Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders
This review (2017) examines studies on psilocybin-assisted therapy to treat psychiatric disorders related to depression, anxiety, and substance abuse. In contrast to conventional paradigms, psilocybin-assisted therapy consists of only a few six-hour medication therapy sessions that may significantly improve symptoms and help patients achieve response or remission within weeks with support from integrative psychotherapy sessions.
Authors
- Benjamin Malcolm
Published
Abstract
Review: Recent research suggests that functional connectivity changes may be involved in the pathophysiology of psychiatric disorders. Hyperconnectivity in the default mode network has been associated with psychopathology, but psychedelic serotonin agonists like psilocybin may profoundly disrupt these dysfunctional neural network circuits and provide a novel treatment for psychiatric disorders. We have reviewed the current literature to investigate the efficacy and safety of psilocybin-assisted therapy for the treatment of psychiatric disorders. There were seven clinical trials that investigated psilocybin-assisted therapy as a treatment for psychiatric disorders related to anxiety, depression, and substance use. All trials demonstrated reductions in psychiatric rating scale scores or increased response and remission rates. There were large effect sizes related to improved depression and anxiety symptoms. Psilocybin may also potentially reduce alcohol or tobacco use and increase abstinence rates in addiction, but the benefits of these two trials were less clear due to open-label study designs without statistical analysis. Psilocybin-assisted therapy efficacy and safety appear promising, but more robust clinical trials will be required to support FDA approval and identify the potential role in clinical psychiatry.
Research Summary of 'Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders'
Introduction
Interest in serotonergic psychedelics has resurged in recent years as neuroimaging and neuroscience advances offer new ways to study brain circuits implicated in psychiatric disorders. The authors describe a context in which default mode network (DMN) hyperconnectivity, particularly involving subgenual and pregenual cingulate regions, has been linked to depressive rumination and illness duration, and they note that diverse rapid-acting interventions (for example, electroconvulsive therapy, ketamine, transcranial magnetic stimulation) may share effects on dysfunctional network dynamics. Psilocybin, a classic 5-HT agonist, is proposed as both a probe of brain function and a potential therapeutic agent capable of disrupting pathological network hubs and enabling healthier reconnection patterns after the acute drug effect subsides. This review aims to synthesize the pharmacokinetic and pharmacodynamic properties of psilocybin together with the clinical trial evidence available through 31 December 2016 for psilocybin-assisted therapy in psychiatric indications related to anxiety, depression, and substance use. Thomas and colleagues therefore set out to evaluate efficacy signals, safety issues, and gaps in the current evidence base to inform whether further robust clinical trials are warranted.
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Study Details
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Thomas, K., Malcolm, B., & Lastra, D. (2017). Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders. Journal of Psychoactive Drugs, 49(5), 446-455. https://doi.org/10.1080/02791072.2017.1320734
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Papers in Blossom that reference this study
Sarparast, A., Thomas, K., Malcolm, B. et al. · Psychopharmacology (2022)
Ginati, Y. D., Ben-Sheetrit, J., Lev-Ran, S. et al. · Journal of Psychoactive Drugs (2021)
Malcolm, B., Thomas, K. · Psychopharmacology (2021)
Siegel, A. N., Lipsitz, O., Gill, H. et al. · Journal of Psychiatric Research (2021)
Ortiz, M. I., Gómez-Busto, F. J. · Clinical Neuropsychiatry (2020)
Anderson, B. T., Danforth, A. L., Daroff, R. et al. · EClinicalMedicine (2020)
Lancelotta, R., Davis, A. K. · Journal of Psychoactive Drugs (2020)
Bienemann, B., Ruschel, N. S., Campos, M. L. et al. · PLOS ONE (2020)
Lewis, C. R., Preller, K. H., Braden, B. B. et al. · Biomedicines (2020)
Malcolm, B., Polanco, M., Barsuglia, J. P. · Journal of Psychoactive Drugs (2018)
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