Psilocybin is a chemical compound that is found in some varieties of mushrooms1. It’s considered a “classic drug” and it has been used for centuries by native indigenous groups of Central America to facilitate spiritual experiences and religious rituals2,3. Recently, an approximately 6000 year old cave mural was found in Spain depicting the hallucinogenic properties of mushrooms, and others have been found in the African continent 4, evidencing the historical worldwide use of this substance.
Effects and therapeutic use
If we look into some of the subjective effects of psilocybin, this substance often produces changes in visual and sensory perception, alterations in the sense of time, thought and mood, as well as synesthesia and illusions5. These effects are often linked to mystical or spiritual experiences, that can involve feelings of connection to the universe and others, experiences of profound beauty and love, and other such type experiences that are intimately connected to a positive life outlook 6. It is also reported that psilocybin increases the emotional connection to oneself, psychological well-being, empathy and satisfaction with one’s life 6,7.
Recently, the interest in this substance has increased due to promising results in the reduction of symptoms of several mental disorders, such as depression, anxiety, obsessive compulsive disorder, as well as the reduction of anxiety related to the grief process. There is also evidence of a reduction of addictive behaviors, especially when it comes to alcohol and tobacco8,9,10.
Besides that, a 2012 study by Carhart-Harris and collaborators11 used magnetic resonance imaging to show that psilocybin seems to increase neural activity in individuals, expanding the connectivity of areas of the brain that are not normally in contact with each other. This induces temporary states of neuroplasticity in the brain, which leads to subjects being more receptive not only to certain cognitive functions, but also to the content of psychotherapy.
It is important to emphasize that the mode of use of psilocybin is relevant when considering its possible benefits. So called ‘bad trips’ can lead to long-lasting negative effects12 if not properly integrated, and the nowadays popularized method of ‘microdosing’, which involves taking very small amounts every few days (in theory, the dosage should be small enough to not cause any notable psychedelic effect) does not show any reliable evidence as of yet 13. On the other hand, several studies show that even one session with higher-dose psilocybin can have long lasting positive effects 14,15,16,17, highlighting the impact this type of psychotherapy could bring to healthcare when contrasted to the long-term use of antidepressants, for whom many people do not even respond to. In combination with a psychotherapeutic program, psilocybin could bring innumerable benefits to the clinical context.
Legal status
In the United States, psilocybin is currently in phase 3 of clinical trials for the treatment of resistant depression, meaning that it’s in a very advanced assessment phase before its official approval for this treatment. In Europe, studies have also taken place, with COMPASS recently publishing its phase 2b trial, the main findings being a fast reduction of depressive symptoms after just a single dose of the substance, with positive maintenance after 12 weeks 18.
Despite its growing scientific and therapeutic interest, the use of psylocibin is still illegal in most countries, including Spain. According to the current legislation, this substance is still classified as a prohibited substance 19. Even though there is a growing debate about the interest in revising the legislation on psychedelic substances, it is currently illegal and inaccessible for clinical and recreational use in the country.
For this reason, at Clinica Synaptica we don’t use or offer psilocybin assisted therapy or other treatments with psilocybin. We are committed to spreading knowledge about the beneficial effects of psilocybin in therapeutic settings, and will keep on following scientific advances and legislative changes, but until the laws allow it, unfortunately, it is not part of our services.
References
1. Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., … Rodriguez, C. I. (2020). Psychedelics and Psychedelic-Assisted Psychotherapy. American Journal of Psychiatry, appi.ajp.2019.1. doi:10.1176/appi.ajp.2019.19010035
2. Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. doi:10.1124/pr.115.011478
3. Samorini, G. (2019). The oldest archeological data evidencing the relationship of Homo sapiens with psychoactive plants: A worldwide overview. Journal of Psychedelic Studies, 3, 1-18. https://doi.org/10.1556/2054.2019.008
4. Earliest evidence for magic mushroom use in Europe [Internet]. New Scientist. 2011. Available from: https://www.newscientist.com/article/mg20928025-400-earliest-evidence-for-magic-mushroom-use-in-europe/
5. Passie, T., Seifert, J., Schneider, U., & Emrich, H. M. (2002). The pharmacology of psilocybin. Addiction Biology, 7(4), 357–364. doi:10.1080/1355621021000005937
6. Griffiths, R., Richards, W., Johnson, M., McCann, U., & Jesse, R. (2008). Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of Psychopharmacology, 22(6), 621–632. doi:10.1177/0269881108094300
7. Lutkajtis, A., & Evans, J. (2023). Psychedelic integration challenges: Participant experiences after a psilocybin truffle retreat in the Netherlands. Journal of Psychedelic Studies, 6(3), 211-221. https://doi.org/10.1556/2054.2022.00232
8. Carhart-Harris, R.L., Bolstridge, M., Day, C.M.J., et al. (2018). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, 235, 399–408. https://doi.org/10.1007/s00213-017-4771-x
9. Breeksema, J. J., Niemeijer, A. R., Krediet, E., et al. (2020). Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies. CNS Drugs, 34(9), 925–946. https://doi.org/10.1007/s40263-020-00748-y
10. Wheeler, S. W., & Dyer, N. L. (2020). A systematic review of psychedelic-assisted psychotherapy for mental health: An evaluation of the current wave of research and suggestions for the future. Psychology of Consciousness: Theory, Research, and Practice, 7(3), 279–315. https://doi.org/10.1037/cns0000237
11. Carhart-Harris, R. L., Erritzoe, D., Williams, T., et al. (2012). Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Proceedings of the National Academy of Sciences of the United States of America, 109(6), 2138–2143.
12. Bienemann B, Ruschel NS, Campos ML, Negreiros MA, Mograbi DC. Self-reported Negative Outcomes of Psilocybin users: a Quantitative Textual Analysis. Carrà G, editor. PLoS ONE. 2020 Feb 21;15(2).
13. Marschall J, Fejer G, Lempe P, Prochazkova L, Kuchar M, Hajkova K, et al. Psilocybin microdosing does not affect emotion-related symptoms and processing: A preregistered field and lab-based study. Journal of Psychopharmacology. 2021 Dec 17;36(1):97–113.
14. Goodwin, G. M. et al. Single-dose psilocybin for a treatment-resistant episode of major depression. N. Engl. J. Med. 387, 1637–1648 (2022).
15. Raison, C. L. et al. Single-dose psilocybin treatment for major depressive disorder: a randomized clinical trial. JAMA 330, 843–853 (2023).
16. Carhart-Harris, R. et al. Trial of psilocybin versus escitalopram for depression. N. Engl. J. Med. 384, 1402–1411 (2021).
17. Bogenschutz, M. P. et al. Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: a randomized clinical trial. JAMA Psychiatry 79, 953–962 (2022).
18. COMPASS Pathways. (2022). Interim review: Psilocybin therapy for treatment-resistant depression (Version 15.05). COMPASS Pathways. Disponible en: https://compasspathways.com/wp-content/uploads/2022/11/Compass_Interim-Review_20221031_v15.05.pdf
19. Observatorio Español de las Drogas y las Adicciones (OEDA). (2022). Informe sobre el estado de las drogas en España. Ministerio de Sanidad. Disponible en: https://pnsd.sanidad.gob.es
