This 2016 clinical trial found that a single moderate dose of psilocybin, combined with psychotherapy, produced rapid, significant, and long-lasting improvements in anxiety and depression in patients with life-threatening cancer-related psychological distress, as well as improving spiritual wellbeing, quality of life, and attitudes towards death.
This randomized, blinded, controlled, crossover study aimed to assess the efficacy of a single psilocybin dosing session (0.3 mg/kg) in conjunction with psychotherapy, compared to one dosing session of an active control (niacin 250 mg), in treating clinically significant anxiety or depression in patients with life-threatening cancer. The total duration of study participation was approximately 9 months (mean 253 days).
Unfortunately, the lack of information provided in these types of studies can lead to confusion among consumers, who may not realize that the dosing used in the study may not be the same as the dosing from consuming whole mushrooms. Without adequate information, people may make assumptions or misunderstand the dosing recommendations, potentially leading to negative or disappointing experiences. In this study, we know that the psilocybin was synthesized in a lab as the authors thanked Organix Inc. for synthesizing it. This means that dosing will differ significantly from consuming a whole mushroom.
Through my own guesswork and calculations, I can estimate that a 0.3mg/kg dose of synthesized psilocybin would be similar to a standard psychedelic dose of whole mushrooms, which typically contain anywhere from ~0.1-2% psilocybin. By making a general assumption that you will have about 1% psilocybin content in the mushroom, and given my current weight of about 75kg, the study would give me about 22.5mg psilocybin. If a psilocybin containing mushroom has 1% psilocybin in it, that would make the dry weight dose of the entire mushroom be about 2.25g, which I would agree is about an average "moderate" psychedelic dose of psilocybin containing mushrooms.
It's important to note that dosing standards can be very confusing for those who are not as knowledgeable about the subject. People may see the 0.3mg/kg dosage and assume that taking a small amount of whole mushrooms would have the same effect, leading to disappointment and confusion when it doesn't work as expected. This is why it's important to understand the specifics of each study before attempting to replicate its results.
The majority of participants in the study had advanced stages III or IV cancer, primarily breast or reproductive and gastrointestinal. Additionally, 59% of participants had previously been treated with antidepressant or anxiolytic medication before the study, but none were on any psychotropics at the time of enrollment. Psilocybin resulted in immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life.
Furthermore, at the 6.5-month follow-up, psilocybin was associated with enduring anxiety reducing and anti-depressant effects, with approximately 60-80% of participants still experiencing clinically significant reductions in depression or anxiety. Additionally, psilocybin provided sustained benefits in existential distress and quality of life, as well as improved attitudes towards death.
The study found that psilocybin produced mystical-type experiences in participants and these experiences correlated with improvements in anxiety and depression scores, as well as other measures related to quality of life and attitudes towards death. The more intense the mystical experience, the greater the improvement in the primary outcome measures. The results suggest that the psilocybin-induced mystical experience mediated the therapeutic effects of psilocybin on anxiety and depression.
This study is novel in the field of psychiatry as it demonstrates that a single dose of a medication can lead to immediate reduction in depression and anxiety, with sustained clinical benefits, which is not typically observed with traditional anti-depressant medications. It also highlights the potential of psilocybin, when administered in conjunction with appropriate psychotherapy, as a novel pharmacological-psychosocial treatment modality for cancer-related psychological and existential distress.
While there were limitations to the study, such as a small sample size and non-nationally representative patient population, the findings offer promising results for the potential use of psilocybin in treating cancer-related anxiety and depression when used in conjunction with psychotherapy. Further research is needed to confirm its efficacy and explore its potential for a wider range of patients.
In conclusion, the results of this study provide promising evidence that psilocybin, used in combination with psychotherapy, could be a novel treatment modality for cancer-related psychological distress. The rapid and sustained clinical benefits observed, along with the positive impact on spiritual wellbeing and quality of life, highlight the potential of psilocybin as a transformative medicine in the field of psychiatry. The study also emphasizes the need for continued exploration of alternative therapies for mental health conditions, particularly in cases where traditional treatments have been ineffective. Overall, these findings offer new hope for patients and clinicians seeking effective and holistic approaches to mental health care.Study Title: Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial
Study Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367551