Jessica Wiebe

 Psilocybin: A Useful Alternative? Jessica Wiebe For Anna Nagy Ryerson University CPSY 325 ID500794593 In today’s fast-paced and ever changing society, more and more people are being diagnosed with mental health disorders. Approximately half a billion people in the world are plagued by mental health problems, and one million deaths each year are a result of suicide (Hendricks, Thorne, Clark, Coombs & Johnson, 2015). In North America, approximately twenty percent of people living with depression don’t respond to typical treatments, and many who do, eventually relapse (Hendricks, Johnson & Griffiths, 2015). For this reason, it is important to examine the possibility of alternative forms of treatment for those who do not respond well to standard therapies. In recent years, researchers have begun to look at the effects of psychedelic alternatives, such as ayahuasca, LSD, peyote and psilocybin, (magic mushrooms), on the treatment of disorders such as depression, addiction and obsessive-compulsive disorders. Results have been promising as these psychedelics can result in meaningful experiences that lead to a long-term positive mood (Hendricks et al., 2015), without long term side effects, are non-addictive, and there is no evidence to indicate they cause brain damage or long-term mental health problems (Krebs & Johansen, 2013). What follows is evidence of the safety and efficacy of psychedelics, psilocybin in particular, in treating mental disorders that, until recently, have been difficult to manage. Researchers now know that the amygdala is an important element of how we perceive and generate of emotions (Kraehenmann, et al., 2015). According to Kraehenmann et al., (2015), there is a relationship between hyperactivity in the amygdala and negative mood in response to negative stimuli. This has been consistently found in people with depression and those with increased risk of major depression. After using SSRIs (selective serotonin reuptake inhibitors), hyperactivity decreased, and there was an increase in positive mood. Psilocybin, which is the main psychoactive component of many species of mushroom, acts as a selective agonist on serotonin receptors (Kraehenmann et al., 2015). It has been shown to alter neural activity and to allow changes in the way we process emotions. This suggests that psilocybin has antidepressant characteristics, because it increases positive states of mind and reduces the negative responses to negative stimuli, which can last for up to six months (Kraehenmann et al., 2015). Using fMRI, Kraehenmann et al., (2015), studied the neural effects of psilocybin on brain activity during the processing of emotions, with focus on the amygdala. After looking at emotion inducing pictures and videos and rating their emotional state, results showed that psilocybin significantly increased positive affect but not negative affect and it significantly reduced right amygdala activation to both positive and neutral pictures. Overall, it reduced amygdala reactivity and increased subjective reports of positive mood without increasing anxiety. This means that psilocybin has the potential to counteract the amygdala hyperactivity in people with depression. As previously mentioned, psilocybin acts as an agonist on serotonin receptors, specifically, the 5-HT2A receptor (Hendricks et al., 2015). It is novel in this sense because current SSRIs are not direct agonists for the 5-HT2A receptor, which appears to be the receptor most closely related to the reuptake of serotonin (Carhart-Harris et al., 2016). Increased 5-HT2A receptor density is associated with suicide risk factors and suicidal behaviour (Hendricks et al., 2015). Other risk factors for suicide include impulsive-aggressive personality traits and traumatic life-events, (Hauton & van Heeringen, 2009 as cited in Hendricks et al., 2015). Disturbances in affect, however, is one of the most significant contributors to suicidality (Hendricks et al., 2015). The use of psilocybin may lead to improvements in “inner peace, patience, good humour, anger and compassion,” and can help with “processing trauma by enhancing the recall of autobiographical memories” (Carhart-Harris et al., 2012 as cited in Hendricks et al., 2015, p.182). Research was conducted by Hendricks et al. (2015), to examine the relationship between lifetime psychedelic use and past month psychological distress and past year suicidality. They used data from the 2008-2012 National Survey of Drug Use and Health in the United States. Of the 191,832 people who completed the survey in those years, 27,235 were lifetime psychedelic drug users and of those, 20,274 reported lifetime psilocybin use. Only 12,657 users reported psychological distress in the last month, 10,445 reported past year suicidal thinking, 3157 reported past year suicidal planning and 1716 reported past year suicidal attempt. Overall, these results show that lifetime psilocybin use is associated with a 19% reduction in the likelihood of psychological