Psilocybin is a psychedelic that affects the serotonin system in the brain. This is the same system that is targeted by many medications prescribed by health care practitioners for anxiety and/or depression
For that reason (and others) researchers have investigated whether psilocybin could be used successfully to treat anxiety and depression. International research has shown that psilocybin can be very helpful to treat these two categories of mental illnesses.
Unlike recreational use of psilocybin , researchers use purified psilocybin, and the dose given is precise. Also, controlled studies use either a placebo or much lower doses for comparison purposes.
Also, most formal research includes having a therapist present to help the research subject discuss what they are experiencing and to process it in a way that is therapeutic. This approach is called “psilocybin-assisted therapy.”
In Germany, psychiatrists can legally provide treatment for anxiety and depression using psilocybin during a psychotherapy session. The psychiatrists have to demonstrate competency providing appropriate psychotherapy with these patients.
Yerubandi and colleagues wanted to find out about possible side-effects from psilocybin-assisted treatment. They published results from an analysis of 6 clinical trials with a total of 528 patients in JAMA Network Open on April 10, 2024.
The patients were mostly white, middle-aged adults. The doses of psilocybin used in the studies were: low dose 1-3 mg, moderate dose 10-20 mg, and high dose 20-30 mg.
The research showed that “… headaches, nausea, anxiety, dizziness, and elevated blood pressure occurred significantly more frequently with psilocybin vs comparators,” i.e., placebo, low-dose psilocybin, niacin, or escitalopram (Lexapro is the common Brand name). Headache and nausea were the two most common side-effects.
They did not find any association “with risk of paranoia and transient thought disorder” even though researchers thought they might occur.
The side-effects they did identify “resolved within 48 hours” and were found to be “tolerable.” The authors acknowledged that the studies did not look into the possibility of rare long-term adverse effects; additional studies will need to be done to find out if that occurs.
To me, the bottom line is that purified psilocybin given at precise doses during a therapy session can provide meaningful benefit to patients with depression and anxiety disorders such as PTSD.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
Health and Culture 