Because the study was small and lacked participant diversity, it’s unclear whether the positive results would extend to wider populations. Still, “the current results are clear,” says Jay Olson, a psychology researcher at Harvard University who wasn’t involved in the study. “At least for some people, psilocybin can reduce depression better than several common treatment options.”
Existing antidepressant drugs don’t work well for an estimated 30 to 50 percent of the people who try them; when they do work, the effects can take weeks to kick in. Psilocybin, a compound that can profoundly alter consciousness and perceptions of reality, might be a powerful alternative, says coauthor Roland Griffiths, a neuropsychopharmacologist at Johns Hopkins School of Medicine.
In the new study, patients with moderate or severe depression received two doses of psilocybin pills spaced about a week and a half apart. Participants also received therapy and support from researchers, before, during and after taking psilocybin.
A comparison group of 11 people waited eight weeks, then also received the two doses of psilocybin and supportive therapy. This delay allowed the researchers to look for improvements in symptoms that were not related to the drug.
Clinicians used a common depression rating scale consisting of 17 items to measure participants’ symptoms. Scores can range from 0 to 52, with higher numbers indicating more severe depression. Before receiving psilocybin, participants who got the drug without delay scored an average of 22.9 points, signaling the high end of moderate depression. Four weeks after the second dose, average scores dropped to 8.5. A score of 7 or below indicates no depression. Scores among the comparison group hovered around 23 while those people waited their turn to get the drug.
Overall, 13 of 24 people — including those who got psilocybin immediately and those who got it later — met the definition of remission four weeks after their respective treatments. The drops in depression symptoms are substantial compared with those found by some analyses of standard antidepressants, Griffiths says.
As with clinical studies in general, positive effects might arise simply from participants’ expectations, not the drug itself. But such effects are unlikely to account for the magnitude of the drop observed, Olson says.
Overall, the approach is promising, Griffiths says, but questions remain. “We still need to collect more safety data and we need to know conditions for optimal administration,” he says.
Other questions relate to who might benefit from the drug, and who might not, and a diverse study population could help address that. In the new study, however, almost all participants were white; there was just one Asian participant and one African-American participant. “We really need to think more about who we are including in these studies,” says psychologist Monnica Williams of the University of Ottawa, who wasn’t involved in the research.
Boosting participation rates among people of color calls for additional effort, particularly in the context of ongoing racial health disparities. A history of negative health care experiences might shape a psychedelic treatment experience, which is sensitive to the setting, Williams says. “A person of color might have a lot of reasons to feel very guarded and anxious in that situation, which is going to make it harder for that approach to be effective,” she says.
Of 282 people who participated in psychedelic studies from 1993 to 2017, the vast majority — 82 percent — were white, Williams and colleagues reported in a review article published in 2018 in BMC Psychiatry. “We’re in the 21st century now,” she says. “There’s just no reason for this anymore.”
Psychedelics have returned from the fringes and entered the mainstream in a huge way, whether through successful ballot initiatives, on the stock market or in Silicon Valley. But today, it’s not profoundly visual, earth-shattering trips like the ones that inspired Steve Jobs to create the iPhone that are being hyped. It’s microdosing.
Microdosing involves regularly consuming a small, sub-perceptual amount of a psychedelic substance, such as psilocybin mushrooms or LSD.
But when it’s endorsed by the likes of Joe Rogan and Gwyneth Paltrow (let’s not forget the $145,000 she had to pay for suggesting you put rocks in your vagina), it’s fair to start asking tough questions. Microdosing is trending as companies ideate products for legal markets that have yet to exist, but what do scientists have to say about it?
In February, a study published in the journal Psychopharmacology relied on the results of an international survey to find out whether mental health and substance use disorders could be improved with microdosing.
Conducted in 2018, the online survey asked respondents about their use of microdosing psychedelics for therapeutic purposes, and if it led to positive outcomes. Of 1,102 participants, 57 % of which had been previously diagnosed with a mental health disorder, 39% said that improving their mental health was their main reason for microdosing with psychedelics. (It’s worth noting that of this subgroup, 85% said they had tried tried other medications or received counselling prior to microdosing.)
Twenty-one percent said they microdosed to help with symptoms of depression, while 7% said they were self-medicating for anxiety. Another 9% had other mental health conditions they were seeking to treat, and 2% were microdosing to help them stop using other substances.
Results showed that 44% said microdosing improved their mental health significantly, with 50% saying they were able to successfully stop taking antidepressants and almost 40% saying the same about psychiatric meds. Nineteen percent said microdosing resulted in “no perceived changes” to their mental health, and just 1.3% reported that microdosing made their mental health “somewhat worse.”
What Makes A Microdose?
Another study published in the same journal and conducted in a similar manner (this time with 909 participants) compared survey respondents who had microdosed with LSD, psilocybin, or both with a group that had not microdosed at all. Of the group of microdosers, most reported using an average of 13 micrograms of LSD or 0.3 grams of psilocybin on a one-day-on, two-days-off schedule.
Researchers found that microdosers were significantly less likely to report a history of substance use or anxiety disorders than those that did not microdose, while microdosers were more likely to have reported recent recreational substance use than their non-microdosing counterparts.
Users Say Benefits Outweigh Challenges
The Global Drug Survey 2019 offered a subsection of questions on microdosing to nearly 7,000 respondents who reported psychedelic use. This data was used in an October 2020 study published in Psychopharmacology, which concluded that “the perceived benefits associated with microdosing greatly outweigh the challenges.”
“Our results suggest a partial replication of previously reported benefits and challenges among the present sample often reporting enhanced mood, creativity, focus and sociability,” the study reads. “Counter to our prediction, the most common challenge participants associated with microdosing was ‘None’.”
Still, the conclusions in each of these papers are of a similar tone: double-blind, controlled studies are needed to make concrete conclusions.
Clinical Trials Are In The Works, But Are Few And Far Between
While respected institutions such as Johns Hopkins and NYU conduct placebo-controlled clinical trials using larger doses of psilocybin (one ongoing trial at Johns Hopkins is looking at the effects of psilocybin on anorexia and another study on depression), trials employing microdosing are not common.
How Small Doses Of Acid Could Affect Time Perception
A double-blind, placebo-controlled study conducted at the University of London looked at how small doses of LSD affected a person’s perception of time. (A purported benefit of microdosing LSD is that it does not have the same time-extending effects afforded by a full tab of acid, which generally contains anywhere from 50 to 150 micrograms and might last 8 to 10 hours, but can feel like forever).
In administering doses of five, ten, and 20 micrograms of LSD to a group of 48 healthy older adults, researchers found that, “LSD conditions were not associated with any robust changes in self-report indices of perception, mentation, or concentration.”
The Safety Risks Of Microdosing LSD
A more recent phase one trial considered how safe and tolerable the same doses would be in older adults. A total of 48 volunteers were given either a placebo or a set dose of LSD administered every four days for 21 days straight.
Results of the study were positive and suggested that low doses of LSD “carried no safety risk” and were well-tolerated over the three-week period. Cognitive effects were so minimal that researchers said doses ranging from five to 20 micrograms may have been “insufficient.” Either that, or such doses of LSD, “do not have an effect on cognition in a healthy population.”
Can LSD Change The Way We Feel Pain?
In August, a trial published in Psychopharmacology used the Cold Pressor Test (submerging hands in ice water) in a group of 24 individuals who had received either a dose of five, ten, or 20 micrograms of LSD or a placebo.
Results showed volunteers who had been given the highest dose were able to leave their hand submerged for significantly longer than others in the trial, and also experienced the least pain or feelings of unpleasantness. “LSD elevated mean blood pressure within the normal range and slightly increased ratings of dissociation, anxiety and somatization,” the study reads. Exactly how LSD influences pain perception remains unclear.
New Programs, Startups Mean More Science To Come
A recent trial from the U.K.’s Beckley Foundation examined how different low doses of LSD might positively affect mood and cognition, and the results were a mixed bag. At 20 micrograms, LSD increased positive mood, friendliness, arousal, and decreased attentional lapses. But it also increased confusion and anxiety for some volunteers. The same was true for some volunteers who were only given five micrograms of the drug.
“Overall, the present study demonstrated selective, beneficial effects of low doses of LSD on mood and cognition in the majority of observations,” it concluded. “Next to that, negative effects like increased anxiety were shown too.”
Between Johns Hopkins, NYU, the Beckley Foundation, and the newly launched research program dedicated to microdosing at the University of Toronto, not to mention the work being conducted by private and public companies around the world, there’s hope ongoing research can come to harder conclusions about the latest fad.
“People are now coming out of the psychedelic closet, but it’s a risk you take,” said Melissa Lavasani, who led decriminalization efforts in Washington, D.C.
Bolstered by a growing body of research and greater acceptance of cannabis for recreation and medicine, psychedelics are experiencing a renaissance as voters and lawmakers rethink the so-called war on drugs.Max Loeffler / for NBC News
By Alicia Victoria Lozano
Melissa Lavasani never expected to grow psychedelic mushrooms in her Washington, D.C., home or become a force behind a successful measure that makes cultivation and possession of plant and fungi medicines the lowest priority for local police and prosecutors.
But the mother of two grew desperate in 2018 as her mental health suffered from a yearslong battle with postpartum depression and chronic pain. She had tried everything: antidepressants, talk therapy, meditation and even cupping. None of it seemed to work.
After listening to a podcast about the use of psilocybin, a naturally occurring chemical compound found in certain types of mushrooms, Lavasani became part of a movement she never intended to join.
“People are now coming out of the psychedelic closet, but it’s a risk you take,” she said. “There’s a stigma to it.”
Bolstered by a growing body of research and a greater acceptance of cannabis for recreation and medicine, psychedelics are experiencing a renaissance as voters and lawmakers rethink the so-called war on drugs.
When voters in Washington, D.C., passed Initiative 81 on Nov. 3, their counterparts in Oregon approved a ballot initiative to legalize the use of psychedelic mushrooms in therapeutic settings. The Canadian Minister of Health recently granted permission to four terminally ill patients to use psilocybin to treat end-of-life anxiety.
In California, state Sen. Scott Wiener, D-San Francisco, said last week that he will introduce a bill next year to decriminalize psychedelics. In New Jersey, lawmakers amended a cannabis bill on Thursday to include language that will downgrade penalties for possessing up to an ounce of mushrooms.
The cities of Denver and Oakland, California, each adopted resolutions in 2019 decriminalizing mushrooms.
Wiener said he was encouraged by developments around the country and is talking with experts about what form his proposal should take, The Associated Press reported. He said he was leaning toward Oregon’s supervised-use approach while allowing for the use of synthetic psychedelics such as LSD.
Wiener, who said he does not take psychedelics himself, noted that cultures all over the world have been using them since the beginning of time.
“Any substance can be harmful, so I’m not suggesting that anything is like nirvana,” he said. “But we know that psychedelics can be used safely. We know they appear to have significant medicinal uses.”
For Lavasani, mushrooms proved to be a revelation.
After delivering a healthy baby in 2017, Lavasani, a budget officer in the district’s Department of Energy and Environment, started to hear voices and experience panic attacks. She gradually spent less time with her husband and children. She eventually feared she would take her own life.
Concerned, a friend recommended listening to an episode of “The Joe Rogan Experience” podcast featuring mycologist Paul Stamets, who extolled the benefits of mushrooms. Looking back, Lavasani calls it her “Hail Mary” moment.
“It blew my mind a little bit,” she said. “I do try to keep my life as natural as possible. I eat well, try not to use too many chemicals at home. This made sense to me.”
Lavasani and her husband scoured the internet for tutorials on how to grow the fungus at home. They dedicated the top shelf of their bedroom closet to the experiment and waded through trial and error before the mushrooms blossomed.
At first, Lavasani, who had never used psychedelics, took only tiny doses, or microdoses, of the fungi. She said it was like “waking up after a great night’s sleep.”
As Lavasani became more comfortable with mushrooms, she decided to experiment with ayahuasca, a psychoactive tea often ingested during shamanic rituals. She attended a few guided ceremonies and returned home with a new perspective.
“Our health care system doesn’t have solutions for mental health issues,” she said. “I think people are fed up with being prescribed medications that don’t work.”
Therapeutic hallucinogens have been studied in the U.S. since the discovery of LSD’s effects in the 1940s. But research stalled when psychedelics became illegal in the 1960s. Interest renewed in the last 20 years as institutions around the world, including Johns Hopkins University in Baltimore, received regulatory approval to kickstart research in the field.
Medical associations appear largely united in supporting more studies and psychedelic therapies. The American Psychiatric Association opposed Oregon’s measure but only because psilocybin has not been approved by the Food and Drug Administration and requires more scientific understanding.
Still, advocates and researchers have started to recommend mushrooms; ketamine, a prescription pain reliever and sedative; and MDMA, sometimes called by its street name ecstasy, to treat a host of mental health disorders, including depression, post-traumatic stress disorder and anxiety.
In a recent study conducted by Johns Hopkins, researchers found that psilocybin, the active ingredient found in mushrooms, combined with psychotherapy was more effective at treating major depressive disorder than traditional antidepressants.
Participants in the study received two doses of psilocybin weeks apart between August 2017 and April 2019. The doses were administered in a comfortable, supervised setting with facilitators standing by to offer physical or emotional assistance if needed. Each treatment, which included supportive psychotherapy, lasted about 11 hours with the participants lying on a couch, wearing eye shades and listening to music on headphones.
“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” said Alan Davis, co-author of the study and a faculty member at Johns Hopkins medical school. “Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold-standard’ placebo-controlled clinical trials.”
In a separate Johns Hopkins study, patients received synthetic psilocybin to help with cancer-related depression and anxiety. Eighty percent said their symptoms faded, and the effects lasted six months.
Dr. Evan Wood, an addiction specialist at the University of British Columbia, said psychedelic therapy is radical because it aims to cure disorders, not just manage them.
“If you look at the existing medications to treat mental health disorders, a number of them are very addictive, others have nasty side effects,” he said. “These therapies are not about symptom management. It’s about approaching disorders with a curative intent.”
The recent Johns Hopkins research comes less than two years after the FDA approved a nasal spray containing ketamine for treatment-resistant depression.
Jackee Stang, a Southern California resident and co-founder of Delic Corp., a wellness company focused on destigmatizing psychedelics, has been using doctor-prescribed ketamine for the last year to treat her anxiety and depression. When combined with psychotherapy, ketamine has done more for her in one year than a lifetime of traditional medications.
“It takes away the doubt monster on your shoulder and shoves it in the closet,” she said.
Psychedelics clinics started popping up around the country after the FDA approved ketamine nasal spray. Field Trip Health, a Toronto-based company, has three locations in the U.S. where patients can combine talk therapy with the drug.
The experience is more like a luxury spa than the raves and nightclubs often associated with ketamine, according to Ronan Levy, Field Trip co-founder and executive chairman. He credits the cannabis industry with the emergence of a legal psychedelic market driven by science, not activism.
“Supportive therapy is as important as the drug,” he said. “That is where the magic happens.”
Kevin Matthews, the driving force behind Denver’s decriminalization effort, described a “fog lifting” when he started using psilocybin to self-treat his depression. The former West Point cadet was forced to leave the academy in 2008, one year shy of graduating, because his mental health was crumbling.
He turned to mushrooms first for fun and then for wellness. Eventually, he weaned himself off sleep aids and antidepressants. He remembers his initial experience with psilocybin as “joyous” yet challenging. He cried, but he also “plugged back into life,” a feeling that had been erased when he was taking traditional pharmaceuticals.
“Drugs are winning the drug war right now,” he said. “Prepare to see a lot more of this.”
CORRECTION (Nov. 15, 2020, 10:45 a.m. ET): A previous version of this article misspelled the last name of California state Sen. Scott Wiener, D-San Francisco. He is Scott Wiener, not Weiner.
Alicia Victoria Lozano
Alicia Victoria Lozano is a Los Angeles-based digital reporter for NBC News.
Psilocybin rapidly increases the expression of several genes related to neuroplasticity in the rat brain, according to new research published in the Journal of Psychopharmacology. The new findings might help explain the underlying neurobiological mechanisms responsible for long-lasting changes associated with psychedelic drug use.
“Psilocybin induces remarkable subjective effects, but has been largely ignored, scientifically, for many years. Recent studies suggest that it might, in combination with psychotherapy, be effective for treating certain mental disorders. As an aspiring scientific researcher it is very exciting to be part of the re-opening of a scientific field that has been hibernating for decades,” said study author Oskar Hougaard Jefsen, a visiting researcher at the Translational Neuropsychiatry Unit at Aarhus University.
Psilocybin produces profound changes in perception and consciousness through stimulation of serotonin receptors in the brain. But the researchers were interested in learning why the substance has also been shown to produce long-term positive effects on several clinical symptoms.
In their study, 80 rats were injected with one of seven different doses of psilocybin or an inert saline solution. Ninety minutes later, the animals were euthanized so the researchers could extract RNA samples from key brain regions.
The researchers found that psilocybin increased the expression of several plasticity-related genes in the rodent’s prefrontal cortex and hippocampus, areas of the brain associated with executive functioning and memory.
“Psilocybin induces immediate changes in rat brains that resemble the changes we see when nerve cells are stimulated to form new connections. These changes may be part of the explanation why a psilocybin-trip sometimes induces lasting changes in the brain,” Jefsen told PsyPost.
The findings are in line with some previous research. For instance, a study published in Cell Reports found psychedelic drugs increased the number of neuronal branches (dendrites), the density of small protrusions on these branches (dendritic spines), and the number of connections between neurons (synapses) in rats and flies.
But Jefsen cautions that the research is still in its early stages.
“We still really don’t know 1) if human and rodent brains react similarly to psychedelic drugs and 2) which of the neurobiological effects that should be considered as important and which should be considered as irrelevant/by-products of the drug effects. It is very difficult to compare effects on rats with effects on humans because rats do not speak (or we don’t speak Rat),” he explained.
