People grappling with terminal illnesses frequently experience intense emotional distress, including depression, anxiety, existential angst, and a loss of purpose, which further complicates their circumstances.
Though current treatments such as counselling or cognitive-behavioural therapy (CBT) can provide some relief, they do not suffice for all. This has prompted researchers to investigate alternative, novel approaches to end-of-life care.
There is a growing body of research suggesting that psychedelic therapy could potentially alleviate existential suffering in patients with incurable diseases. A review in Neuropsychopharmacol Biol Psychiatry implies that psychedelics may help reduce depression and anxiety symptoms, improve the quality of life, and lessen the fear of death in patients with life-threatening conditions.
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How Psilocybin Affects the Brain
The National Institutes of Health categorizes psychedelics derived from shrooms as potent substances that can alter cognition. They impact mood and perception by affecting the brain’s serotonin circuits.
Let’s delve into what various studies have discovered:
| Investigators | Conclusions |
| Department of Psychiatry and Behavioral Sciences, University of Texas | Psychedelics such as psilocybin affect serotonin 2A receptors that regulate emotions and perception. |
| A report from Mental Health News | Psilocybin, a hallucinogenic compound naturally found in over 200 species of fungi, could potentially reconfigure the brains of individuals with depression, potentially leading to a solution. |
| Researchers from UC San Francisco and Imperial College London | Psilocybin bolsters connections between different brain regions in individuals with depression, potentially aiding them in overcoming excessive self-absorption and rumination. |
| A randomized, double-blind study by John Hopkins University | High doses of psilocybin significantly diminished depression, anxiety, and fear of death, while improving the quality of life, sense of life’s purpose, and optimism. |
| Clinical trial from New York University | Between 60% and 80% of participants reported a decrease in anxiety and depression after undergoing psilocybin therapy, which resulted in alleviation of existential distress. The research also noted a connection between the therapeutic effects and the psychedelic experience evoked by psilocybin. |
Investigative Study
In order to validate these findings, researchers from the UCSF Weill Institute for Neurosciences executed 2 studies involving 60 participants who underwent fMRI brain scans.
Methodology
- First Study. The participants in this study all had treatment-resistant depression and were given psilocybin.
- Second Study. Participants with milder depression were not informed whether they were given psilocybin or an antidepressant placebo (escitalopram). All participants also received the same psychotherapy.
Brain scans were taken before and after the treatment to assess the effects.
Results
- Psilocybin therapy weakened connections within the brain areas associated with depression, including the default mode, salience, and executive networks. Conversely, it bolstered connections to less integrated brain regions.
- It reduced emotional avoidance effects and produced significant improvements in cognitive functioning.
The influence of psilocybin on brain rewiring was observed to last for up to three weeks post the second dosage. Therefore, psilocybin offers a potential alternative for treating depression by reshaping the brain and reducing the entrenched negative thought patterns associated with the disorder. This outcome suggests that psilocybin operates differently from conventional antidepressants.
Psilocybin Therapy – A Promising Treatment Approach
The regulated administration of psilocybin in a therapeutic setting, often combined with psychological support, is what constitutes psilocybin therapy. This method is gaining recognition for its potential to address treatment-resistant depression, anxiety, and existential distress in patients with terminal diseases.
A recent survey carried out by researchers from Université Laval’s Faculty of Pharmacy, McGill University, Université de Montréal, and UQAR aimed to understand public opinion on the medical usage of psilocybin for end-of-life care. According to the survey published in Palliative Medicine, nearly 4 One in every five Canadians supports the use of psilocybin in addressing existential distress at the end of life.
Lead researcher Michel Dorval noted that current research shows that psilocybin, when used alongside psychotherapy, can provide swift, significant, and sustained relief for individuals grappling with terminal cancer. It’s important to highlight that psilocybin therapy can induce a deep sense of understanding and relief that can persist for up to six months.
Moreover, the survey indicates that those who have had exposure to palliative care or previous psilocybin use are more likely to support its use. Dorval suggests that firsthand experiences with end-of-life distress may contribute to this receptivity to innovative treatments.
Despite existing prejudices against psychedelic drugs, the research suggests a growing acceptance of psilocybin therapy in Canada, particularly within the context of palliative and end-of-life care. The researchers expect that these findings will help increase the accessibility of this groundbreaking therapy.
