Mental Health Nurses, Psilocybin and the 5-HT2A receptor

The Journal of Psychosocial Nursing and Mental Health Services is a monthly, peer-reviewed journal for mental health nurses in a variety of community and institutional settings. For more than 50 years, the Journal has provided the most up-to-date, practical information available for today’s psychosocial nurse, including short contributions about psychopharmacology, mental health care of older adults, and child/adolescent disorders and issues.

An article (below) just published in the Journal of Psychosocial Nursing and Mental Health Services was written by Dr. Robert H. Howland, an Associate Professor of Psychiatry at the University of Pittsburgh with clinical and research experience in psychopharmacology, psychotherapy, and novel and alternative therapies for mood and anxiety disorders. Dr. Howland has numerous publications in the field of Psychiatry.

Antidepressant, Antipsychotic, and Hallucinogen Drugs for the Treatment of Psychiatric Disorders: A Convergence at the Serotonin-2A Receptor.
Abstract
Antidepressant, atypical antipsychotic, and hallucinogen drugs mediate their actions in part by interactions with the serotonin-2A (5HT2A) receptor. Serotonergic hallucinogen drugs, such as psilocybin, bind most potently as agonists at the 5HT2A receptor, producing profound changes in perception, mood, and cognition. Some of these drugs have been or are currently being investigated in small Phase 2 studies for depression, alcoholism, smoking cessation, anxiety, and posttraumatic stress disorder. However, unlike the synergistic effects of combining antidepressant and atypical antipsychotic drugs, the potential therapeutic effects of hallucinogen drugs may be attenuated by the concurrent use of these medications because antidepressant and atypical antipsychotic drugs desensitize and/or down-regulate 5HT2A receptors. This finding has important implications for optimizing the potential therapeutic use of hallucinogen drugs in psychiatry.
Howland RH.
J Psychosoc Nurs Ment Health Serv. 2016 Jul 1;54(7):21-4. 
PMID: 27362381

The take-home message from this article is the potential therapeutic effects of hallucinogen drugs may be attenuated by the concurrent use of antidepressant and atypical antipsychotic drugs because they desensitize and/or down-regulate 5HT2A receptors.

Not many nurses currently have the opportunity to be involved with this promising avenue of treatment for depression, alcoholism, smoking cessation, anxiety, and posttraumatic stress disorder since their use is limited to a relatively few Clinical Trials. However, many individuals desperate for effective treatment of these disorders have been attempting to self-treat without professional guidance which is unfortunate and can only be changed by removing medicine such as psilocybin from Schedule I status.