A one-time, single-dose treatment of psilocybin, a compound found in psychedelic mushrooms, combined with psychotherapy appears to improve the emotional wellbeing of cancer patients for up to five years, researchers at NYU Grossman School of Medicine have found.
In a landmark study carried out in 2016, the team found that psilocybin combined with psychotherapy sessions produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralisation and hopelessness, improved spiritual well-being, and increased quality of life in a group of 29 cancer patients.
Six months later, they found that 60 per cent to 80 per cent of participants continued with clinically significant reductions in depression or anxiety, sustained benefits in existential distress and quality of life, as well as improved attitudes toward death.
Now, in a follow-up study five years later, more than 70 per cent of the participants said the psilocybin-assisted therapy brought about long-term positive life changes and rated it as among the most personally meaningful and spiritually significant experiences of their lives.
“Adding to evidence dating back as early as the 1950s, our findings strongly suggest that psilocybin therapy is a promising means of improving the emotional, psychological, and spiritual well-being of patients with life-threatening cancer,” said lead researcher Stephen Ross. “This approach has the potential to produce a paradigm shift in the psychological and existential care of patients with cancer, especially those with terminal illness.”
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Although the exact way psilocybin works is not fully understood, the researchers believe that the drug can make the brain more flexible and receptive to new ideas and thought patterns.
Previous research indicates that it targets a network of the brain known as the default mode network, which becomes activated when we engage in self-reflection and mind wandering, and helps to create our sense of self. In patients with anxiety and depression, this network becomes hyperactive giving rise to rumination and worry. Psilocybin appears to shift activity in this network and helps people to take a more broadened perspective on their behaviours and lives.
However, the researchers warn against any attempt to self-medicate using psilocybin, noting that it should be taken in a controlled and psychologically safe setting, preferably in conjunction with counselling from trained mental health practitioners or facilitators.
Reader Q&A: How do psychedelics affect the brain?
‘Classic psychedelics’ like LSD and psilocybin (found in magic mushrooms) are chemically similar to the neurotransmitter serotonin produced by the brain. Serotonin is involved in many neural functions including mood and perception. By mimicking this chemical’s effects, the drugs exert their profound effects on subjective experience.
DMT (or dimethyltryptamine) too acts via serotonergic pathways (the system involving serotonin), but also through other routes – for instance, DMT binds with sigma-1 receptors that are involved in the communication between neurons.
Meanwhile, ketamine – among many other effects – blocks NMDA receptors that are involved in the functioning of the neurotransmitter glutamate.
A key brain area for psychedelic drugs’ effects appears to be the temporal lobe, the location of much emotional and memory functioning. For instance, removal of the front part of the temporal lobe (as a radical treatment for epilepsy) has been shown to prevent the psychological effects of taking LSD.
Interestingly, abnormal activity in the temporal lobe, such as during seizures, can lead to events similar to near death experiences.
An effect shared by different psychedelic substances is that they increase the amount of disorganised activity across the brain – a state that neuroscientists describe as being ‘higher in entropy’.
One consequence of this is a reduction in the activation of a group of brain structures known collectively as the ‘default mode network’, which is associated with self-conscious and self-focused thought.
One theory, then, is that psychedelics provoke a spiritual state of oneness with the world by increasing the brain’s entropy and suppressing the ego-sustaining activity of the default mode network.