Shutterstock/Eva Kristin Almqvist
Psilocybin is a psychedelic drug produced by hundreds of species of magic mushroom. In the body, psilocybin is converted into a slightly different molecule, psilocin, which acts on serotonin receptors in the brain. Its effects are very similar to LSD, but shorter lasting and requiring much higher doses.
Psychedelic trips are highly variable and difficult to describe, but typical features include distorted perception or hallucinations, an altered sense of space and time and a loss of the normal boundaries of personhood, often accompanied by euphoria. Despite its powerful effects on the mind, psilocybin has almost no physical toxicity in the body and is unlikely to cause harm or addiction.
Brain imaging studies show that psilocybin decreases blood flow as well as connectivity between important areas of the brain that control perception and cognition.
Psilocybin is being investigated as a possible treatment for mental illness, including anxiety related to advanced cancer and depression. Small studies suggest that a single dose of psilocybin can lead to long-term reductions in depression symptoms, perhaps by interrupting patterns of negative thoughts and allowing the brain to remodel itself. In 2021, a trial found that two doses of psilocybin-assisted therapy is at least as effective at reducing depression as a six-week course of escitalopram, an SSRI antidepressant.
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Several larger trials are now under way, including a study testing three different doses of psilocybin, involving multiple treatment centres in Europe and North America led by Compass Pathways, a company that aims to bring psilocybin therapies to market in the next five to 10 years.
In 2018, the US Food and Drug Administration (FDA) gave psilocybin a “Breakthrough Therapy” designation, indicating that the therapy is considered highly promising and will receive support from the FDA to accelerate the approval process.
Psilocybin is illegal in most of the world, but in 2020 Oregon became the first state to legalise its use in therapy. Denver voted to stop law enforcement agencies from targeting psilocybin users in 2019, effectively decriminalising it. Psychedelic truffles containing psilocybin can be bought legally in the Netherlands. Sam Wong
