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Magic Mushrooms as Mental Health Treatment

Discussion in 'Psychiatry' started by Ghada Ali youssef, Jan 29, 2017.

  1. Ghada Ali youssef

    Ghada Ali youssef Golden Member

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    It's about research, not recreation. Early studies suggest psilocybin, the active ingredient in magic mushrooms, may help people let go of tough-to-treat mental health problems. Under safe, carefully controlled conditions, study participants take psychedelic trips in an effort to dig deep within and escape from persistent depression and dangerous addictions.

    Sherry Marcy, 74, a former mathematician in Ann Arbor, Michigan, felt little relief after completing treatment for stage 3 endometrial cancer in late 2010. Marcy says her therapy included "a whole bunch of chemo and a whole bunch of radiation" and surgery that left behind troublesome scar tissue. "I came out of the whole thing completely depressed," she says. "I had no feeling that I wouldn't get cancer again."

    Although Marcy had a devoted partner, and a daughter and son making their way in college and grad school, she felt disconnected from family as she dwelt on the physical costs of her treatment. Mentally, she couldn't concentrate enough to read much and felt "dumbed down."

    An April 2012 New York Times story caught Marcy's attention: It described research using psychedelic drugs to help late-stage cancer patients reduce their fear of death. The consuming anxiety and depression detailed in the story echoed her own.

    Marcy learned about an ongoing study at Johns Hopkins University using psilocybin for cancer patients with persistent, treatment-resistant depression. Marcy, who had never tried psychedelic drugs recreationally – she didn't disapprove; it just wasn't her thing – experienced her first drug trip as a study volunteer.

    Under supervision, in a living room-like setting with comfortable furniture and attractive artwork, Marcy reclined on a couch wearing noise-canceling headphones and eyeshades, listening to music. "And they fed me grapes when I got thirsty," she says. "My, God, they tasted good."

    For Marcy, the mystical aspect of her trip involved musings around math – imaginary numbers and patterns related to fractal geometry. In essence, she says, "It felt like I picked up my head and started looking around again. [The session] got me in touch with things I couldn't have accessed before. It was like it lit up my head, which was delightful."

    The study involved two sessions, two weeks apart. Participants received a low-dose psilocybin capsule in one six-hour session and a higher-dose capsule in the other. "At the end of five hours, I remember saying, 'I don't know if this is a high dose or a low dose, but it's enough," Marcy recalls. Nearly five years later, Marcy's depression appears to be gone for good.

    In the 1970s, research on psychedelic drugs such as LSD and psilocybin was essentially halted by a strict U.S. regulatory environment. Studies began reemerging around the new millennium. Psilocybin, like LSD, is a Schedule I controlled substance and remains illegal outside of research settings.

    Another caution: The psilocybin in studies is synthetic, given in capsule form with precise doses. Research participants are continually supervised in a safe environment. In contrast, someone who illegally uses magic mushrooms on his or her own risks a bad trip – including panic reactions and hallucinations – without supervision.

    People who volunteer to participate in psilocybin research must first pass extensive psychiatric screenings. They are informed of potential side effects during the consent process, says Matthew Johnson, an associate professor in the department of psychiatry at Johns Hopkins.

    In the psilocybin research on cancer-related depression, he says, "the most remarkable finding is the persisting nature of the changes – the decreases in depressive and anxiety symptoms that we see six months after only a single administration of the substance."

    People have reported side effects like headaches during treatment sessions but not long-lasting physical effects. While all medications have some adverse events, Johnson says, the nature of those with psilocybin "are certainly unique." Although the experience is pleasant for some, he says, other participants can have a "strongly challenging experience."

    Sometimes, in the context of cancer, Johnson says: "They'll go to some really dark places. Any emotion, any experience can be amplified. They can experience the grief of their own death, potentially, and feel it at a very strong level."

    The sessions include safeguards to avoid unintentional but potentially dangerous behavior, Johnson says. Participants lie on the couch the entire day under constant supervision. The staff is trained to guide people back to a state of mindfulness, in which they're observing but not reacting to their experiences. People who go through bad trips can still reap the drug's benefit, he says, and may consider unsettling experiences a powerful part of the therapeutic process.

    Promise of Psilocybin

    It's still uncertain exactly how psychedelic drugs like psilocybin and LSD affect the brain. They may work by "rebooting" certain brain regions, says Peter Hendricks, an associate professor at the University of Alabama–Birmingham. His team is conducting a pilot study on psilocybin-facilitated treatment for cocaine addiction. In people with mental health conditions, he says, these specific brain networks may become hyperactive and hyper-connected. People stuck in this mode may have a sensation of thoughts circling as they fixate on an anxiety-provoking trigger, he says. "They're pessimistic, and they can't get out of that rut."

    Psilocybin may shut those faulty networks down for a period, Hendricks says, allowing the brain to normalize. "So whereas you would have felt, say in the case of suicide, stuck in a pessimistic rut – you couldn't stop ruminating," he says." And suddenly, after this experience, you might feel that you're no longer in that rut. You're maybe thinking more creatively; you're able to think outside the box. You may be thinking a little more optimistically – you don't feel like you're spinning your wheels."

    Scientists have long been intrigued by potential medical uses for psychedelic drugs. But their history as recreational drugs, peaking in the 1960s counterculture era, made lawmakers and regulators wary of psychedelics in any form. "We don't know as much as we'd like because this line of research has only [recently] begun again," Hendricks says. "And the renaissance, if you call it that, is pretty modest."

    Other studies have evaluated psilocybin for treating alcohol dependence, smoking cessation and psychological distress and suicidality.

    Cautiously Optimistic

    Larger and longer studies are needed to show whether psilocybin is more effective than existing treatments, if at all. Studies must take place in a carefully controlled research setting, Hendricks emphasizes, with medical supervision and interpersonal support and preparation. "I always want to make clear that those of us who work in this area do not at all promote recreational use," he adds.

    But the research is worth pursuing, Hendricks says. "This class of drugs may have a medical application in the same way cocaine has an application as a local anesthetic or that morphine is used as a pain-management medication," he says. "In the same way that stimulants are used to treat ADHD and depressants are used to treat anxiety." As scientists trying to develop more effective treatments, Hendricks says, he and his peers owe it to those who are suffering to leave no stone unturned.

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