Psilocybin Assisted Therapy

What if we were to tell you that psilocybin, the active ingredient in an illegal drug called magic mushrooms, could be used to treat psychiatric disorders? Research is showing that this magical chemical compound may help to rewire the brain. Clinical trials have shown that Psilocybin Assisted Therapy can possibly improve mental health and reduce the symptoms of depression and anxiety along with a range of other conditions. Read on to learn more.

Psilocybin Assisted Therapy Explained

Psilocybin Assisted Therapy is basically a medical practice in which a predetermined dosage of psilocybin is administered to a patient (by a therapist) during a supervised therapy session. Psilocybin affects a person’s brain function which results in a change in their cognition, perception or behaviour. Moreover, research suggests that psilocybin assisted therapy has the potential to cause positive and lasting changes within individuals. Therefore, it can be a helpful and positive driving factor for psychological change in people who struggle with mental illness, when it is used correctly.

What is Psilocybin?

Psilocybin is a powerful neuro-pharmacological agent that has a strong modulatory effect on our brain processes. In other words, psilocybin is a psychedelic compound that can affect the way our brains work. Interestingly, it’s the active ingredient found in “magic mushrooms,” a term many people are more familiar with. Psilocybin is quite potent actually, and even low doses of it may cause notable psychoactive effects. When used correctly (dosage-wise) and with appropriate medical supervision, the effects of psilocybin have proven to be impressively positive.

Psychedelic Medicine

In the 1960s, psychedelics were widely used in experimental research and clinical settings. However, soon after, they made their way out of research labs and to grab the attention of the youth. Young people became obsessed with using psychedelic substances recreationally. Due to this rise of counterculture and the lack of evidence surrounding their efficacy, psychedelics were deemed illegal throughout the world in the 1970s. Lately, however, research involving psychedelics as a medicine has slowly started to re-emerge with renewed investigations taking place around the world. This has led to an increasing amount of evidence suggesting that psychedelics may be used in the treatment of a variety of conditions.

Psilocybin Effects

Psilocybin has a wide range of effects that are often subjective and these effects are usually also context-dependent. They include relaxation, spiritual experiences, hallucinations (mostly visual) and sometimes synesthesia (a mind-bending neurological phenomenon in which a person is temporarily able to, for example, taste colours and see sounds). Clearly, psilocybin has a powerful effect on the brain and its neurological processes. This is why people generally consider it to be “mind-altering.”

It is important, however, to note that these effects are mostly reported by people who use recreational doses of psilocybin. The dosage used in research settings is often much lower and it is, in fact, known as “micro-dosing”. This means that only about one tenth of the recreational dosage is used by clinical researchers. The effects of possible therapeutic micro-dosing, therefore, are different. They may include an improvement in both convergent and divergent thinking in ways that may increase cognitive flexibility, creativity and problem-solving. Further studies have shown that psilocybin may also be able to reset the functional connectivity of our brain circuits, which play a role in depression. For this reason, psilocybin can be used to effectively “rewire” our brains for the better.

Medical vs Recreational Use of Psilocybin

Many people are quick to list the possible dangers of using psychedelic drugs. However, this information usually comes from cases in which people used psychedelics in unsupervised, nonmedical situations. Such cases are often associated with people who used incorrect dosages in unsuitable settings. The inappropriate use of psilocybin most likely increased their risk of experiencing negative effects and made them more susceptible to a potentially nightmarish “bad trip”.  

The medicinal use of psilocybin, on the other hand, has not shown any likelihood of increased risks, due to the low dosages used in supervised clinical settings. In fact, the medicinal use of psilocybin has been shown to slow down overactive and hyper-connected higher-level brain functioning (scientists call this the brain’s “Default Mode Network”). At the same time, psilocybin (used medicinally) can increase flexibility and fluidity between other parts of the brain; including the areas involved in fear, relaxation and memory. Ultimately, this leads to a recalibration of the brain. This “recalibration”affects the brain in such a way that it increases alternate ways of thinking and perception along with decreasing oppressive self-reflections that are associated with depression, anxiety and other mental disorders.

What is it Used For in Therapy?

Recent research suggests that functional connectivity changes in the brain may be involved in the origin of psychiatric disorders. Therefore, psilocybin assisted therapy can be used to treat a variety of mental disorders including anxiety, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). However, particular emphasis is placed on using psilocybin assisted therapy in the treatment of treatment-resistant depression, which is a serious problem that people face in the world of mental health today.   