distress, (compared to non-users), a 14% reduction in suicidal thinking, a 29% reduction in suicidal planning, and a 36% reduction in suicide attempt (Hendricks et al., 2015, p.182). The limitation to this however, is that it’s a self-report study. In September of 2015, Henricks, Johnson and Griffiths expanded on their previous study to focus solely on psilocybin. Using the same data, they used four mutually exclusive groups: psilocybin only, psilocybin and other psychedelics, non-psilocybin psychedelics, and no psychedelics. Of the same 191,832 respondents, 7550 used only psilocybin, 12,724 used psilocybin and others, 6963 used no psilocybin and 164,595 were non-users. Looking at the same factors as previously studied (past month distress and past year suicidality), the odds of all four outcomes were reduced in the psilocybin only group as compared to the no psychedelics group. Past year suicidal thinking and planning were reduced in the psilocybin only group as compared to the psilocybin and others group, and the odds of past month distress were reduced in the psilocybin group as compared to non-psilocybin psychedelics group. These results suggest that psilocybin has the greatest therapeutic potential and that lifetime use may be especially protective against psychological distress and suicidality (p.1042) Carhart-Harris et al. (2016), conducted research on the use of psilocybin to alleviate treatment-resistant depression. All participants had moderate to severe depression and had previously tried two different treatments with no success. Using two small, controlled doses one week apart, results showed that depression scores were significantly reduced after only one week. While maximum effects were seen at the two-week mark for four of the patients, eight of the twelve were in complete remission after two weeks, and seven of the twelve patients had kept those low scores at the three-month follow-up. It is also important to note that under these controlled conditions, there were only mild side-effects including brief anxiety and confusion as well as temporary headache. The results of this particular study may be hard to generalize due to the small study size, but the positive results here definitely warrant further studies, perhaps also integrating a placebo group for result comparison. Finally, psilocybin may be useful for more than just depression. In another small study, Moreno, Weigand, Taitano and Delgado (2006), wanted to know if this psychedelic treatment could be used to reduce symptoms of obsessive-compulsive disorder (OCD). OCD is commonly comorbid with panic, suicidality and depression (Moreno et al., 2006). Currently, SSRIs are one of the most effective treatments besides cognitive behaviour therapy, but they only reduce 30-50% of symptoms and 40-60% of patients fail to respond to standard therapies (Moreno et al., 2006). As cited in Moreno et al., (2006), Moreno and Delgado (1997) came across the story of a 34-year-old man with OCD who began using magic mushrooms at the age of 18. He found that he was symptom free when using the drug. Repeated use eventually made him tolerant to the psychedelic effects of the drug but he noticed he remained symptom-free and even after quitting, he remained in remission for several months. For the study mentioned above, Moreno et al., (2006) recruited seven people with OCD who had undergone at least one failed treatment with SSRIs. They received one dose per session (each week) for a period of four weeks. The only side effect noted was mild hypertension. Results showed an overall reduction of symptoms that began within twenty-four hours and lasted up to one week. Again, small study size is a limitation but shows the importance of further research in this area. In summary, past and current research has shown amazing potential for the use of psilocybin for treatment-resistant depression, obsessive-compulsive disorder and even addiction (Johnson, Garcia-Romeu, Cosimano & Griffiths, 2014). It has limited to no adverse side-effects and no evidence of long-term mental health problems as a result of use. It has been shown to greatly reduce rates of panic attack symptoms and a to lower rates of inpatient mental health treatment and psychological medication treatment (Teris & Pal-Orjan, 2013). Despite the small numbers of participants in the aforementioned studies, it is quite obvious that this particular drug warrants further research into its overall use as a treatment for psychological disorders, and it seems particular focus should be placed on its use as a serotonin receptor agonist. Psilocybin shows great promise as a treatment for people with mental health problems where other treatments have failed. No one should have to learn to simply deal with major symptoms and this novel drug could ease, if not completely eradicate, their symptoms to help them live normal and productive lives. References Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day, C. 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