Psilocybin therapy

Potential anxiolytic and antidepressant mechanisms of psilocybin include serotonergic and psychedelic effects in the brain.[1][2]

In vitro research indicates that mechanisms of psilocybin pharmacological action are mediated by binding to 5-HT2 receptors.[3]

In October 1799, the first experiment investigating mushrooms and their psychedelic effects took place in London. It was conducted by Dr. Everdad Brande, who visited and observed families whose members were seized with visions and laughter following consumption of wild mushrooms. Later, these mushrooms were examined and classified as Agaricus Glutinosus and reclassified as Psilocybe Semilanceata at a later point in time.[8]

As European travelers, traders and missionaries arrived in these areas where mushroom consumption was common, they attempted to ban mushroom consumption and possession, arguing they were unhallowed, indulgent and dangerous.

In 1959, Albert Hofmann, as Swiss chemist, was the first person to ever extract pure psilocybin from the mushrooms that commonly contain it (Psilocybe mexicana). Sandoz, the company that Hofmann worked for at that time, then began to sell the active compound to clinicians and physicians all across the world, which then used the drug as an aiding substance in psychedelic psychotherapy.

In August 1960, Timothy Leary, a psychology professor from Harvard University, traveled to Mexico to conduct a self-experiment using psilocybin mushrooms. After trying pure, extracted psilocybin he decided to experiment even more with the substance, even administering it to his students. In conducting his experiment, he was assisted by his colleague, prof. Dr. Richard Alpert. One of their experiments consisted of administering psilocybin to prisoners, attempting to find out whether it could help reduce recidivism rate and constitute an effective psychotherapy aid. In fact, the results showed a recidivism rate that was 40% lower than expected. In another experiment, Leary and Alpert gave psilocybin to divinity graduate students with the aims of observing the effects of the drug on spiritually predisposed subjects. Students confirmed afterwards that their experience had made positive, lasting changes in their lives.

In 1963, however Dr. Leary and Dr. Alpert were faced with disapproval from other colleagues at Harvard University, eventually leading to their suspension from their jobs at the University. Academics criticized their experiments and their project, describing it as irresponsible and dangerous.[9]

Around the years 1960-1977, psilocybin was first studied as a psychotherapeutic drug. Research on humans in this field was approved by the Food and Drug Administration (FDA), but after a while it was ended and did not continue until the late 1990s, when research on the medical use of psilocybin was finally picked up again.

In 2011, a study conducted at Johns Hopkins School of Medicine showed that about 60% of the subjects that were given psilocybin under controlled conditions underwent significantly positive personality changes concerning traits like openness, imagination or feelings. On the basis of these findings, researchers have since been working on studies of psilocybin treatments in patients with cancer, who frequently experience depression, anxiety or ache.[10]

Psilocybin is listed as a Schedule I drug under the United Nations 1971 Convention on Psychotropic Substances.Therefore, the legal status of psilocybin varies internationally. In Jamaica, any kind of psilocybin is legal and openly sold.[11] Psilocybin is partially legal in the Netherlands. Possessions of 0.5g dried or 5g fresh psychoactive mushrooms is allowed, but everything whereas major amount will lead to a penalty.[12] In Australia, Bulgaria, Belgium, Canada, Denmark, Finland, France, Germany, Hong Kong, Indonesia, Ireland, Japan, New Zealand, Poland, Russia, South Africa, Sweden, Taiwan, Turkey, the UK and the US psilocybin is illegal and therefore possession, use or cultivation will usually lead to significant punishment. Psilocybin is not legal worldwide, but psilocybists argue that it is very important to have research on the positive consequences on mental illnesses. Thus, there is a bureaucracy to follow for the permission of psilocybin as use for researches.[13][14]

In Germany, psilocybin therapy is not illegal per se but the usage of psychedelic drugs like LSD or psilocybin while therapy generally is unlawful. Furthermore, the German Medical Association stated in 2010 an explicit warning about the application of drugs as part of therapy after two patients died during a poly-drug therapy session that year. The drugs used, although including psilocybin and LSD which are known to be reasonably safe, also included more dangerous drugs such as MDMA, heroin and amphetamine.[15]

In the United States it is only possible to receive a psilocybin therapy in context of a study to the effects of this therapy form on different psychological illnesses. The same is true for the United Kingdom and the Netherlands. All three countries are pioneers in studying psilocybin therapy. In 2006 for example people with Obsessive-compulsive Disorder were able to apply for a study at the University of Arizona which observed the effects of psilocybin therapy on OCD.[16]

Since 2014 the Swiss authorities give permission for the usage of psilocybin in some individual cases.[17]

The usage of psilocybin holds a low but unpredictable chance of eliciting panic attacks, lasting flashbacks of the drug experience or even a psychosis, which serves as one of the reasons why psilocybin is illegal in many countries and not used in therapy.[18] Another reason was formulated by the president of the German Medical Association in 2010 appealing to official psychotherapies as aiming to support a patient's self-organization instead of a drug-based therapy.[15] On the other hand, there is increasing evidence for the medical practicality of psilocybin. Also, different studies showed that it is not likely that psilocybin induces dependence and the therapeutic index for psilocybin is about 1000, contrasting, for example 10 in alcohol.[19]