“Always be careful of hype and confirmation bias,” Jefsen added. “The evidence that psilocybin is effective for treating psychiatric disorders such as major depressive disorder is still rather weak because of small studies and methodological limitations.”
Two doses of psilocybin in conjunction with psychotherapy help relieve the symptoms of major depression quickly, according to a recent study by Johns Hopkins University in the United States.
Psilocybin is a psychedelic substance that causes aberrant, dreamy states of consciousness. It occurs naturally in some fungi.
The study was published in the journal Jama Psychiatry.
The previous one once, university researchers investigated the effect of psilocybin in the treatment of depression in 2016, when patients diagnosed with cancer acted as subjects.
Research by even a single dose of psilocybin reduced patients ’depression, anxiety, and fear of death, and increased a sense of relevance and optimism. The effects were seen in four of the five patients for another six months after a single dose.
Read more: Sweden is starting to study psychedels in the treatment of depression: the results can be revolutionary
Now published fresh research investigated the effect of psilocybin in a wider population. The subjects were 24 patients with major depression whose symptoms of depression had persisted for approximately two years prior to enrollment.
Prior to the trial, patients had to discontinue all antidepressants under the supervision of a psychiatrist.
In an experiment patients received psilocybin under controlled conditions for approximately a five-hour therapy session. Patients lay on the couch with their eyes covered and listened to music with headphones.
The session was repeated again after two weeks. Thus, in total, each subject received two doses of psilocybin.
Researchers investigated the effect of psilocybin by measuring the depth of depression on the Hamilton scale before the experiment and one and four weeks after the experiment. A score of more than 24 points on the scale means major depression, 17 to 23 moderate depression, and 8 to 16 points mild depression.
Prior to the experiment, patients received an average of 23 points on the test. After the experiment, the average score dropped to eight, the lower limit of mild depression.
After four weeks of treatment, 71 percent of the patients felt that their symptoms had improved significantly, by at least 50 percent. More than half of the patients felt that their symptoms had completely disappeared.
Johns Hopkins University Assistant Professor of Psychiatry Alan Davisin according to them, the effect of psilocybin was four times higher in their trial compared to the effect of antidepressants sold in the market in clinical trials.
“Usually, the effects of antidepressants only become apparent after weeks or months, and in addition, they may be associated with adverse side effects,” Davis said in a statement.
“If these findings can be verified in placebo-controlled clinical trials, this will be a major reversal in the industry.”
The researchers plan to monitor the subjects for another year after the experiment to find out how long the antidepressant effect of psilocybin treatment lasts.
World World Health Organization (WHO) by more than 300 million people worldwide suffer from depression.
More than a third of people with depression and anxiety do not benefit from the treatments currently available, ie medicines and therapy.
The therapeutic benefits of psilocybin and other psychedelic agents were first discovered as early as the late 1940s, and as early as the 1960s they were actively studied in the treatment of mental health problems.
By the 1970s, psychedels were classified almost all over the world as illegal drugs, and at the same time their scientific research ceased.
Again psychedelics began to be studied at the turn of the millennium, when the Johns Hopkins research team was the first to be allowed to initiate psychedelic experiments in healthy volunteers who had not previously used psychedels.
Last year, the university announced to set up an entire psychedelic and awareness research center. It aims to determine how well psychedels are suitable for the treatment of opiate dependence, Alzheimer’s disease, Lyme disease, anorexia, post-traumatic stress disorder, and depressive alcoholism.
In addition to the United States, psychedelics are being studied in Europe, especially at Imperial College London. The Swedish Karolinska Institutet also started in November 2020 to investigate the effect of psilocybin in the treatment of depression.
Before his first facilitated “magic” mushroom trip, Chad Kuske couldn’t escape his own road rage.
If another driver pulled in front of him, he’d become consumed with anger, speeding ahead all of the cars on busy highways. For hours following a drive, Kuske couldn’t let go of the anger, tension, and anxiety he felt during them, no matter how brief.
But after more than a decade self-medicating with drugs and alcohol to cope with PTSD, Kuske, a retired Navy SEAL who served for 18-and-a-half years until 2016, learned of an underground psychedelic retreat where army vets like himself could take psilocybin, the psychedelic compound in “magic” mushrooms as a potential treatment for anxiety and depression.
In August 2019, Kuske had his first therapeutic mushroom trip. He told Insider the experience transformed his life, breaking destructive patterns, reducing PTSD symptoms, and helping him feel less distressed about daily life.
“I came out of it feeling rejuvenated, feeling this massive weight had been lifted off of me that I’ve been carrying around needlessly for decades,” Kruske, 39, told Insider. “I came out of the session with the desire and the willingness to make the changes necessary to start moving in the other direction.”
Soon, this type of alternative psychedelic-drug treatment could be more widely available in the United States.
Research on psilocybin as a potential depression treatment
The five cities of Denver, Colorado, Oakland, California, Ann Arbor, Michigan, Santa Cruz, California, and Washington D.C. have decriminalized the substance so people who are in possession of it are the lowest priority to law enforcement.
After hearing journalist Michael Pollan discuss psychedelics research on an episode of Joe Rogan’s podcast and using them recreationally in his youth, Kuske was intrigued by their therapeutic potential.
So when a veteran organization introduced him to a group that could facilitate a psilocybin trip, he took the opportunity.
He had his trip with five other participants at an undisclosed location in a cozy, living room-like space due to the still widely illegal nature of psilocybin.
Beforehand, Kuske set an intention to let go of the anger and apathy he felt and remember what it was like 20 years prior when he enjoyed life. After an eight-hour session where Kuske laid on his own twin-sized mattress alongside the five others, all listening to curated calming music while shades covered their eyes, that intention clicked.
Decades of therapy in just one drug trip
Kuske said his initial psilocybin trip had an immediate effect on him, and he’s noticed nothing but positive changes since.
“I think the single biggest lasting effect that I’ve taken away is just a much greater awareness. So now, instead of reacting to things in life, I can respond. When depression is setting in, or when something angers me or any of the things I used to get frustrated or upset about, I can see it happening,” Kuske said.
Since then, Kuske said he’s done “magic” mushrooms every four months in facilitated underground settings to maintain his intention for a more grounded and self-aware life.
Each of these sessions includes an integration portion following the trip, where Kuske talks to the facilitator about what he experienced and how to apply those messages into his daily routine.
“I spent decades in therapy just trying to figure out for myself what caused this, or why am I like this? And psilocybin, just in a moment, makes all of these things crystal clear to where you’re left with not a doubt in your mind about why something was, or where to go, or how it’s not serving you,” Kuske said of the clarity his psilocybin trips has provided him.
Kuske believes legal ‘magic’ mushrooms could help other veterans like him
As someone who’s spent most of his youth in Oregon and the past three years living there following his retirement, Kuske has high hopes Measure 109 can help folks like him who are struggling with their mental health.
Though the exact procedures and rules for the bill have yet to be decided, Kuske said affordable psilocybin could help people who wouldn’t otherwise be able to obtain it, or those who would get the drug from riskier underground sources.
Kuske said he’d like to train to become a facilitator one day and pay forward the psilocybin benefits he’s experienced firsthand.
As for his driving, “I expect people to cut me off. I want them to cut me off because it gives me a chance to just be patient and understanding. That one change alone, it sounds so simple, but for me that was massive.”
An Oxford researcher into psychedelics thinks so. Eddie Jacobs offers a disturbing premise, “What if a pill can change your politics or religious beliefs?” The background is that some jurisdictions are contemplating licencing the otherwise illegal psychedelic psilocybin (“magic mushrooms”) in the near future as a treatment for depression. He writes,
How would you feel about a new therapy for your chronic pain, which—although far more effective than any available alternative—might also change your religious beliefs? Or a treatment for lymphoma that brings one in three patients into remission, but also made them more likely to vote for your least preferred political party?
Citing three studies, Jacobs argues that the relationship between magic mushrooms and liberal values is “causal,” meaning that the hallucinogen literally causes liberal values:
Scientific reports associating psychedelic use and liberal values stretch back as far as 1971, and although these findings have been replicated more recently, a noncausal explanation is readily available. Those with conservative attitudes tend to look more disapprovingly on illicit drug use, making them less likely than liberals to try a psychedelic drug in the first place.
However, emerging evidence suggests the relationship could be causal, with clinically administered psilocybin actively shifting political values, just as it shifts many other nonclinical characteristics. Notably, one study of psilocybin for treatment-resistant depression reported that the treatment decreased authoritarian political views in patients. That clinical trial also detected another effect that had previously been reported in healthy participants: psilocybin use leads to increases in the personality domain of openness, itself a predictor of liberal values.
Readers who remain skeptical may wonder how religious and political values— so often rooted in decades of history, family history, and personal experience—could really be overturned by a mere trip.
Some researchers have wondered about that too. In a response op-ed, Johns Hopkins psychedelic researchers Matthew W. Johnson and David B. Yadenreplied to Jacobs, “there is no evidence that people change political or religious affiliations from psychedelic treatments, and current evidence for other kinds of belief changes is weak.”
They address the three studies Jacobs cites:
The concern about political beliefs largely rests on evidence from a small pilot study of psilocybin for treating depression. The study showed an average reduction on a measure of “authoritarianism” from baseline to one week after psilocybin in seven people. Authoritarianism, as it is operationalized here using five questions that were reduced from the original version of the scale, likely does not fit neatly into a particular political party. Many people, for example, would likely disagree with the scale item “The law should always be obeyed, even if a particular law is wrong,” regardless of political affiliation.
So there may well have been a temporary reduction in “authoritarianism” in this small sample but, as Johnson and Yaden go on to point out, authoritarianism can exist (or not) across the political spectrum. By itself, it probably does not signify a change in affiliation.
The second study Jacobs cites points, oddly enough, in the opposite direction from his claim:
Jacobs’ piece alluded to another study about political beliefs, a 1971 study exploring the association between LSD increased liberalism. This study compared three groups: 1) people who had taken LSD as a medical treatment, 2) people who had taken LSD on their own, and 3) people who had not used LSD. Only those who had taken LSD on their own indicated more support for policies like “individual freedom” and “foreign policy liberalism” compared to those who had not taken LSD.
It is possible that those who were willing to take LSD outside of medical treatment may have already been more influenced by the liberal hippie movement that encouraged these beliefs at that time (Jacobs notes that this is correlational and not causal data). Importantly, no differences were found in this study between the political beliefs of those who received LSD under medical treatment compared to those who did not take LSD. Therefore, this study actually suggests that medical psychedelic treatments do not alter political beliefs!
The reasonable conclusion is that those who had taken LSD on their own were already experimenting with alternative lifestyles and attitudes. By contrast, the medical users were simply seeking relief from a distressing condition, not realignment of their lives—thus they did not experience any realignment of their lives.
The third study, which focused on religious beliefs, was done by Johnson and Yaden’s own research group at Johns Hopkins. Here, Johnson and Yaden believe that their research has not been accurately represented:
This survey specifically recruited individuals who had a “God encounter experience” after taking a psychedelic outside of a research context. Before having such an experience during their psychedelic session, 21 percent retrospectively identified as atheist, whereas only 8 percent did after the experience. This decrease was accompanied by a decrease in identification with major religions, alongside increases in spiritual types of self-identification.
Of course, as Johnson and Yaden point out, that was a highly self-selected sample and probably does not represent the vast public that does not use mind-altering recreational drugs.
They end by observing that, while psychedelics can produce documented personality change toward more openness, so can a number of psychotherapeutic interventions. The mushroom isn’t magic after all. They conclude,
Lastly, the correlation between openness to experience and liberal political views is small, accounting for only around 2 percent of the relationship between the two variables. In other words, the pathway from psychedelics through openness to experience to political belief change is, for all practical purposes, negligible.
Incidentally, Johnson doesn’t recall any instances among the hundreds of participants in studies of psilocybin changing their political or religious beliefs.
So why did Scientific American publish such a poorly sourced op-ed as the first one? Why might many people believe such things? Perhaps some aspire to the certainty of a world in which they can simply control the minds of others by a simple formula. But that’s not the world we live in.
As voters in Oregon and DC opt to decriminalize psilocybin, there is growing evidence that the active compound in “magic,” or hallucinogenic, mushrooms might benefit individuals with moderate to severe depression—at least when used alongside psychotherapy under a doctor’s supervision.
“The findings that we have in our study, we believe, are related to the fact that it was in a controlled setting where we have trained professionals,” explained Alan Davis, a psychologist, social work researcher at Ohio State University, and adjunct assistant professor at Johns Hopkins University’s Center for Psychedelic and Consciousness Research.
“We certainly would not suggest that someone go out and take this on their own,” he added. “However, there are currently multi-site trials going on in the US and Europe, testing this in phase 2 and phase 3 trials in order to hopefully garner FDA approval in the next couple years.”
Davis and his colleagues published findings from a small phase 2 clinical trial on psilocybin-assisted therapy in the journal JAMA Psychiatry in early November. There, they reported a steep decline in symptoms in two-dozen individuals with major depressive disorder who received 11 hours of supportive psychotherapy, on average, along with two doses of synthetic psilocybin, downed with water in gel capsule form. To enroll in the trial, individuals could not be taking other antidepressant medication at the time.
Charles Reynolds III, a geriatric psychiatry expert and distinguished professor of psychiatry emeritus at the University of Pittsburgh School of Medicine, who was not involved in the study, but penned a related JAMA Psychiatryeditorial, credited the team with doing “a nice rigorous job in the design of the study and in documenting both its positive effects but also its potentially negative effects.”
One week after treatment, the team saw a clinically meaningful dip in depression symptoms in 67 percent of the participants using a standard depression assessment method called the GRID-Hamilton Depression Rating Score, and 14 individuals appeared to be in remission. Four weeks out from treatment, more than half of participants were in remission and 71 percent had a significant response to the treatment.
When it came to potential side effects, some patients had headaches the evening of, or morning after, treatment, Davis noted, adding that temporary anxiety can turn up during psilocybin sessions but does not seem to last or require treatment.
The results are encouraging since a subset of individuals with major depressive disorder do not response to available treatment options such as selective serotonin reuptake inhibitor (SSRI) treatment, ketamine, or psychotherapy alone, or struggle to find a treatment that’s the right fit.
“Depression is one of the most prevalent and debilitating conditions globally, and the current medications approved for depression, and psychotherapy used for depression, are lacking in adherence and efficacy,” Davis said. “They don’t work for everyone.”
The study is not the first to find a potential psychiatric benefit for treatments that include psilocybin: results from studies done in the past few years suggest the hallucinogenic compound might benefit individuals with difficult-to-treat depression or depression symptoms that arise after cancer diagnoses.
“We first tested psilocybin to see whether it had an anti-depressant effect in 2016, in a published study of people with life-threatening illness like cancer,” Davis noted. “And what we found was that among the group of people with cancer who had subsequently become depressed because of the cancer diagnosis, that reduced their depression.”
But there’s much more to the proposed treatment than a mouthful, or a microdose, of magic mushrooms.
Investigators tested two sequential doses of psilocybin in major depressive disorder patients ranging in age from 21 to 75-years-old who were randomized to start the psilocybin-assisted therapy immediately or after a two month delay. The trial took place in an out-patient setting, which excluded very severe cases with psychotic disorder, suicide attempts, or hospitalization.
In both of those groups, psychotherapist guides talked them through their psychedelic trips, Davis explains, adding that this direction may have been key to the symptom relief reported by the study’s participants.
The benefit “seems to be related to the psychological experience that people have during the psilocybin session—so people typically report having what’s called a mystical or spiritual experience where they feel connected to the universe or outside of their normal sense of themselves,” Davis said. “But they also described having obtained or received insight into their life during the session.”
“It’s the combination of these experiences that seem to be related to the antidepressant effects of the experience,” he suggested, calling the therapeutic component “critical” in helping patients achieve and make sense of these events.
The team is continuing to explore psilocybin-assisted treatment in the context of depression, and expects to report long-term outcomes for the depression patients profiled in the current study using data collected over 12 months following the psilocybin-assisted therapy sessions.
It remains to be seen how long the effects last, and whether there may be a benefit to longer-term, maintenance treatments to avoid relapse. But such studies take time, and they’re not cheap.
The current research was partly supported by entrepreneur, author, and investor Tim Ferriss and a crowd-funding campaign he spearheaded. With the apparent success of the current study, some say more traditional funders may start to pay more attention to the field, too.
“In many ways, it’s still early days from a rigorous scientific perspective,” Reynolds suggested. “But I think Davis and colleagues at Hopkins really did a nice job in carrying out what I think of as a small, but important, proof-of-concept study.”
He called the work “a step forward,” but cautions that larger and more diverse randomized control trials are needed to understand if, and when, the psilocybin-supported psychotherapy is clinically warranted—and to look at how it fares compared to standard treatment options for depression and other conditions such a prolonged and debilitating grief disorders.
“What we need now, as I suggested in my editorial, is a randomized control trial that might use placebo or might use an active comparator of some kind, perhaps another antidepressant, that would allow us to see what is the specific impact of psilocybin” Reynolds said.
In another study on the use of psychedelic compounds as medicine, two doses of psilocybin—the compound that gives “magic mushrooms” their magic—was found to significantly reduce major depressive symptoms in adults when it was combined with assisted psychotherapy.
24 adults were included in the small study that consisted of two five-hour psilocybin therapy sessions and 24 weeks of follow up—and the results seemed to shock researchers at the Center for Psychedelic and Consciousness Research (CPCR) at Johns Hopkins School of Medicine.
“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” says Alan Davis, Ph.D., professor of psychiatry and behavioral sciences.
According to data from the U.S. Centers For Disease Control (CDC), tens of millions of adults have at some point in their life suffered from chronic anxiety disorder. One in 6 will have depressive symptoms during some period in their life.
