HerbalEGram: Volume 3

A trial published in the online edition of Psychopharmacology on July 7 concluded that a pill containing psilocybin, an alkaloid derived from the Psilocybe mushroom (Psilocybe cubensis), induced profound mystical experiences in the majority of study participants.¹ The small placebo-controlled, double-blind trial, conducted by researchers at Johns Hopkins University, was touted in the media to be the first clinical study to investigate the effects of the hallucinogenic substance psilocybin in more than 4 decades.²*

For this trial, 30 volunteers were randomly given either 30 mg/70 kg of body weight of psilocybin or 40 mg/70 kg of methylphenidate hydrochloride (the attention-deficit disorder drug Ritalin®, Novartis Pharmaceuticals Corporation, East Hanover, NJ) for an 8-hour session, and then given the other treatment in a subsequent session 2 months later.¹ Another 6 volunteers completed 3 sessions; they were assigned Ritalin twice and given unblinded psilocybin in a third session. Neither participants nor study monitors were told which or how many participants would be given the 3 sessions, thereby enhancing the blinding of the trial and further reducing drug expectancy. Volunteers ranged in age from 24 to 64, had declared no history of hallucinogen use, and were predominantly college graduates. All participants indicated at least intermittent participation in religious or spiritual activities.
 
Sessions were conducted individually, with 2 monitors present with each volunteer. The participants were encouraged to lie down on a couch, use an eye mask, and listen to headphones playing classical music while focusing on inner experiences. Monitors were to provide assurances to any volunteers expressing fear or anxiety. Seven hours after the pills were administered, participants completed detailed questionnaires to assess subjective drug effects and mystical experience. Participants completed follow-up questionnaires 2-months after each session, before beginning any other sessions. Researchers also surveyed a few family members, friends, or co-workers of each volunteer twice after sessions.
 
According to the study’s results, 22 of the total 36 volunteers were judged to have had a “complete” mystical experience while taking psilocybin, whereas only 4 had such an experience on Ritalin. Based on data from 24 participants (excluding all 6 subjects from the unblinded psilocybin sessions) 33% of volunteers rated their experiences with psilocybin as the single most spiritually significant experience of their lives, and an additional 38% rated it among their top 5 most spiritually significant experiences. Only 8% of participants rated Ritalin among their top 5 (but not the single most) spiritually significant experiences. Seventy-nine percent of volunteers expressed that psilocybin increased their sense of personal well-being or life satisfaction, either moderately or very much, immediately following the session, as opposed to 21% for Ritalin. Follow-up surveys of participants and community observers also indicated that psilocybin may have generated lasting positive influences on participants’ behaviors and attitudes. Monitor ratings during sessions indicate that participants had higher incidences of stimulation, joy, fear, anxiety, crying, and peace during sessions with psilocybin than during sessions with Ritalin. Eleven of the total 36 participants claimed to have experienced fear during psilocybin use, and 4 of these volunteers stated that the entire session was dominated by anxiety.
 
The published trial was accompanied by 4 commentaries by medical experts, all praising the trial for its reintroduction of hallucinogens into medical study.^2,3,4,5 David E. Nichols, PhD, professor of medicinal chemistry and molecular pharmacology at Purdue University, wrote that research into psychoactive, hallucinogenic substances (sometimes termed “psychedelics,” a more controversial term still used in some of these editorials) such as LSD (lysergic acid diethylamide) was actively pursued in the 1950s and 1960s, then abruptly halted by laws passed in response to fears of widespread recreational use.² Herbert Kleber, MD, director of the Division of Substance Abuse at Columbia University, noted that the trial’s results are promising for further research into treatment of pain, depression, and substance abuse, as well as studies into the nature of consciousness.³ The commentators also praised the study’s design, which demonstrated that research with hallucinogens can be safely administered and convincingly blinded. Two commentators pointed out that even the medically trained monitors mistook psilocybin for Ritalin in 25% of the sessions.^3,4
 
