神经科学与心理学2018sciencedirect.com
难治性抑郁症患者使用 psilocybin 后 amygdala 反应增强
Increased amygdala responses after psilocybin for treatment-resistant depression
进阶 · 约 45 分钟读完前置知识：fMRI 基础、抑郁症与精神药理学、杏仁核与情绪加工
导读
这篇论文研究难治性抑郁症患者在接受裸盖菇素（psilocybin）治疗后杏仁核反应的变化。标题提示治疗后杏仁核反应增强，研究可能借助神经影像探讨这种变化与情绪加工或治疗效应之间的关系；具体结论需以原文为准。
HN 关注点：迷幻药物对难治性抑郁的潜在疗效、监管与专利障碍，以及大量亲历者关于裸盖菇素/LSD 改善抑郁和丛集性头痛的讨论。
HN 评论精选
这几条评论里：质疑 1 补充 1 亲历 2
亲历亲历者称裸盖菇素不仅改善抑郁，还让丛集性头痛缓解近4年，并批评其非法地位。
我可以证明裸盖菇素有抗抑郁作用，而且在阻止丛集性头痛方面几乎有奇效。丛集性头痛又叫自杀性头痛，因为疼痛剧烈到很多人自杀；它被比作无麻醉截肢。对我来说，主要感觉像一只眼睛被压碎，同时一根烧红的拨火棍穿过它。丛集性指发作成簇，可持续数周、数月或数年。知道随时可能毫无预兆地经历一生最痛的疼痛，令人衰弱；一有症状苗头我就恐慌发作。上次丛集期我吃了蘑菇，完全消除了头痛。文献说可能停一年，但快4年了我仍未复发。为了安心我愿再服一次，但蘑菇非法且难找。它对我的抑郁也很好，情绪提升持续数月。我希望它合法；它比实际抗抑郁药让我害怕少得多，而且是唯一有效预防丛集性头痛的治疗。
TipVFL查看英文原文
I can vouch for the antidepressant properties of psilocybin, as well as it's nearly miraculous efficacy at stopping cluster headaches. If any of you are unaware of cluster headaches, they are also called suicide headaches, because the pain is so great that many people just kill themselves. The pain level has few peers, it's been compared to amputation without anaesthetic. For me, the bulk of the sensation is of one of my eyes being crushed while a hot poker is run through it. The cluster part comes from the fact that they occur in clusters that can last weeks, months, or years. It is debilitating to know that at any moment you could suddenly, and with very little warning, start experiencing the worst pain of your life. I had panic attacks at the first hint of symptoms. During my last cluster I took mushrooms, and it completely eradicated them. The literature I read said it could stop them for a year, but it's been almost 4 years now and I'm still clear of them. I'd prefer to dose again for peace of mind, but mushrooms are illegal and hard to find. It was also very nice for my depression, I had an elevated mood for several months. I wish it was legal, it scares me a lot less than the actual antidepressant medications, and it's the only effective treatment for preventing cluster headaches.