Rather than targeting “reactive” types of anxiety or depression—those resulting from traumatic experiences—his team was urged by public health officials to explore psilocybin’s effects in the broader population for those with long-term, persistent, and less-defined major depressive disorders, because of the greater potential impact on public health.
Depression into Remission
“Because there are several types of major depressive disorders that may result in variation in how people respond to treatment, I was surprised that most of our study participants found the psilocybin treatment to be effective,” says Roland Griffiths Ph.D., Director of the CPCR, and a pioneer of psychedelic treatment research who published his results this week in JAMA Psychiatry.
In the clinical trial, of the group of 24 participants, 67% showed a more than 50% reduction in depression symptoms at the one-week follow-up and 71% at the four-week follow-up. Overall, four weeks post-treatment, 54% of participants were considered in remission, meaning they no longer qualified as being depressed.
The researchers say they will follow the participants for a year after the study to see how long the antidepressant effects of the psilocybin treatment remain, and will report their findings in a later publication.
“Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold-standard’ placebo-controlled clinical trials,” says Davis.
Becoming more mainstream
Having worked at Johns Hopkins since 2003, Roland Griffiths’ psychedelic experiments were first viewed with skepticism, but under his leadership the CPCR has now completed many trials and studies of psychedelic compounds, such as:
His work has resulted in the U.S. Food and Drug Administration bestowing ‘Breakthrough Therapy’ designations to other compounds like a chemical variant of ketamine, which was approved in a nasal spray form used to treat depression in veterans in Virginia.
MDMA also won ‘Breakthrough Therapy’ status from the FDA in 2017, after research proved its “astonishing” success in sending PTSD into remission.
Meanwhile, its status as an illegal drug is changing. On Tuesday, voters in the state of Oregon passed a first-of-its-kind measure to formally legalize access to psilocybin mushrooms for therapy, with the state establishing and regulating a program whereby adults can obtain and use them. And, voters in Washington D.C. approved a measure that will effectively decriminalize “magic mushrooms” and other organic psychedelic drugs.
When combined with psychological counseling, a single dose of a mind-altering compound contained in psychedelic mushrooms significantly lessens mental anguish in distressed cancer patients for months at a time, according to results of a clinical trial led by researchers at NYU Langone Medical Center.
Published in the Journal of Psychopharmacology online Dec.1, the study showed that one-time treatment with the hallucinogenic drug psilocybin — whose use required federal waivers because it is a banned substance — quickly brought relief from distress that then lasted for more than six months in 80 percent of the 29 study subjects monitored, based on clinical evaluation scores for anxiety and depression.
The NYU Langone-led study was published side by side with a similar study from Johns Hopkins. Study results were also endorsed in 11 accompanying editorials from leading experts in psychiatry, addiction, and palliative care.
“Our results represent the strongest evidence to date of a clinical benefit from psilocybin therapy, with the potential to transform care for patients with cancer-related psychological distress,” says study lead investigator Stephen Ross, MD, director of substance abuse services in the Department of Psychiatry at NYU Langone.
“If larger clinical trials prove successful, then we could ultimately have available a safe, effective, and inexpensive medication — dispensed under strict control — to alleviate the distress that increases suicide rates among cancer patients,” says Ross, also an associate professor of psychiatry at NYU School of Medicine.
Study co-investigator Jeffrey Guss, MD, a clinical assistant professor of psychiatry at NYU Langone, notes that psilocybin has been studied for decades and has an established safety profile. Study participants, he says, experienced no serious negative effects, such as hospitalization or more serious mental health conditions.
Although the neurological benefits of psilocybin are not completely understood, it has been proven to activate parts of the brain also impacted by the signaling chemical serotonin, which is known to control mood and anxiety. Serotonin imbalances have also been linked to depression.
For the study, half of the participants were randomly assigned to receive a 0.3 milligrams per kilogram dose of psilocybin while the rest received a vitamin placebo (250 milligrams of niacin) known to produce a “rush” that mimics a hallucinogenic drug experience.
Approximately half way through the study’s monitoring period (after seven weeks), all participants switched treatments. Those who initially received psilocybin took a single dose of placebo, and those who first took niacin, then received psilocybin. Neither patients nor researchers knew who had first received psilocybin or placebo. Guss says, “The randomization, placebo control, and double-blind procedures maximized the validity of the study results.”
One of the key findings was that improvements in clinical evaluation scores for anxiety and depression lasted for the remainder of the study’s extended monitoring period — specifically, eight months for those who took psilocybin first.
All patients in the study — mostly women age 22 to 75 who are or were patients at the Perlmutter Cancer Center of NYU Langone — had either advanced breast, gastrointestinal, or blood cancers and had been diagnosed as suffering from serious psychological distress related to their disease. All patients, who volunteered to be part of the study, were provided with tailored counseling from a psychiatrist, psychologist, nurse or social worker, and were monitored for side effects and improvements in their mental state.
Co-investigator Anthony Bossis, PhD, a clinical assistant professor of psychiatry at NYU Langone, says patients also reported post-psilocybin improvements in their quality of life: going out more, greater energy, getting along better with family members, and doing well at work. Several also reported variations of spirituality, unusual peacefulness, and increased feelings of altruism.
“Our study showed that psilocybin facilitated experiences that drove reductions in psychological distress,” says Bossis. “And if it’s true for cancer care, then it could apply to other stressful medical conditions.”
Bossis cautions that patients should not consume psilocybin on their own or without supervision by a physician and a trained counselor. He also says “Psilocybin therapy may not work for everyone, and some groups, such as people with schizophrenia, as well as adolescents, should not be treated with it.”
The use of the psychedelic drug psilocybin, in combination with cognitive behavioral therapy (CBT), is more effective than current smoking cessation treatments, according to a recent study published online this July in The American Journal of Drug and Alcohol Abuse. The study provides preliminary evidence that psilocybin-use, as part of a structured treatment program, holds considerable promise in promoting long-term smoking abstinence.
Smoking remains a leading public health concern, with almost 6 million tobacco-related deaths per year worldwide, and that number projected to rise further. Therefore, there is an urgent need to explore innovative treatment approaches, especially given that even the most successful available smoking cessation treatments fail to promote long-term abstinence in most people.
Psilocybin is a naturally occurring psychedelic compound produced by more than 200 species of mushrooms. It increases serotonin, which is a chemical that influences mood, and is showing promise as a treatment for several psychiatric illnesses, as well for the treatment of addiction.
The study, by Matthew Johnson, Albert Garcia-Romeu and & Roland Griffiths of the Johns Hopkins University School of Medicine, assessed the long-term effects of a program which combines the use of psilocybin with CBT aimed at smoking cessation. The study was a follow-up to an earlier pilot study which found that this combination resulted in substantially higher smoking abstinence rates after 6 months compared to other medications or CBT alone.
Participants underwent a 15-week combination treatment consisting of four weekly preparatory meetings integrating CBT, elements of mindfulness training, and guided imagery for smoking cessation. They received a moderate (20 mg/70 kg) dose of psilocybin in week 5 of treatment, and a high dose of psilocybin (30 mg/70 kg) approximately 2 weeks later. Participants also had the opportunity to participate in a third, optional high-dose psilocybin session in week 13 of study treatment.
The results revealed that at 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. Furthermore, 13 of the participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives.
The researchers highlighted, “In controlled studies, the most effective smoking cessation medications typically demonstrate less than 31% abstinence at 12 months post-treatment, whereas the present study found 60% abstinence more than a year after psilocybin administration.”
They concluded, “These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence.”
Psilocybin – a hallucinogenic compound derived from magic mushrooms – may offer a possible new avenue for antidepressant research, according to a new study published in The Lancet Psychiatry today.
The small feasibility trial, which involved 12 people with treatment-resistant depression, found that psilocybin was safe and well-tolerated and that, when given alongside supportive therapy, helped reduce symptoms of depression in about half of the participants at 3 months post-treatment. The authors warn that strong conclusions cannot be made about the therapeutic benefits of psilocybin but the findings show that more research in this field is now needed.
“This is the first time that psilocybin has been investigated as a potential treatment for major depression,” says lead author Dr Robin Carhart-Harris, Imperial College London, London, UK. “Treatment-resistant depression is common, disabling and extremely difficult to treat. New treatments are urgently needed, and our study shows that psilocybin is a promising area of future research. The results are encouraging and we now need larger trials to understand whether the effects we saw in this study translate into long-term benefits, and to study how psilocybin compares to other current treatments.” 
Depression is a major public health burden, affecting millions of people worldwide and costing the US alone over $200 billion per year. The most common treatments for depression are cognitive behaviour therapy (CBT) and antidepressants. However, 1 in 5 patients with depression do not respond to any intervention, and many relapse.
“Previous animal and human brain imaging studies have suggested that psilocybin may have effects similar to other antidepressant treatments,” says Professor David Nutt, senior author from Imperial College London “Psilocybin targets the serotonin receptors in the brain, just as most antidepressants do, but it has a very different chemical structure to currently available antidepressants and acts faster than traditional antidepressants.” 
The trial involved 12 patients (6 women, 6 men) with moderate to severe depression (average length of illness was 17.8 years). The patients were classified as having treatment-resistant depression, having previously had two unsuccessful courses of antidepressants (lasting at least 6 weeks). Most (11) had also received some form of psychotherapy. Patients were not included if they had a current or previous psychotic disorder, an immediate family member with a psychotic disorder, history of suicide or mania or current drug or alcohol dependence.
Patients attended two treatment days – a low (test) dose of psilocybin 10mg oral capsules, and a higher (therapeutic) dose of 25mg a week later. Patients took the capsules while lying down on a ward bed, in a special room with low lighting and music, and two psychiatrists sat either side of the bed. The psychiatrists were present to provide support and check in on patients throughout the process by asking how they were feeling. Patients had an MRI scan the day after the therapeutic dose. They were followed up one day after the first dose, and then at 1, 2, 3, and 5 weeks and 3 months after the second dose (figure 1).
The psychedelic effects of psilocybin were detectable 30 to 60 minutes after taking the capsules. The psychedelic effect peaked at 2-3 hours, and patients were discharged 6 hours later. No serious side effects were reported, and expected side effects included transient anxiety before or as the psilocybin effects began (all patients), some experienced confusion (9), transient nausea (4) and transient headache (4). Two patients reported mild and transient paranoia.
At 1 week post-treatment, all patients showed some improvement in their symptoms of depression. 8 of the 12 patients (67%) achieved temporary remission. By 3 months, 7 patients (58%) continued to show an improvement in symptoms and 5 of these were still in remission. Five patients showed some degree of relapse (figure 4).
The patients knew they were receiving psilocybin (an ‘open-label’ trial) and the effect of psilocybin was not compared with a placebo. The authors also stress that most of the study participants were self-referred meaning they actively sought treatment, and may have expected some effect (5 had previously tried psilocybin before, table 1). All patients had agreement from their GP to take part in the trial. They add that patients were carefully screened and given psychological support before, during and after the intervention, and that the study took place in a positive environment. Further research is now needed to tease out the relative influence of these factors on symptoms of depression, and look at how psilocybin compares to placebo and other current treatments.
Writing in a linked Comment, Professor Philip Cowen, MRC Clinical Scientist, University of Oxford, Oxford, UK, says: “The key observation that might eventually justify the use of a drug like psilocybin in treatment-resistant depression is demonstration of sustained benefit in patients who previously have experienced years of symptoms despite conventional treatments, which makes longer-term outcomes particularly important. The data at 3 month follow-up (a comparatively short time in patients with extensive illness duration) are promising but not completely compelling, with about half the group showing significant depressive symptoms. Further follow-ups using detailed qualitative interviews with patients and family could be very helpful in enriching the assessment.”
A new study from the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine provides insight into the psychoactive effects that distinguish psilocybin from other hallucinogenic substances. The findings suggest that feelings of spiritual and/or psychological insight play an important role in the drug’s popularity.
“Recently there has been a renewal of interest in research with psychedelic drugs,” explained Roland R. Griffiths, a professor of psychiatry and behavioral sciences who is the corresponding author of the new study.
“Studies from the Johns Hopkins Center for Psychedelic and Consciousness Research and elsewhere suggest that psilocybin, a classic psychedelic drug, has significant potential for treating various psychiatric conditions such as depression and drug dependence disorders. This study sought to address a simple but somewhat perplexing question: Why do people use psilocybin?”
“Psilocybin, in the form of hallucinogenic mushrooms, has been used for centuries for the psychoactive effects. Recent US survey studies show that lifetime psilocybin use is relatively modest and quite stable over a period of decades,” Griffiths explained.
“However, the National Institute on Drug Abuse does not consider psilocybin to be addictive because it does not cause uncontrollable drug seeking behavior, does not produce classic euphoria, does not produce a withdrawal syndrome, and does not activate brain mechanisms associated with classic drugs of abuse.”
In the double-blind study, 20 healthy participants with histories of hallucinogen use received doses of psilocybin, dextromethorphan (DXM), and a placebo during five experiment sessions.
“Dextromethorphan was chosen as a comparator to psilocybin because, although it is a hallucinogen with some effects similar to psilocybin, it has a substantially lower rate of non-medical use despite its widespread availability as an over-the-counter cough medicine,” Griffiths told PsyPost.
Each experimental session was separated by about two to seven days. The sessions took place in a living room–like environment, and the participants were instructed to lie down on a couch and listen to music.
The participants completed various assessments during the experimental sessions and wrote a brief description of their experiences afterward. In addition, the participants completed a follow-up questionnaire one week and one month after their last session.
The researchers found that most of the participants reported wanting to take psilocybin again. But only 1 in 4 reported wanting to take DXM again.
“The study showed that several subjective features of the drug experience predicted participants’ desire to take psilocybin again: psychological insight, meaningfulness of the experience, increased awareness of beauty, positive social effects (e.g. empathy), positive mood (e.g. inner peace), amazement, and mystical-type effects,” Griffiths explained.
Nearly half of the participants rated their experience following the highest psilocybin dose to be among the top most meaningful and psychologically insightful of their lives.
“The study provides an answer to the puzzle for why psilocybin has been used by people for hundreds of years, yet it does not share any of the features used to define classic drugs of abuse. The answer seems to reside in the ability of psilocybin to produce unique changes in the human conscious experience that give rise to meaning, insight, the experience of beauty and mystical-type effects,” Griffiths said.
“Future research should determine whether there are other subjective domains of subjective experience or other effects of psilocybin that motivate people to use psilocybin.”
Psilocybin is a hallucinogenic compound found in so-called “magic mushrooms”. A recent meta-analysis published in Psychiatry Research provides tentative support for psilocybin in the treatment of depression and anxiety.
Researchers have made important advancements when it comes to the treatment of depression and anxiety, including both pharmacological and behavioral interventions. Nevertheless, existing treatments often have ill side effects or are ineffective for certain patients, pointing to the need for more treatment options. Study authors Simon B. Goldberg and his team wanted to investigate one possible new treatment option.
“Researchers have recently resumed investigating psychedelic compounds as a novel treatment approach,” the authors say. “One such substance is psilocybin (4-phosphoroyloxy-N,N-dimethyltryptamine), a plant alkaloid and 5-HT2A receptor agonist.”
Goldberg and associates conducted the first meta-analysis to examine clinical trials investigating the effects of psilocybin among individuals with heightened anxiety or depression.
The analysis included four studies published between the years 2011-2018 and a total of 117 subjects. Three studies took place in the United States and one in the United Kingdom. The samples had an average of 29 participants each and were largely female (58%) and White (86%). All participants had clinically relevant anxiety or depression symptoms, or a combination of both.
One trial had a single-group, non-controlled design where all participants were administered a dosage of psilocybin. The three remaining trials employed a random design where roughly half the participants received a psilocybin dose and half received a placebo (the control group). In addition to the drug treatment, all four studies incorporated behavioral interventions and support throughout the trial.
Results of the meta-analysis indicated that participants in all four studies showed large reductions in anxiety and depression after receiving psilocybin dosages. Furthermore, the effects of psilocybin were significant even at the six-month follow-up. For the three double-blind studies comparing placebo and psilocybin conditions, the effects of psilocybin on anxiety and depression were also found.
While the results provide support for psilocybin in the treatment of anxiety and depression, the authors discuss several limitations with the analysis. First, as only four studies were included, the observed effects may not be reliable. Additionally, most studies had a high risk of bias, including detection bias caused by insufficient blinding of participants.
One possible avenue for future research is in the treatment-resistant population. “Additional large-scale studies examining the effects of psilocybin on treatment-resistant depression may be warranted, as only one of the four studies focused on this population,” the authors say.
“Nonetheless,” the researchers conclude, “the current meta-analysis suggests psilocybin in combination with behavioral support may provide a safe and effective treatment option for reducing symptoms of anxiety and depression. This is an area for additional careful, scientific study.”
New research provides evidence that the active ingredient in so-called magic mushrooms can affect brain processes related to emotional functioning long after the substance has left one’s body. The findings, published in Scientific Reports, shed new light on the long-term effects of psilocybin.
Rather than examining the brain while it’s under the influence of psilocybin, the researchers from Johns Hopkins University School of Medicine were interested in the enduring impact of the substance.
“Nearly all psychedelic imaging studies have been conducted during acute effects of psychedelic drugs. While acute effects of psychedelics on the brain are of course incredibly interesting, the enduring effects of psychedelic drugs on brain function have great untapped value in helping us to understand more about the brain, affect, and the treatment of psychiatric disorders,” said Frederick S. Barrett (@FredBarrettPhD), an assistant professor and the corresponding author of the study.
In the study, 12 volunteers received a single administration of a high dose of psilocybin. One day before, one week after, and one month after psilocybin administration, the volunteers completed three different tasks to assess the processing of emotional information (specifically, facial expressions) while the researchers used magnetic resonance imaging to record their brain activity. During these three sessions, the volunteers also completed various surveys about their emotional functioning.
