedelic renaissance is currently ongoing and investigation on psilocybin’s therapeutic effects is expanding more than ever. In this paper, I review the research conducted so far on the therapeutic effects of psilocybin on psychiatric disorders. The inclusion criteria used were very broad given the scarce research on the matter. Twelve studies were included: three randomized controlled trials, six open-label trials and three case-reports. The psilocybin’s effects studied focused on three disorders: depression, obsessive-compulsive disorder and substance use disorder (namely tobacco and alcohol). All studies showed that psilocybin has a relatively safe profile and reported very promising results with reductions observed on most of the psychiatric rating scale scores used. Research on depression had the most solid evidence and the three randomized controlled trials included have addressed psilocybin’s effects on this disorder. Studies on obsessive-compulsive disorder and substance use disorder show more limitations due to their open-label or case report designs. Nonetheless, the results reported in regard to these disorders are equally promising. The mechanisms underlying psilocybin’s effects are poorly understood; however, several hypotheses have been proposed. Altogether, the results from the studies reviewed in this paper suggest a substantial therapeutic potential from psilocybin. This calls for further research with more randomized controlled trials, with larger samples to confirm the results observed so far and further explain the underlying mechanisms.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Psilocibina Depressão Ansiedade Perturbação obsessivo-compulsiva Uso de substâncias Psiquiatria