质疑质疑监管与专利动机，并认为裸盖菇素的风险可能低于现有抗抑郁药。
这很引人注目，因为抑郁是我们这代人的瘟疫。抑郁极其使人衰弱，而英国心理保健已衰退到除处方药外几乎不存在。英国早先一项小样本研究也显示类似效果。让我在意的是：由于对一类药物严格监管，临床试验耗时多年、花费巨大。这很荒谬。很多其他处方药我买也非法，为什么偏偏禁止草坪上长的蘑菇？这让我怀疑真正阻力在于未改造的蘑菇药物无法申请专利，如果人们停药改种更有效的蘑菇，对大药厂将是财务灾难。许多人担心迷幻蘑菇副作用，但可以对比 Seroxat 的副作用：可能导致男性无法达到高潮、停药多年后仍不做梦、成瘾、判断力模糊，甚至使人有自杀或杀人倾向。我不列其他药了，但我知道我会先试蘑菇，也会劝家人需要时这样做。
jimnotgym查看英文原文
This is fascinating as this is the plague of our generation. depression is such a debilitating condition, and in the UK mental health care has fallen to the level where it doesn't really exist outside of prescription medication. There was an earlier study in the UK [0] which showed similar effects, again on a small sample. The following interested me > A clinical trial, which took years and significant money to complete due to the stringent regulatory restrictions imposed around the class 1 drug This seems insane. Lots of other prescription drugs would be illegal for me to buy, why is this reserved for mushrooms that grow in our lawn? It makes me wonder if the real resistance to this research is that an unmodified mushroom medicine would not be patentable, and it would be financially catastrophic to big pharma if people stopped taking their medication and grew their own more effective ones. I note that many people are concerned about the side effects of magic-mushrooms. Perhaps you could consider that weighed against the side effects of the Seroxat[1] which amongst other things can stop a man reaching orgasm, or stop you dreaming(!) for years after taking it, is addictive and clouds your judgment. It can turn you suicidal or homicidal. I wont bother to list any of the others and their side effects, but I know I would try the mushrooms first, and I would urge my family to do the same if they needed help. [0]https://www.theguardian.com/science/2016/may/17/magic-mushrooms-lift-severe-depression-in-clinical-trial [1]https://www.theguardian.com/uk/2001/jun/11/highereducation.medicalscience
补充补充相关研究和私人资助/MAPS 筹资，强调迷幻药研究经费困难。
这与纽约大学关于裸盖菇素缓解晚期癌症患者焦虑的研究，以及约翰霍普金斯精神科医生的一项综合调查相呼应：84% 使用过裸盖菇素的人称体验有一定益处。由于联邦资金很难支持迷幻药研究，这为私人资助和公民科学提供了巨大机会。MAPS（迷幻药多学科研究协会）刚在 Pineapple 筹款活动中收到两位思想开放的慈善家捐赠的 111 BTC。
indescions_2018查看英文原文
Joins other studies from NYU investigating psilocybin mitigation of anxiety in advanced stage cancer patients. As well as a comprehensive survey by psychiatrists at Johns Hopkins showing 84% of those who tripped describing the experience as somewhat beneficial: Survey study of challenging experiences after ingesting psilocybin mushrooms http://journals.sagepub.com/doi/full/10.1177/0269881116662634 As federal dollars may face a difficult path to providing the funding for psychedelic research. This represents an enormous opportunity for privately funded as well as citizen oriented science. Indeed, MAPS, the Multidisciplinary Association for Psychedelic Studies was just gifted 111 BTC from two free thinking philanthropists as part of its Pinapple Fundraising campaign! https://www.maps.org/
亲历LSD 亲历者称一次不愉快的大剂量体验在数月后促成戒烟、锻炼和返校，但明确不建议他人尝试。
以个人经历来说，一次性使用 LSD（作用类似裸盖菇素，主要通过 5-HT2A 激动）让我走上自我改善之路。我在青春期、青少年和成年早期抑郁多年，经常想自杀，对生活悲观。高中修过多门 AP 且通过，但大学第一学期就退学，因为看不到上学的意义。后来我一次性服了大剂量 LSD，体验非常不愉快。变化不是立刻发生，但接下来几个月我的看法开始改变：重新在意生活，戒烟并开始锻炼，回到大学。现在我已完全不碰毒品，有妻子和学位，对未来乐观。我不建议别人尝试，因为我的经历让我理解为什么有人会因此发疯。但我相信它让我走上自我改善之路，绝对应继续研究。
TheAdamAndChe查看英文原文
Anecdotally, one-time use of LSD(which acts similarly to psilocybin, primarily through 5-ht2a agonism) set me on a path to self improvement. I had depression for years during my puberty, teens, and early adulthood. I contemplated suicide regularly and had a pessimistic outlook on life. I dropped out of college in my first semester despite taking and passing multiple AP classes in high school because I didn't see the point of college. Then I took a large dose of LSD once. It was a very unpleasant experience. The changes weren't immediate, but in the following months, my outlook started to change. I started caring about life again, quit smoking and started exercising, and went back to college. Now, I'm completely drug free, have a wife and a degree, and am optimistic for the future. I wouldn't recommend other people try it, because my experience made me understand why some people go insane from it. I believe, though, that it put me on a path of self-improvement, and should absolutely continue to be studied.
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