Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study
In a single-group proof-of-concept study of 10 participants with DSM‑IV alcohol dependence, psilocybin administered alongside motivational enhancement therapy produced a significant increase in abstinence after dosing that was largely maintained to 36 weeks, with the intensity of the first session strongly predicting subsequent reductions in drinking, craving and increased abstinence self‑efficacy. There were no significant treatment‑related adverse events, supporting the need for larger controlled trials to evaluate efficacy and mechanisms.
Authors
- Michael Bogenschutz
- Rick Strassman
- Paulo Barbosa
Published
Abstract
Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants’ responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration ( p < 0.05). Gains were largely maintained at follow-up to 36 weeks. The intensity of effects in the first psilocybin session (at week 4) strongly predicted change in drinking during weeks 5–8 ( r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. TRIAL REGISTRATION: NCT02061293
Research Summary of 'Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study'
Introduction
Classic (5HT2A agonist) hallucinogens were widely researched from the 1950s to the early 1970s for conditions including addiction. A meta-analysis of randomized trials of LSD for alcoholism reported an odds ratio favouring LSD at first post-treatment follow-up, and more recent work has renewed clinical interest in psilocybin. Small modern trials have examined psilocybin for anxiety in advanced cancer and as an adjunct for smoking cessation, and clinical research has generally supported the safety of classic hallucinogens when subjects are carefully screened and supervised. Despite this background and mechanistic rationale, there were no prior studies specifically testing psilocybin in people with alcohol dependence. Bogenschutz and colleagues therefore conducted a single-group, proof-of-concept study to quantify the acute psychoactive effects and tolerability of oral psilocybin in alcohol-dependent participants, and to provide preliminary outcome and safety data across a 36-week follow-up. The study aimed to evaluate whether administration of psilocybin, given alongside a manualised psychosocial intervention, was associated with changes in drinking behaviour and related psychological measures and whether acute subjective effects predicted clinical outcomes.
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Study Details
- Study Typeindividual
- Journal
- Compound
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- APA Citation
Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A., Wilcox, C. E., Barbosa, P., & Strassman, R. J. (2015). Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. Journal of Psychopharmacology, 29(3), 289-299. https://doi.org/10.1177/0269881114565144
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