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Psilocybin (mushrooms)

Medically reviewed on Dec 01, 2016 by L. Anderson, PharmD

Psilocybin and psilocyn are both chemicals obtained from certain mushrooms found in Mexico and Central America.

Like peyote, the mushrooms have been used in native rites for centuries. Dried mushrooms contain about 0.2 to 0.4 percent psilocybin and only trace amounts of psilocyn. The hallucinogenic dose of both substances is about 4 to 8 milligrams or about 2 grams of mushrooms with effects lasting for about six hours. Both psilocybin and psilocyn can be produced synthetically.

Although psilocybin has been used for centuries in rituals, modern medicine has recently reported uses, as well. In December 2016, a report was published in the Journal of Psychopharmacology detailing two small studies that noted the ingredient in "magic mushrooms" - psilocycbin - can reverse the feeling of "existential distress" that patients often feel after being treated for cancer. Reportedly, cancer can leave patients with this type of psychiatric disorder, feeling that life has no meaning. Typical treatments such as antidepressants may not be effective. However, use of a single dose of synthetic psilocybin reversed the distress felt by the patients and was a long-term effect. Some advanced cancer patients described the effect from the drug as if "the cloud of doom seemed to lift."

Two studies using psilocybin were completed: one at New York University (NYU) Langone Medical Center in New York City and one at Johns Hopkins Medical School in Baltimore. For both studies, trained monitors were with patients as they experienced the effects of the drug, which can lead to hallucinations.

In the NYU study, 29 patients with advanced cancer were given either a single dose of psilocybin or the B vitamin known as niacin. After seven weeks, the patients switched treatments (a cross-over study). In 80 percent of the patients receiving psilocybin, a relief from distress occured rapidly and lasted over six months. The long-term effect was evaluated by researchers looking at test scores for depression and anxiety.

At Johns Hopkins, the researchers treated 51 adults with advanced cancer with a small dose of psilocybin followed five weeks later with a higher dose. As with the NYU study, most patients experienced relief from their anxiety and depression that lasted up to six months.

Currently, psilocybin is not available to doctors in the clinical setting because it is listed as a Schedule I drug by the US Drug Enforcement Agency (DEA). Researchers for the study were only able to get access to the illegal compound for the study through special waivers from the U.S. Food and Drug Administration (FDA). Other drugs found in Schedule I include marijuana, LSD, and heroin. In order for psilocybin to be prescribed for patients, it would have to be reclassified as a Schedule II medication, meaning it has a currently accepted medical use, but with severe restrictions due to addiction potential.

Larger studies with psilocybin are expected. Researchers at NYU are waiting on the FDA to approve a Phase III trial. However, even if approved by the FDA, psilocycbin would have to be reclassified by the DEA for it to be available for patients.

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