People grappling with terminal illnesses typically experience substantial emotional distress, including depression, anxiety, existential dilemmas, and loss of purpose, further complicating their already challenging circumstances.
Although existing therapies such as counselling or cognitive-behavioural therapy (CBT) can be helpful, they may not prove effective for everyone. This has prompted researchers to investigate new and inventive alternatives for end-of-life care.
There is growing evidence suggesting that psychedelic therapy could be a viable solution for addressing existential anxiety in patients with incurable diseases. A review in Neuropsychopharmacol Biol Psychiatry indicates that psychedelics could help lessen depression and anxiety symptoms, improve quality of life, and reduce fear related to mortality among patients with life-threatening conditions.
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Psilocybin’s Impact on the Brain
The National Institutes of Health characterizes psychedelics derived from mushrooms as powerful substances that can alter cognition. They affect mood and perception by interacting with the brain’s serotonin pathways.
Let’s examine the findings of various studies:
| Researchers | Findings |
| Department of Psychiatry and Behavioral Sciences, University of Texas | Psychedelics like psilocybin interact with serotonin 2A receptors that regulate emotions and perception. |
| A report from Mental Health News | Psilocybin, a natural hallucinogenic compound found in over 200 species of fungi, could potentially restructure the brains of individuals battling depression, leading to a possible cure. |
| Researchers from UC San Francisco and Imperial College London | Psilocybin enhances connections between various brain areas in individuals with depression, potentially aiding them in overcoming excessive self-focus 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 life quality, sense of life’s meaning, and optimism. |
| Clinical trial from New York University | Between 60% and 80% of participants reported decreased anxiety and depression after undergoing psilocybin therapy, leading to a reduction in existential distress. The study further noted that the therapeutic benefits were associated with the psychedelic experience triggered by psilocybin. |
Clinical Investigation
To validate this, researchers from the UCSF Weill Institute for Neurosciences conducted 2 studies involving 60 participants who underwent fMRI brain scans.
Methodology
- First Study. All participants were battling treatment-resistant depression and were treated with psilocybin.
- Second Study. Participants experiencing less severe depression were unaware if they received psilocybin or an antidepressant placebo (escitalopram). All participants also participated in the same psychotherapy.
Scans were performed before and after treatment to assess the effects.
Results
- Psilocybin treatment reduced connections within brain areas linked to depression, such as the default mode, salience, and executive networks. It also bolstered connections to less integrated brain regions.
- It mitigated emotional avoidance behaviors and significantly improved cognitive functioning.
The effect of psilocybin on brain reconfiguration lasted for up to three weeks following the second dosage. Therefore, psilocybin offers a potential alternative treatment for depression by reshaping the brain and alleviating entrenched negative thought patterns related to the condition. This finding suggests that psilocybin operates differently compared to conventional antidepressants.
Psilocybin Therapy – A Promising Treatment Approach
Psilocybin therapy refers to the controlled use of psilocybin in a therapeutic setting, usually paired with psychological assistance. This approach is increasingly being recognized for its capability to treat 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 gauge public opinion on the medicinal use of psilocybin for end-of-life care. According to the survey published in Palliative Medicine, nearly 4 One in five Canadians supports the use of psilocybin to mitigate existential distress at the end of life.
Lead investigator Michel Dorval noted that research has shown that psilocybin, when used alongside psychotherapy, can provide immediate, substantial, and long-lasting relief for individuals grappling with advanced cancer. It’s important to highlight that psilocybin-assisted therapy can induce a deep sense of comprehension and solace that can persist for up to six months.
Additionally, the survey indicates that those with prior experience in palliative care or previous psilocybin use expressed more support. Dorval suggested that personal encounters with end-of-life distress could contribute to this receptivity towards new treatment approaches.
Despite prevailing prejudice against psychedelic drugs, the research signals a growing acceptance of psilocybin therapy in Canada, particularly in palliative and end-of-life care contexts. The authors predict that these results will improve the accessibility of this groundbreaking treatment.
