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September 14, 2018

Psilocybin as a therapeutic treatment

dried psilocybin mushrooms

Although psilocybin, found in “magic mushrooms”, has been used for spiritual or religious purposes in different cultures for centuries, the popularisation of psychedelics for recreational use in the 1960s resulted in a moral panic that led to its criminalisation.1

Now, new research on the potential for psilocybin to treat conditions such as depression, obsessive-compulsive disorder, drug dependencies, and to assist individuals facing a life-threatening disease is part of the groundswell of renewed interest being hailed as a ‘psychedelic renaissance’.

The research is ongoing, but what is evident from the current trials is that psilocybin has the potential to break an individual’s habitual patterns of thought, which can help produce a change in their outlook – what some people are referring to as ‘resetting’ the brain.

What is psilocybin

Psilocybin is the active chemical found in “magic mushrooms”, but when used in a therapeutic setting the drug is prepared as a high-quality, controlled dose. It’s commonly classified as a psychedelic (‘mind manifesting’) drug.2

Psychedelic describes drugs that can change an individual’s perception of the world, mood and thoughts.

Debate surrounding the classification of psilocybin means it’s alternatively described both as an entheogen (a drug that inspires spiritual experiences) and an empathogen (a drug that encourages feelings of empathy and connectedness).

Effects on the brain

How psilocybin and other psychedelics affect the brain is currently being researched. Neuroscientists have discovered that, although their chemical structures are different, a common feature of psychedelic drugs is to act as an agonist (activator) of the serotonin 2A receptor.3 Brain-imaging technology shows that psychedelic drugs also decrease blood flow to the ‘default mode’ network of the brain, quieting it or ‘switching it off’.4 The default mode network regulates things like self-reflective thought, memory, and how we place our body in space.5

If psilocybin causes the brain to no longer process information in its routine way, this could potentially explain the experiences people have on psychedelic drugs – and how it helps change entrenched patterns of thought.6

Connectedness: helping to address issues

Reports from participants in psilocybin studies indicate that the experience helps address the underlying issues affecting their mental health.

Exactly how psychedelic drugs change an individual’s perceptions and feeling of connectedness is still being researched, but it is suggested increased feelings of connectedness to others, to the world, and to the self can address an underlying disconnection present in many mental health disorders.7

This has been voiced by participants in studies on the therapeutic application of psychedelic drugs, where an increased appreciation and connection with the world beyond themselves is expressed, lasting up to months in some circumstances.8

This contrasts with other potential treatments for depression, such as the prescription of anti-depressants like selective serotonin reuptake inhibitors (SSRIs), which have been found to fail in achieving remission for many patients.9 Research into  how these drugs can be applied therapeutically to various conditions is suggesting that their effectiveness may be connected to their ability to induce a ‘mystical experience’ –  that is, an experience which creates feelings of grand connectedness or unity.10

Current research is positive

Today the therapeutic benefits of psilocybin are picking up where previous studies left off decades ago.

A study on psilocybin for smoking cessation found that 60% of participants had abstained 12 months after their psilocybin treatment, and 86.7% of participants rated their experience as one of the five most meaningful experiences in their life.11

A trial looking at the effectiveness of psilocybin for alcohol dependence also found there was a significant improvement in abstinence post-psilocybin administration, with these results lasting around nine months for some participants.12

Psilocybin for the treatment of depression has produced promising results, with one study reporting that there were rapid improvements in the symptoms of depression for up to six months in some participants.13 Obsessive Compulsive Disorder (OCD) has been found to respond to psilocybin as well, with a 2005 study reporting that all nine participants showed some level of reduction in their OCD symptoms, however the length of time that this was experienced varied significantly between participants.14

The effects of psilocybin on individuals with life-threatening cancer is perhaps one of the more illuminating studies, with 80% of participants indicating that their well-being and life satisfaction had increased as a result.15

The researchers concluded in their findings that there was an association between the significance of a ‘mystical’ type experience and the outcomes reported by the participant.16

Where to now?

The long-term benefits for individuals, along with the long-term effects of psilocybin on the brain are still largely unknown.

While psilocybin has been found to produce rapid results in these trials, due to their small participant numbers they should primarily be viewed as indicators of the potential the drug may have, rather than conclusive evidence of its therapeutic benefits. However, the promise psilocybin shows for treating drug dependencies, as well as treatment-resistant depression, remains positive – and so does the potential for it to advance neuroscience and our understanding of the brain.

References
  1. Wark, C., & Galliher, J. F. (2010). Historical analysis: Timothy Leary, Richard Alpert (Ram Dass) and the changing definition of psilocybin. The International Journal of Drug Policy, 21234-239.
  2. ADF 2018. Psilocybin. Alcohol and Drug Foundation: Drug Facts.
  3. Carhart-Harris, R. L., Roseman, L., Bolstridge, M., Pannekoek, J. N., Wall, M. B., Kaelen, M., & … McGonigle, J. (n.d). Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific Reports, 7.
  4. Nutt, David. 2012. Drugs without the hot air: minimising the harms of legal and illegal drugs. Cambridge: UIT.
  5. Ibid
  6. Ibid
  7. Gaynes, B. (2009). Identifying Difficult-to-Treat Depression: Differential Diagnosis, Subtypes, and Comorbidities. Journal of Clinical Psychiatry, (SUPP/6). 10.
  8. Carhart-Harris, R. L., Erritzoe, D., Haijen, E., Kaelen, M., & Watts, R. 2017. Psychedelics and connectedness. Psychopharmacology, 235(2), 547-550.
  9. Ibid
  10. Ibid
  11. Johnson, MW, Garcia-Romeu, A, & Griffiths, RR 2017, ‘Long-term follow-up of psilocybin-facilitated smoking cessation’, The American Journal of Drug and Alcohol Abuse, vol. 43, no. 1, pp. 55-60.
  12. Bogenschutz, M., Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A., Wilcox, C. E., Strassman, R. J., & Barbosa, P. R. (n.d). Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology, 29(3), 289-299.
  13. Carhart-Harris, R. L., Bolstridge, M., Day, C. J., Rucker, J., Watts, R., Erritzoe, D. E., & … Nutt, D. J. (2018). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, 235(2), 399-408.
  14. Moreno, F.A., Wiegand, C.B., Keolani Taitano, E., Delgado, P.L. 2005. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. Journal of Clinical Psychiatry, 67(11), 1735-1740.
  15. Griffiths, R. R., Johnson, M. W., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & … Carducci, M. A. (n.d). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181-1197.
  16. Ibid
  17. Ibid