December 9, 2020

Psilocybin for Depression

Introduction:

Natural remedies nerve damage such as psilocybin can assist patients with conditions such as depression.1 Psilocybin is the psychedelic substance found in magic mushrooms.1 Psilocybin is a controlled substance schedule 1 in the United States.1 This means it is currently not accepted to have any medicinal value and has a high potential for abuse.1 Recently the FDA approved psilocybin for use in drug trials.1 Researchers have found that psilocybin is similar to electroconvulsive therapy because of the similar brain activity occurs.1 This substance is thought to help relieve symptoms in people suffering from major depressive disorder according to a study done on November 4th, 2020 in JAMA Psychiatry.1 The study consisted of 24 people and over two-thirds responded well to the treatment.1 Over a course of 4 weeks after psilocybin treatment 50% of participants met the criteria for remission of their depression.1

What is depression?

Depression is a mood disorder where people experience symptoms of sadness, loss and anger.2 Where depression becomes a problem is in depression disorders, where a person’s sadness and loss starts to negatively impact a person’s social, health and daily interactions.2 This can lead to lost time and lower productivity and interference with work.2 Symptoms of depression may vary among men and women.2 Men typically experience symptoms related to their mood, behavior, emotional-well-being, cognitive abilities, sleep patterns, sexual interest, and physical well-being.2 Women experience symptoms related to their mood, emotional well-being, behavior, cognitive abilities, physical well-being, and sleep patterns.2 Depression can have several causes such as family history, early childhood trauma, medical conditions, brain structure and drug use.2 If depression is left untreated it can lead to some serious complications.2 Complications of depression include weight gain, physical pain, panic attacks, relationship problems, social isolation, self-harm, substance use problems and thoughts of suicide.2 There are two main types of depression disorders Major depressive disorder (MDD) and persistent depressive disorder (PDD).2 Major depressive disorder is where a person has persistent feelings of hopelessness, worthlessness, and sadness.2 To be diagnosed clinically with depression a person must have 5 or more of these symptoms within 2 weeks.2 The symptoms include feeling depressed for the majority of the day, loss of interest in regular activities, sleeping or not being able to sleep, significant wight loss or gain, slowed thinking, fatigue, feeling of guilt, loss of concentration, and recurring thoughts of death or suicide.2 The other main type of depression, persistent depressive disorder (PDD) is a milder chronic form of depression.2 Symptoms need to last 2 years in duration and its common for people to lose interest in daily activities, feel hopeless, have low self-esteem, and lack productivity.2 Treatment for depression is very complicated and there are a few options.2 Prescription medication such as antidepressants, antianxiety and antipsychotic medications are typically first line for patients with depression.2 Psychotherapy such as speaking with a therapist is another treatment option.2 Alternative therapies such as psilocybin is another treatment option being researched currently and its possible role in depression.2

How does psilocybin help with depression?

The exact mechanism of psilocybin and depression is unknown, but researchers think it is due to similar brain activity effects compared to electroconvulsive therapy.1 Psilocybin can provide a “temporary kick start” that patients may need to break out of their depression.1 The psilocybin in magic mushrooms can assist people with treatment resistant depression.1 Treatment resistant depression is when depression symptoms are not relieved with prescription medications, counseling therapy sessions, or lifestyle changes.1 Another benefit of psilocybin is the onset of action.1 In prescription medications it can take several weeks too see an effect of the medications whereas depression symptoms in one study improved in one week in patients taking psilocybin.1 This can be very beneficial in patients that are experiencing self-harm or suicidal thoughts as timing can play a major role on treatment success. Psilocybin also avoids some of the side effects that comes with taking prescription medications.1 These side effects include insomnia, fatigue and drowsiness, weight gain, loss of sexual desire and diarrhea.1

An open label trial measured the safety and efficacy outcomes for 6 months of psilocybin for treatment-resistant depression.3 This trial consisted of twenty patients (6 females) with a majority having severe, unipolar treatment resistant major depression.3 These patients received psilocybin in two oral doses, a 10mg and 25mg strength 7 days apart.3 Study subjects used the self-rated QIDS-SR16 as the primary outcome measure.3 Subjects generally tolerated the treatment and depressive symptoms were monitored from 1 week to 6 months post treatment.3 A total of 9 out of 20 patients met criteria for remission in 5 weeks.3 The study concluded that tolerability of psilocybin was good, depression symptoms showed improvements very quickly and symptoms improvement lasted for at least 6 months after treatment.3 Limitations of this trial were that it was an open-label trial, so participants knew they were getting treated with psilocybin for their resistant depression symptoms.3 More research is needed such as randomized controlled blinded trials to further test the efficacy of psilocybin and its role in depression.3

How do you take psilocybin?

Psilocybin the psychoactive component in magic mushrooms can be consumed in a variety of ways.1 It is available as a mushroom in a fresh or dried form.4 In its powdered form psilocybin can be snorted.4 Typically, it is taken orally and mixed with tea, added to foods, or fruit juice.4 Depending on how much someone takes its effects can vary depending on a variety of factors.4 Factors include how much is consumed, age and weight, location at the time of consumption, past drug use, personality and foods consumed around the time of taking psilocybin.4 People usually feel the effects of psilocybin within 30 minutes and lasts around 3-6 hours.4 Psilocybin is currently illegal in the united states but has been approved for use in clinical trials.1

Safety of psilocybin

Overall psilocybin is relatively safe as subjects in clinical trials have tolerated the psychoactive drug. Side effects have been reported in some people such as high blood pressure, fast heart rate, anxious feeling, nausea and vomiting and numbness of the tongue or mouth.4 Long term effects of psilocybin are currently unknown. Special populations of people that should not take psilocybin include people who are pregnant or plan on becoming pregnant, and children.4 Since psilocybin has not been studied in these populations it cannot be known if it has a negative effect or not. Psilocybin can also potentially interact with certain foods and medications as well.4 Avoid the combination of psilocybin with alcohol and other drugs as it could lead to additional health problems.4 It is important to discuss with your doctor prior to taking psilocybin to see if it is right for you.4

Conclusion

Natural remedies for nerve damage such as psilocybin can help patients struggling with depression.1 There are two major types of depression, Major Depressive Disorder (MDD) and Persistent Depressive Disorder (PDD).2 There is no recommended dosage due to the drug being illegal in the United States and is only approved for use in clinical trials.1 Although generally well tolerated some side effects may include nausea, high blood pressure, insomnia, and fast heart rate.4 Psilocybin has the potential to interact with substances such as alcohol and should not be used in children or if pregnant.4 It is important to discuss with your provider if psilocybin is appropriate for you. Trials have been done demonstrating psilocybin and its positive effects on people struggling with depression.1,3 Based on this information psilocybin can be possibly be considered for patients struggling with depression in the near future.1,3

References:

1. Ford, Valon. “Mushrooms for Depression? The Pros & Cons Revealed.” Success TMS, 25 Feb. 2020, successtms.com/blog/mushrooms-for-depression.

2. Higuera, Valencia. “Everything You Want to Know About Depression.” Healthline, Healthline Media, 11 Feb. 2020, www.healthline.com/health/depression.

3. Carhart-Harris, R L et al. “Psilocybin with psychological support for treatment-resistant depression: six-month follow-up.” Psychopharmacology vol. 235,2 (2018): 399-408. doi:10.1007/s00213-017-4771-x

4. Poison and Drug Information Services. “Magic Mushrooms.” Alberta, Alberta Health Services, 20 Aug. 2019, myhealth.alberta.ca/Alberta/Pages/What-are-magic-mushrooms.aspx.