Evidencias y perspectivas del potencial antidepresivo del “alcaloide mágico” psilocibina: una revisión narrativa

Resumen

La psilocibina es un alcaloide psicodélico producido naturalmente por diversas especies de hongos, especialmente del género Psilocybe, cuyo uso por parte de culturas precolombinas ha sido ampliamente documentado. En la última década, tras años de estigmatización y restricción de uso, se han reactivado las investigaciones sobre las potencialidades terapéuticas de este psicodélico clásico para el tratamiento de múltiples trastornos psiquiátricos, entre ellos el trastorno depresivo mayor. La depresión es un desorden afectivo del estado de ánimo cuya prevalencia mundial se ha incrementado considerablemente en los últimos años y cuyo tratamiento con fármacos convencionales tiene limitada eficacia. Los hallazgos recientes señalan que la psilocibina, en cambio, pueden tener un efecto antidepresivo rápido y sostenido, incluso en individuos con depresión resistente al tratamiento. Aunque aún no se han dilucidado por completo los mecanismos subyacentes a dicho efecto, se ha planteado que estaría mediado por cambios a nivel de neurotransmisión, de plasticidad estructural y funcional y de conectividad de diferentes redes cerebrales. En esta revisión narrativa se presenta una síntesis de la evidencia clínica a favor del efecto antidepresivo de la psilocibina, se exponen algunos mecanismos de acción plausibles que han sido objeto de estudio y se discuten algunos interrogantes y perspectivas del uso del alcaloide en el ámbito clínico.

Palabras clave:

psicodélicos clásicos

trastorno depresivo mayor

sistema serotoninérgico

plasticidad neuronal

redes neuronales

classic psychedelics

major depressive disorder

serotonergic system

neuronal plasticity

neuronal networks

Citas

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