Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder
Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder
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DOI：
10.4088/jcp.v67n1110
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发表时间：
2006-11-01
影响因子：
5.3
通讯作者：
Delgado, Pedro L.
中科院分区：
文献类型：
--
作者：
Moreno, Francisco A.;Wiegand, Christopher B.;Delgado, Pedro L.
背景：传闻报告表明，迷幻剂可以缓解强迫症（OCD）的症状。这种修改后的双盲研究调查的安全性，耐受性和临床效果的裸盖菇素，一种有效的5-HT 1A和5-HT 2A/2C激动剂，在患者与OCD.Method：9名受试者与DSM-IV定义的强迫症和没有其他当前的主要精神疾病参与了多达4个单剂量暴露裸盖菇素的剂量范围从subhallucinogenic坦率地致幻。按顺序分配低（100 μ g/kg）、中（200 μ g/kg）和高（300 μ g/kg）剂量，并在首次给药后的任何时间以双盲方式随机插入极低剂量（25 μ g/kg）。测试日间隔至少1周。每个疗程在门诊的受控环境中进行8小时，然后将受试者转移到精神病住院部进行过夜观察。Yale-Brown强迫症量表（YBOCS）和视觉模拟量表测量整体强迫症状的严重程度，在0，4，8和24小时后摄入。在8小时时给予致幻剂评定量表，并在摄入后0、1、4、8和24小时记录生命体征。结果：9例受试者共服用裸盖菇素29次。1例受试者出现一过性高血压，与焦虑或躯体症状无关，但未观察到其他显著不良反应。在所有受试者中，在一次或多次测试期间观察到不同程度的强迫症症状明显减轻（YBOCS评分降低23%-100%）。所有YBOCS值的重复测量方差分析显示，时间对Wilks lambda有显著的主要影响（F = 9.86，df = 3，3; p = 0.046），但剂量无显著影响（F = 2.25，df = 3，3; p = 0.26 1）或时间和剂量的相互作用（F = 0.923，df = 9，45; p = 0.515）。改善一般持续过去的24小时timepoint.Conclusions：在一个受控的临床环境中，裸盖菇素是安全使用的受试者与强迫症，并与急性减少核心强迫症症状在几个科目。
Background: Anecdotal reports suggest that psychedelic agents may relieve symptoms of obsessive-compulsive disorder (OCD). This modified double-blind study investigated the safety, tolerability, and clinical effects of psilocybin, a potent 5-HT1A and 5-HT2A/2C agonist, in patients with OCD.Method: Nine subjects with DSM-IV-defined OCD and no other current major psychiatric disorder participated in up to 4 single-dose exposures to psilocybin in doses ranging from subhallucinogenic to frankly hallucinogenic. Low (100 mu g/kg), medium (200 mu g/kg), and high (300 mu g/kg) doses were assigned in that order, and a very low dose (25 mu g/kg) was inserted randomly and in double-blind fashion at any time after the first dose. Testing days were separated by at least I week. Each session was conducted over an 8-hour period in a controlled environment in an outpatient clinic; subjects were then transferred to a psychiatric inpatient unit for overnight observation. The Yale-Brown Obsessive Compulsive Scale (YBOCS) and a visual analog scale measuring overall obsessive-compulsive symptom severity were administered at 0, 4, 8, and 24 hours post-ingestion. The Hallucinogen Rating Scale was administered at 8 hours, and vital signs were recorded at 0, 1, 4, 8, and 24 hours after ingestion. The study was conducted from November 2001 to November 2004.Results: Nine subjects were administered a total of 29 psilocybin doses. One subject experienced transient hypertension without relation to anxiety or somatic symptoms, but no other significant adverse effects were observed. Marked decreases in OCD symptoms of variable degrees were observed in all subjects during 1 or more of the testing sessions (23%-100% decrease in YBOCS score). Repeated-measures analysis of variance for all YBOCS values revealed a significant main effect of time on Wilks lambda (F = 9.86, df = 3,3; p = .046), but no significant effect of dose (F = 2.25, df = 3,3; p = .26 1) or interaction of time and dose (F = 0.923, df = 9,45; p = .515). Improvement generally lasted past the 24-hour timepoint.Conclusions: In a controlled clinical environment, psilocybin was safely used in subjects with OCD and was associated with acute reductions in core OCD symptoms in several subjects.