Psilocybin: a single dose relieves Existential Distress in cancer patients

Location: 2015 Meeting of the American College of Neuropsychopharmacology
Date: 10 December 2015
Synopsis: Dr. Roland Griffiths (Johns Hopkins) presented some pre-publication results of a study that utilized psilocybin to reduce the anxiety and depression that frequently accompanies patients with a life threatening cancer diagnosis. Patients receiving relatively high doses of psilocybin sufficient to induce changes in perception and to frequent a mystical experience reported significantly decreased levels of anxiety and depression compared with patients that received a low dose of the drug. The positive effects on mood were still present in those patients at a 6 month follow-up. Both Johns Hopkins and NYU have recently completed studies with cancer patients given therapeutic doses of psilocybin although there were nuances that made each study unique.  My best guess is their research may be published in early 2016.  It is my hope they will both be published at the same time, separately but in the same journal/issue for maximum public/media impact.

The following is from the meeting abstract found in Neuropsychopharmacology (2015) 40, S1–S105:

Methods: The study used a randomized, double-blind, cross-over design to investigate the acute and sustained effects of a very low psilocybin dose (1 or 3 mg/70 kg) vs. a moderate-high dose (22 or 30 mg/70 kg). Instructions to participants and staff minimized expectancy effects. 51 patients with a life-threatening cancer diagnosis who had symptoms of anxiety or depression received a low or high dose of psilocybin in counterbalanced order with about 5 weeks between sessions and a final follow up at 6 months. For this preliminary analysis, results between the low (n=25) and high (n=26) dose groups on the first session were compared. Enduring effects were assessed at a 6 month follow-up.
Results: On session days, the high dose group showed substantially greater effects including perceptual changes, mystical-type subjective experiences, and labile mood. At the 5-week follow-up the high dose group showed significantly lower anxiety (STAI Trait Anxiety, HAM-A) and depression (BDI, HAM-D) compared to the low dose group (effect size mean and range 0.98, 0.60-1.30). The participants attributed significantly greater positive changes in attitudes about life/self, positive social effects, and positive behavior changes to the experience, and a higher percentage reported the experience to be among the 5 most personally meaningful of their lives (54% vs. 16%). Total mystical experience scores at the end of the session showed significant negative correlations with the above measures of anxiety and depression at 5 weeks. Partial correlation analysis showed this relationship remained significant after controlling for ratings of intensity of drug effect. The decreases in anxiety and depression were sustained at 6 month follow-up.
Conclusions: A single moderate-high dose of psilocybin, when administered under supportive conditions to carefully screened and prepared participants, can produce substantial and enduring decreases in anxiety and depression in patients with a life-threatening cancer diagnosis.

My assessment: Psilocybin is non-addicting with less toxicity than caffeine. There are no currently available medications that improve cancer patient's mental health this significantly and it only has to be taken once or twice with the proper Set and Setting. Cancer patients with a life threatening diagnosis often experience a profound Existential Distress as do those with PTSD so it is reasonable to expect psilocybin given in a therapeutic dose in a supportive environment will provide a similar benefit to those with PTSD.

DoD and/or VA researchers, the science is there, it just needs to be followed.  Those with PTSD need your help and courage.

A New Understanding: The Science of Psilocybin in an excellent 1 hour documentary that profiles two cancer patients, both now deceased, who had experienced profound benefit from participating in the psilocybin trials being conducted at Johns Hopkins, UCLA and NYU. A panel discussion following the screening of the documentary 'A New Understanding: The Science of Psilocybin' is 1.5 hours long and features many of the researchers producing this life altering knowledge. During the panel discussion, it was mentioned that an application for compassionate use was submitted to the FDA for cancer patient to be allowed access to psilocybin but they were doubtful it would be passed.