Breakthrough Therapy

Even people who advocate against using mind-altering drugs may admit that psilocybin has the potential to be used therapeutically. People who have added psilocybin to their therapeutic process have seen impressive results, even with just one or two doses. It has shown rapid effects in therapy. Currently, Selective Serotonin Re-uptake Inhibitors (SSRIs) are most popularly anti-depressants used to treat depression. Psilocybin differs from these medicines in the sense that it inhibits serotonin-dependent neurons and essentially “resets” the brain. The results have been so promising that psilocybin has received “Breakthrough Therapy” Designation from the US Food and Drug Administration (FDA), after evidence showed that it may be more beneficial than current treatments.

Treatment Resistant Depression

Treatment resistant depression is diagnosed when someone continues to suffer from depression, despite having been on treatment. Doctors might prescribe rounds after rounds of antidepressants along with ongoing psychotherapy, but the person’s symptoms just do not seem to improve substantially enough. The drop-out rates of traditional treatments for depression vary. However, a meta-analysis found that the average drop-out rate is around 17.5%. Interestingly, the highest drop-out rate was found for cognitive behavioural therapy (CBT), which is why it should be emphasized that psilocybin could be used in conjunction with this therapy for improved results.

The Need for Alternative Treatments

These drop-out rates, and the ever-rising rates of depression are two very important factors that emphasize the need for alternative treatments. It has been established that 6.7% (16.2 million) of adults in the United States experienced an episode of depression at some point last year. These rates of depression have become progressively worse and antidepressant usage has increased tremendously (by about 65%). Depression, and the associated risk of suicide, is certainly on the rise with no sign of remittance. Additionally, there are not many new depression medications in the pipeline. This clearly shows how important the need is for alternative treatments.

Psilocybin Assisted Therapy for Depression Treatment

Let’s look at Psilocybin Assisted Therapy in a little more detail.

What Happens During a Session?

The way in which therapy progresses may differ from doctor to doctor. However, the sessions usually take place in three main phases namely: assessment, preparation, administration and finally “integration.” 

During the administration session, the therapist will give the individual a micro-dosage of psilocybin. Once the effects start to kick in (about 60 minutes after ingestion), the therapist will offer guidance and assistance where needed (without interfering too much, but rather playing an assistive role). 

A few days later, the integration session happens during which the client and therapist discuss and reflect upon the experience. The therapist uses normal therapeutic and interviewing skills here to solidify the meaning of the experience by delving into the client’s perceptions, sensations and experiences.  

Does it Work?

Research has shown largely positive results for psilocybin assisted therapy treatment (even after just one or two doses), with studies showing improvements in depression lasting for up to 5 weeks after taking psilocybin just once.

Which Other Kinds of Concerns is Psilocybin Assisted Therapy Good For?

As mentioned above, psilocybin assisted therapy is good for a range of mental health disorders such as anxiety, addiction, PTSD and OCD. Some studies even suggest that it may help with neurogenesis, which involves the growing of new nerve-brain cells. However, more research is needed to study the potential benefits of this substance.  

Risks and Benefits of Psilocybin Assisted Therapy

The benefits of psilocybin assisted therapy include reductions in depression rates, relaxation, increased productivity and boosted creative thinking. Some users even report an increased connection to their own sense of religion and/or spirituality; and this drug enables some to make peace with their mortality (especially in the case of life-threatening diseases such as cancer). Psilocybin use can be risky, however. Users may experience vomiting, panic, paranoia and potentially traumatic “bad trips”. If you’ve ever been diagnosed with bipolar disorder or psychosis, it’s important to steer clear of psilocybin seeing as it is a hallucinogen which can trigger or worsen psychosis. 

Clinical Trials

In August 2018, Compass Pathways received FDA approval for a clinical trial using psilocybin. This study will be conducted throughout 2019 (and it may take up to 18 months to complete) with 216 participants across different research sites situated in Europe and North America. Ultimately, the aim is to bring psilocybin to market within the next five years.

Psilocybin: Medicine or Dangerous Drug?

Although the use of psilocybin in therapy seems like a bizarre (and even dangerous) idea, the positive results thus far are undeniable. It may be a daunting prospect for many people, but (as humans) we are creatures of habit, so the thought of anything new may not be welcomed by us so easily. In light of all of this, perhaps it’s time for us to welcome this new and exciting option for improving mental health. Just be sure, however, to only use substances such as psilocybin under the strict guidance of a medical professional!

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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