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Fortschr Neurol Psychiatr 2017; 85(07): 383-392
DOI: 10.1055/s-0043-103085
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Psychotherapie mit adjuvanter Gabe von serotonergen psychoaktiven Substanzen – Möglichkeiten und Hindernisse

Psychotherapy with Adjuvant use of Serotonergic Psychoactive Substances: Possibilities and Challenges
Tomislav Majić
1   Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin
,
Henrik Jungaberle
2   FINDER Institut für Präventionsforschung, Berlin
,
Timo T. Schmidt
3   Bernstein Center for Computational Neuroscience, Berlin
,
Andrea Zeuch
4   DRK Westend, Spandauer Damm 130, Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, Berlin
,
Leo Hermle
5   Klinik für Psychiatrie und Psychotherapie, Christophsbad, Göppingen
,
Jürgen Gallinat
6   Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
02 August 2017 (online)

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Zusammenfassung

Hintergrund Der Einsatz von serotonergen Halluzinogenen (Psychedelika) wie Lysergsäure-Diethylamid (LSD) und Psilocybin und Entaktogenen wie 3,4-Methylendioxymethamphetamin (MDMA) im Rahmen von Psychotherapie ist in den letzten Jahren wieder zunehmend ins Licht des wissenschaftlichen Interesses gerückt. Die vorliegende Arbeit fasst die aktuelle Evidenz zur substanzunterstützten Psychotherapie mit serotonergen Psychoaktiva zusammen.

Methode Eine selektive Literaturrecherche erfolgte in PubMed und der Cochrane Library, wobei nach Studien gesucht wurde, in denen der Einsatz von serotonergen Psychoaktiva in der Psychotherapie seit 2000 untersucht wurde.

Ergebnisse Es fanden sich Studien für die folgenden Behandlungsindikationen: Alkoholabhängigkeit (LSD und Psilocybin), Nikotinabhängigkeit (Psilocybin), Behandlung von Angst und Depression bei lebensbedrohlicher körperlicher Erkrankung (LSD und Psilocybin), Zwangsstörungen (Psilocybin), therapieresistente Major Depression (Psilocybin) und posttraumatische Belastungsstörung (MDMA).

Diskussion Abhängigkeitserkrankungen, posttraumatische Belastungsstörung sowie Angst und Depression bei lebensbedrohlicher körperlicher Erkrankung stellen derzeit die am besten evaluierten Indikationen für die substanzunterstützte Psychotherapie mit serotonergen Psychoaktiva dar. Bisher zeigten sich Hinweise für eine Wirksamkeit bei relativ guter Verträglichkeit. Weitere Studien sind erforderlich, um einzuschätzen, ob diese Substanzen in Zukunft in der Behandlung bestimmter therapieresistenter psychischer Erkrankungen eine Option darstellen können.

Abstract

Background Recently, scientific interest in the therapeutic potential of serotonergic and psilocybin hallucinogens (psychedelics) such as lysergic acid diethylamide (LSD) and entactogens like 3,4-methylendioxymethamphetamine (MDMA) within the framework of psychotherapy has resumed. The present article provides an overview on the current evidence on substance-assisted psychotherapy with these substances.

Method A selective search was carried out in the PubMed and Cochrane Library including studies investigating the clinical use of serotonergic psychoactive substances since 2000.

Results Studies were found investigating the following indications: alcohol (LSD and psilocybin) and tobacco addiction (psilocybin), anxiety and depression in patients suffering from life-threatening somatic illness (LSD and psilocybin), obsessive-compulsive disorder (OCD) (psilocybin), treatment-resistant major depression (psilocybin), and posttraumatic stress disorder (PTSD) (MDMA).

Discussion Substance use disorders, PTSD and anxiety and depression in patients suffering from life-threatening somatic illness belong to the indications with the best evidence for substance-assisted psychotherapy with serotonergic psychoactive agents. To date, studies indicate efficacy and relatively good tolerability. Further studies are needed to determine whether these substances may represent suitable and effective treatment options for some treatment-resistant psychiatric disorders in the future.

Schlüsselwörter

LSD - Psilocybin - Psychotherapie - Psychedelika - Entaktogene - MDMA

Key words

LSD - psilocybin - psychedelics - entactogens - psychotherapy - MDMA
 

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