Blog | Monday, January 9, 2017

Mushrooms (psilocybin) studied for oncology and depression

In “study of the week” news, major media outlets reported on two small studies looking at the possible benefits of the chemical psilocybin, the ingredient found in psychedelic mushrooms.

Both studies were conducted in volunteers with cancer who also had concomitant depression and anxiety that was assumed related to their cancer.

The interesting headline-grabbing finding was that after a single dose (“trip”) with psilocybin, a majority of patients in both trials reported improved mood, decreases in mental health symptoms, and positive experiences with the drug (i.e. good trips).

Here's the kicker: Six months after their trips, without additional drug, many of the study participants still reported improved mental health.

Study 1 was conducted at NYU and involved 29 patients. The study found that at 6.5 months, “60-80% of the participants continued with clinical significant reductions in depression or anxiety.”

The second study was conducted at Johns Hopkins, involved 51 patients, and had similar findings. Note how the second study describes the orchestration of its sessions:

“Psilocybin sessions

“Drug sessions were conducted in an aesthetic living-room-like environment with two monitors present. Participants were instructed to consume a low-fat breakfast before coming to the research unit. A urine sample was taken to verify abstinence from common drugs of abuse (cocaine, benzodiazepines, and opioids including methadone) …

“For most of the time during the session, participants were encouraged to lie down on the couch, use an eye mask to block external visual distraction, and use headphones through which a music program was played. The same music program was played for all participants in both sessions. Participants were encouraged to focus their attention on their inner experiences throughout the session. Thus, there was no explicit instruction for participants to focus on their attitudes, ideas, or emotions related to their cancer.”

Both studies appeared in the Journal of Psychopharmacology. While I agree this news is of general interest, I think the media reporting on the studies is overly sensational. Many doubts remain about the safety of psilocybin. Cancer patients, and indeed the lay public, are vulnerable to this sort of unchecked hype. Issues unaddressed:
• negative effects of psilocybin (i.e. no reporting on any adverse effects), which were listed in the studies
• cost
• alternatives
• small sample sizes in the studies

Overall, I'm glad that researchers are reconsidering ideas long thought too risky or out of bounds. But more science needs to be done before psilocybin is ready for mainstream use.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.