Further Benefits of Psilocybin Therapy
1. Treatment for Alcohol Use Disorder
A double-blind, randomized trial involving 93 participants, which was published in JAMA Psychiatry in August 2022, revealed that combining psilocybin with psychotherapy resulted in significantly fewer heavy drinking days over approximately eight months compared to a placebo group. The psilocybin group also drank less alcohol on the days they chose to drink.
2. Assistance in Ceasing Smoking
Although smoking cessation is notoriously difficult, a small pilot study carried out by researchers at Johns Hopkins University and published in The American Journal of Drug and Alcohol Abuse in January 2017, suggested that psilocybin, in conjunction with cognitive behavioural therapy (CBT), allowed 10 out of 15 participants to stay smoke-free for a year. A subsequent study implied that the psychedelic experience could potentially reshape a smoker’s self-perception, thereby encouraging long-term abstinence.
3. Therapy for Anorexia
Growing evidence suggests that psilocybin may be advantageous for individuals battling anorexia. An initial study published in Biological Psychiatry in May 2022 reported notable reductions in eating disorder symptoms and anxiety in adults with anorexia who underwent psilocybin-aided psychotherapy.
4. Alleviating End-of-Life Anxiety
Existence
For many facing terminal illnesses, anxiety and depression are common feelings. Encouragingly, there’s growing evidence to suggest that therapy involving psilocybin can help lessen these symptoms. Studies have revealed significant decreases in both depression and anxiety among patients diagnosed with life-threatening cancers who have undergone psilocybin therapy.
What to Expect from Psilocybin Therapy?
Psilocybin therapy offers the potential to deliver profound healing results swiftly, with the possibility of long-lasting benefits. Each session is individually tailored and adheres to the specific guidelines of the clinic or trial.
| Stage | Explanation | Length |
| Before | Initial sessions are geared towards discussing any fears and treatment goals with a facilitator in order to establish a strong relationship and a secure environment. | 1 to 6 hours |
| During | The participant ingests a dose of psilocybin in a relaxed environment, lying down, with an eye mask on, listening to a chosen playlist, and under the supervision of a therapist. | 5 to 8 hours |
| After | Subsequent sessions offer an opportunity to make sense of the experience with the therapist, assisting in the integration of the insights into daily life. | Several sessions spread over hours |
Recommendations for Undertaking Psilocybin Therapy
- Research clinics where psilocybin is legal and if necessary, consider joining a waiting list.
- Choose a clinic that offers psilocybin treatment under the supervision of a therapist or a professional guide for a more effective therapeutic experience.
- Interview potential therapists, asking about their credentials, experiences, therapy styles, and expertise in mental health conditions.
- Be honest about your motivations for seeking treatment, mental health status, medical history, and family mental health background.
- Consider therapists who specialize in treating your specific mental health condition and consult with organizations like the Psilocybin Assisted Therapy Association (PATA) for guidance and training.
- Make a full disclosure of your medical and mental health history, particularly if there’s a family history of schizophrenia or psychosis.
- Discuss your choice to pursue psilocybin therapy with your existing mental health provider and see if they are open to collaborating with your psilocybin therapy team.
- Discuss the dosage, protocol, and the necessity to start particularly if you are a novice to psilocybin therapy.
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Frequently Asked Questions
Who makes a suitable candidate for psilocybin therapy?
If you are battling depression, anorexia, alcohol addiction, trying to quit smoking, or dealing with a terminal illness, you might want to consider psilocybin therapy.
Conversely, if you have a history of schizophrenia or psychosis, or these conditions run in your family, hallucinogenic substances like psilocybin may exacerbate your symptoms. Likewise, bipolar disorder and borderline personality disorder are generally not recommended.
What’s the usual dosage of psilocybin in therapy?
The dosage generally differs, starting with smaller doses in a therapeutic setting and adjusted based on individual responses. Clinical research has shown that a single 25-milligram dose of synthetic psilocybin, in conjunction with psychological support, led to a reduction in depression scores in cases of treatment-resistant depression.
Can psilocybin be utilized to treat PTSD?
This is a rapidly developing area of research. However, studies on MDMA, a non-traditional psychedelic with stimulant properties used in combination with psychotherapy for PTSD treatment, are more advanced. Trials on this psychedelic have reached phase 3 clinical trials, and it’s expected that MDMA may be approved for PTSD treatment this year.
