Psilocybin in neuropsychiatry: a review of its pharmacology, safety, and efficacy
Seetal Dodd, Trevor R. Norman, Harris A. Eyre, Stephen M Stahl, Arnie Phillips, André F. Carvalho, Michael Berk
CNS Spectrums July 11, 2022 DOI: 10.1017/s1092852922000888 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | LSD Psilocybin |
| Keywords | Hallucinogen Pharmacology Tryptamine Neuropsychiatry |
| Citations | 61 |
| Key findings | Psilocybin and its active metabolite psilocin show potential as treatments for neuropsychiatric conditions, but their clinical use depends on balancing therapeutic benefits against harms through careful evaluation. |
Abstract
Abstract Psilocybin is a tryptamine alkaloid found in some mushrooms, especially those of the genus Psilocybe. Psilocybin has four metabolites including the pharmacologically active primary metabolite psilocin, which readily enters the systemic circulation. The psychoactive effects of psilocin are believed to arise due to the partial agonist effects at the 5HT2A receptor. Psilocin also binds to various other receptor subtypes although the actions of psilocin at other receptors are not fully explored. Psilocybin administered at doses sufficient to cause hallucinogenic experiences has been trialed for addictive disorders, anxiety and depression. This review investigates studies of psilocybin and psilocin and assesses the potential for use of psilocybin and a treatment agent in neuropsychiatry. The potential for harm is also assessed, which may limit the use of psilocybin as a pharmacotherapy. Careful evaluation of the number needed to harm vs the number needed to treat will ultimately justify the potential clinical use of psilocybin. This field needs a responsible pathway forward.
Comparable studies
Other narrative reviews on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population | 2019 | Integrative review | |
| The pharmacology of psilocybin | 2002 | Review | |
| Serotonin research: contributions to understanding psychoses | 2008 | Review | |
| Psychedelics, Meditation, and Self-Consciousness | 2018 | Review | |
| The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act | 2018 | Review |
Citations in the library
Cited by 59
- Sub-acute effects of psilocybin on EEG correlates of neural plasticity in major depression: Relationship to symptoms Journal of Psychopharmacology June 30, 2023
- The evolution and ecology of psilocybin in nature. Fungal Genetics and Biology June 1, 2023
- Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive–compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial Frontiers in Psychiatry April 25, 2023
- Safety pharmacology of acute psilocybin administration in healthy participants Neuroscience Applied 2024
- Pharmacokinetics of Psilocybin: A Systematic Review Pharmaceutics March 25, 2025
and 54 more in the library
Cites 74
- 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
- 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
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
and 69 more in the library