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Monday, September 06, 2010

JAMA - Moderate Doses of Psilocybin Reduce Anxiety and Depression in Advanced-Stage Cancer Patients

File:Psilocybe Cubensis.JPG

More support for the therapeutic use of psilocybin (and other hallucinogens) for anxiety, depression, and other mental health issues. This comes from the Archives of General Psychiatry, a publication of the American Medical Association, so it's as mainstream as it gets.

Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer

Charles S. Grob, MD; Alicia L. Danforth, MA; Gurpreet S. Chopra, MD; Marycie Hagerty, RN, BSN, MA; Charles R. McKay, MD; Adam L. Halberstadt, PhD; George R. Greer, MD

Arch Gen Psychiatry. Published online September 6, 2010. doi:10.1001/archgenpsychiatry.2010.116

ABSTRACT

Context Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer.

Objective To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety.

Design A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin.

Setting A clinical research unit within a large public sector academic medical center.

Participants Twelve adults with advanced-stage cancer and anxiety.

Main Outcome Measures In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment.

Results Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance.

Conclusions This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field.

Trial Registration clinicaltrials.gov Identifier: NCT00302744

The dose used was pretty small - for me, at 185 lbs, it would have been about 17 mgs. When I was using, I would often consume small dose of 3.5 grams of Psilocybe cubensis, which have an average psilocybin content of about 0.65 percent per gram, giving me a dose of about 23 mgs. Often, I used as much as 7 grams of dried mushrooms, providing 46 milligrams of the drug, so 17 mgs is a good conservative dose, through enough to produce effects in a novice.

Interestingly, of 10 subjects, 8 had prior hallucinogen experience in their lives.

Finally, this is from the discussion:

Although past researchers reported more pronounced therapeutic effects with a higher-dose model, even the lower dose of psilocybin used in the current study gave some indication of therapeutic benefit in quantitative psychological evaluations. In particular, we found that the STAI trait anxiety subscale demonstrated a sustained reduction in anxiety that reached significance at the 1- and 3-month points after treatment. This reduction might reflect a reduced level of stress and anxiety over time. Although the state anxiety on the STAI showed a modest elevation at 6 months, the change was not statistically significant and might have resulted from the deteriorating medical status of most subjects over time.

Mood also improved for 2 weeks after treatment with psilocybin, with sustained improvement on the BDI reaching significance at the 6-month follow-up point. The POMS scores also reflected improved mood 2 weeks after receiving psilocybin. Although not statistically significant, there was a trend toward positive outcome. With a larger cohort of subjects and use of a higher dose of psilocybin, it seems possible that significant results would be obtained on these measures.
Good to see.


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