Psilocybin history, action and reaction: A narrative clinical review
Pravesh Sharma, Quang Anh Nguyen, Erin Carpenter, Douglas B Mathews, Sadie J. Matthews, Christi A. Patten, Christopher J. Hammond
Journal of Psychopharmacology August 31, 2023 DOI: 10.1177/02698811231190858 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Peer reviewed |
|---|---|
| Intervention | Psilocybin-assisted therapy |
| Topics | Anxiety Psilocybin |
| Keywords | Hallucinogen Adverse effect |
| Citations | 32 |
| Key findings | Psilocybin-assisted therapy has modest evidence for treating depression and anxiety disorders and may reduce harmful drinking in alcohol use disorder, but a recent trial found increased suicidal ideations and self-injurious behaviors. |
Abstract
Hallucinogenic mushrooms have been used in religious and cultural ceremonies for centuries. Of late, psilocybin, the psychoactive compound in hallucinogenic mushrooms, has received increased public interest as a novel drug for treating mood and substance use disorders (SUDs). In addition, in recent years, some states in the United States have legalized psilocybin for medical and recreational use. Given this, clinicians need to understand the potential benefits and risks related to using psilocybin for therapeutic purposes so that they can accurately advise patients. This expert narrative review summarizes the scientific basis and clinical evidence on the safety and efficacy of psilocybin-assisted therapy for treating psychiatric disorders and SUDs. The results of this review are structured as a more extensive discussion about psilocybin’s history, putative mechanisms of action, and recent legislative changes to its legal status. There is modest evidence of psilocybin-assisted therapy for treating depression and anxiety disorders. In addition, early data suggest that psilocybin-assisted therapy may effectively reduce harmful drinking in patients with alcohol use disorders. The evidence further suggests psilocybin, when administered under supervision (psilocybin-assisted therapy), the side effects experienced are mild and transient. The occurrence of severe adverse events following psilocybin administration is uncommon. Still, a recent clinical trial found that individuals in the psilocybin arm had increased suicidal ideations and non-suicidal self-injurious behaviors. Given this, further investigation into the safety and efficacy of psilocybin-assisted therapy is warranted to determine which patient subgroups are most likely to benefit and which are most likely to experience adverse outcomes related to its use.
Comparable studies
Other narrative reviews on psilocybin for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelics as anti-inflammatory agents Animal models and cellular studies | 2018 | Review | |
| Ayahuasca: Pharmacology, neuroscience and therapeutic potential | 2016 | Review | |
| Psychedelic Drugs in Biomedicine | 2017 | Review | |
| A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses | 2020 | Review | |
| Psychedelics and health behaviour change | 2021 | Review |
Citations in the library
Cited by 30
- Psilocybin promotes neuroplasticity and induces rapid and sustained antidepressant-like effects in mice Journal of Psychopharmacology April 28, 2024
- Single-dose psilocybin for U.S. military Veterans with severe treatment-resistant depression - A first-in-kind open-label pilot study. Journal of Affective Disorders January 15, 2025
- Current Understanding on Psilocybin for Major Depressive Disorder: A Review Focusing on Clinical Trials Clinical Psychopharmacology and Neuroscience November 30, 2023
- Clinical Effects of Psychedelic Substances Reported to United States Poison Centers: 2012 to 2022. Annals of emergency medicine December 1, 2024
- In vivo validation of psilacetin as a prodrug yielding modestly lower peripheral psilocin exposure than psilocybin Frontiers in Psychiatry January 8, 2024
and 25 more in the library
Cites 90
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
and 85 more in the library