The researchers found that self-reported emotional distress was reduced one week after psilocybin administration, but returned to baseline levels at one month after psilocybin administration. Barrett and his colleagues also observed decreases in amygdala responses to emotional information one week after psilocybin administration, but this also returned to normal at one month post-psilocybin.
In addition, the researchers found increases in resting-state functional connectivity, which measures how blood oxygen level-dependent signals are coordinated across the brain, at both one week and one month after psilocybin administration.
“A single high dose of psilocybin, administered to properly screened individuals in a carefully controlled setting, can have lasting positive effects on emotional functioning in healthy individuals. These effects were reflected in transient changes in the function of brain regions that support emotional processing,” Barrett told PsyPost.
Because of the small sample size and lack of a control group, however, the findings should be considered preliminary.
“This study needs to be replicated in a larger sample with proper experimental controls, and we need to determine whether psilocybin exerts the observed effects by directly acting on emotional brain circuits, or by acting on brain circuits that control attention and cognition that may have down-stream effects on emotional brain circuits,” Barrett explained.
New research provides evidence that a single psilocybin dose can result in long-term increases in mindfulness, even in the absence of explicit mindfulness training. The study, published in European Neuropsychopharmacology, suggests that these changes in mindfulness are related to changes in the serotonin 2A receptor, one of the 14 serotonin receptors in the brain.
Psilocybin is a powerful psychedelic drug and the active ingredient in so-called “magic mushrooms.”
“Psilocybin is being intensely studied by both the pharmaceutical industry and academic institutions, and most published studies suggest that psilocybin therapy may be very beneficial for a number of psychiatric disorders,” said Martin Korsbak Madsen, the corresponding author of the study and a PhD student at the University of Copenhagen.
“Our Neurobiology Research unit has for years been at the forefront of mapping the brain’s serotonin system using positron emission tomography (PET) brain imaging. Now, psilocybin acts by stimulating the brain’s serotonin 2A receptors, and since we developed a very good serotonin 2A PET imaging radiotracer in our lab, the need to understand if psilocybin affect the serotonin 2A receptors in the brain converged nicely with our PET imaging expertise.”
Ten healthy volunteers without prior experience with psychedelic drugs completed assessments of mindfulness, personality, and other factors before undergoing a neuroimaging session. On another day, the volunteers received a dose of psilocybin and then listened to a standardized music playlist. Eight of the ten volunteers had a “complete mystical experience” based on the Altered States of Consciousness questionnaire.
One week later, the volunteers again underwent neuroimaging and, three months later, the volunteers again completed assessments of mindfulness, personality, and other long-term effects.
The researchers found that the volunteers’ levels of mindfulness and openness tended to increase from baseline to the follow-up. In other words, the participants became less likely to agree with statements such as “I find it difficult to stay focused on what’s happening in the present” and “I do jobs or tasks automatically, without being aware of what I’m doing.”
Changes in serotonin 2A receptor binding after one week were also negatively correlated with changes in mindfulness three months after the psilocybin session.
“Psilocybin seems to increase mindful awareness in a long-term fashion in people who have never tried a psychedelic drug. Our results also show that subtle changes in brain serotonin 2A receptor levels and/or the serotonin levels probably contributes to these changes,” Madsen told PsyPost.
The volunteers also reported that the psilocybin session had resulted in long-term enhancements in mood, spirituality and outlook on life.
“Our results are in line with much anecdotal evidence and are in line with a recent study from Switzerland, which found that psilocybin boosted the mindfulness enhancing effect of an intensive mindfulness retreat,” Madsen added.
“It is striking that we found a large long-term mindfulness increase without any mindfulness training in healthy individuals, and it is likely that this effect — the increase in mindfulness — also happens in patients and is important for clinical response.”
But — like all research — the study includes some limitations. “Most importantly, our results should be replicated in a larger sample and in a double-blind study using a placebo control,” Madsen said.
New research published in Biological Psychology sheds light on the neurophysiological underpinnings of the psychedelic experience. The study provides new details about how psilocybin — the active component in “magic” mushrooms — changes the communication patterns between regions of the brain.
“Psychedelics are currently being investigated for the treatment of psychiatric disorders. However, it is still unclear how they change brain activity and connectivity to induce their unique effects,” explained study author Katrin Preller of the University of Zurich and Yale University.
“We therefore conducted a study to investigate the time-dependent effects of psilocybin on brain connectivity and the association between changes in brain connectivity and receptor pharmacology.”
In the study, 23 healthy human participants underwent MRI brain scanning 20 minutes, 40 minutes, and 70 minutes after receiving either psilocybin or a placebo. The researchers observed reduced connectivity between brain areas involved in planning and decision-making but increased connectivity between areas involved in sensation and movement while the participants were under the influence of the psychedelic drug.
“Psilocybin – similar to LSD – induced a pattern of brain connectivity that is characterized by increased synchronization of sensory brain regions and decreased connectivity of associative networks,” she told PsyPost.
“Increased sensory processing but altered integration of this sensory information may therefore underlie the psychedelic state and explain the symptoms induced by psilocybin. Furthermore, this pattern of changes in connectivity was closely associated with spatial expression of the serotonin 2A and 1A receptors – pinpointing these receptors as critical for the effects of psilocybin.”
Another drug called ketanserin, a serotonin 2A antagonist, prevented the effects of both psilocybin and LSD, suggesting that changes in brain connectivity caused by these psychedelic drugs are linked to stimulation of the serotonin 2A receptor.
“In this study we investigated different time points from administration to subjective peak effects. Future studies need to investigate how psilocybin impacts brain connectivity during a later phase and post-acutely,” Preller noted.
New research indicates that psilocybin-assisted mindfulness meditation is associated with changes in functional brain connectivity — and these changes are related to an altered state of consciousness known as ego dissolution. The findings appear in the journal NeuroImage.
A team of scientists from the University of Zurich were interested in investigating the topic because both psychedelic drugs and meditation have been shown to alter brain regions involved in self-awareness.
In the randomized, double-blind study of 38 experienced meditators, the researchers administered a single dose of psilocybin or a placebo to participants during a 5-day mindfulness retreat. Six hours after receiving psilocybin or placebo, the participants completed an assessment of altered states of consciousness.
The participants also underwent fMRI brain scans the day before and the day after the retreat to investigate changes in functional connectivity while resting, while engaging in focused attention meditation, and while engaging in open awareness meditation.
The researchers were particularly interested in a network of interacting brain regions known as the default mode network, which has been associated with processing feelings of self.
Compared to those who received a placebo, those who received psilocybin were more likely to feel like the boundary that separates them from the rest of the world had been dissolved — an altered state of consciousness known as oceanic self-boundlessness or ego dissolution.
The researchers found that this altered state of consciousness was associated with changes in brain connectivity. In particular, psilocybin-induced ego dissolution was associated with a decoupling of functional connectivity between the medial prefrontal cortex and posterior cingulate cortex regions of the default mode network while engaging in open awareness meditation.
“We here report for the first time psilocybin-induced functional connectivity changes in self-referential brain networks in a group of experienced meditators after a mindfulness retreat,” the researchers said.
Psilocybin-induced ego dissolution and changes in brain connectivity also predicted positive changes in attitudes about life, self, social behavior, mood, and spirituality at a 4 months follow-up assessment.
“An experience of ego dissolution may further imply cognitive reappraisals, reifications, self-inquiry, or insights and contribute to enduring psychological changes,” the researchers wrote in their study. “Our double-blind study presents a notable case because its participants were primarily in middle adulthood and already engaged in meditative practices, and yet the psilocybin-treatment group still reported a significant beneficial effect of the retreat.”
The results are largely in line with a previous study that examined the combination of psilocybin and meditation.
That study, published in the Journal of Psychopharmacology in 2017, found that psilocybin-occasioned experience, in conjunction with meditation and other daily spiritual practices, were associated with enduring increases in traits such as altruism, gratitude, forgiveness, and interpersonal closeness, as well as decreases in fear of death.
New research provides more evidence that psilocybin, the active ingredient in magic mushrooms, can improve creative thinking, empathy, and subjective well-being. The findings appear in the Journal of Psychoactive Drugs.
“In the last decade, there has been a renewed scientific interest in the utility of psychedelics. Increasing evidence suggests that psychedelics like psilocybin may have potential therapeutic value for disorders like anxiety, depression, and PTSD,” said Natasha Mason (@NL_Mason), a PhD candidate at Maastricht University and the corresponding author of the study.
“The focus of such investigations has been on psychedelics capacity to reduce symptoms of these disorders, thereby improving mood and well-being. However, of equal importance are the higher-order cognitive processes that may be enhanced, or that may play a role in symptom alleviation of the disorders.”
“Examples of processes that have been found to be decreased in these pathologies include creative, flexible thinking and empathy. Specifically, individuals are characterized by repetitive and rigid patterns of negative and compulsive thoughts, as well as reduced empathic abilities. Thus we wanted to assess whether psilocybin enhanced these processes, and if so, how long effects lasted,” Mason explained.
“Furthermore, we wanted to see whether enhancement in creativity and/or empathy correlated with participants ratings of subjective well-being. This would give further insight into the potential underlying cognitive mechanisms of symptom alleviation that has recently been reported by clinical studies.”
For their study, the researchers recruited 55 participants from a Psychedelic Society retreat in the Netherlands. The participants at the retreat consumed psilocybin-containing mushrooms in a tea form. About half of them had previously used the psychedelic drug.
Mason and her colleagues administered the participants various psychology tests to assess their creativity, empathy, and general life satisfaction three separate times: once the evening before ingesting psilocybin, once the morning after ingesting psilocybin, and finally 7 days after ingesting psilocybin.
“We found that psilocybin, when taken in a naturalistic setting, increased aspects of creativity and empathy the morning after, and 7 days after use. Furthermore, psilocybin also enhanced subjective well-being. Interestingly, changes in well-being correlated with changes in empathy after psilocybin use,” Mason told PsyPost.
The researchers examined two types of creativity — convergent thinking and divergent thinking. The former represents the ability to generate a single optimal solution to a problem, while the latter represents the ability to generate many solutions to a problem with several possible answers.
Participants’ divergent thinking abilities were improved the morning after ingesting psilocybin but their convergent thinking abilities were not affected. A week later, however, their divergent thinking performance had returned to normal while their convergent thinking abilities had improved.
“These findings are important in trying to understand psychedelics’ therapeutic utility in the treatment of certain pathologies. Specifically, in a therapy session, enhancements in empathy could increase feelings of openness and trust between patient and therapist, thus strengthening the therapeutic alliance,” Mason said.
“Furthermore, enhancements in flexible, creative thinking could allow individuals to break out of their old patterns of thought, and generate new and effective cognitive, emotional, and behavioral strategies. Importantly, our data suggest that these effects outlast the acute phase and persist over time, thus potentially opening up a ‘window of opportunity’ where therapeutic interventions could prove more effective.”
Another group of researchers investigated how a microdose of psilocybin affected 36 people who were present at a psychedelic retreat. They, too, found that participants had increased creativity after consuming a minute amount of the psychedelic drug, while their intelligence scores and general analytical abilities did not change.
But the study — like all research — includes some limitations.
“This study was a naturalistic study, assessing effects of psilocybin in volunteers who chose to attend a psychedelic retreat. Thus, selection bias of individuals restricts the generalizability of our results,” Mason explained.
“Additional caveats include the lack of placebo control. Thus, it could be argued that effects are influenced by uncontrolled factors such as individuals’ psychological expectations, or the environment that the drug is taken in. Previous research has shown that both factors, termed set and setting, play an important role in the outcome of the psychedelic experience.”
“Accordingly, future placebo-controlled experimental studies could ideally control for these potential influences, as well as assess the role of these cognitive processes in symptom alleviation in a pathological population,” Mason said.
The psychedelic drug psilocybin could help alleviate depression by causing people to have a less pessimistic outlook on life, according to preliminary research published in Frontiers in Psychology.
Previous research has found that depression is associated with unrealistic negative predictions of future life events. Scientists from the Psychedelic Research Group at Imperial College London were interested in whether psilocybin — the main psychoactive compound in magic mushrooms — could reduce these pessimism biases.
In their study, 15 participants with treatment-resistant depression were administered psilocybin in two dosing sessions. Psychological support was provided before, during, and after each session.
The participants — along with group of matched, untreated non-depressed controls — completed measures of depression and predictions of future life events before and after the psilocybin sessions.
Before the treatment, the depressed participants predicted they would experience an roughly equal number of undesirable events and desirable events in the future. The non-depressed participants, on the other hand, predicted they would experience more desirable events than undesirable events.
But treatment with psilocybin appeared to alter the depressed participants’ predictions of future life events. After the psilocybin sessions, depressed participants expected more desirable than undesirable life events to occur, which was in turn associated with a reduction in depressive symptoms.
“Before treatment with psilocybin, patients were excessively and unrealistically pessimistic when predicting the occurrence of future life events — and this pessimism was significantly correlated with the severity of their depressive symptoms. One week after treatment, the patients’ pessimism was alleviated and their depressive symptoms greatly improved; moreover, the magnitude of change in both variables was related – such that as their depression improved, so did their ability to accurately forecast their future,” the researchers explained.
“No such bias nor change in forecasting was seen in a matched control group assessed over an equivalent time period. Taken together, these findings indicate that the psychologically supportive administration of psilocybin remediates negative cognitive biases characteristic of severe depression – enabling individuals to forecast their futures more accurately, unfettered by unrealistic pessimism.”
The findings are promising, but need to be replicated with a larger sample of participants, the researchers noted.
New research sheds light on why the psychedelic drug psilocybin helps to lessen the mental anguish experienced by people with advanced cancer.
“The findings of the study support the conclusion that psilocybin-assisted psychotherapy is well accepted by participants and constitutes a promising intervention for the treatment of existential and psychological distress provoked by a cancer diagnosis,” said the researchers, who published their findings in the Journal of Humanistic Psychology.
Psilocybin is the primary mind-altering substance in psychedelic “magic” mushrooms. The drug can profoundly alter the way a person experiences the world. It produces changes in mood, sensory perception, time perception, and sense of self.
“Despite the resurgence in research using psilocybin in recent years, the psychological mechanisms of action involved in psilocybin-assisted psychotherapy are not yet well understood,” the researchers explained.
In the study, the researchers interviewed 13 adults with clinically-elevated anxiety associated with a cancer diagnosis. The participants in the study underwent 3 months of psychological treatment as part of a Phase II clinical trial. They received two therapist-guided drug sessions (psilocybin or a placebo), which were separated by 7 weeks. They also received nine sessions of psychotherapy from two licensed psychotherapists.
Five participants were interviewed within 1 week following their psilocybin session, while eight participants were interviewed during a 1-year follow-up.
Even though the interviewers did not ask about personal relationships, all of the participants said that their psilocybin experience had resulted in them seeing their loved ones in a new way.
As one participant told the interviewers: “Bit by bit, my daughters were turning into these radiant beings, cleansed of all these fears. It was incredibly emotional, because it was something I have, as their father, long known, but it’s a very great pain when you see your children being victimized by fears . . . to see these beautiful beings not realizing their essence.”
The forgiveness of others and seeing loved ones as spiritual guides was also a common theme. The psychedelic experience also caused a shift in their life priorities. “We forget what’s really important; we get carried away with work and making our money and paying our bills, and this is just not what life is about,” one participant remarked.
The participants also reported experiencing a heightened sense of emotion and a wide range of vivid closed-eye visual phenomena. It helped them find a sense of belonging too. Participants reported that they had found their “place in the cosmos” or experienced a feeling of “global connectedness.”
“It’s the first time I ever really felt like I was part of the world instead of separate from it.”
But the psychedelic experience wasn’t uniformly positive and glowing. A little over half of the participants recounted experiencing fear, confusion, panic, or paranoia during their psilocybin session. Experiencing an alteration in self-identity and the sense of self was also common.
Of the 13 who underwent psilocybin therapy, only one said he didn’t want to use psilocybin again. He explained, “You have a lot of things to learn from it, but how much fun is learning, you know? It is not that fun especially when you have to face some hard things… you start putting everything together, and at the end you are a better person because you know more. You know, but the experience itself is not fun.”
People who take microdoses of psychedelic drugs consistently report that it results in improved mood and creativity, while having few side effects, according to new research published in the Journal of Psychopharmacology.
Study author Rotem Petranker, director of the Canadian Centre for Psychedelic Science, and his colleagues noticed a growing public interest in taking sub-threshold doses of LSD or psilocybin to enhance cognitive or emotional functioning. But scientific research on the issue is scant.
“I’ve always been curious about mind-expansion: I’ve been meditating formally since I was 19, have had periods of extensive lucid dreaming training, and have had a near-death experience. Psychedelics seem to be in the same vein, and so anyone who is interested in mapping out consciousness would be wise to consider psychedelics as a useful paradigm,” said Petranker, who is also the associate director of the Psychedelic Studies Research Program at the University of Toronto and a PhD student at York University.
“When I started doing this research, it was with the notion that while the study of psychedelics has returned to the mainstream in the 21st century and the results look promising, there are still many gaps in our knowledge. When I started, there was no published research on microdosing and so I thought that this is a good way to establish legitimacy in the field.”
“We didn’t have any funding or other support, so my colleague Thomas Anderson and I just used our previous knowledge about building surveys for research purposes to get an idea of what people who microdose experience, and whether they are different from non-microdosers on a few key dimensions like mental health and creativity,” Petranker said.
The researchers’ previous work, based on 278 self-identified microdosers, found that people who took very small doses of psychedelic substances commonly reported improved mood, focus, and creativity.
