The impact of antidepressant discontinuation prior to treatment with psilocybin for treatment-resistant depression

IF 3.7 2区 医学 Q1 PSYCHIATRY
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Abstract

It has been suggested that the recent use and discontinuation of antidepressant drugs compromises the action of psilocybin. As evidence is only available from small or uncontrolled samples, this post hoc analysis investigated this using data from the largest, phase II, randomized controlled trial of psilocybin treatment to date. Data from 233 participants with treatment-resistant depression (TRD) who received 25 mg, 10 mg, or 1 mg of investigational drug COMP360 psilocybin (a proprietary, pharmaceutical-grade synthetic psilocybin formulation, developed by the sponsor, Compass Pathfinder Ltd.), administered with psychological support, were compared for groups of participants who either discontinued one or more antidepressant drugs during screening or entered the trial antidepressant drug free. Measures of depression symptom severity change during the antidepressant drug discontinuation period, baseline suicidality, acute subjective psychedelic effects, and the study's primary endpoint (change in depression symptom severity between Baseline and Week 3) are described for both groups. Antidepressant drug discontinuation was not related to worsening of depression severity before Baseline. Suicidality was comparable between groups at Baseline. Psilocybin treatment efficacy and the subjective psychedelic experience did not appear to be compromised by antidepressant drug discontinuation. Thus, it does not limit the feasibility of psilocybin treatment for the future. These findings also support the overall homogeneity of our findings with psilocybin treatment as a monotherapy for TRD. The prior contradictory reports may come to appear misleading.
在使用迷幻药治疗耐药性抑郁症之前停用抗抑郁药的影响。
有人认为,最近使用和停用抗抑郁药物会损害迷幻剂的作用。由于只有小样本或非对照样本可以提供证据,因此本研究利用迄今为止规模最大的斯洛赛宾治疗 II 期随机对照试验的数据进行了事后分析。233 名患有治疗耐受性抑郁症(TRD)的参与者接受了 25 毫克、10 毫克或 1 毫克的研究药物 COMP360 茜洛赛宾(一种由赞助商 Compass Pathfinder 有限公司开发的专有医药级合成茜洛赛宾制剂),并在心理支持下接受了治疗,对在筛选期间停用一种或多种抗抑郁药物或未服用抗抑郁药物而进入试验的参与者组别进行了数据比较。报告对两组参与者在停用抗抑郁药物期间抑郁症状严重程度的变化、基线自杀倾向、急性主观迷幻效应以及研究的主要终点(基线与第 3 周之间抑郁症状严重程度的变化)进行了描述。停用抗抑郁药物与基线前抑郁严重程度的恶化无关。两组在基线时的自杀率相当。西洛赛宾的疗效和主观迷幻体验似乎不会因停用抗抑郁药物而受到影响。因此,这并不会限制未来迷幻剂治疗的可行性。这些发现也支持了我们将迷幻剂治疗作为TRD单一疗法的整体一致性。之前相互矛盾的报道可能会产生误导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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