There are few medications with demonstrated efficacy for the treatment of posttraumatic stress disorder (PTSD). Treatment guidelines have unequivocally designated psychotherapy as a first line treatment for PTSD. Yet, even after psychotherapy, PTSD often remains a chronic illness, with high rates of psychiatric and medical comorbidity. Meanwhile, the search for and development of drugs with new mechanisms of action has stalled. Therefore, there is an urgent need to explore not just novel compounds but novel approaches for the treatment of PTSD. A promising new approach involves the use of psychedelic drugs. Within the past few years, 2 psychedelics have received breakthrough designations for psychiatric indications from the US Food and Drug Administration, and several psychedelics are currently being investigated for the treatment of PTSD. This review discusses 4 types of compounds: 3,4-methylenedioxymethamphetamine, ketamine, classical psychedelics (e.g., psilocybin and lysergic acid diethylamide), and cannabinoids. We describe the therapeutic rationale, the setting in which they are being administered, and their current state of evidence in the treatment of PTSD. Each compound provides unique qualities for the treatment of PTSD, from their use to rapidly target symptoms to their use as adjuncts to facilitate psychotherapeutic treatments. Several questions are formulated that outline an agenda for future research.

中文翻译：

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回顾迷幻药治疗创伤后应激障碍的潜力。


很少有药物能够有效治疗创伤后应激障碍 (PTSD)。治疗指南明确指定心理治疗为 PTSD 的一线治疗方法。然而，即使经过心理治疗，创伤后应激障碍通常仍然是一种慢性疾病，精神和医学合并症的发生率很高。与此同时，寻找和开发具有新作用机制的药物已陷入停滞。因此，迫切需要探索治疗 PTSD 的新化合物和新方法。一种有前途的新方法涉及使用迷幻药物。在过去的几年里，有两种致幻剂获得了美国食品和药物管理局精神科适应症的突破性认定，并且目前正在研究几种致幻剂用于治疗创伤后应激障碍（PTSD）。本综述讨论了 4 种类型的化合物：3,4-亚甲二氧基甲基苯丙胺、氯胺酮、经典迷幻药（例如裸盖菇素和麦角酰二乙胺）和大麻素。我们描述了治疗原理、治疗环境以及治疗 PTSD 的证据现状。每种化合物都为治疗 PTSD 提供了独特的品质，从用于快速针对症状到用作促进心理治疗的辅助剂。提出了几个问题，概述了未来研究的议程。