In their new study, the researchers sought to replicate and extend those findings using data from the 2019 wave of the annual Global Drug Survey. The survey included responses from 123,814 participants in 215 countries and territories. Importantly, 4,783 participants reported having microdosed LSD in the last 12 months, 2,832 reported having microdosed psilocybin in the last 12 months, and 862 participants reported microdosing both of the psychedelic drugs in the last 12 months.
In line with the previous research, the two most commonly reported benefits of microdosing were improved mood and creativity. But improved focus was less commonly reported than expected, while improved energy and social benefits were more commonly reported than expected.
“Similar but non-identical findings are not surprising given that the methodologies used in the two studies were quite different,” the researchers noted.
Microdosing to approach desired goals, such as to be more productive, was associated with fewer microdosing benefits than microdosing to avoid certain mental states or behaviors, such as to escape negative feelings or get away from bad habits.
When asked to report their most common challenge from microdosing, more than half of the participants selected the item “none; I experienced no side effects.” For LSD, the next most commonly reported challenges were impaired energy and mental confusion, while for psilocybin the next most commonly reported challenges were physiological discomfort and impaired focus.
“Generally speaking, those who microdose report that the benefits greatly outweigh the drawbacks,” Petranker told PsyPost.
The researchers also found a diversity of opinions when it came to whether microdosing psychedelics was more beneficial than taking a higher dose. One-third of the participants reported that microdosing was more beneficial compared to higher doses, while two-fifths said higher doses were more beneficial. One-quarter reported that they were equally beneficial.
But despite the studies, scientists are still “a far cry from knowing everything we need to know about psychedelics in general and microdosing in particular, and that includes both benefits and drawbacks,” Petranker said.
To determine the real effects of microdosing, randomized placebo-controlled experiments are needed.
“We don’t know if microdosing does anything at all — it may be that everything reported in the literature is the placebo effect. Published research in the field is either of samples of convenience — people who microdose and want it to work — or involves underpowered designs that don’t really tell us anything at all. We also don’t know about the long-term health effects of microdosing, which may be good, bad, or negligible,” Petranker explained.
Psychedelic drugs could be commonly used to treat mental health patients in as little as half a decade, according to a leading expert in the field.
David Nutt, professor and neuropharmacologist at Imperial College London and former U.K. government drug adviser, told Newsweek he believes we are “less than five years” away from such drugs being given to patients.
Nutt made the forecast after co-authoring a commentary in the journal Cell, which explores the resurgence of research investigating the potential benefits of using drugs such as LSD and magic mushrooms in controlled medical settings to treat mental disorders like depression, anxiety and PTSD.
During the 1950s and 1960s, LSD was researched widely and considered a potential breakthrough drug by psychiatrists, according to the team, but work ground to a halt after such substances were taken recreationally and subsequently banned.
In the article, Nutt and colleagues argue that the war on drugs, which ended such research, was “one of the worst examples of censorship of human research in the history of science.”
“In the past decade, research on these compounds has been re-established by a few groups around the world, culminating in new centers for psychedelic research at Imperial College London and Johns Hopkins University,” they said.
For instance, after “battling” with regulators to use the schedule 1 drug psilocybin, the active ingredient in magic mushrooms, researchers found “remarkable” effects on patients who were given it alongside psychological support. Two experiences with the drug appeared to ease symptoms of depression in some people for weeks, and even years “positioning it as one of the most powerful therapeutics for treatment-resistant depression,” the team wrote.
Nutt and colleagues will soon finish a trial comparing psilocybin with the antidepressant drug escitalopram on patients with depression.
The writers said psychedelics may have a profound effect on participants in such trials, as patients suffering from conditions like anxiety and depression often dwell too much on negative thoughts, such as their own failings, and the combination of these drugs and therapy sessions seem to break these cycles.
“Standard antidepressants protect against the stressors that lead to and perpetuate depression, but don’t directly access and remedy underlying biopsychosocial causes,” the team wrote.
“In contrast, psychedelic therapy harnesses a therapeutic window opened up by the brain via the effects of the drugs to facilitate insight and emotional release and, with psychotherapeutic support, a subsequent healthy revision of outlook and life-style.”
However, more work is needed, they said, to explain the mechanism behind the effects of these drugs.
The writers also cast doubt on microdosing, where drugs are taken at small enough doses not to change a person’s state in any conceivable way but which some claim can balance a person’s mood. A study last year concluded there is no evidence to show the practice works. Nutt and colleagues questioned how, for instance, microdosing psilocybin three times a week could elicit the same effect as a “macrodose” used in trials where participants have experiences that are “variously called breakthrough, peak, or mystical.”
Nutt and his co-authors also argued that regulators should consider rescheduling psychedelics drugs, particularly psilocybin, in order to make it easier for them to be studied by researchers.
“The resurrection of research into the neuroscience and therapeutic application of psychedelics represents one of the most important initiatives in psychiatry and brain science in recent decades,” they wrote.
The team concluded: “What is now needed is a combined, multi-level, multidisciplinary program of research into the mechanisms underpinning” recent finding on psychedelics.”
Ravi Das of the UCL Clinical Psychopharmacology Unit, who did not work on the commentary, told Newsweek: “I am in complete agreement with Professor Nutt that we need more robust research into whether these drugs are effective and particularly into how they produce beneficial changes.”
Das said he agreed that it could be beneficial to reschedule certain psychedelics so they are easier to research and gather “proper empirical data” on.
“The way drugs are currently classified legally has little relation to their underlying pharmacology, toxicity, or potential for harm or benefit,” said Das. “The psychedelic drugs Nutt reviews are far less toxic than alcohol and tobacco, for example, with much greater potential for benefit.”
Asked how many years he predicts will pass before psychedelics are commonly used to treat patients, Das said: “Owing to the stagnation in psychiatry that Nutt and colleagues note in their review, research scientists and psychiatrists tend to get excited about new ‘step-change’ developments in treatment approaches.”
Das said there was a tendency, particularly in private clinics in the U.S. to offer treatments too prematurely, before mechanisms are properly understood.
“I have no doubt that we will see private clinics offering such treatments in the next few years, albeit without a solid empirical grounding. Nutt and colleagues highlight the need for mechanistic research into these drugs and I think this is critical to ensuring they are used most effectively and safely in disorders where they are likely to have most benefit,” said Das.
The take-home message for the general public is clear, according to Das and Nutt.
Nutt told Newsweek it is unsafe for the general public to experiment with psychedelic drugs at home, as the powerful therapies require trained medical supervision. Drugs like LSD, for instance, can trigger mental health problems, according to health officials.
Das said many people use psychedelics recreationally and do not experience the lasting, or “life-changing” insights some study participants report.
“There is therefore no guarantee that experimenting at home will have effects remotely like those seen in carefully controlled studies,” he said. “Given that the leading researchers in the field still don’t really understand how psychedelics work to improve mental health, those choosing to experiment at home would be truly ‘flying blind’. As with all potential psychiatric treatments, potential psychedelic therapies should be overseen by a qualified healthcare professional.”
Das concluded: “I do think there is real promise in psychedelic therapies and agree with Nutt et al’s recommendations on almost all fronts.
“I would like to stress, however, that we’re really still at the very early stages of this research and understanding how these drugs work. Whether they truly represent the ‘revolution’ in psychiatry some tout them to be still needs to be shown by research.”
Allie Nawrat20 August 2020 (Last Updated August 21st, 2020 15:39)
Psychedelics have been used throughout history for medical purposes. After going out of favour in the 1960s and 1970s, they have begun to return to the mainstream as rigorous clinical trials have demonstrated their potential as treatment for unmet needs in mental health. Allie Nawrat talks to four companies working in the psychedelics space.
In 2018, countries around the world saw a dramatic change in attitudes towards medical cannabis. In the US, 33 states and the federal district of Washington, DC legalised the use of medical cannabis, and across the pond, the UK Government moved many cannabis products from Schedule 1 drugs to Schedule 2, allowing them to be prescribed by specialists to those who might benefit from its therapeutic potential in childhood epilepsy, amongst others.
This medical cannabis breakthrough was followed in early 2019 by the approval of esketamine nasal spray for supervised administration to adults suffering with treatment-resistant depression. This breakthrough marked the first major advance in the treatment of depression since the late 1980s.
In this context of more open-mindedness towards once stigmatised illegal and recreational drugs as medicines, another Schedule 1 drug, ‘mind manifesting’ psychedelics, such as psilocybin from magic mushrooms, LSD and mescaline, are also beginning to be greeted with optimism by the clinical community, regulators and investors.
These positive attitudes are due to how, like ketamine, psychedelics have the potential to be a game-changing treatment in mental health. Not only have mental health disorders proven incredibly challenging to treat, but the incidence and impact of these conditions is only growing; the world is undoubtedly living in an escalating mental health crisis.
To find out if their promise can become a reality, a healthy competitive landscape of pharma companies have begun working on developing and trialling psychedelic drugs, including Champignon Brands, ATAI Life Sciences, Field Trip Psychedelics and Eleusis.
Explaining the current renaissance
Despite being used as medicines for thousands of years, psychedelics didn’t become commonplace in mainstream Western culture until the 1940s and 1950s. Initially this was focused in academic settings, but over time “psychedelics moved out of these settings into the hippie movement and counterculture,” explains Field Trip Psychedelics founder and executive chairman Ronan Levy. This prompted political backlash and their designation as Schedule 1 products in the 1960s and 1970s.
This made research incredibly challenging, but non-profit organisations such as the nary Association for Psychedelic Studies (MAPS) and the Beckley Foundation were undeterred. Over the next three decades or so, scientists “amassed data that suggested there was something quite intriguing about psychedelics from a mental health perspective,” notes ATAI chief scientific officer Srinivas Rao.
Due to the hard, clinically rigorous work of the non-profits and academic researchers, including Roland Griffiths at John Hopkins University and David Nutt at Imperial College London, by the 2000s and 2010s psychedelics had begun to experience a resurgence.
Data showing psychedelics’ promise in mental health caught the eye of the FDA, leading the regulator to declare the psychedelic psilocybin as a possible breakthrough drug and giving it “unmatched credibility,” explains Champignon CEO Dr Roger McIntyre. To date, two psilocybin-based drugs have received FDA breakthrough designation – ATAI’s investment portfolio company COMPASS Pathways for treatment-resistant depression and the Usona Institute’s for major depressive disorder. The European Medicines Agency has taken a similar approach to psychedelics in the past few years.
Psychedelics have been used for thousands of years but in a provocative new book “The Immortality Key” author Brian Muraresku explores their impact on early Western civilization. Were the ancient Greeks, Romans and early Chrisitians influenced in their religious practices by psychedelics? Psilocybin, known by many as magic mushrooms, is being used to treat an array of mental disorders, from anxiety and depression to addiction and end of life issues with profound effects for patients. Today, the medical community is once again embracing research into the therapeutic benefits of hallucinogens.
In a small study in adults with severe depression, researchers at Johns Hopkins Medicine report that two doses of the psychedelic substance psilocybin given with supportive psychotherapy resulted in rapid and severe reductions in depressive symptoms, with most participants showing improvement and half of the study participants achieved remission through the four-week follow-up.
Psilocybin is a compound found in so-called magic mushrooms that causes visual and auditory hallucinations and profound changes in consciousness within a few hours of ingestion. In 2016, researchers at Johns Hopkins Medicine first reported that treatment with psilocybin in psychologically-assisted settings significantly relieved existential anxiety and depression in people with a life-threatening diagnosis of cancer.
Now the results of the new study, published on November 4th in JAMA Psychiatrysuggest that psilocybin may be effective in the much broader population of patients suffering from major depression than previously thought.
“The magnitude of the effect we saw was about four times greater than what clinical trials of traditional antidepressants have shown in the market,” said Alan Davis, Ph.D., associate professor of psychiatry and behavioral science at Johns Hopkins University School of Medicine. “Since most other depression treatments take weeks or months to complete and can have undesirable effects, this could mean a change if these results hold up in future gold-standard placebo-controlled clinical trials.” The published results only cover four weeks of follow-up at 24 Participants who went through every two five-hour psilocybin sessions led by the researchers.
“Because there are different types of depressive disorder that can cause people to respond differently to treatment, I was surprised that most of our study participants found psilocybin treatment effective,” says Dr. Roland Griffiths Oliver Lee McCabe III Professor of Neuropsychopharmacology of Consciousness in the Faculty of Medicine at Johns Hopkins University and Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. He says the major depression treated in the new study may have been different from the “reactive” form of depression in patients they looked at in the 2016 cancer study. Griffiths said his team was encouraged by public health officials to study the effects of psilocybin in the broader population of people with major depressive disorder, as the potential public health effects are far greater.
For the new study, the researchers recruited 24 people with a long-term documented history of depression, most of whom had symptoms that had persisted for about two years prior to enrollment in the study. The average age of the participants was 39 years; 16 were women; and 22 identified as white, one person as Asian, and one person as African American. Participants, with the help of their personal physician, were required to remove all antidepressants prior to the study to ensure safe exposure to this experimental treatment.
Thirteen participants received the psilocybin treatment immediately after enrollment and after the preparatory sessions, and 11 participants received the same preparation and treatment after an eight week delay.
Treatment consisted of two doses of psilocybin given by two clinical monitors who provided guidance and confirmation. The doses were administered two weeks apart between August 2017 and April 2019 in the Behavioral Biology Research Building at Johns Hopkins Bayview Medical Center. Each treatment session lasted approximately five hours, with the participant lying on a couch in the presence of the monitors, wearing visors and headphones that played music.
All participants received the GRID Hamilton Depression Rating Scale – a standard tool for assessing depression – upon enrollment and one to four weeks after completing their treatment. On the scale, a value of 24 or more indicates major depression, 17-23 indicates moderate depression, 8-16 indicates mild depression, and 7 or less indicates no depression. At enrollment, participants had an average depression score of 23, but one week and four weeks after treatment, they had an average depression scale of 8. After treatment, most participants showed a significant decrease in their symptoms, and almost half were in remission from depression at the follow-up examination. The participants in the delayed group showed no decrease in their symptoms prior to treatment with psilocybin.
For the entire group of 24 participants, 67% showed a greater than 50% reduction in symptoms of depression at the one-week follow-up and 71% at the four-week follow-up. In total, four weeks after treatment, 54% of participants were classified as remitted, meaning they were no longer classified as depressed.
“I believe this study is critically important proof of concept for the medical approval of psilocybin for the treatment of depression that I have personally struggled with for decades,” says entrepreneur and philanthropist Tim Ferriss, who supported the funding campaign for this study . “How do we explain the incredible extent and longevity of effects? Treatment research involving moderate to high doses of psychedelics can uncover entirely new paradigms for understanding and improving mood and mind. This is a taste of what Johns Hopkins has to offer. ”
The researchers say they will follow participants for a year after the study to see how long the antidepressant effects of psilocybin treatment last, and publish their results in a later publication.
Griffiths, whose research on psilocybin begun in the early 2000s was initially viewed with skepticism and concern by some, says he was delighted with Johns Hopkins’ support and encouraged by the dozen of startups and research laboratories who have followed with their own research. Numerous companies are currently actively developing marketable forms of psilocybin and related psychedelic substances.
According to the National Institute of Mental Health, more than 17 million people in the United States and 300 million people worldwide have experienced major depression.
Psychedelic drug to be tested for treatment-resistant depression in Houston
Provided by the Johns Hopkins University School of Medicine
The first-ever randomized controlled trial of long-term depression patients who took psilocybin, the psychedelic compound in “magic” mushrooms, found the drug improved the majority of their symptoms after two trip sessions.
Johns Hopkins researchers who conducted the study also found 54% of the patients were in “remission” because they had no more symptoms four weeks following the eight-week experiment.
The study adds to a mounting body of research that suggests psilocybin could be a depression treatment alternative to traditional anti-depressant medications.
A new study from Johns Hopkins researchers adds to a mounting body of research that suggests psilocybin, the psychedelic compound in “magic” mushrooms, has the potential to treat anxiety and depression symptoms.
The study, published in the journal JAMA Psychiatry on November 4, was the first randomized controlled trial to look at how psilocybin administered in a clinical setting could affect people with long-term, clinically diagnosed depression.
The researchers looked at 24 people who were, on average, 39 years old. The majority of participants were college-educated, heterosexual, and white, and 16 were female while eight were male.
On average, the participants had experienced depression for 21.5 years and didn’t have underlying psychotic disorders, such as bipolar disorder or schizophrenia, which could lead to adverse side effects if a person with such a condition were to take psychedelics, study co-author Matthew Johnson told Insider. None of the participants were taking depression medication.
Each participant underwent two day-long sessions where two drug facilitators gave them a capsule of psilocybin — first a 20 mg “moderately high” dose then a 30 mg “high” dose, and they wore eye shades and listened to instrumental music while lying on a couch.
The two sessions were 1.6 weeks apart, and the participants also did eight hours of preparatory meetings with facilitators, plus two-hour debriefs following each trip session.
The researchers found that 67% of the 24 study subjects reported more than a 50% decrease in depression symptoms after the first drug-trip session. After the second session, 71% of the participants said they noticed a 50% decrease in symptoms.
After seeing patients four weeks following the experiment, 54% of them had no depression symptoms and were considered “in remission.”
Psilocybin’s anti-depressive effects in this study were four times greater than traditional anti-depressant medication.
Previous studies found benefits for cancer patients with anxiety or depression
Though this isn’t the first study to look at how psilocybin given in a clinical setting could improve depression symptoms, it is the first randomized controlled study of people with long-term depression that wasn’t the result of an illness.
“Because there are several types of major depressive disorders that may result in variation in how people respond to treatment, I was surprised that most of our study participants found the psilocybin treatment to be effective,” Roland Griffiths, study co-author and director of the Johns Hopkins Center for Psychedelic and Consciousness Research, said in a press release.
Could psilocybin be the future of depression treatment?
Johnson previously told Insider we’ve been using SSRI-type drugs since the 1950s for depression, but there’s evidence that they don’t work for everyone experiencing mental health problems.
