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Psilocybin therapy is the use of the psilocybin (the active ingredient in psilocybin mushrooms) in a therapeutic context. It is one of several forms of psychedelic therapy. As of 2021, psilocybin therapy is not used in standard medical practice and is illegal in most of the world.

Research

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Evidence for classic psychedelic therapy emerged after the formation and identification of LSD in 1943[1]. Original research in the 1960s was most often done using synthetic psilocybin, focusing on its therapeutic potential in terminal cancer-related anxiety and addiction.[1][2] Risk of abuse prevented further studies from being conducted until the 1990s.[2]

As of 2021, preliminary clinical studies on psilocybin therapy has shown effects on anxiety and depression in cancer-diagnosed patients, addiction, alcohol use disorder, obsessive-compulsive disorder (OCD), depressive disorders, and smoking cessation[1][3][4].

Safety

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Administering psilocybin can have a large psychological impact by inducing overwhelming emotions of anxiety, fear, and confusion. Dangerous behaviour can occur in uncontrolled environments[1]. Research on the use of psilocybin indicated it caused hallucinations with inability to establish reality from fantasy, panic reactions, and possible psychoses at high doses.[5]

In the United States, psilocybin is a Schedule I substance under the federal Controlled Substances Act, which defines a substance with having substantial potential for abuse, absence of adequate safety evidence, and no currently accepted clinical uses for therapy.[5][6]

In Canada, both psilocybin and its active metabolite psilocin are controlled under Schedule III in the Controlled Drugs and Substances Act, and are prohibited from sale, possession, or use unless approved for clinical trials and research[7].

History

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The earliest reports of the use of psychoactive mushrooms date back centuries.[8] The existence was initially denied by some, until researchers Roberto J. Weitlaner and Richard-Evans Schultes were able to obtain samples. During World War II, research was halted indefinitely.[9] In 1959, Albert Hofmann, a Swiss chemist, consumed 2.4g of dried mushrooms to prove that it was active and became the first person to extract pure psilocybin from the mushroom Psilocybe mexicana. Hofmann also identified psilocin, the active component of psilocybin mushrooms. The following year, Sandoz, the pharmaceutical company that employed Hofmann started to sell and distribute 2mg of psilocybin under the trade name Indocybin™ as psychedelic pharmacotherapy[9][10].

The Harvard Psilocybin Project was started in August 1960, when Timothy Leary conducted a self-experiment using psilocybin mushrooms. After trying pure, extracted psilocybin, he and Dr. Richard Alpert tested whether it could help reduce recidivism rate and constitute an effective psychotherapy aid. In 1963, Leary and Alpert were suspended from their jobs at Harvard University, due to irresponsible and dangerous experimentation with psilocybin mushrooms.[11] Psilocybin research in the United States ended in 1970 when the use and possession of psilocybin mushrooms became illegal.[12][13] After 25 years, human psychedelic research started up again, providing foundational information for future studies to use.[14]

In 2018, the United States Food and Drug Administration (FDA) granted breakthrough therapy designation to Compass Pathways Ltd. to facilitate further research for psilocybin and its effects on treatment-resistant depression.[9][15] The FDA also approved the same breakthrough therapy status to the Usona Institute for psilocybin treatment for major depressive disorder (MDD).

In November 2020, the U.S. state of Oregon legalized psilocybin for people age 21 and older, and decriminalized possession or use of psilocybin mushrooms for medical conditions, such as depression, anxiety, or PTSD.[16]

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As of 2021, psilocybin has no federally-accepted medical use in the United States.[17] In Germany, psilocybin mushrooms and spores are considered as controlled substances illegal to possess or transport.[18] Psilocybin has been decriminalized in Austria, Italy, Portugal, and Spain. In some places like Brazil and the British Virgin Islands, possession and personal use of magic mushrooms are legal[19].

