A controlled dose of the main ingredient in hallucinogenic mushrooms appears to reduce anxiety and lift spirits in people battling advanced cancer, researchers report.
In a small pilot study, the compound psilocybin appeared to be safe, with no participants reporting a "bad trip," said study author Dr Charles Grob. His research was published onlinewill appear in the January 2011 print issue of the Archives of General Psychiatry.
In fact, the trips tended to be good, with patients and their families reporting improvements up to six months after their single-dose experience with the substance.
Hard work justifying use of mushrooms
But it took four years to get the funding and necessary approvals for the trial, even though it only involved a dozen patients (all with advanced cancer). And it's been 35 years since a similar study was conducted, in the heyday of medical research into hallucinogens in the 1950s and 1960s, before cultural and political forces moved to shut the field down.
This raises the question of if and when psilocybin and other hallucinogens will reach patients who might benefit from it.
"It's slow going justifying this particular application and the data are not overwhelming," said Keith A. Young, vice chair for research in the department of psychiatry and behavioural science at Texas A&M Health Science Centre and core leader at the VA Centre of Excellence for Research on Returning War Veterans.
"This just indicates that there might be room for additional study. . . It seems to be that other approaches might be just as good, for instance a spiritual retreat. These particular results probably warrant more study, but are not overpowering."
Dr Amy Abernethy, director of the Duke University Cancer Care Research Programme in Durham, N.C. added, "We're judicious and, if anything, a bit timid in getting the work done."
The participants in the study acted as their own "controls" and in two separate sessions received either a placebo or a "moderate" dose of psilocybin (0.2 milligrams per kilogram of body weight), both in capsule form.
In addition to feeling calmer and happier, the men and women in the trial said they felt a closer connection to friends and family members, and were better able to address end-of-life issues.
Unlike previous trials, these participants did not report any decrease in pain, although the researchers pointed out that a second dose might result in improvements.
"They suggested in the paper that it might be better to have more than one treatment and I would concur," Young said. "I would think it might take a couple of treatments to get any lasting psychological or spiritual-type good out of this."
Drugs ease the distress
Abernethy said: "We know that with some people with advanced life-threatening illness, there is very truly a substantial existential component and importance and need for meaning-making in life, and that until people start making that transition they can be very, very distressed. It can be hard to get back to the business-of-life closures and other things you need to do at the end of life.
"This kind of intervention [may] allow people time and space and extended cognitive ability to reflect on life and see it in a different way, make that transition and then get back into a more relaxed space and get back to the business of living.
"Being in the business of living is about doing what is important and meaningful to you every day even if you don't have many days left, focusing on things like saying goodbye to loved ones, which can be hard to do if you're distressed," she added.
Psilocybin has already been shown to be safe in individuals with obsessive-compulsive disorder, and Grob, who is professor of psychiatry at Harbor UCLA Medical Centre in Torrance, Calif., would like to extend this protocol to a larger group of patients using higher doses and perhaps adding a second treatment. He'd also like to do studies in chronic alcoholics and in people with Asperger's syndrome.
"We'd be looking at social anxiety to see if individuals had an improved capacity to engage in normative socialisation, an improved capacity for empathic experience," Grob said. "That's an entirely different kind of study than we did with this one but I think there might be potential."
Grob and another study author serve on the board of directors of the Heffter Research Institute in Santa Fe, N.M., which provided funding for the study.
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