Additionally, he said SSRIs take a few weeks to kick in for someone who is just starting to use them, which isn’t helpful for a person dealing with suicidal thoughts. According to a 2015 report from the National Institutes of Health (NIH), about 40 to 60 out of every 100 people notice an improvement in depression symptoms after using antidepressants for six to eight weeks.
“Something with more immediate effects has a huge benefit as a tool in the therapeutic toolbox,” Johnson previously told Insider of psilocybin’s potential benefits for depression treatment.
There were caveats to the study. The researchers could only test a small sample of people who were mainly white and more moderate severity depressions. Also, the researchers only were able to see the effects of the psilocybin four weeks after the trial.
For that reason, they plan to follow the study participants for a year with three-, six-, and 12-month check-ins, and see how long the two psilocybin sessions appear to help their mental health. Then they will report their findings in another study.
Disclaimer: Sources contributing to this storyare editors at the Scribe. The views and opinions expressed by Flannery and Webb are their own and not reflective of the position of the Scribe as an organization.
“The next morning, it was the first time I did not have my nervous system freaking out,” said Brandon Flanery, a senior at UCCS majoring in English secondary education, after his first-time micro-dosing psilocybin mushrooms (shrooms), a psychedelic drug, to treat his anxiety.
There are many prescription drugs available to treat a variety of mental health disorders, and with the findings from current studies, psychedelics may soon be included in these lists. They have been clinically proven to significantly decrease depression, anxiety, PTSD and other symptoms from mental health disorders while improving mood, openness, creativity, self-efficacy and energy.
Though psychedelics have been used for thousands of years, medical studies on their potential positive impacts only began in the 1940s, according to Timeline. The “war on drugs” unfortunately slowed down this research until recently, in the early 2000s, when scientists and doctors began to revisit their research on psychedelics, including LSD — a hallucinogenic synthetically made from the acid in ergot, a type of fungus — and shrooms, according to Psychedelic Science.
When scanning the brains of those under the influence of shrooms, brain activity takes place in areas that normally are not connected, reported LiveScience. One study found that shrooms stimulated neurogenesis, allowing repair and growth to take place in the hippocampus — the area responsible for emotion and memory — according to NYU Langone Health.
According to the U.S. National Library of Medicine, studies using LSD produced a “blissful state … and positively experienced derealization and depersonalization.” LSD and shrooms both produced positive long-term effects on personality and mood.
LSD and shrooms are not chemically addictive, meaning our bodies do not become dependent on the drug, as stated by the U.S. National Library of Medicine. These psychedelics can even help people with substance abuse overcome addiction.
One study found that those who struggled with alcoholism benefited from micro-dosing or experiencing a controlled “trip” — 75 to 200 micrograms of LSD — with over half of those who implemented psychedelics reporting no or significantly less alcohol abuse up to six months later, according to Time Magazine.
Another study reported on by the U.S. National Library of Medicine showed that after using shrooms, terminally ill cancer patients’ quality of life improved, they had better relationships with the people around them, they wanted to participate in more external activities and they experienced less psychological distress.
Joy Webb, a senior majoring in philosophy and English, micro-dosed with shrooms when coming off her anti-anxiety and anti-depressant medications. “It felt like it gave me an increased energy, clear head, an openness and made me feel good,” she said.
Webb has also experimented with larger doses of shrooms, and she described it as an important transformational period for her, especially for her mental health. “It was surreal, special and pivotal to my being.” She said it helped her heal from depression and PTSD, and she claimed it helped her cope with anxiety and allowed her to understand, accept and love herself.
As with most drugs, prescription or otherwise, LSD and shrooms can produce negative side effects. The most generally feared side effect is experiencing a “bad trip” which is a frightening or anxiety-inducing state, or the experience of flashbacks, in response to substances. This can be potentially damaging to the mental state of those who experience it.
However, according to the U.S. National Library of Medicine, in current medical studies performed in controlled environments, no participants have experienced severe anxiety, fear or severe adverse reactions as a side effect. This is more common when psychedelics are used recreationally, in settings where users are more likely to feel unsafe or uncomfortable.
Both Flanery and Webb emphasize the importance of being in a good place, both mentally and physically, before using psychedelics. Flanery combines micro-dosing with counseling and claims that method has been effective for him. “I would not recommend shrooms to people who are not doing the cognitive work of healing trauma in the mind,” he said.
Other side effects of LSD include temporary increases in blood pressure, heart rate, body temperature and pupil size, according to the U.S. National Library of Medicine. Effects including dizziness, imbalance, dry mouth, nausea, lack of appetite and difficulty concentrating may be present for up to 24 hours after use, whereas headaches or feelings of exhaustion may be present for up to 72 hours.
I know from experience that many medications prescribed for mental health disorders are chemically addictive and can produce an array of severe, negative side effects. Unfortunately, natural, nonaddictive and arguably safer alternatives such as the psychedelics discussed in this article are not yet widely available or legal in the U.S.
There are some legal ways to pursue a psychedelic experience. Joining a clinical trial is one option, and you can find ongoing trials at clinicaltrials.gov. There are also some churches in the U.S. that can legally use psychedelic substances as religious sacraments, so joining one of these churches is another option.
That being said, I do not encourage or endorse these activities, and neither does the Scribe.
Hopefully some day in the near future, people can enjoy the benefits of these psychedelic drugs without worrying about being fined or arrested in the process.
A study published in Psychopharmacologysuggests that people may turn to microdosing with psychedelics in an attempt to improve their mental health. According to most self-reports, these attempts may be effective.
Interest in psychedelic drugs as a potential treatment option for mental health disorders has been steadily increasing. One reason for the upsurge in interest might be the lack of effective treatments for certain psychiatric disorders, such as depression and post-traumatic stress disorder (PTSD).
Study authors Toby Lea and his team were motivated to examine a particular gap in the research by focusing on something called “microdosing”. The practice of microdosing refers to the consumption of very small, routine doses of a psychedelic drug, such as LSD or psilocybin, for reasons other than achieving hallucinogenic side effects.
“To date, most quantitative microdosing studies have excluded people with a history of mental illness, have not reported microdosing motivations, and no study has examined the sociodemographic and other correlates of microdosing as mental health and substance use therapies, nor the sociodemographic and other correlates of perceived improvements in mental health that people attribute to microdosing,” Lea and colleagues say.
An international, online survey questioned 1,102 individuals who were either currently microdosing, or had tried microdosing in the past. The average age of respondents was 33, and 57% had at some point been diagnosed with a mental health disorder.
When questioned about their motivations for microdosing, 39% indicated that improving their mental health was their main motivation. Of these, 21% were microdosing to improve their depression, 7% for their anxiety, 9% for other mental disorders including PTSD, and 2% for drug or alcohol use.
Importantly, 85% of those practicing microdosing to improve their mental health had previously received either medication or counselling therapy. Moreover, among those who had received prescriptions for medication, “half (50.6%) reported having ceased antidepressants and 39.7% reported having ceased other psychiatric medications.” This suggests that respondents may have been microdosing as a way to replace traditional forms of therapy.
“Respondents who had been microdosing for a longer duration were also more likely to be motivated to microdose for mental health. This may suggest that microdosing is working for these people, and that they are continuing to microdose as an ongoing therapy to replace or
supplement psychiatric medications, some with the knowledge of their doctor and/or psychotherapist,” Lea and associates note.
The results indicated that, at least from the perspective of respondents, the practice of microdosing elicited positive mental health effects. As the researchers report, “Forty-four percent of all respondents perceived that their mental health was much better and 35.8% perceived that it was somewhat better because of microdosing. Nineteen percent of respondents perceived no changes to their mental health.” Only 1.3% indicated that their mental health was somewhat worse since microdosing, and 0.2% said it was much worse.
Lea and colleagues acknowledge that several key limitations limit the inferences from their findings. It is not possible to discern from their study whether the reported mental health improvements were due to microdosing, or rather the result of a placebo effect or other factors like lifestyle changes.
The authors stress the importance of continued study into the effects of microdosing. “While we await the findings of clinical trials, which could take some years, people will continue to self-manage their health with microdosing. It is therefore important to monitor people’s microdosing practices and experiences in the long term in order to provide appropriate harm reduction resources and other support.”
Controlled psychedelic treatment.Photo: Polaris Insight Center, courtesy of Multidisciplinary Association for Psychedelic Studies (MAPS).
The counterculture years of the 1960’s and 70’s did little for the reputation of psychedelic drug use. Potential therapeutic benefits of psychedelic compounds for researchers and healthcare were quickly dashed by strict social and cultural backlash. Fast forward to 2020, psychedelics are reemerging in new, clinical settings to treat an array of mental disorders, from depression and anxiety, to addiction and end of life care. Patients report an overwhelming impact from just one treatment.
The following interview excerpts have been abbreviated and edited for clarity.
KCRW: What’s the history in researching psychedelics; when did it start and what do we know about these chemicals?
Anthony Bossis: “I appreciate that question because in terms of the history it’s not often understood and it’s quite important. There’s a large amount of literature and media on the topic but it’s important for people to know that this goes back quite a ways. In one regard, the research goes back to the 1950s and 1960s, where LSD, psilocybin and related compounds were used to treat both end of life distress and also alcoholism. These drugs were legal then and were used in contemporary psychoanalysis. People like Cary Grant spoke about how it changed him and saved him in many ways. And the research was well regarded and well respected at universities.
Before that, the experience itself is what we call the ‘mystical experience’ or ‘peak experience.’ They discover that these medicines can reliably, in the right setting, generate this experience that scholars have felt for years was at the core of the major religions. So going back thousands of years, if we look at the foundation of some of the major traditions, we see this central ‘mystical experience.’ We also see it through our time, poetry and everyday people. There was a recent Pew study that showed 49% of Americans report having some kind of peak or mystical experience. So we’re wired for these experiences. I like to say, we’re wired for meaning.
Back in the first wave of the research the results were compelling. But then due to the countercultural chaos of the 1960s, the political issues and some of the recreational use, these medicines were placed outside the hands of research and the public. It’s remarkable, for 30 years or so there was no research. It was the first time ever that a therapeutic compound with promising benefits was taken out of the hands of healthcare, because of social cultural backlash.
So those foundational years are crucial. People like Albert Hoffman and Gordon Watson who bought mushrooms to the west were part of those early days of writing, speaking and researching about it. Even people like Aldous Huxley, the great English literary writer, was a proponent of using psychedelics in treating existential end of life distress. So there’s really a rich history that I invite people to look into. We’re standing upon the shoulders of these great pioneers, and continuing now in the current wave of research, its applications to a variety of clinical syndromes and disorders.”
What are the drugs you’re particularly interested in?
Bossis: “The primary medicine that we’re using now is psilocybin, which is the psychoactive ingredient or compound in a certain species of mushrooms that grow on the earth. People know their street name as ‘Magic Mushrooms’ and they’ve been used recreationally, but in controlled settings we synthesize the psilocybin, so the person hasn’t taken the mushroom but the synthesized medicine. That’s the primary medicine we’re using at UCLA, Johns Hopkins and also at NYU and our clinical trials are FDA approved.
Other trials are using MDMA, which has the street word Ecstasy but MDMA is the compound. It’s not a classic psychedelic but it’s known as a empathogen and there are studies with that as well surrounding PTSD and other disorders. But the main classic hallucinogen, a category that involves LSD, psilocybin and mescaline, we use psilocybin in America and in some sites in Europe as well.
What defines the mystical experience – is that ultimately at the heart of what’s going on?
Bossis: “That is the heart, so much that we’re finding in the studies that the more profound or the more heightened the mystical experience is, the better the clinical outcome, which is remarkable. So what is it about this experience that’s producing these greater clinical outcomes in people? Because not all people have this mystical experience, roughly two thirds of those, who take it and have that peak level.
I also want to point out, which is really important, to the listener, that these medicines are taken once; once or twice in some trials, but not every day. So it’s really a paradigm shift in how we think of medicine. Most medicine people are taking today for cholesterol, for blood pressure, Prozac, or whatever they’re taking, they take every day to achieve the desired effect. This medicine is taken once or twice, but it’s the memory of the profoundly altered state of consciousness that recalibrates and reframes who they are. It provides insight into self, nature and even death itself or consciousness.
So, the mystical experience is defined by a few criteria. One is a sense of unity; the person during the experience senses everything is connected. All people and things are interconnected. Again, this is language you find at the core of the major religions, the ‘noetic quality,’ which is a term coined by William James, the sense that one is encountering ultimate reality. People, when they come out of the experience, after a few hours in it, will say that wasn’t a drug effect that was reality. It’s very profound the authority that it has. A sense of sacredness, love, humility, awe, a deeply felt positive mood. Effability is a core feature, it’s hard to describe in language, it transcends language and what I find the most important of subjective features is this transcendence. The sense of transcending and this sounds a bit far out but time and space and the body as we know it. The sense of pulling back the lens and finding ourselves in a much larger panoramic field that can really recalibrate how we view ourselves and life around us.
Now for a person who’s dying of cancer or some other disorder and their body will soon begin to fail that function, the insight or the idea that they’re connected to something more enduring, possibly outside biology is a profound gift for them. So we know meaning making and transcendence are two important human qualities for mitigating distress or suffering and that provides the platform for the research.
Dr. Anthony Bossis. Photo courtesy of NYU Langone Health
Dinah Bazer what issues were you dealing with and why did you go and see Dr Bossis?
Dinah Bazer: “I had been diagnosed with ovarian cancer, fortunately, stage one. I’d had surgery and I went through chemo and thought when the chemo was done I would feel great and we could celebrate. Instead, I felt terrible and was just consumed about a recurrence. Every time I had an exam to see how I was doing, I became so anxious, I couldn’t sleep, I was eating all kinds of bad stuff and so the nurse practitioner at one of my checkups asked me how I was doing. And I said, ‘Well, I’m fine, except for this terrible anxiety.’ So she put me in touch with Tony’s project.
Can you describe that process?
Bazer: “They had set up a room for the whole experiment to take place in that was very beautiful and very restful, with a comfortable sofa. There was artwork on the walls, bookcases with art books and it was a very peaceful setting. I went twice a week to begin with, because I came into the study, rather late and I had to have a certain number of hours with Tony and another therapist. I would look forward to that as it was a very good thing to go speak with them and prepare for this experience.
What happened when you took psilocybin?
Bazer: “I did a moment of silent meditation because I don’t pray and I took the capsule and sat down on the sofa, picked an art book to look at. After a short while, things began to look a little different to me. I told Tony that and he said, “maybe you should put on the headphones and the mask and lie down.” So I did and the experience started.
It was very rough at first. Tony had described it as sometimes being like a rocket taking off and blasting off. And I was thrown into a very dark frightening space where I had no connection. I was tossed about in the dark and it was terrifying. And I finally realized that Tony and Michelle were there and I stuck my hand out of the blanket and I said I’m so scared. And I think it was Tony who took my hand and he said “just go with it.”
And I did.
I began to live in the music. I think at the beginning it was a lot of Asian Music, maybe Indian, New Age and I just kind of lived in the music and floated with it. Fairly soon, I just had no idea of time really, but fairly soon I saw my fear as a physical, A black thing in my body, under my rib cage on the left side, nothing to do with the cancer. It was fear. It was this fear that was consuming my life and when I saw it there, I became so furious.
‘Who do you think you are? Get the f*** out,’ I screamed. It’s very hard to actually vocalize during this experience, but I think I did. I was so overcome with anger and once I did that, it disappeared. It was gone and it has never come back.”
It’s never come back?
Bazer: “I have never had that kind of fear come back, that fear of the cancer, that anxiety about the cancer. I’ve had a few episodes where I had some symptoms that I thought might be a recurrence and I just went and got them checked out. I didn’t have trouble sleeping, I didn’t worry about it really. It was just like, let’s just make sure this is okay.
But I really have not had any anxiety about it since then. I have been an atheist since I was a teenager and I would describe this as being bathed in God’s love. It was amazing. It changed my life. I’m still an atheist. If I’d had a sliver of belief in my body, I think I would have come out of that believing in something but I didn’t and don’t. I think what was real, was the experience itself, that was real. I did experience being bathed in God’s love. You don’t have to believe in any kind of God or supernatural power to feel that and that changed my life afterwards and I felt that right away.”
Five years ago, psychedelics helped break Ian Roullier free from depression. His mental health had been spiraling for years, despite various antidepressants, counseling, and personal efforts to meditate, walk, and journal his way back to health. In 2014, he heard researchers at Imperial College London were planning to test psilocybin, the psychedelic compound in magic mushrooms, as treatment for depression. Out of desperation, he volunteered to try it.
The treatment, involving two therapy sessions under the influence of psilocybin, was a challenging experience, says Roullier, involving confronting past traumas. But he felt profoundly different afterwards. For three months, Roullier says, he had no depression whatsoever. And for the three months after that, he only had mild symptoms. “Depression is such a brittle rigid state,” he says. “Psilocybin is the opposite end of that and allows you that flexibility and freedom to see things in a different way, maybe for the first time.”
Over time, though, the depression slowly creeped back. And because psilocybin is illegal in the UK, Roullier had no way of accessing the drug. “I didn’t want to just find some mushrooms in the woods somewhere and take them with no support or even with friends,” he says. “This is purely therapeutic, not a recreational experience.” He began emailing researchers, asking if there was any way he could access psilocybin.
The lead clinical psychologist for the study at Imperial’s Centre for Psychedelic Research, Rosalind Watts, heard similar stories from several participants. “Having worked in two psilocybin for depression studies, I could see what we were giving our participants was an experience that was really helpful,” says Watts. She repeatedly saw patients who got relief from the psilocybin study, but then had depression return when they couldn’t get more. “By the fiftieth time of seeing that same thing happen, I started to feel like rather than continuing research, I really wanted to build something for those people,” says Watts.
