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Psilocybin

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Psilocybin, Psilocibin, Psilocybe mexicana, Teonanacatl, Magic Mushroom

  • See Also
  1. Hallucinogen
  • Definitions
  1. Psilocybin
    1. Tryptamine alkaloid Hallucinogen extracted from Psilocybe mexicana (Teonanacatl, Magic Mushrooms)
  • Indications
  1. Psilocybin (and Magic Mushrooms) have a long history of ilicit recreational use as a Psychedelic (DEA Schedule I)
  2. Has been proposed for management of mental health conditions
    1. Major Depression
    2. Anxiety Disorder
    3. Post-Traumatic Stress Disorder
  • Mechanism
  1. After ingestion, Psilocybine is rapidly dephosphorylated into the active agent, psilocin
  2. Psilocin activates CNS Serotonin 2A (5-HT2A)
  3. Psilocin has Hallucinogenic, Anxiolytic, and psychoactive properties
  • Precautions
  1. Even micro-dosing has potential risks (see adverse effects)
    1. However, overall appears to be a safe agent in therapeutic doses
    2. Kopra (2022) J Psychopharmacol 36(8):965-73 +PMID: 35388724 [PubMed]
  2. Online or Vape shop products have unknown safety and are not recommended
  3. Psilocybin carries Substance Abuse potential
    1. Johnson (2018) Neuropharmacology 142:143-66 +PMID: 29753748 [PubMed]
  4. Safety and efficacy in mental health studies have been in controlled settings
    1. Standardized dosing with reliable product source
    2. Medical or psychiatry supervision
    3. Adequate social support
  • Adverse Effects
  1. Mania
    1. Increased risk in personal or Family History of Bipolar Disorder
  2. Overdose or Death
    1. Increased risk in cardiovascular disease
    2. Bae (2023) Cureus 15(5):e38669 +PMID: 37288212 [PubMed]
    3. Honyiglo (2019) J Forensic Sci 64(4):1266-70 +PMID: 30548541 [PubMed]
    4. Kopra (2024) Prog Neuropsychopharmacol Biol Psychiatry +PMID: 39437962 [PubMed]
  • Drug Interactions
  1. Serotonin Syndrome
    1. Increased risk with other serotonergic agents (e.g. SSRI, St Johns Wort)
  • Efficacy
  1. Major Depression
    1. Major Depression Management has the best associated evidence for Psilocybin treatment
    2. Gukasyan (2022) J Psychopharmacol 36(2):151-8 +PMID: 35166158 [PubMed]
    3. Raison (2023) JAMA 330(9):843-53 +PMID: 37651119 [PubMed]
  • References
  1. (2024) Presc Lett 31(11): 66
  2. Lowe (2021) Molecules 26(10):2948 +PMID: 34063505 [PubMed]