See also

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  1. ^ a b c d Johnson, Matthew W.; Griffiths, Roland R. (2017-07-XX). "Potential Therapeutic Effects of Psilocybin". Neurotherapeutics. 14 (3): 734–740. doi:10.1007/s13311-017-0542-y. ISSN 1933-7213. PMC 5509636. PMID 28585222. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  2. ^ a b Geiger, Haden A.; Wurst, Madeline G.; Daniels, R. Nathan (2018-10-17). "DARK Classics in Chemical Neuroscience: Psilocybin". ACS Chemical Neuroscience. 9 (10): 2438–2447. doi:10.1021/acschemneuro.8b00186. ISSN 1948-7193.
  3. ^ Andersen, Kristoffer A. A.; Carhart‐Harris, Robin; Nutt, David J.; Erritzoe, David (2021-02-XX). "Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies". Acta Psychiatrica Scandinavica. 143 (2): 101–118. doi:10.1111/acps.13249. ISSN 0001-690X. {{cite journal}}: Check date values in: |date= (help)
  4. ^ Johnson, Matthew W.; Garcia-Romeu, Albert; Griffiths, Roland R. (2017-01-02). "Long-term follow-up of psilocybin-facilitated smoking cessation". The American Journal of Drug and Alcohol Abuse. 43 (1): 55–60. doi:10.3109/00952990.2016.1170135. ISSN 0095-2990. PMC 5641975. PMID 27441452.{{cite journal}}: CS1 maint: PMC format (link)
  5. ^ a b "Psilocybin" (PDF). Drug Enforcement Agency, US Department of Justice. 1 April 2020. Retrieved 24 March 2021.
  6. ^ "Psilocybin (magic mushrooms)". Drugs.com. 2021. Retrieved 24 March 2021.
  7. ^ Canada, Health (2012-01-12). "Psilocybin and psilocin ("Magic mushrooms")". aem. Retrieved 2021-04-14.
  8. ^ Akers, Brian P.; Ruiz, Juan Francisco; Piper, Alan; Ruck, Carl A. P. (2011-06-XX). "A Prehistoric Mural in Spain Depicting Neurotropic Psilocybe Mushrooms?1". Economic Botany. 65 (2): 121–128. doi:10.1007/s12231-011-9152-5. ISSN 0013-0001. {{cite journal}}: Check date values in: |date= (help)
  9. ^ a b c Nichols, David E. (2020-10-XX). "Psilocybin: from ancient magic to modern medicine". The Journal of Antibiotics. 73 (10): 679–686. doi:10.1038/s41429-020-0311-8. ISSN 0021-8820. {{cite journal}}: Check date values in: |date= (help)
  10. ^ Daniel, Jeremy; Haberman, Margaret (2018-03-23). "Clinical potential of psilocybin as a treatment for mental health conditions". The Mental Health Clinician. 7 (1): 24–28. doi:10.9740/mhc.2017.01.024. ISSN 2168-9709. PMC 6007659. PMID 29955494.
  11. ^ "When Did Psilocybin Mushrooms First Appear In Human Culture?". The Third Wave. 2016-07-27. Retrieved 2018-05-15.
  12. ^ "Psilocybin" (PDF). Drug Enforcement Agency, US Department of Justice. 1 April 2020. Retrieved 24 March 2021.
  13. ^ Daniel, Jeremy; Haberman, Margaret (2018-03-23). "Clinical potential of psilocybin as a treatment for mental health conditions". The Mental Health Clinician. 7 (1): 24–28. doi:10.9740/mhc.2017.01.024. ISSN 2168-9709. PMC 6007659. PMID 29955494.
  14. ^ Carhart-Harris, Robin L.; Goodwin, Guy M. (2017-10). "The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future". Neuropsychopharmacology. 42 (11): 2105–2113. doi:10.1038/npp.2017.84. ISSN 1740-634X. PMC 5603818. PMID 28443617. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  15. ^ "FDA grants Breakthrough Therapy Designation to Usona Institute's psilocybin program for major depressive disorder". www.businesswire.com. 2019-11-22. Retrieved 2019-11-25.
  16. ^ "Act: Be It Enacted by the People of the State of Oregon" (PDF). Elections Division, Secretary of State, Oregon. 2 July 2019.
  17. ^ "Psilocybin" (PDF). Drug Enforcement Agency, US Department of Justice. 1 April 2020. Retrieved 24 March 2021.
  18. ^ "Anlage I BtMG - Einzelnorm". www.gesetze-im-internet.de. Retrieved 2021-03-24.
  19. ^ "Magic Mushroom Legality Around the World". EntheoNation. 2019-05-22. Retrieved 2021-04-22.