Mindfulness meditation enhances positive effects of psilocybin

October 24, 2019

Science Daily/University of Zurich

Recent years have seen a renewed interest in the clinical application of classic psychedelics in the treatment of depression and anxiety disorders. Researchers of the University of Zurich have now shown that mindfulness meditation can enhance the positive long-term effects of a single dose of psilocybin, which is found in certain mushrooms.

Hallucinogens such as LSD or psilocybin, the active ingredient in "magic mushrooms," alter the perception of those who take them: The boundaries between the self and the world begin to dissolve and feelings of bliss and unity are triggered. Such experiences of self-transcendence and reduced self-focus are similar to those brought about by mindfulness meditation. They can reduce stress, prompt feelings of enduring happiness and increase empathy and altruism. In contrast to this, exaggerated self-focus, recurring negative thoughts and emotions about one's self, and impaired social interactions are characteristic features of psychiatric disorders such as depression.

Enhanced experience of self-transcendence

Researchers at the University Hospital of Psychiatry Zurich have now for the first time examined the potential synergistic effects of combining mindfulness meditation and psilocybin. The scientists recruited 40 meditation experts who were taking part in a five-day mindfulness retreat. In the double-blind study, the participants were administered either a single dose of psilocybin or a placebo on the fourth day of the group retreat. Using various psychometric and neurocognitive measurements, the team of researchers were able to show that mindfulness meditation increased the positive effects of psilocybin, while counteracting possible dysphoric responses to the psychedelic experience. "Psilocybin markedly increased the incidence and intensity of self-transcendence virtually without inducing any anxiety compared to participants who received the placebo," says first author Lukasz Smigielski, who conducted the study directed by UZH professor of psychiatry Franz Vollenweider.

Sustained beneficial effects

At the four-month follow-up, the meditation experts who had been given psilocybin demonstrated more beneficial changes in psychosocial functioning, better self-acceptance and more empathy than the placebo control group. According to Vollenweider, the intensity of self-transcendence experienced during the retreat played a key role for these enduring changes. In a previously published study, he and his team used magnetic resonance imaging to show that experiences of self-transcendence result in lasting changes to neural connections in the brain, and more specifically in the regions that are active when we think about ourselves.

The research group found that besides meditation depth, the participants' openness and optimism were conducive to a positive response to psilocybin. "These factors can help us predict a positive response," says Vollenweider. At the same time, skills that are trained during mindfulness meditation -- such as regulating one's attention and reappraising emotions -- seem to buffer potential negative reactions to psilocybin.

Potential for treating affective disorders

"Our findings shed light on the interplay between pharmacological and extra-pharmacological factors in psychedelic states of mind," says Vollenweider. "They indicate that mindfulness training enhances the positive effects of a single dose of psilocybin, and can increase empathy and permanently reduce ego-centricity. This opens up new therapeutic avenues, for example for the treatment of depression, which is often accompanied by increased self-focus and social deficits."

https://www.sciencedaily.com/releases/2019/10/191024075003.htm

Reclassification recommendations for drug in 'magic mushrooms'

Reclassification recommendations for drug in 'magic mushrooms'

If phase III clinical trials are successful, researchers suggest categorizing the drug as schedule IV

September 26, 2018

Science Daily/Johns Hopkins Medicine

In an evaluation of the safety and abuse research on the drug in hallucinogenic mushrooms, Johns Hopkins researchers suggest that if it clears phase III clinical trials, psilocybin should be re-categorized from a schedule I drug -- one with no known medical potential -- to a schedule IV drug such as prescription sleep aids, but with tighter control.

 The researchers summarize their analysis in the October print issue of Neuropharmacology.

 "We want to initiate the conversation now as to how to classify psilocybin to facilitate its path to the clinic and minimize logistical hurdles in the future," says Matthew W. Johnson, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "We expect these final clearance trials to take place in the next five years or so."

Following the Controlled Substances Act of 1970, any drug with the potential for abuse is categorized based on criteria that take into account whether the drug has accepted medical use, and its safety and the potential for abuse. Although preliminary research studies suggest that psilocybin may be effective for smoking cessation and for disorders such as cancer-specific depression and anxiety, it must clear phase III clinical trials before the Food and Drug Administration can be petitioned to reclassify it.

Studies in animals and humans both show low potential for abuse, the researchers say. When rats push a lever to receive psilocybin, they don't keep pushing the lever like they do for drugs such as cocaine, alcohol or heroin. When it comes to human studies, people who have used psilocybin typically report using it a few times across their lifetime.

As for safety, studies show it frequently falls at the end of the scales with the least harm to users and society, say the researchers. Psilocybin also is lowest in the potential for lethal overdose as there is no known overdose level.

"We should be clear that psilocybin is not without risks of harm, which are greater in recreational than medical settings, but relatively speaking, looking at other drugs both legal and illegal, it comes off as being the least harmful in different surveys and across different countries," says Johnson.

That being said, although psilocybin is relatively less harmful than other drugs and not prone to compulsive abuse, the researchers don't recommend releasing psilocybin into patients' hands even with a prescription. "We believe that the conditions should be tightly controlled and that when taken for a clinical reason, it should be administered in a health care setting monitored by a person trained for that situation," says Johnson. The researchers foresee that the process for psilocybin use in the clinic would be similar to how an anesthesiologist prescribes and administers a drug, minimizing the potential for abuse or harm.

https://www.sciencedaily.com/releases/2018/09/180926082159.htm