Recent studies have produced some great news about psilocybin, the psychoactive ingredient in “magic mushrooms.” This compound may have promise in treating obsessive-compulsive disorder (OCD). Conducted by Dr. Terrence Ching, a clinical trial demonstrated the efficacy of a single dose of psilocybin in alleviating OCD symptoms when compared to a placebo. Yet, for all of these promising results, psilocybin remains a Schedule I illegal drug in the U.S., on par with heroin. This classification presents a serious challenge for researchers interested in further exploring its therapeutic potential.
In his trial, Dr. Ching adopted extreme measures to maintain ethical standards. The training included prevention policies that put up rigorous boundaries to physical interaction. Facilitators were limited to touching a participant on the shoulder or forearm. In the dosing sessions, patients reclined on a couch with two facilitators sitting alongside. The facilitators provided little direction, focusing instead on open-ended questions. Dr. Ching’s study provided comparative data for a meta analysis review paper by Dr. Michael Van Ameringen. In particular, the paper highlighted the ability of psilocybin to induce “mystical experiences” that would assist patients on the OCD spectrum.
Researchers who want to study psilocybin face overwhelming and convoluted regulatory hurdles. They are required to work with a Drug Enforcement Administration (DEA) liaison and to keep the substance stored under tight security. Any researcher is required to have a DEA-approved safe for their use of research materials. This safe must be bolted down and housed in a secure, private, windowless room.
So now, Dr. Ching is preparing to publish the results from his trial. He intends on running a second clinical trial, in which OCD patients will receive two different doses of psilocybin at different times. Dr. Mohamed Sherif will be leading the new trial. We look forward to having him bring his experience and expertise to deepen our understanding of psilocybin’s therapeutic benefits.
“What we need to do now is to seriously treat psychedelics as any other worthwhile medication, to investigate in a controlled, rigorous way, in a way that is ethical, that pays homage to traditional Indigenous users of psychedelics, because there is great wisdom there too.” – Dr. Michael Ching
The first trial’s results show that patients had clinically meaningful improvement in their OCD symptoms following treatment with psilocybin. Conversely, when it came to using cannabis for the same therapeutic purposes, it didn’t play out the same way. As a result, Dr. Ching wants people to know that cannabis can assist in addressing deeper-rooted concerns associated with OCD. Too often it becomes a tool of evasion instead.
“One could use cannabis for the same therapeutic reason, of confronting something deeper about their OCD or their obsessive fears. But conventionally, people tend to use cannabis for an avoidance function.” – Dr. Michael Ching
In her study, Dr. Ching noticed that psilocybin consistently brought on mystical experiences for patients. Most of them only experience the shallows rather than truly diving into the deeps and coming back healed and renewed. He noted that participants frequently pulled back when they felt psilocybin pushing them to deeper, more meaningful experiences.
“What we see in OCD is more often partial mystical experiences; people are kind of pumping the brakes when they have a sense that the psilocybin wants to take them into a deeper state of experiencing.” – Dr. Michael Ching
Dr. Sherif wants to convey the complexity of treating OCD as well, especially where hoarding is concerned. He goes on to describe how the default mode network (DMN) is central to self-referential thinking and rumination, both major hallmarks of the disorder.
“Essentially, it is involved in self-referential thinking and rumination. The default mode network is really activated in OCD.” – Dr. Mohamed Sherif
The medical community is understandably excited yet cautious about psilocybin’s therapeutic potential for those suffering from OCD. Additional research is already in the planning stages to investigate these exciting prospects. Researchers need to have scientific integrity and social responsibility. These principles will be important as they government employees to develop more as they continue in this promising treatment development.
Dr. Van Ameringen’s review highlights the need for evidence-based approaches to determine whether psilocybin and other psychedelics can serve as next-step treatments for mental health disorders.
“We wanted to hone down and really understand, is there evidence for these things that have been talked about to be used as the next step treatments?” – Dr. Michael Van Ameringen