Abstract | BACKGROUND: The primary psychoactive drug in magic mushrooms, psilocybin, induces profound alterations in consciousness through the 5-HT2A receptor. This review consolidates current research findings to elucidate the pharmacology, safety profile, and clinical applications of psilocybin. AREAS OF UNCERTAINTY: Despite initial concerns that psilocybin could cause psychosis, contemporary research has demonstrated that psilocybin is generally safe. The most common adverse effects are nausea and headache, yet both tend to be transient. Serious adverse events can generally be avoided in controlled settings such as clinical trials. However, in the largest clinical trial to date, there were a total of 7 reported cases of suicidal ideation, up to 12 weeks after receiving a single 25 mg dose of psilocybin. That being said, all 7 cases did not respond to the treatment. Although selective serotonin reuptake inhibitors may blunt the hallucinogenic qualities of psilocybin, preliminary research suggests that they may enhance its antidepressant effects. THERAPEUTIC ADVANCES: LIMITATIONS: However, larger Phase II trials with more than 100 depressed participants have shown a much smaller remission rate of 25%-29%, though these studies still observed that psilocybin causes a significant reduction in depressive symptoms. CONCLUSIONS: Aside from ketamine, psilocybin is the most clinically well-researched psychedelic drug, with trials that have enrolled hundreds of participants and multiple therapeutic applications. Phase III trials will determine whether psilocybin lives up to the promise that it showed in previous clinical trials.
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Authors | Burton J Tabaac, Kenneth Shinozuka, Alejandro Arenas, Bryce D Beutler, Kirsten Cherian, Viviana D Evans, Chelsey Fasano, Owen S Muir |
Journal | American journal of therapeutics
(Am J Ther)
2024 Mar-Apr 01
Vol. 31
Issue 2
Pg. e121-e132
ISSN: 1536-3686 [Electronic] United States |
PMID | 38518269
(Publication Type: Review, Journal Article)
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Copyright | Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. |
Chemical References |
- Antidepressive Agents
- Hallucinogens
- Psilocybin
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Topics |
- Humans
- Antidepressive Agents
(adverse effects)
- Depressive Disorder, Major
(drug therapy)
- Hallucinogens
(adverse effects)
- Primary Health Care
- Psilocybin
(adverse effects)
- Clinical Trials as Topic
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