Psilocybin-gestützte Therapie von Depression, Angst und Suchtstörungen: Neurobiologische Grundlagen und klinische Anwendung

Zusammenfassung

Eine erfolgreiche Therapie psychischer Störungen ist angesichts des häufig vorhandenen Leidensdrucks der Betroffenen sehr wichtig. Da anerkannte pharmazeutische und psychotherapeutische Ansätze leider nicht für alle Patient:innen zur erwünschten Besserung ihres Leidens führen, findet intensive Forschung zu ergänzenden oder alternativen Behandlungsmethoden statt. Besonders vielversprechend zeigte sich zuletzt die Psilocybin-gestützte Psychotherapie, die in den USA deshalb für klinische Studien mit größeren Stichproben als bisher zugelassen wurde. Psilocybin gehört zu den Psychedelika und beeinflusst in seiner Wirkung das psychische Erleben. Bei der gestützten Therapie wird Psilocybin in kontrollierten Dosen unter medizinischer Aufsicht verabreicht. In den bisher durchgeführten Studien konnten bereits nach einer, bis wenigen Einnahmen längerfristige positive Effekte in Hinblick auf die jeweiligen Störungsbilder gezeigt werden. Um ein besseres Verständnis der potenziellen therapeutischen Mechanismen zu ermöglichen, sollen in diesem Artikel zunächst Erkenntnisse zur Wirkweise von Psilocybin auf neurobiologischer und psychologischer Ebene vorgestellt werden. Anschließend soll die Analyse der bisher durchgeführten klinischen Studien mit einer Anwendung von Psilocybin bei Patient:innen helfen, das Potential der Psilocybin-gestützten Psychotherapie für verschiedene Störungsbilder besser einschätzen zu können.

Abstract

Successful therapy of mental disorders is very important in view of the high level of suffering of those affected. Since established pharmaceutical and psychotherapeutic approaches do not lead to the desired improvement in all cases, complementary or alternative treatment methods are intensively researched. Psilocybin-assisted psychotherapy seems particularly promising, and has been approved in the USA for larger clinical trials. Psilocybin belongs to the group of psychedelics and influences psychological experiences. In assisted therapy, psilocybin is administered in controlled doses under medical supervision to patients with different mental disorders. In the studies conducted so far, longer-term positive effects could be shown after just one or a few doses. In order to provide a better understanding of the potential therapeutic mechanisms, this article will first describe neurobiological and psychological effects of psilocybin. To better assess the potential of psilocybin-assisted psychotherapy for various disorders, clinical studies conducted so far with patients administered psilocybin are reviewed.

Schlüsselwörter

Psilocybin - Therapie - Depression - Neurobiologie - 5-HT-2A Rezeptor - Terminale Erkrankungen

Key words

Psilocybin - therapy - depression - neurobiology - 5-HT-2A receptor - terminal diseases

^‡ Diese Autorinnen/Autoren haben zu gleichen Teilen beigetragen und sind gemeinsame Erstautorinnen/Erstautoren.

Publication History

Received: 13 July 2021

Accepted: 23 February 2023

Article published online:
19 May 2023

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