Can Psilocybin Replace Traditional Pharmaceuticals for Depression & Anxiety?

by Pamela Hadfield

We seem to have gone through and almost come out on the other side of marijuana prohibition. Societal stigma has drastically reduced, and a new normal is beginning to prevail as people start to understand the medicinal benefits of cannabis. But, while the very public battle for cannabis legalization continues, there’s another plant-based medicine that’s quietly been making strides towards legalization. Psilocybin, or “magic mushrooms,” has been fast-tracked by the FDA, for the second year in a row, as a “Breakthrough Therapy.” This status puts psilocybin-based pharmaceuticals at the front of the line for quick approval for the development of new legally-available psilocybin-based drugs, and it’s happening fast.

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What can Psylocibin Treat?

Besides clinical depression, psilocybin is being explored as a possible treatment for anxiety, acute PTSD, addiction to opioids, alcohol, and even tobacco. A host of new research is available regarding the therapeutic potential psilocybin may hold. A recent study by The Journal of Psychopharmacology shows that psilocybin decreased depression and anxiety in patients with life-threatening cancer. The Usona Institute, is currently in Phase 2 clinical trials, to determine whether a single dose of psilocybin may be useful in treating patients suffering from depression.

On a global scale, depression affects some 264 million people. Between 76%-86% of low income to middle-income people never receive treatment for the disorder, which may be a leading factor in why one person every 40 seconds commits suicide. Also, anxiety disorders are estimated to affect some 284 million, making it the most prevalent mental health disorder globally. Lastly, addiction, which covers a wide array of substances, is said to claim some 240 million when looking at alcohol alone. Traditional treatments, whether pharmaceutical or otherwise, have failed to treat these diseases adequately.

How Does Psylocibin Work?

Psilocybin is found within some 180 mushroom species across the world. When ingested, psilocybin converts to psilocin, the psychoactive component, which causes a hallucinogenic or psychoactive response. Physically, a person feels the effects of psilocybin when it takes action on serotonin receptors in the brain (5-HT). Serotonin, a vital chemical in our mind and body, is sometimes referred to as the “happy chemical” as it contributes to our sense of well being and fulfillment. After ingesting psilocybin, some common positive feelings may be euphoria, relaxation, a sense of spiritual connection, and “being at one with the universe.” On the flip side, a person may feel nervous or paranoid, otherwise known as a “bad trip.”

Some, but not all people, experience hallucinations such as abstract visuals, and some people have even reported seeing sounds or feeling colors. These sensations occur as psilocybin works across many regions of the brain, creating unusual connections that are known as “cross talk.” It’s thought by making new connections, psilocybin creates a virtual 'reset' in the brain, and may loosen other connections that interact with our default mode network (DMN), a robust neural network that is most active while we are at rest or daydreaming,

Interestingly, it’s now thought that mushrooms act in direct opposition to how traditional SSRI’s, or anti-depressants, work. Many patients who consume SSRI’s report a feeling of “emotional blunting,” whereas consumption of psilocybin translates for most people into a longer-lasting sense of connectedness. Psilocybin is thought to enhance emotional receptivity by creating increased responsiveness in the amygdala, the area that processes emotional reactions.

When a person is on a SSRI, brain scans show there’s a decrease in this area of the brain. Conversely, when a person consumes psilocybin, there is an increase in activity within the amygdala, showing more emotional connectivity. The results of these brain scans may be the key to us knowing why mushrooms are having such a positive effect on people with clinical depression and anxiety.

The FDA’s Stance & Legality

Researchers have been busy gathering evidence for psylocibin’s clinical potential, and communities of psychiatrists and psychopharmacologists seem to be hopping on board. Last year, the FDA granted COMPASS Pathways Breakthrough Therapy status to begin work on a new drug for treatment-resistant depression.

Legally, psilocybin is a Schedule 1 drug, similar to cannabis, and is not federally recognized to have any medicinal value, the same category as heroin. This scheduling status, however, is poised to change more quickly than cannabis. Research and the FDA's stance has helped, but the real reason scheduling will change quickly is that psilocybin will most likely enter into a more recognizable pharmaceutical, prescription-based model vs. the recreational context marijuana lives within. Perhaps, by focusing on the most challenging diseases to treat, where standard pharmaceuticals have primarily failed, psilocybin has leapfrogged cannabis and is now considered a more "serious" medicine.

Despite being a Schedule 1 narcotic, psilocybin is being decriminalized in some jurisdictions across the US. Denver, CO voted in May to forbid law enforcement spending on possession charges for psilocybin. Oakland, CA voted similarly this year to decriminalize, and it appears Chicago, Ill. is next up. In 2020, Oregon may be the first to decriminalize at the state level if the psi-2020 “Real Healing. Real Change” ballot passes, which it is expected to do.

What’s Next for Psylocibin?

Don’t expect psilocybin dispensaries to be popping up in your neighborhood anytime soon. This is partly because psilocybin is a much more complex drug than cannabis and needs to be treated as such. The most likely outcome is a regulated framework where psilocybin is approved for administration in clinical settings for specific medical conditions. In the coming years, expect to see psychedelic treatment centers where psilocybin is administered under the watchful eye of trained clinicians.

Photo credit: ST Saw/Flickr

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