When one day at an intersection she mulled whether it would be so bad to get hit by a car, she realized her mental health was almost as depleted as her physical state.
That’s when her 27-year-old son sent her a link to an invitation from the Johns Hopkins University School of Medicine, seeking cancer patients to sign up to take psilocybin, the active ingredient in magic mushrooms, to alleviate their anxiety and depression. “Start thinking about all the existential questions you want to ponder while your window is open to the universe!” her son wrote.
Roughly 40 percent of people with cancer suffer from a mood disorder, which increases their risk of suicide and impairs treatment. Evidence they can be helped by antidepressants is weak. “People are facing their own mortality, their own demise,” said Roland Griffiths, a professor at the the Johns Hopkins University School of Medicine and the lead author of one of the studies. “That’s a very special and quite poignant vulnerability that many people have in facing life-threatening illnesses.”
Two teams of researchers, one led by Griffiths and the other by psychiatrist Stephen Ross at the New York University Langone Medical Center, simultaneously ran the studies on participants who had life-threatening cancers as well as a psychiatric diagnosis of anxiety or depression.
Vincent describes her six-hour trip as “spectacularly gorgeous” and “beyond words.” She saw a sea of green and purple shapes, then a deep-space emptiness with a monolithic presence, similar to the Borg Collective from Star Trek. At one point, a series of Egyptian ships and Russian dolls paraded before her. As she laughed and wept, something popped out at her from the mental kaleidoscope: A small, creamy-white, animated crab.
“It’s Cancer the crab,” she thought later, referring to the zodiac sign. “It could have been a big, horrifying monster crab that was about to tear me up and eat me. But it wasn’t, it was comic relief. There is still humor in life, there’s still beauty in life.”
In the Johns Hopkins study, half of the 51 participants were given a low dose of psilocybin as control, followed by a high dose five weeks later. (For the other half, the order of the doses was reversed.) The results were remarkable: Six months later, 78 percent of the participants were less depressed than they started, as rated by a clinician, and 83 percent were less anxious. Furthermore, 65 percent had almost fully recovered from depression, and 57 percent from their anxiety, after six months. By comparison, in past studies antidepressants have only helped about 40 percent of cancer patients, performing about as well as a placebo. At the six-month follow-up, two-thirds of the participants rated the experience as one of the top five most meaningful of their lives. They attributed their improvements to positive changes in their attitudes about their lives and their social relationships. Their quality of life improved, as did their feelings of “life meaning” and optimism—even though several of them would later die. “People will say, ‘I know I’m dying, I’m sad that I’m dying, but it’s okay,” Griffiths said. “Things are going to be alright.”
The researchers aren’t sure exactly how psilocybin works—a rather common problem in drugs aimed at brain chemistry. Psilocybin seems to quiet the prefrontal cortex, a part of the brain where increased activity has been associated with depression. It also might be acting on the brain’s use of glutamate, a neurotransmitter that affects learning and memory. Ross said what might be happening is a sort of “inverse PTSD”—a profoundly positive memory that affects participants for months, much like a severe trauma might in post-traumatic stress disorder.
There were no serious negative side-effects of the treatment, allaying concerns that the cancer patients might “look into the existential void and come out even more fearful,” as Griffiths put it. About 15 percent of the Johns Hopkins participants became nauseated, and a third experienced temporary paranoia and elevated blood-pressure. In the New York University study, 28 percent of participants developed a headache, and 17 percent became temporarily anxious. But more than 2,000 doses of psilocybin have been given out in clinical settings since the early 1990s, the NYU researchers pointed out, and there have so far been no reports of lasting medical or psychiatric issues.
These studies add to the evidence that psilocybin might help people who struggle with different types of intractable mental-health issues. Smaller studies have hinted at the drug’s effectiveness in treating alcoholism, obsessive-compulsive disorder, treatment-resistant depression, and smoking. It’s also been found to help change peoples’ personalities, making them more “open,” meaning imaginative or broad-minded. The study has implications for terminally ill individuals considering physician-assisted suicide, a decision sometimes prompted by the kind of existential dread that psilocybin alleviates.
In a New Yorker story about the curative potential of psilocybin published last year, Michael Pollan wrote, “As the drug war subsides, scientists are eager to reconsider the therapeutic potential of these drugs.”
However, president-elect Donald Trump’s choice of Alabama Sen. Jeff Sessions, a staunch hard-liner on drugs, to lead the Justice Department, suggests the drug war might not be wrapping up as promptly as some hoped.
George Greer, the medical director of the Heffter Research Institute, which funded these studies, said he doesn’t yet have “total clarity” on what recent political developments mean for his work with regulators.
“What I can say is this: We expect the FDA’s assessment of psilocybin to move forward,” he said. “As the research evidence grows on psilocybin’s safety and effectiveness, we think the FDA will want to learn more, and the process for helping cancer patients with depression and anxiety will continue to advance.”
For now, above-board psilocybin treatments will be limited to people like Vincent, who sign up for studies. To paraphrase the aphorism, it’s a nice remedy—if you can get it. A few months after her psilocybin experience, Vincent was driving on a sunny day and listening to music. She found herself cheerily singing along. “Oh my God,” she thought, “I’m happy! I’m me again!”
By: Olga Khazan From: The Atlantic