“Man is not destroyed by suffering. He is destroyed by suffering without meaning.” Victor Frankl

Microdosing psilocybin

The focus of this website is to encourage psilocybin research for the treatment of PTSD. However, there has been numerous news articles recently exploring the use of microdoses of psilocybin and other 5-HT2A receptor agonists.  Reported benefits include lifting of depression, increased energy, and increased creativity. Two of these articles have been from prominent, traditional publications:

• Short Trip? More People 'Microdosing' on Psychedelic Drugs  NBC News July 2015
• LSD Microdosing Deserves More Serious Research  Forbes November 2015

James Fadiman Ph.D., who has been involved with psychedelic research since the 1960's, published a book in 2011 titled The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys.  One chapter of the book is devoted to microdosing.

I'm not sure at what point a "low dose" becomes a "microdose" but the concepts are similar.  In an earlier post, "Comment on low dose psilocybin for treatment of PTSD", I discussed how The article by Catlow BJ et al. (Exp Brain Res. 2013 Jun 2. [Epub ahead of print]), demonstrates how a low dose (0.1 mg/kg) of psilocybin helps mice overcome a conditioned fear response significantly quicker than a medium (0.5 mg/kg) or high dose of psilocybin (1.0 mg/kg) and results in hippocampal neurogenesis while the higher doses result in a decrease in cell survival.

Antidepressant medication known as SSRIs (serotonin reuptake reuptake inhibitors) are thought to work by increasing synaptogenesis/neurogenesis.  Given the results of the Catlow study above, it is reasonable to conclude that microdosing also results in an increase in hippocampal synaptogenesis/neurogenesis as well.

The good thing about microdosing with psilocybin is that no prescription is required.  The bad thing about microdosing with psilocybin is that no prescription is available. This discrepancy will change when Federal authorities move psychedelics from Schedule I to Schedule II status. Reclassification as schedule II will allow unimpeded research to determine how it works, effective dosages, and potential side effects.  Since a significant portion of the American public is attempting to work this out themselves, professional guidance would be prudent.

A recent article in the Journal of the American Medical Association (Aug 4, 2015) found that current treatments for post-traumatic stress disorder (PTSD) such as Prolonged Exposure Therapy and Cognitive Processing Therapy are not proving effective. "There is a need for improvement in existing PTSD treatments and for development and testing of novel evidence-based treatments, both trauma-focused and non–trauma-focused".   Psilocybin is a novel treatment that deserves to be investigated as it holds great promise to end the suffering of many with PTSD when provided with appropriate Set and Setting. The therapeutic psilocybin sessions could be couched within concurrent Cognitive Behavioral Therapy to allow the therapeutic integration of the psychedelic/spiritual experience. The JAMA article above has been cited by (Google Scholar).

NSI-189

Another promising antidepressant, NSI-189, has just completed a phase 1B Clinical Trial, led by Massachusetts General Hospital (MGH) investigators with the results published in Molecular Psychiatry on 8 December 2015 (PDF). What makes this compound especially promising is it a nicotinamide derivative that was first developed as part of a Defense Advanced Research Projects Agency (DARPA) funded program and it promotes hippocampal neurogenesis. Niacin, or vitamin B3, is rapidly converted into nicotinamide after ingestion.

Astaxanthin and exercise are two additional adjuncts to hippocampal neurogenesis.

Choosing compounds that are closely related to natural, essential nutrients and avoiding halogenated hydrocarbons may be a wise choice.  Many pharmaceutical companies will add a fluorine or chlorine atom to an organic compound to give it a specific shape.  The addition of a halogen to an organic compound will frequently increase it's toxicity. "Unlike the aromatic or aliphatic hydrocarbons, the halogenated hydrocarbons tend to cause a wider range of toxicity" (source Medscape). A good method of determining if drugs have added halogens is to look in Wikipedia for the chemical structure of to Google the drug name with the added term 'structure' in the search.  Next choose 'Images' as the Google option.  Examples:

NSI-189 (Wikipedia)

NSI-189 (Google Images)

If you own a pet and treat them for fleas, you may want to stay away from Frontline for fleas. This is the 'Mother of all halogenated hydrocarbons' and I'm wondering if it doesn't increase cancer rates significantly.