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PSILOCYBIN RESEARCH UPDATE: March 2024
Image via Riitta Ikonen & Annie Collinge
WHAT'S NEW IN PSILOCYBIN RESEARCH?
Written by: Dr. Lindsay Mackay, MD, CCFP
Over the last year, there has continued to be a remarkable interest in psilocybin in clinical research. From groundbreaking studies investigating its efficacy in treating mental health disorders to examinations of its mechanisms of action in the brain, the landscape of psilocybin research is rapidly evolving. This overview of recent research highlights the latest research and key findings, shedding light on its potential applications, challenges, and implications for mental health, neuroscience, and society at large.
Findings: This study treated adults with depression that was resistant to treatment and included people with bipolar disorder type 2 who were currently in a depressive episode. Participants had between one to three psilocybin assisted therapy sessions. This study found that more sessions resulted in a greater improvement in depression symptoms and that there were no safety concerns. This research is important because past psilocybin research has excluded people with bipolar disorder and it helps contribute to safety data in this population. More research with larger populations will need to be done to confirm psilocybin therapy’s safety and benefit in individuals with bipolar disorder.
Findings: A single dose of psilocybin was given to 15 people with bipolar disorder type 2 who were in a depressive episode. At the study 12 week end point, 80% of participants met both response and remission criteria for depression. This study is important as it adds more safety evidence for treating individuals with bipolar type 2 disorder. Larger studies will be required to confirm these beneficial findings as well as safety in this population; however, these results are very promising.
Increased low-frequency brain responses to music after psilocybin therapy for depression
Findings: This study used brain scans (fMRI) before and after psilocybin treatment for depression to assess response to music. This study found elevated responsiveness to music in the brain after psilocybin therapy that was associated with the subjective intensity of the experience with psilocybin.
How does psilocybin therapy work? An exploration of experiential avoidance as a putative mechanism of change
Findings: Data was used from a research study that compared two psilocybin therapy sessions with escitalopram (a commonly used antidepressant) among individuals with depression. With psilocybin therapy, but not escitalopram, improvements in mental health outcomes including well-being, depression severity, suicidal ideation, and anxiety, occurred because of a reduction in experiences avoidance (i.e. avoiding negative emotions and thoughts) and increased feelings of connectedness. Feelings of ego dissolution and new insights as a result of psilocybin therapy increased the reduction in experiential avoidance.
Findings: This small study using psilocybin therapy to treat individuals with body dysmorphic disorder, a condition where individuals are preoccupied by misperceptions of their appearance as defective or ugly, who did not respond to antidepressant treatment. 58% of people responded to treatment and continued to benefit three months after treatment.
Findings: This study used an electroencephalogram (EEG), which is a test that measures electrical activity in the brain using electrodes, to assess for changes in the brain activity in individuals with depression treated with psilocybin. They were specifically looking for changes on the EEG that could indicate improved brain plasticity. The researchers found that markers of plasticity were associated with improvement in depression symptoms. These results complement the emerging idea that psilocybin’s antidepressant effect could be in part due to improved brain plasticity.
Findings: This case study described the first three cases recorded of sense of smell improvement after using psilocybin and LSD in individuals who had lost their sense of smell. In the first case, a man lost his sense of smell after a respiratory infection and experienced improvement in smell after using 6 g of psilocybin containing mushrooms. In the second case, a woman with no sense of smell since childhood reported olfactory improvement after ingestion of 100 µg (or one “hit”) of LSD. In the third case, a woman with COVID-19-related loss of smell reported improvement after microdosing 0.1 g of psilocybin mushrooms three times. Typically cases like this help to guide future research directions so it will be interesting to see if psychedelics like psilocybin will be studied as a potential treatment for loss of or reduction in smell, which has become more common as a result of COVID-19.
Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder
Findings: Thirty participants with cancer and depression were given a single dose of psilocybin simultaneously in groups of three to four with 1:1 therapist support followed by group therapy support before and after treatment. Eight weeks after treatment, 80% percent of participants' depression significantly improved and 50% showed full remission of depression symptoms. This study helps contribute to safety and feasibility data on treating people with cancer with psilocybin in a group setting. Group treatment could be a more cost effective and supportive option in the future if and when psilocybin therapy becomes more widely available.
CCH attack frequency reduction after psilocybin correlates with hypothalamic functional connectivity
Findings: Chronic cluster headache is an excruciating and difficult-to-treat condition. In this study, participants were given three doses of psilocybin (0.14 mg/kg) on the first day of weeks five, six, and seven. Headache frequency was reduced by 31% on average from before treatment. One patient experienced over five months of complete remission with no headaches. Further research with larger numbers of participants will be required to determine safety and benefit in this population, although this is promising early data for a condition which is debilitating and lacking effective treatments.
Findings: This study assessed psychological mechanisms of change in the first randomized controlled trial of psilocybin-assisted psychotherapy to treat alcohol use disorder. Participants reported that the psilocybin treatment helped them process emotions related to painful past events and increased self-compassion, self-awareness, and feelings of interconnectedness. Participants also described newfound feelings of belonging and an improved quality of relationships following the treatment.
In conclusion, the latest discoveries in psilocybin research show a lot of exciting possibilities. Scientists are starting to expand the indications for treatment, studying conditions in early phase research like bipolar type 2 disorder, addictions and cluster headaches. We are also learning more about how psilocybin works to improve these conditions at a psychological and biological level. As our understanding deepens, psilocybin stands poised to become a valuable therapeutic tool for individuals struggling with mental health challenges. With continued careful study, the transformative possibilities of psilocybin may offer profound avenues for healing and well-being.
Dr. Lindsay Mackay, MD, CCFP
Dr. Lindsay Mackay MD, CCFP, Department of Family Medicine, UBC is a clinician-scientist and addiction specialist. She is a primary care and addiction medicine physician with PHS Community Services Society and Vancouver Coastal Health in Vancouver’s Downtown Eastside. She currently provides ketamine, psilocybin, and MDMA-assisted therapy for people with mental health concerns.
Lindsay is a graduate of the British Columbia Centre on Substance Use, NIDA-funded International Collaborative Addiction Medicine Research Fellowship. She is experienced in the exploration of psychedelics as novel therapies and is currently involved with clinical trials evaluating psychedelic therapy for treating mental health conditions and problematic substance use.
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