As we were getting desperate pleas for further access, it didn’t feel like something that could be left to programs that are years away in the UK.
Psilocybin is still illegal in the UK, and has not been approved as medical treatment. But Watts was approached by Synthesis, a psychedelic wellness retreat in Amsterdam, the Netherlands, with the idea for creating a therapy program there. Psilocybin-infused truffles—related to magic mushrooms—are legal in the Netherlands, and Synthesis has been offering them to clients since April 2018. Initially, Synthesis turned away potential visitors with depression, as staff were not qualified to offer mental health therapy. “We rejected around 40% of all folks that applied,” says co-founder Martijn Schirp. “It’s the thing I struggled the most with, because these were the individuals who needed us the most, and we had to tell them we’re not ready to accept you yet.”
Now that Synthesis has hired Watts, the retreat is prepared to accept participants with depression. Its first group has already had their first therapy session, part of a 13-month course that includes monthly group therapy and a five-day retreat with two psilocybin sessions. Those who enroll will typically pay $10,000 for the treatment, though, in order to make the program accessible, Synthesis plans to accept at least one person per eight-person group for free. The first to enroll are all former patients from previous Imperial psilocybin studies and received a significant discount, paying on average $775. Roullier is one of them.
The ethics of unproven treatment
The question of how to support patients who’ve been in a clinical trial and now can’t access further treatment is not unique to psychedelics. Many countries have “expanded access” programs, which allow patients who haven’t benefited from existing legal treatments to use an experimental drug. Such access for psilocybin is still very far off in the UK, says Watts: “As depression came back, and we were getting desperate pleas for further access, it didn’t feel like something that could be left to programs that are years away in the UK.”
Another way to extend access would be to create an observational follow-up clinical study, says Steve Hyman, director of the Stanley Center for psychiatric research at Broad Institute of MIT and Harvard. This would have the benefit of ethical regulatory approval, and would provide evidence about the long-term effects of psilocybin therapy. Watts sees this as a short-term solution: “What happens when they get depressed again? Another follow up study?,” she says.
Plus, the opportunity and funding for such a study wasn’t available at Imperial, says Watts. The psychedelic field has limited resources, and researchers face pressure to conduct new studies to advance the science rather than run follow-up studies to support previous participants.
The program at Synthesis is an unusual alternative borne of those limitations. It is legal and designed to benefit patients, but there are ethical concerns with offering a treatment to patients with depression before it’s been proven as safe and effective. According to contemporary medical standards, all treatments must go through three stages of trials involving hundreds if not thousands of patients before they can be approved for widespread use. Psilocybin studies for depression are currently in the most advanced stage of research, but haven’t yet met that bar.
There’s a reason why there’s this extensive infrastructure built around consent and risk evaluation and reporting and liability and accountability.
Some question why, if researchers are working in clinical trials to understand psilocybin’s safety and efficacy, they would offer the unproven treatment at Synthesis. “Have they already decided psilocybin is effective and minimal risk in multiple rounds of therapy?” asks Boris Heifets, a professor of anesthesiology at Stanford University. “There’s an inconsistency here. Why are you doing clinical trials if you already know the answer?” Heifets is running a psilocybin clinical trial on chronic pain and is not involved in Synthesis.
Rushing ahead while it’s still unproven could bring risks, says Heifets. Psychiatric treatments of the past, such as lobotomies or shock therapy, failed to adequately protect patients. “There’s a reason why there’s this extensive infrastructure built around consent and risk evaluation and reporting and liability and accountability when you try a new therapy, whatever it is,” he says.
For Watts, the existing research on psilocybin and her personal involvement in two studies is enough to convince her that the benefits outweigh risks. The research so far shows psilocybin therapy works well, and none of the 80 participants in the Imperial studies experienced worse suicidal thoughts following treatment. “The risk of suicide due to lack of available treatments for depression is probably greater than the risk of suicide from psilocybin therapy,” she writes.
Though unusual, Heifets says Synthesis can operate ethically as long as it commits to both transparency and oversight. Crucially, if a participant in the program suffers what’s known in clinical research as an “adverse event”, such as a suicide attempt, then Synthesis will report the incident to both the public and the Dutch medical regulatory agency, Inspectie Gezondheidszorg en Jeugd (IGJ.) The IGJ would investigate, and a consulting psychiatrist would also review the situation and share recommendations with the ICJ. “We are still at an early stage in forging a new path, there is no blueprint for everything yet, for instance where adverse events could be published,” says Watts.
When researchers are paid to provide a therapy they’re still evaluating, it adds an additional ethical tension. For any clinical research, Heifets says participants should be aware that Watts is paid for her work at Synthesis: “People need to understand that while I’m recommending a therapy, I also have a financial benefit,” he says. The therapy as Synthesis will not form part of a clinical trial, though Watts plans to write up patients’ experiences as part of a field study, and hopes to collaborate with a university to potentially do a follow-up study after participants have left the program.
Addressing the risks
Though the Synthesis program doesn’t fit neatly in the model of medical research on psychedelics, its creators hope they can apply these safety standards to a more communal version of psychedelic therapy.
Both Schirp and Watts say Synthesis will have a cautious approach to enrolling participants with depression. Four times a year, groups of eight people will attend Synthesis on the therapy program, though in-person visits are currently on hold amid the coronavirus pandemic. The program follows many of the same screening principles as Imperial’s research study, and won’t accept anyone with a personal history or first degree relative with schizophrenia, psychosis, or bipolar disorder. The Synthesis team will also be in touch with participants’ existing doctors, and won’t accept someone if their psychiatrist or GP (primary care doctor) advises against it. “We’re erring on the side of caution,” says Watts.
All over the world, people are engaging in psychedelic therapy with no support system.
In other ways, the Synthesis retreat intentionally deviates from clinical practices. Medical research into psychedelics is individualistic, and patients are alone with their therapists while taking the drugs. By contrast, the Synthesis program is inspired by indigenous Celtic group healing practices. At Synthesis, the group of eight will get to know each other through group therapy and will take psilocybin together—though each person will have their own guide and can choose to be alone while high. Participants will also have far more therapy both before and after the psychedelic experience than in a clinical trial, and the program draws on Celtic traditions that emphasize connections to nature and cyclical rhythms of healing.
Though there is more therapeutic support than in clinical trials, Watts acknowledges that any kind of therapy involves risks. Patients can be destabilized as they work to address mental health issues, and it’s impossible to rule out worsening depression. The solution, Watts believes, is to provide the best possible version of psychedelic therapy. Watts says she receives ever-growing requests for psilocybin treatment, and knows of many untrained, unregulated psychedelic retreats. Others are self-medicating by using magic mushrooms at home. “All over the world, people are engaging in psychedelic therapy with no support system,” she says.
Even when psychedelics do work in clinical studies, Watts emphasizes that it’s not an easy, quick fix. The “overhype effect,” whereby patients expect an instant cure, can cause dangerous levels of disappointment in patients with severe depression.
Roullier is aware that psychedelic therapy is part of a longer process. But even he had a disappointing experience. Last year, he managed to enroll in a second clinical trial on psilocybin therapy, this time run by psychedelic company Compass Pathways. “The effect wasn’t the same,” he says. Roullier was reminded of the work he needs to do to combat his depression, but didn’t have those months of relief without symptoms.
Still, he’s relieved to have the chance to try psilocybin therapy again through Synthesis, and hopes another couple of sessions will bring him permanent relief. “The aim for me is to get to a point where I no longer need it,” he says.
How would you feel about a new therapy for your chronic pain, which—although far more effective than any available alternative—might also change your religious beliefs? Or a treatment for lymphoma that brings one in three patients into remission, but also made them more likely to vote for your least preferred political party?
These seem like idle hypothetical questions about impossible side effects. After all, this is not how medicine works. But a new mental health treatment, set to be licensed next year, poses just this sort of problem. Psychotherapy assisted by psilocybin, the psychedelic compound in “magic mushrooms,” seems to be remarkably effective in treating a wide range of psychopathologies, but also causes a raft of unusual nonclinical changes not seen elsewhere in medicine.
These are undoubtedly interesting findings, but should any of it matter? However unusual a treatment’s consequences, shouldn’t we prioritize the preferences of an informed, consenting patient? Yes, I understand that this might change me in strange ways. But my depression is debilitating. I will roll that dice. Putting aside the matter of how well-informed one could really be about such radical transformations, political realities make things more complicated, with the case of psilocybin— currently a Schedule 1, highly illicit drug—showing vividly how values, politics and social narratives can influence the development of biomedical science.
The taboo of the illicit is not an insuperable obstacle. The Multidisciplinary Association for Psychedelic Studies (MAPS), an organization that advocates for “careful uses” of psychedelics, has gone an impressive way in rehabilitating MDMA (i.e., ecstasy) into a legitimate medicine. MAPS’s masterstroke was to focus on demonstrating its potential for treating PTSD. By articulating how MDMA-assisted therapy could help veterans, support for whom enjoys a rare level of bipartisan agreement, MAPS have attracted supporters from across the political spectrum, receiving positive coverage from MSNBC and Fox News alike.
Advocates of psilocybin-assisted therapy tout it as the solution to the burgeoning mental health crisis. But, like MDMA, psilocybin is far from a culturally neutral drug, carrying both the shame of Schedule 1 status and a checkered social history. It too may need to build the kind of politically heterogeneous coalition of supporters that MDMA-assisted therapy enjoys.
But to generate a breadth of appeal, one challenge stands out: psilocybin seems to make people more liberal. Scientific reports associating psychedelic use and liberal values stretch back as far as 1971, and although these findings have been replicated more recently, a noncausal explanation is readily available. Those with conservative attitudes tend to look more disapprovingly on illicit drug use, making them less likely than liberals to try a psychedelic drug in the first place.
If psilocybin does change political values, the significance of this effect goes deeper than which politicians or media outlets will seek to support or impede psilocybin-assisted therapy. A well-established consensus on the secular democratic state is that it should remain neutral and agnostic on a number of matters, allowing a diversity of values, political attitudes and religious beliefs among its citizens. Where such states have universal health care systems, is it permissible to not only endorse, but fund through taxpayer contributions, a treatment which shifts values in one direction?
With sample sizes currently small, more research is needed to understand whether there truly is a causal relationship at work, and, if so, what its nature might be. Perhaps psilocybin doesn’t so much induce liberal values, but rather consolidates whatever values were present before treatment. A health care modality that entrenches preexisting political sentiments is, at the least, unlikely to make enemies. The same could not be said of a treatment that shifts patients in one direction along the political spectrum.
To overcome this obstacle, advocates of psilocybin-assisted therapy need an inspiring banner that members of any political tribe could rally around. With few things that unite us as powerfully as politics can divide us, perhaps the most alluring banner will be the one thing that unites us all: death. While psilocybin is neither a cure for, nor a prophylactic against, death, studies haverepeatedlydemonstrated that it could play a profound role in the future of palliative care. The existential distress experienced when faced with a life-threatening or terminal illness can steal away what little quality of life remains for the dying. Such distress responds poorly to our standard pharmaceutical approaches, but the powerful mystical experiences induced by psilocybin consistently transmute demoralization, anxiety and depression into acceptance, peacefulness and meaning, as patients prepare to meet their death.
However else they differ, conservatives and liberals are united in knowing that they, and their loved ones, will eventually die. And for conservatives and liberals alike, psilocybin could help them welcome the end with greater acceptance and less fear. Psilocybin looks set to become a licensed medicine by 2022. But how many ultimately benefit from it will be a matter not just of how well it works, but also the narrative surrounding it when it arrives: does psilocybin underline how we are different, or how we are the same?
Around the world, people’s mental health is in trouble. Even before the pandemic hit, rates of depression and anxiety were rising globally. Now that we also have Covid-19 to contend with, the problem is even more glaring.
Studies show that all the virus-induced losses — of life, of jobs, of social connection — have come with serious upticks in mental illness worldwide. In the US, for example, the prevalence of depression is four times as high as it was in the second quarter of 2019.
The pandemic has highlighted the inadequacy of our existing tools for coping with these problems. It’s not just that a health crisis can easily disrupt access to mental health services, though we’ve definitely seen that to be true. It’s also that drugs like traditional antidepressants are, at best, only a partial solution. While their effectiveness has been hotly contested over the past decade, the evidence now shows that they are more effective than a placebo, but notthat muchmore effective. (Once we account for the placebo response, the effect size of the drugs themselves is modest.) And for some folks who have treatment-resistant depression, the drugs don’t work at all.
So if you want to invest in the mental health of people around the world, making us all more resilient to future crises, what can you do?
The promise of psychedelics to treat depression and PTSD, explained
Believe it or not, your best bet might be to fund drug development for psychedelic-assisted mental health treatments. At least that’s the upshot of a new in-depth report by Founders Pledge, an organization that guides entrepreneurs committed to donating a portion of their proceeds to effective charities.
Psilocybin, the active ingredient in magic mushrooms, is being investigated as a potential treatment for depression. Over the past decade, a fewstudies have investigated the effectiveness of psilocybin for treating depression and end-of-life anxiety in cancer patients, and found that the psychedelic had a surprisingly large effect.
Meanwhile,the drug MDMA (also known as ecstasy)is being studied for use in people with post-traumatic stress disorder. MDMA, which affects serotonin, dopamine, and norepinephrine levels, is best known as a party drug. But researchsuggests it can also relieve depression and help users access and process memories of emotional trauma. The usersin studies participate in psychotherapy sessions where a therapist helps them integrate what they experienced while taking MDMA — which often includes increased feelings of empathy and bonding — into daily life.
There’s some evidence to suggest that ingesting these substances, in a safe setting and under the supervision of trained therapists, can be more helpful with depression and PTSD than traditional drugs; in somestudies, the reported effect sizes for psilocybin, say, are greater than the effect sizes of the current best treatments for depression (though these studies have limitations, so we would need more data to establish this with certainty). Psychedelics might also be helpful for anxiety, addiction, and other issues.
If this seems surprising, it’s worth noting that medical research into psychedelics has been going on since the late 1800s. In the 1940s and 1950s, psychiatrists used LSD to treat pain, anxiety, and depression.(There are promising preliminary results from studies of LSD for anxiety, though larger controlled studies are needed.)And in the 1970s and 1980s, psychotherapists and psychiatrists administered MDMA to thousands of patients.As psychedelics became popular for recreational use, though, MDMA was banned in 1985 in the US, and the research slowed in many countries.
As Michael Pollan detailed in How to Change Your Mind, research into the therapeutic potential of psychedelic drugs has been undergoing a renaissance over the past decade. These therapies are now gaining traction in some quarters. In Oregon, Measure 109 is on the ballot in November, and if passed, the state will be the first in the US to allow psilocybin therapy to be administered by licensed facilitators.
We still need a lot more research on these treatments, though — and one of the benefits of funding the drug development process is that that process will involve doing high-quality studies to prove efficacy and safety. We also need organizations willing to do the hard work of getting a drug approved for medical use nationwide.
The Usona Institute is one such organization that the Founders Pledge report highlights. It’s currently working on drug development for psilocybin as a depression treatment in the US, and it’s already got a preliminary Breakthrough Therapy Designation from the FDA. That’s an acknowledgment that the FDA thinks the early evidence shows psilocybin may have an advantage over available therapy, and it means the FDA offers Usona intensive guidance on its drug development so that it may gain expedited approval. Founders Pledge thinks Usona will put your dollars to better use than any other organization in this space. If interested, you can donate here.
A close runner-up is the Multidisciplinary Association for Psychedelic Studies, which is carrying out drug development for MDMA-assisted psychotherapy for PTSD in the US, Canada, Israel, and soon Europe. If interested, you can donate here. This treatment is already in phase 3 trials, which means approval of MDMA as a therapy could be granted in these countries in a few years.
But the large-scale rollout of new drugs takes a long time. Founders Pledge estimates that for MDMA, it’ll take six to nine years, while for psilocybin the timeline will be more like eight to 11 years.
What if you want to improve mental health right now, during the pandemic?
Investing in causes that may have a big positive impact in the long term is a wise thing to do. But during a pandemic, some people will want to relieve the suffering they see happening right now.
“The psychedelics drug development won’t be done for years. So in terms of having an impact now, that’s not the way to go,” Aidan Goth, who co-wrote the Founders Pledge report, told me.
He emphasized, though, that investing in global mental health during the pandemic is a worthy cause. Mental illness can feed into physical illness, and in itself may cause as much suffering as physical illness in some cases. It can also harm people’s ability to hold a job or care for their dependents. Plus, we should not fall prey to the misconception that mental health is a so-called first-world problem.
“We’ve looked at the burden of mental health globally, and it is a really, really big problem in lower- and middle-income countries as well. It’s not true that it’s just affecting people in high-income countries,” Goth said.
If you’re itching to improve people’s mental health while the pandemic is in full swing, you’d do well to invest in a project that gives you an immediate return on your investment. For that purpose, Founders Pledge recommends a couple of organizations: StrongMinds and Action for Happiness.
There’s a serious lack of mental health professionals in many developing countries in Africa. StrongMinds, a Uganda-based organization, understood that in order to treat the millions of African women suffering from depression, it would have to train laypeople.
Since its founding in 2013, it’s scaled up pretty quickly. Lay facilitators have led group talk therapy sessions reaching a total of 70,000 women. Over a 12-week period, the women learn to identify the triggers of their depression and devise strategies to overcome them.
As demonstrated in two randomized controlled trials, this is a powerful and cost-effective intervention, Founders Pledge researchers say. They estimate that StrongMinds prevents the equivalent of one year of severe major depressive disorder for a woman at a cost of around $248 — a pretty good deal, especially when you consider this helps the woman as well as her dependents.
StrongMinds says it is “uniquely positioned” to meet the demand for depression treatment in sub-Saharan Africa during the pandemic. It’s offering teletherapy, a chatbot, and other treatment approaches in line with social distancing requirements.
