Treatment with psilocybin may improve mental health issues among patients with cancer when accompanied by psychotherapy and could result in lasting, positive personality changes in patients with alcohol use disorder, according to two recent studies published by Petridis et al in Nature Mental Health and Pagni et al in The American Journal of Psychiatry.
Background
Psilocybin is a naturally occurring compound derived from fungi with mind-altering qualities similar to those of lysergic acid diethylamide and mescaline. Most participants experience profound alterations in perception, emotions, and sense of self—often including experiences that are felt to be of great personal and spiritual significance. Because the drug raises blood pressure and heart rate and can sometimes cause incapacitating and overwhelming psychological effects, researchers caution that it should only be used in controlled settings and in conjunction with medical and psychological evaluation as well as careful preparation.
First Study Methods and Findings
In the first study, researchers analyzed data from two previous clinical trials using psilocybin-assisted psychotherapy to address anxiety and depression in 79 male and female patients with cancer. In the trials, about 50% of the participants initially received a large dose of psilocybin, whereas the rest received placebo as either vitamin B3 or a small dose of the psychedelic drug. Neither the researchers nor the patients were told which drug was administered. After a period of 6 or 7 weeks, the groups switched treatments. Psychotherapy preceded and followed each dosing session, and the participants completed a questionnaire regarding their mental health symptoms at the beginning of the study and 6 months following the second dosing.
The researchers discovered that psilocybin accompanied by psychotherapy significantly reduced anxiety, depression, obsessive thoughts, anger toward others, and physical symptoms associated with psychological distress—with improvements lasting up to 6 months. They also revealed that the mood-altering psilocybin did not appear to cause any lasting paranoia, psychosis, or deep feelings of fear. As a result, their analysis added to evidence that psilocybin may be safely administered under close medical supervision.
Second Study Methods and Findings
In the second study, researchers examined personality changes in male and female patients participating in a previous clinical trial that used psilocybin-assisted psychotherapy to treat alcohol dependence. During the trial, the participants randomly received two doses of either psilocybin or an antihistamine placebo and received psychotherapy prior to and following each dosing session. The researchers tested 83 of the patients using a standard personality assessment prior to psychotherapy initiation and again 8 months following the first dose of study medication.
The researchers found that psilocybin therapy may also improve mental health in patients with alcohol use disorder. Compared with the patients who received placebo, those treated with psilocybin were found to be significantly less impulsive, depressed, and vulnerable than they were prior to initiation of the therapy. Additionally, these patients became more accepting of their thoughts and emotions. These changes were observed 7 months after the participants received their second dose of psilocybin.
Notably, the findings demonstrated that male participants were more likely to experience a boost of positive emotions, whereas female participants were more likely to see an increase in openness. However, further research may be needed to better understand the reasons behind these differences or what they might mean for any given patient.
The researchers plan to explore whether the personality changes observed in the current investigation may also occur in psilocybin trials for opioid-use disorder.
Conclusions
The researchers cautioned that in both studies, most participants were able to correctly guess whether they had received psilocybin or a placebo.
“Our findings suggest that the mental health benefits of psilocybin therapy for patients [with cancer] may reach far beyond what we have previously understood,” underscored lead study author of the first study Petros Petridis, MD, Clinical Assistant Professor in the Department of Psychiatry at the New York University (NYU) Grossman School of Medicine.
“Since impulsiveness has long been linked to both excessive drinking and relapse after treatment, the personality changes brought about by psilocybin-assisted psychotherapy may help those recovering from alcohol dependence remain resilient to internal and external stressors known to trigger relapse,” concluded lead study author of the second study Broc Pagni, PhD, a postdoctoral fellow in the Department of Psychiatry at the NYU Grossman School of Medicine.
Disclosure: The research in the first study was provided by the National Institutes of Health, the Heffter Research Institute, the RiverStyx Foundation, the Betsy Gordon Foundation, the Fetzer Institute, the Usona Institute, the Canadian Institutes of Health Research, Carey and Claudia Turnbull, W. Linton, R. Barnhart, A. Altschul, K. Fitzsimmons, the McCormick Family, G. Goldsmith, and E. Malievskaia. The research in the second study was provided by the Heffter Research Institute and individual donations from Carey and Claudia Turnbull, Dr. Efrem Nulman, Rodrigo Niño, and Cody Swift. For full disclosures of the study authors, visit nature.com and psychiatryonline.org.
