Psilocybin: Definition, use, indications and risks

Psilocybin: Definition, use, indications and risks

What is psilocybin? Is the consumption of this mushroom authorized in Europe and in what cases? Update with psychiatrist Hugo Bottemanne, psychiatrist at the Brain Institute, researcher on depression and the effects of psychedelics.

Commonly called hallucinogenic mushrooms or magic mushrooms (magic mushrooms in English) or even magic truffles (Magic Truffles) when used in a recreational setting, the psilocybine (“psilocybin” in English) is the main substance psychoactive hallucinogenic mushrooms. In fact, it comes from a molecule called “psychedelic” or, in common parlance “hallucinogenic”. “Its use and consumption are not yet available or authorized in Europe”recalls Hugo Bottemanne, psychiatrist at the Brain Institute, researcher on depression and the effects of psychedelics.

Psilocybin: origin and use over time

The psilocybin molecule, psilocinsis extracted from various mushroom varieties (psilocybe, strophariades, etc.) which are found a little around the world. In each country, we have categories of mushrooms of different shapes containing this molecule, psilocin. Species bearing distinct names according to each culture, but which are therefore very close chemically. “It is also an interesting dimension from an anthropological point of view, because it is what helped to become something quite common in the history of humanity“, notes the psychiatrist. These varieties have also been used for millenniabut within the framework of rituals.

Indeed, “psilocybin was not initially used to treat patients, it was consumed by shamans to perform divination or practice medicine, he specifies. It is to Albert Hofmann, a Swiss chemist notably known for having discovered LSD, that we owe the first research into psilocybin in 1958. Today, psylocybin is tested in certain countries as part of a therapeutic use to see if consuming this substance could help improve Mental Health of certain patients. And specifically in the case of patients suffering from symptoms of resistant depression.

Psylocybin: studies and clinical trials

In the 1950s, the first scientific studies were carried out by researchers (including Albert Hofmann) on the effects on mental health of the consumption of psychotropic substances derived from psychedelic molecules (psilocybin and LSD). “A ban followed which meant that there were no more experimental studies on these molecules until the early 2000s”, reports Professor Bottemanne. Currently, he continues, “we are facing a revival of this psychedelic medicine in the medical field, with highly regulated use and not yet authorized in Europe regarding psilocybin”.

In fact, the only equivalent psychedelic molecule available and which is authorized in medicine in Europe is ketamine. “It has psychedelic effects quite similar to psilocybin”, confirms Hugo Bottemanne. On the other hand, abroad, clinical trials have begun and show positive effects, interesting results of psilocybin, particularly in the case of treatment-resistant depression, that is to say when you have depression resistant to taking two successive anti-depressants. In this context, “psilocybin, through several studies, has shown rapid effectiveness on the patient’s state of psychological health”he confirms.

In addition to depression, studies are underway to evaluate the effects of this molecule on touch (obsessive compulsive disorder), anxiety disorders and in particular on end-of-life anxiety. “Approaching death can make you anxious, especially if it is accompanied by pain, and it seems that taking psilocybin can make the approach of death much smoother”notes the psychiatrist.

Differences between psilocybin and anti-depressants?

Fast-acting effect

“The classic anti-depressants that we call conventional generally take between 2 weeks and a month to act”, reports the psychiatrist. Like ketamine, psilocybin can act from the first hours or even the first days of taking it with an improvement in depressive symptoms. “Ketamine and psilocybin are therefore part of the class of fast-acting anti-depressants which can be distinguished from classic anti-depressants., he emphasizes. Note that ketamine is a synthetic product, used in particular in anesthesia and available in Europe in specialized units for resistant depression. It can be administered intranasally or intravenously and therefore requires the installation of an infusion. “On a technical level, ketamine is more complex, but in terms of effects, it is quite similar”he explains.

Prolonged anti-depressant effect

Likewise, unlike conventional anti-depressants which must continue to be taken on average between 6 months and 1 year after remission, psilocybin could have a prolonged anti-depressant effect after a single dose. However, he says, these are still only preliminary studies, so they must be supplemented and confirmed by other studies. The main one, published in 2021 in the New England Journal of Medicine is the one led by Robin Carhart-Harris (“Trial of Psilocybin versus Escitalopram for Depression”), one of the main researchers who worked on this molecule in England. More recently, in November 2022, another study appeared in the NEJM, entitled “Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression” reveals how a single dose of psilocybin could help treat episodes of resistant major depression.

Psychedelic effects and modification of perception

Another specificity of psilocybin compared to classic antidepressants according to our expert: “It has subjective psychedelic (i.e. mind-opening) effects that can resemble hallucinogenic effects when taken”. Consuming psilocybes also causes change in perception and what is called ego dissolution. “This dissolution of the ego give it feeling of being in a strong connection with the surrounding world and an impression of understanding, discovery, extralucencyhe adds.

Finally, the advantage of psilocybin is that it is not addictive in the biological sense of the term. “This molecule does not cause an addictive effect, it is not considered addictogenic”, reveals the psychiatrist. Be careful, however, he warns: it can create a psychological dependencenamely causing the consumer to want to find the same effects.

Psilocybin: what effects?

The molecule present in these so-called “magic” mushrooms can cause hallucinations like another drug: LSD. “But psilocyne has other effects, notably that of modify the brain’s state of consciousnessthis is why we prefer the term ‘psychedelic'”, explains the psychiatrist. Furthermore, as the Government of Canada reports on its site, the consumption of psilocybin can lead to other symptoms and side effects such as numbnessparticularly of the face, increased heart rate and blood pressureand dry mouthof the nauseavomiting, muscular weaknessof the spasms, convulsions or even exaggerated reflexes. Finally, just like alcohol and other drugs, taking this psychedelic mushroom can result in what is called a bad trip (bad trip in French).

Use and precautions for use

“In the medical context, in pharmacology, this treatment is offered to patients in the form of capsules, reports Hugo Bottemanne. In general, “There is one to two takesoften a first taking of a small dose to see if the effects are well tolerated, then one to two weeks later, the actual taking, and which is the therapeutic taking that we find in particular in the protocols ofe Dr Robin Carhart-Harris (member of the neuropsychopharmacology unit at Imperial College London), details Hugo Bottemanne. He also strongly advises against recreational use by consuming it like a drug. : it is important that taking psilocybin is supervised by a doctor specializing in psychedelic medicine. According to him, we must therefore be careful – especially when traveling abroad – of people presenting themselves as specialists in psychedelic medicine. The reason ? Their practices may not be consistent with good usage practices. This is for example the case of ayahuasca, a hallucinogenic drug served in the form of a drink made from the bark of lianas. Its promise: to live a psychedelic experience allowing you to enter into contact with the world of spirits.

Even if they are natural drugs, like cannabis or mescaline (psychoactive compound found in certain species of cactus), this mushroom, like all drugs, should only be consumed in a strict and supervised medical framework. We therefore forget the idea of ​​growing it using seed kits to grow yourself that can be ordered on certain websites. Yale University, in the United States, has also issued practices for the proper use of psilocybin, during clinical trials for medical purposes. In Europe, as explained by Professor Bottemanne who also works in the psychedelic medicine section of the French Psychiatric Society, “we are thinking about…