Additional Benefits of Psilocybin Therapy
1. Treatment for Alcohol Use Disorder
In a double-blind, randomized trial involving 93 participants, published in JAMA Psychiatry in August 2022, the combination of psilocybin and psychotherapy was found to significantly reduce the number of heavy drinking days over approximately eight months compared to a placebo control group. The psilocybin group also drank less alcohol on the days they did consume alcohol.
2. Aid in Smoking Cessation
Although quitting smoking is notoriously difficult, a small pilot study by researchers at Johns Hopkins University, published in The American Journal of Drug and Alcohol Abuse in January 2017, suggested that psilocybin, in combination with cognitive behavioural therapy (CBT), helped 10 out of 15 participants stay smoke-free for a year. A subsequent study indicated that the psychedelic experience could possibly aid in reshaping a smoker’s identity, thereby encouraging long-term abstinence.
3. Treatment for Anorexia
Emerging studies suggest that psilocybin may be helpful for individuals struggling with anorexia. A preliminary study published in Biological Psychiatry in May 2022 reported significant reductions in symptoms of eating disorders and anxiety in adults with anorexia who underwent psilocybin-assisted psychotherapy.
4. Mitigation of End-of-Life Anxiety
Life
Many individuals diagnosed with terminal diseases often grapple with anxiety and depression. Encouragingly, there is growing evidence suggesting that psilocybin therapy can help alleviate these mental health conditions. Studies demonstrate significant reductions in depression and anxiety levels among patients with life-threatening cancer who received psilocybin therapy.
Expectations from Psilocybin Therapy
Psilocybin therapy offers powerful healing swiftly, with the potential for lasting benefits. Each session is customized to cater to individual needs, adhering to specific clinic or trial protocols.
| Phase | Description | Duration |
| Prior | The initial sessions are dedicated to discussing any apprehensions and treatment goals with a facilitator. The aim is to foster a robust relationship and a secure environment. | 1 to 6 hours |
| During | The participant ingests a dose of psilocybin in a soothing setting, lying down, wearing an eye mask, listening to a selected playlist, and under the supervision of a therapist. | 5 to 8 hours |
| Subsequent | Follow-up sessions offer an opportunity to discuss and interpret the experience with the therapist, thereby assisting in integrating the insights into daily life. | Several sessions spanning hours |
Guidelines for Undertaking Psilocybin Therapy
- Investigate clinics where psilocybin is legally administered and consider joining a waiting list if necessary.
- Choose a clinic that provides psilocybin treatment under the supervision of a therapist or a professional guide for an enhanced therapeutic experience.
- Interview potential therapists, inquiring about their qualifications, experience, therapeutic approaches, and proficiency in treating mental health disorders.
- Be open about your genuine reasons for seeking therapy, mental health status, medical history, and family mental health background.
- Consider therapists who specialize in treating your particular mental health condition and seek guidance and training from organizations such as the Psilocybin Assisted Therapy Association (PATA).
- Provide a detailed account of your medical and mental health history, especially if there’s a family history of schizophrenia or psychosis.
- Discuss your decision to pursue psilocybin therapy with your current mental health provider and see if they are open to collaborating with your psilocybin therapy team.
- Discuss the dosage, protocol, and the requirement to start with safety in mind, especially for those new to psilocybin therapy, lower doses are recommended under the guidance of a psilocybin therapist.
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Frequently Asked Questions
Who can benefit from psilocybin therapy?
If you’re grappling with conditions like depression, anorexia, alcohol addiction, attempts to quit smoking, or dealing with a terminal illness, you might find psilocybin therapy beneficial.
However, if you have a history of schizophrenia or psychosis, or if these conditions run in your family, hallucinogenic substances such as psilocybin could exacerbate your symptoms. Similarly, individuals with bipolar disorder and borderline personality disorder are generally advised to avoid it.
What is the usual dosage of psilocybin in therapy?
The dosage is often adjusted according to individual responses and typically starts with lower amounts in a therapeutic context. Clinical research has shown that a single 25-milligram dose of synthetic psilocybin, when used in conjunction with psychological support, led to reduced depression scores in treatment-resistant depression.
Is psilocybin effective in treating PTSD?
Research in this area is developing quickly. However, studies on MDMA, a non-traditional psychedelic with stimulant properties used alongside psychotherapy for PTSD treatment, are more advanced. Phase 3 clinical trials are currently underway for this substance, and it is expected that MDMA may be approved for PTSD treatment within this year.
