The medical use of psilocybin, the main psychoactive component of psilocybin-producing (“magic”) mushrooms, has been explored in a litany of disease states, as recently reported in a comprehensive review evaluating the medical application of psilocybin in a smattering of conditions related to neuropsychiatry.
Global concern for mental health disorders rose swiftly in the year 2020, with annual data reporting an estimated worldwide incidence of disorders relating to mental-health or substance-abuse affecting up to one billion individuals. The coronavirus (COVID-2019) pandemic exacerbated the incidence of such conditions, many of which fall under the umbrella of anxiety and depression. Currently, psilocybin is the most studied psychedelic, with most modern psychedelic research focusing on psilocybin’s application in mood and anxiety disorders.
Several studies included in the review evaluated psilocybin treatment in depressive disorders related to cancer, AIDS, psychopathy, borderline and narcissistic personality disorders, and more. Studies investigating psilocybin use for anxiety-related disorders such as post-traumatic stress disorder, social and generalized anxiety disorders, obsessive-compulsive disorder, adjustment disorder, and others were discussed in conjunction with studies evaluating psilocybin treatment of substance abuse disorders relating to alcohol, stimulants, cocaine, tobacco, nicotine, opioids, and cannabis. Disorders related to criminality such as domestic abuse and intimate partner violence were mentioned, with multiple studies delivering positive findings associated with a reduction in partner-directed violence after psilocybin use, further emphasizing the potential psilocybin carries for improving emotional regulation.
Numerous clinical studies featured in the review showcased the analgesic, i.e., pain relieving, merits of psilocybin, demonstrating its potential to alleviate pain from cluster (“suicide”) headaches, uncontrollable phantom-limb pain, and chronic pain syndromes. Authors of the review suggested pain relieving effects of psilocybin to be attributed to the chemical’s interaction with nerve pathways responsible for pain sensation and cessation. Notably, some studies reported the analgesic effects of psilocybin to be comparable to or more effective than traditionally used pain-relieving medications such as opioids.
Following the 1971 United Nations Convention on Psychotropic Substances leading to the Schedule 1 classification of psilocybin (deeming the substance unsafe and unviable for accepted medical treatment), years of legislative blockade curbed the use of psychedelics in clinical research endeavors; however, the past decade has seen resurging interest in the utility of psychedelics, namely psilocybin, in medicine. November 3, 2020 marked a milestone in psilocybin legalization, with the state of Oregon (USA) spearheading plans to regulate the psychoactive drug for therapeutic use. The following day, promising results from the first randomized controlled trial utilizing psilocybin for the treatment of major depressive disorder were released by Johns Hopkins, one of many breakthrough studies included in this review. Another study presented in the review evaluated the use of psilocybin for treatment of depressed mood and anxiety in cancer patients, demonstrating results suggesting potential for psilocybin to alleviate symptoms and increase the quality of life in patients with life-threating cancer diagnoses.
Many studies featured in this review have confirmed the potential of psilocybin-assisted therapy as an effective tool for aiding treatment of many psychiatric mood-related disorders, in addition to alleviating the physical pain of several chronic pain syndromes.
Authors emphasized the need for increased research efforts directed towards psilocybin synthesis to meet the demands of a global market that is seeing renewed research focus, thereby an increased demand for psilocybin that cannot be satiated by continued extraction of the psychoactive chemical from naturally growing or cultivated mushrooms. Such demand has been further catalyzed by the globally increasing rate of mood and anxiety disorders in conjunction with increased decriminalization efforts, cultural acceptance, and number of scientific publications evaluating medicinal use of psilocybin, as demonstrated in this review. As investable opportunities in cannabis ventures have waned, a business-case has emerged followed rapidly changing global trends turning the spotlight to psilocybin, with attention evidenced by increased public offerings of psychedelic companies and investors eagerly following suit. Globally, the psychedelic therapeutic market is predicted to reach a valuation of 6.8 billion USD by 2027 at a compound annual growth rate of 16.3%.
Comprehensive exploration of a multitude of scientific publications featuring psilocybin-assisted treatment within this review has demonstrated strong marked potential for its role as an effective, safe, and most importantly, feasible adjunctive tool for medical use in a diverse array of conditions. Development of psilocybin-based drugs used in therapeutic regiments officially approved by governmental and medical bodies for treatment of such conditions may be achievable soon. Larger, thoroughly vetted clinical studies to assess the safety, dose-response relationships, and pharmacological interactions of psilocybin are necessary to propel such endeavors. Standardization of psilocybin treatment practices and the elimination of years of residual stigmatization surrounding the medical use of psychedelic substances must be achieved before such a future is realized.