The mainstream media has also publicized this trial and its potentially positive and negative ramifications. A story from ABC News quoted Nora Volkow, MD, director of the National Institute on Drug Abuse, who expressed reservations about the study of psilocybin, which she said can cause deleterious psychological effects.⁶ Although some sources quoted in the article praised the study and argued for renewed study of psychotropic substances, others criticized the study for using dangerous and unpredictable substances, having unimpressive results, and relying on questionnaires that might influence participants’ responses. A story in the Wall Street Journal emphasized that some trial participants experienced increased fear/anxiety while taking psilocybin, and it was suggested that research into hallucinogens might encourage increased recreational use and abuse of such agents.⁷ According to an article in the UK newspaper The Independent, interest in the therapeutic use of psychedelic drugs has been growing around the world.⁸

* Another U.S.-based human trial on psilocybin from Europe was initiated in 1994-1995, but it was not completed. The study was approved by both the Food and Drug Administration and the Drug Enforcement Agency, and funded by National Institute on Drug Abuse. The trial was conducted by Rick Strassman, MD, clinical associate professor of psychiatry at the University of New Mexico School of Medicine, but the research was not completed. Strassman began dose-finding work with the drug, but moved to Canada for family reasons and has not resumed the research since moving back to the United States. According to Dr. Strassman, the dose the Johns Hopkins group used -- 0.45 mg/kg for their psychedelic-naive volunteers -- is what his psychedelic-experienced volunteers found to be “the just barely psychedelic dose. Were we to have begun the full dose-response study,” he wrote in an e-mail, “0.9 mg/kg would have been our ‘high’ dose” (R. Strassman, e-mail, September 6, 2006).

-Courtney Cavaliere

References

1. Griffiths RR, Richards WA, McCann U, Jesse R. Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology [Online First]. July 7, 2006. Available at: http://www.springerlink.com/(nwvc0g45xgilxmn0ncv2lf45)/app/home/issue.asp?referrer=parent&backto=journal,1,714;linkingpublicationresults,1:100390,1. Accessed: July 13, 2006.
2. Nichols D. Commentary on: psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance by Griffiths et al. Psychopharmacology [Online First]. July 7, 2006. Available at: http://www.springerlink.com/(nwvc0g45xgilxmn0ncv2lf45)/app/home/issue.asp?referrer=parent&backto=journal,1,714;linkingpublicationresults,1:100390,1. Accessed: July 13, 2006.
3. Kleber H. Commentary on: psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance by Griffiths et al. Psychopharmacology [Online First]. July 7, 2006. Available at: http://www.springerlink.com/(nwvc0g45xgilxmn0ncv2lf45)/app/home/issue.asp?referrer=parent&backto=journal,1,714;linkingpublicationresults,1:100390,1. Accessed: July 13, 2006.
4. Snyder S. Commentary on: psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance by Griffiths et al. Psychopharmacology [Online First]. July 7, 2006. Available at: http://www.springerlink.com/(nwvc0g45xgilxmn0ncv2lf45)/app/home/issue.asp?referrer=parent&backto=journal,1,714;linkingpublicationresults,1:100390,1. Accessed: July 13, 2006.
5. Schuster C. Commentary on: psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance by Griffiths et al. Psychopharmacology [Online First]. July 7, 2006. Available at: http://www.springerlink.com/(nwvc0g45xgilxmn0ncv2lf45)/app/home/issue.asp?referrer=parent&backto=journal,1,714;linkingpublicationresults,1:100390,1. Accessed: July 13, 2006.
6. Victory J, Radhakrishnan B, Carter A. Tripping out: scientists study mystical effects of mushrooms. ABC News. July 11, 2006. Available at: http://abcnews.go.com/Health/print?id=2174998. Accessed: July 12, 2006.
7. Winslow R. Go ask Alice: mushroom drug is studied anew. Wall St. Journal. July 11, 2006: B1.
8. Laurance J. Magic mushrooms can induce mystical effects, study finds. The Independent. July 11, 2006. Available at: http://news.independent.co.uk/uk/health_medical/article1171389.ece. Accessed: July 13, 2006.