Like StrongMinds, Action for Happiness brings people together in small groups and it’s run by volunteers in each local community. But this one is a UK-based organization that mostly operates in Europe, though it’s also reached countries like the US and Australia.
Action for Happiness provides eight-week courses, called Exploring What Matters, where participants talk through strategies for crafting a happier life, such as developing a mindfulness practice. The course has been shown to improve subjective well-being, with reductions in depression and anxiety and increases in happiness and life satisfaction. Based on a randomized controlled trial, Founders Pledge found this program to be extremely cost-effective, with high potential for scale-up.
During the pandemic, Action for Happiness has gone from in-person courses to virtual ones, launching a free online coaching program to improve wellbeing.
Given that Founders Pledge evaluated StrongMinds and Action for Happiness before the pandemic, you might wonder whether these organizations are still helping people cost-effectively now that they’ve had to shift from an in-person to an online methodology.
Goth explained that when Founders Pledge researchers evaluate an organization, they examine not only the specific programs it’s running but also the organization as a whole — whether its leadership is strong and whether its management can be trusted to competently carry out its mission. So the researchers still believe in StrongMinds’ and Action for Happiness’s ability to serve people effectively now.
“We trust that they’re well-run and we think they’re doing good work given the circumstances,” Goth said. “They’re the best we’re aware of.”
Over time, it’s easy to become entrenched in how we view and move through the world. Firing up the same well-worn neural pathways becomes effortless, leading most of us to live more confined existences than we’d like to admit. For some, these ingrained habits may be a preference for a certain kind of takeout or other triviality, but for others, it can result in mood disorders or addiction.
So how hard is it to change your mind? A 2020 study published in Scientific Reports suggests a single dose of psilocybin may change your outlook on life—for good. Psilocybin is a naturally occurring psychedelic drug found in certain mushrooms. Like cannabis, psychedelics are becoming accepted and celebrated as potent plant medicine. Psilocybin may help forge new neural networks, helping individuals shake off harmful behaviors and thinking patterns.
What are psychedelics?
Long-term effects of psilocybin
While there is past research on the short-term effects of psilocybin, less is known about its enduring effects. The 2020 Scientific Reports study set out to explore the impacts of a single high dose of psilocybin up to one month after administration.
Twelve healthy volunteers took a single high dose of psilocybin—25mg per ~150 lbs (70 kg) of body weight—and completed a battery of standardized measures and evaluations. These gauged mood, anxiety, depression, stress, and negative and positive affect one day before, one week after, and one month after the psilocybin dose. Affect refers to an individual’s emotions, feelings or mood.
Participants’ responses were compared to explore whether the dose had enduring effects on emotional state, personality traits, and affect. The volunteers also underwent fMRI measurements to check how psilocybin affected their responses to emotional stimuli, and whether the dose had a long-lasting impact on brain connectivity.
Effective brain connectivity delivers a bundle of benefits: think improved cognitive function, memory, imagination, language skills, and stronger physical endurance. Connectivity patterns in the brain are formed by synapses that structurally link different parts of the brain. The level of connectivity in the brain critically affects the way neural networks process information.
5 medical conditions psychedelics may be able to help treat
Reduced negative vibes, increased positive vibes
One significant outcome of the research was psilocybin’s influence on affect—an individual’s emotions, feelings or mood: Psilocybin appeared to reduce negative affect and increase positive affect. Scales and tests measuring stress, negative feelings, anxiety, tension, depression, and mood disturbances were significantly lower one week after the psilocybin dose. However, these ratings returned to baseline after the one-month mark.
Negative affect is one of the hallmarks of mood disorders and has also been linked to addiction. A 2017 survey showed that psychedelics may disrupt the affective elements of craving and withdrawal.
According to the authors of the 2017 survey, psilocybin might kickstart a dynamic process of neuroplasticity that is sustained for at least several weeks. Neuroplasticity refers to the brain’s incredible capacity to adapt to changing needs and environmental stimuli.
Throughout our lives, neural connections in the brain reorganize, allowing us to learn from and adjust to diverse experiences. During this period, individuals may become more positively inclined, potentially inhibiting mood disorders and addictive behaviors.
This inclination toward positive affect may also be driven by higher-level changes in emotional control and perception. The long-term upshot of reduced negative affect is lasting positive changes in mood, attitude, and well-being, and feelings of being connected to life and the ability to draw meaning from events.
New company to put psilocybin on dissolvable sublingual strips to help treat depression
Boosted brain connectivity
The 2020 study also reported another significant finding: At the one-month mark, there was an ongoing increase in functional connectivity across diverse brain networks. Connectivity across diverse sections of the brain is vital to maintaining healthy brain function. Disruptive networks or dysconnectivity can be a sign of mental illness or conditions such as schizophrenia.
In addition to this study, psilocybin’s ability to build connections across the brain’s networks has been documented in other research.
Other key findings
The Scientific Reports study authors also noted increased responses in reward-learning, attentiveness, and decision-making circuits of the brain following the dose. Taking psilocybin is commonly linked to changes in personality, promoting open-minded thinking and extroversion. In this research, psilocybin led to an increase in conscientiousness among participants.
Possibly the most critical element of the findings was that some effects endured long after the residue of psilocybin left the body. The authors also emphasized that any temporary changes in receptors that bind to psilocybin were resolved after one week. In other words, long-lasting changes occurred because psilocybin appeared to kickstart a process that increased neural connectivity in the brain. These changes subsequently transform how participants see and interact with the world around them.
Seasoned psychonauts weigh in
Nick Levich is a psychedelic integration specialist and co-founder of Psychedelic Passage. For Levich, the significance of this study is its emphasis on the utility of increased brain connectivity.
“Increased connectivity allows us to rewire our brain, literally,” said Levich. “When your brain makes new connections while under the influence of psychedelics, it can help to undo the social conditioning or ‘programming’ that has taken place over years or decades, in just a single experience. Think of it as an interruption to your regularly scheduled programming.”
New neural connections formed as a result of this increased connectivity overcome feelings of being stuck, explained Levich. Psilocybin can help replace these ingrained habits with new, ideally more desirable, ways of being. He underlined that how this increased connectivity manifests all comes down to an individual’s specific intention.
“The brain has a relatively high level of plasticity, meaning that it can adapt and change pretty easily based on new experiences—and ingesting psilocybin is a new experience that catalyzes change,” he explained. “Psilocybin presents us with an opportunity to fire and wire new neural pathways. This means a single dose of psilocybin has the potential to, quite literally, change your day-to-day life.”
Healing With the Psychonauts: Psychedelic Medicine Goes Mainstream
So, what changes can be expected? For Psychedelic Passage’s co-founder Jimmy Nguyen, a single experience with psilocybin redirected his life trajectory and struggles with depression. Nguyen observed three central changes that endured beyond that single dose, many of which resonate with the Scientific Reports study findings.
“Firstly, psilocybin allowed me the potential of being happy for no reason. The experience rendered me curious, jovial, and excited at new thoughts or situations that arose,” he said. “Even more serious introspection into the stresses in my life was viewed through a light-hearted lens, which allowed me to tackle troubling topics. Knowing that feeling contentment was possible has anchored my life experiences in a more meaningful way.”
Nguyen also emphasizes a sense of connectivity to the wider environment and those around him after taking psilocybin.
“The experience reminded me that I was one individual interconnected to 7 billion people experiencing a mosaic of life events, and that I had unlimited support available to me,” he explained. He believes this outlook has empowered him to discuss mental health and emotions more openly long after the effects wore off, positively contributing to his well-being.
Finally, Nguyen reflected that one of the most significant changes came in the afterglow of the psilocybin experience.
“I would wake up in the mornings feeling mentally clear. My emotions were both more balanced and more vivid than before,” he stated. “It was as though I’d been practicing deep meditation for years and achieved a level of persisting calm. This mental state allowed me to continue my deep introspection, and connect dots about my life experiences, reframing them in more positive and meaningful ways.”
A small study of adults with major depressive disorder (MDD) by Johns Hopkins Medicine researchers has found that two doses of a psychedelic compound found in “magic mushrooms,” can produce large reductions in depressive symptoms, when administered with supportive psychotherapy. The randomized, waiting list-controlled clinical trial involved 24 participants diagnosed with MDD, who weren’t using other antidepressant medicines during the trial. The results showed that psilocybin-assisted therapy led to improvements in most of the patients, with half of the study participants achieving remission through the four-week follow-up.
“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” said Alan Davis, PhD, adjunct assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold-standard’ placebo-controlled clinical trials.”
Major depressive disorder (MDD) affects more than 300 million individuals worldwide, and is a “substantial public health concern,” the authors wrote. “In the United States, approximately 10% of the adult population has been diagnosed with MDD in the past 12 months, and the yearly economic burden of MDD is estimated to be $210 billion.”
Current drug treatments for depression have limited efficacy, and are associated with adverse side effects, which can lead patients to stop taking them, the researchers continued. Most of the drugs currently used—including selective serotonin reuptake inhibitors (SSRIs)—increase levels of the brain neurotransmitters serotonin and norepinephrine. More recently, increasing evidence has suggested that newer, ketamine-like drugs have therapeutic efficacy in MDD through their effects on glutamate neurotransmission. However, the team pointed out, ketamine has a high abuse liability, and its use can be associated with moderate physiological risk that needs to be monitored. Given the public health impact of MDD, much more research into drugs with rapid and sustained antidepressant effects is needed. “Novel antidepressants with rapid and sustained effects on mood and cognition could represent a breakthrough in the treatment of depression and may potentially improve or save lives.”
Psilocybin, a compound found in magic mushrooms, produces visual and auditory hallucinations and profound changes in consciousness over a few hours after ingestion. In 2016, Johns Hopkins Medicine researchers first reported that treatment with psilocybin under psychologically supported conditions significantly relieved existential anxiety and depression in people with a life-threatening cancer diagnosis. The compound demonstrates combined serotonergic and glutamatergic activity, and the early evidence of its antidepressant effects suggests the potential for psilocybin-assisted therapy as a novel approach to treating depression, the team commented. “Moreover, psilocybin has lower addiction liability and toxic effects compared with ketamine and is generally not associated with long-term perceptual, cognitive, or neurological dysfunction.”
For the new study, the team recruited 24 people with a long-term documented history of depression, most of whom experienced persisting symptoms for approximately two years before enrolling in the study. The average age of participants was 39 years; 16 participants were women. Participants had to taper off their use of any other antidepressants prior to the study, with the help of their personal physician to ensure safe exposure to this experimental treatment.
Thirteen participants received the psilocybin treatment immediately after recruitment and after preparation sessions, and 11 participants received the same preparation and treatment after an eight-week delay. Treatment consisted of two psilocybin doses given by two clinical monitors who provided guidance and reassurance. The doses were given two weeks apart between August 2017 and April 2019 at the Johns Hopkins Bayview Medical Center Behavioral Biology Research Building. Each treatment session lasted approximately five hours, with the participant lying on a couch wearing eyeshades and headphones that played music, in the presence of the monitors.
All participants were given the GRID-Hamilton Depression Rating Scale – a standard depression assessment tool—when they enrolled into the trial, and then at one week, and four weeks following completion of their treatment. On the scale, a score of 24 or more indicates severe depression, 17–23 indicates moderate depression, 8–16 mild depression, and 7 or less no depression. At enrollment, participants had an average depression scale rating of 23, but one week and four weeks after treatment, they had an average depression scale score of 8. After treatment, most participants showed a substantial decrease in their symptoms, and almost half were in remission from depression at the follow-up. Participants in the delayed group didn’t show decreases in their symptoms before receiving the psilocybin treatment.
For the entire group of 24 participants, 67% showed a more than 50% reduction in depression symptoms at the one-week follow-up and 71% at the four-week follow-up. Overall, four weeks post-treatment, 54% of participants were considered in remission—meaning they no longer qualified as being depressed.
“Because there are several types of major depressive disorders that may result in variation in how people respond to treatment, I was surprised that most of our study participants found the psilocybin treatment to be effective,” said Roland Griffiths, PhD, the Oliver Lee McCabe III Professor in the Neuropsychopharmacology of Consciousness at the Johns Hopkins University School of Medicine, and director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Griffiths, whose research with psilocybin started in the early 2000s, suggested that the major depression treated in the new study may have been different when compared with the “reactive” form of depression in patients they studied in a 2016 cancer trial. He further noted that his team was encouraged by public health officials to explore psilocybin’s effects in the broader population of those with major depressive disorder because of the much larger potential public health impact.
The researchers say they will follow the participants for a year after the study to see how long the antidepressant effects of the psilocybin treatment last, and will report their findings in a later publication. “This randomized clinical trial documented the substantial rapid and enduring antidepressant effects of psilocybin-assisted therapy among patients with MDD,” the authors concluded. “The present trial showed that psilocybin administered in the context of supportive psychotherapy (approximately 11 hours) produced large, rapid, and sustained antidepressant effects … The effectiveness of psilocybin therapy after a single or only a few administrations represents another substantial advantage over commonly used antidepressants that require daily administration.”
The team acknowledged that there were some limitations to their study, including short-term follow-up, and small sample size, and say further research with larger, more diverse patient populations, longer-term follow-up, and placebo control, will be needed to better investigate the safety (including abuse potential of psilocybin, suicide risk, and emergence of psychosis) and efficacy of psilocybin therapy among patients with MDD. Nevertheless, they wrote. “These data expand the findings of previous studies involving patients with cancer and depression as well as patients with treatment-resistant depression by suggesting that psilocybin may be effective in the much larger population of MDD. Further studies are needed with active treatment or placebo controls and in larger and more diverse populations.”
(CNN)While magic mushrooms are known for their hallucinogenic effects, they may also have a role to play in the treatment of some mental health treatment.Or they might, if they weren’t illegal in most states.Oregon has become the first US state to make psilocybin, the hallucinogenic compound in magic mushrooms, legal for mental health treatment in supervised settings.They have more evidence for their case with a new small study of 24 adults with major depression that published this week in the journal JAMA Psychiatry, which found that two doses of psilocybin led to a large reduction in depressive symptoms.
Psychedelics: Can getting high improve your mental health? “The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” said Alan Davis, an adjunct assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, in a news statement.”Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold-standard’ placebo-controlled clinical trials.”While not without limitations, the study is the latest research to explore how psilocybin could help ease mental health problems. Other studies have suggested that the compound may help in the treatment of anorexia, obsessive-compulsive disorder and addictions.The participants in the John Hopkins study had experienced depression for around two years before being recruited and had to give up existing antidepressants. Thirteen participants received the psilocybin treatment immediately after being enrolled, and 11 participants were put on a waiting list and received the same treatment after an eight-week delay.
Mazatec psilocybin mushrooms ready for harvest May 19, 2019, in Denver.The study offered more evidence of psilocybin’s “rapid and powerful effect,” said David Nutt, a professor and director of the neuropsychopharmacology unit in the division of brain sciences at Imperial College London. The results could have been skewed by the fact that patients knew they were going to get the drug, with expectations potentially increasing the size of the effect, said Nutt, who wasn’t involved with the research.A 2016 study conducted by some of the same John Hopkins researchers found that psilocybin could ease depression and anxiety in patients who had life-threatening cancer.”Because there are several types of major depressive disorders that may result in variation in how people respond to treatment, I was surprised that most of our study participants found the psilocybin treatment to be effective,” said Roland Griffiths, an author of the new study and the 2016 paper, and a professor at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Center for Psychedelic and Consciousness Research.Psilocybins can produce visual and auditory hallucinations and profound changes in consciousness over a few hours after ingestion, the study said.In the United States, possession of the compound is a felony, as they are classified as a Schedule I substance.The vote in Oregon requires the Oregon Health Authority to allow licensed, regulated production and possession of psilocybin, exclusively for administration by licensed facilitators to clients.
How it might affect the brain
How psilocybin affects the brain still isn’t completely understood, but Nutt at Imperial College said that it appeared the compound disrupted negative thinking circuits through the 5HT2Z receptor in the brain.”Standard anti-depressants protect against the stressors that lead to and perpetuate depression but don’t directly access and remedy underlying biopsychosocial causes,” he wrote in a paper he coauthored and published earlier this year.
The Canadian government is allowing 4 terminally ill patients to use psychedelic mushrooms to help ease their anxiety“In contrast, psychedelic therapy harnesses a therapeutic window opened up by the brain via the effects of drugs to facilitate insight and emotional release.”He said that the substance tended to work with “internalizing disorders” like depression or obsessive-compulsive disorder whereby individuals ruminate on failings or intrusive thoughts.Another explanation could be more straighforwardly pharmacological, said Guy Goodwin, a professor emeritus of psychiatry at the University of Oxford — that psilocybin “is just a kick up the backside” of the serotonin system. Serotonin is a chemical and neurotransmitter in the digestive system, brain and blood systemthat regulates mood, social behavior, appetite, sleep, memory and sexual function.Goodwin, who wasn’t involved with the research, said the main limitation of the John Hopkins study was the absence of longer-term follow-up — the team followed up with the participants only four weeks after the treatment. Depression for many people is a long-term condition, and determining if the treatment had lasting effects is a key missing factor.What’s more, with studies like these, it can be hard to tease out the effects of the drug from the process of administering it, Goodwin said.The study participants received about 11 hours of psychotherapy and received the drug under the care of trained professionals and in a setting designed to put the patient at ease.”You get an effect irrespective of whether the treatment works because everyone is caring for you and looking out for you and measuring things. People like that and feel better for that. In a real comparison you’d do everything the same but the actual drugs.”Get CNN Health’s weekly newsletter
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.However, he said that larger studies were underway that should address the questions raised by early proof of concept studies like this one.”This is a nice, small preliminary study with a lot of weaknesses but equally the positive results promise better things.”