If you’re interested in medical marijuana, you may also be open to the idea of other natural plants as medicine. This blog explores psilocybin mushrooms and discusses whether it could be the ‘next’ cannabis.
Table of contents
- The Similarities and Differences Between Psilocybin Mushrooms and Cannabis
- What Conditions Could Psilocybin Mushrooms Be Used For?
- For What Conditions are Psilocybin Mushrooms Contraindicated?
- Why Does Psilocybin Work?
- How Does Psychedelic-Assisted Therapy Work?
- How Long Does It Work For?
- What is a Psychedelic Experience Like?
- More About Fungi and Mushrooms
- What Are Magic Mushrooms or Psilocybin Mushrooms?
- Psilocybin Pharmacodynamics
- Psilocybin Pharmacokinetics
- Psilocybin/Psilocin Effects
- How Successful is Psychedelic Therapy?
- How Does Cannabis and CBD Interact with Magic Mushrooms?
- Why Magic Mushrooms and Not Other Psychedelics?
- Can I Use Magic Mushrooms If I Am Using Antidepressants?
- What’s the Overall Verdict?
- Further Reading
- Psilocybin is a serotonin receptor agonist that has huge therapeutic potential for depression, anxiety, PTSD, addiction, and cluster headaches.
- Psilocybin disrupts the default mode network (DMN), which can give us new insights and help break the “loser script” – the repetitive, negative intrusive thoughts that can build up to a sense of helplessness and the feeling of not being able to achieve anything.
- Psilocybin can promote structural and functional neural plasticity.
- Learning to integrate what you have learned from your psychedelic experience into your everyday life is essential for success with this form of therapy. Having the appropriate set and setting, as well as two sitters (one male, one female) and a medical professional is also necessary.
- One-on-one and group therapy sessions with a trained psychiatrist will also be necessary for proper treatment. Establishing networks for help is essential.
- Psilocybin is not recommended for people with schizophrenia, schizotypal disorders, or bipolar disorder.
- Cannabis and magic mushrooms work on very different receptors in the human body but do have some interesting similarities and interactions.
- Much of the research is promising but still small in scale.
Broaching the subject of magic mushrooms as a form of therapy for psychiatric illnesses is not something one usually does in polite company. Yet, perhaps one sometimes should. It is, after all, something we here at Leafwell take a brief look at on our cannabis for addiction page. After all, we already use opioids and benzodiazepines to treat opioid and alcohol withdrawals, so why not less addictive substances like cannabis and magic mushrooms?
We in the cannabis industry have a difficult enough time getting people thinking of cannabis as medicine, although many have come around to the idea recently. Hence, many in the cannabis industry are wary of ever mixing the two, in fear that it may end up diluting the message of cannabis as medicine and turning off people who might otherwise be convinced.
Yet, this is not an area we should fear. There could be a huge value to psychedelic-assisted therapy for a huge number of conditions. We here at Leafwell thought to look at psilocybin in more detail and compare and contrast it to cannabis in terms of therapeutics, use on disorders like PTSD, and its rise to mainstream recognition over the past year or so.
The Similarities and Differences between Psilocybin Mushrooms and Cannabis
There is no doubt that cannabis and psilocybin mushrooms share many similarities. Both are natural and from the earth. Both have associations with counterculture movements. Both are illegal. Both tend to instill a strong appreciation of nature, art, and music in users. Both can sometimes cause significant shifts in consciousness and personality. Both have been used by civilizations for spiritual and medical reasons for thousands of years.
Moreover, with the exception of those with psychosis, neither cannabis nor psilocybin has the same potential for harm as many other synthetic, often addictive substances. Psilocybin mushrooms have consistently ranked as one of the least harmful psychoactive substances and have shown real potential for treating a wide range of conditions.
The two also have very many differences. For one, cannabis hails from the plant kingdom, psilocybin mushrooms from the fungi kingdom. Another is that the two have different pharmacology: cannabis targets the endocannabinoid receptors; psilocybin is metabolized into psilocin by the liver, which acts on serotonin receptors in the brain.
Another thing to remember is that both magic mushrooms and cannabis produce a completely different class of compounds that work together, creating an entourage effect that is unique to each one. They are essentially very different, although some may claim that the two are related in a spiritual sense due to the similarities mentioned above. Both also act on serotonin receptors (albeit different types), which may give the two a connection on a biological level as well.
What Conditions Could Psilocybin Mushrooms Be Used For?
Some are now claiming that psilocybin mushrooms (and other psychedelics) have significant therapeutic value, in particular for depression, PTSD, anxiety disorders and treating addiction. Cluster headaches could also be treated with psilocybin! Where cannabis’ mechanism of action seems to be returning balance via interaction with the endocannabinoid system (ECS), psilocybin mushrooms’ is providing insight and connection via serotonergic receptors.
In one study by Johns Hopkins University on using psilocybin to help tobacco smokers quit:
“Johns Hopkins researchers report 15 study participants taking psilocybin achieved an 80 percent abstinence rate over six months, compared to an approximate 35 percent success rate for patients taking varenicline, which is widely considered to be the most effective smoking cessation drug.”
For What Conditions are Psilocybin Mushrooms Contraindicated?
Due to its pharmacodynamics, psilocybin treatment is contraindicated for those with schizophrenia or schizoid personality disorders, as well as bipolar disorder (very similar to THC). Where CBD could help such conditions, psilocybin/psilocin does not. There is little research on how psilocybin works on developing brains, so younger people under the age of 21 ought to avoid using psychedelics.
There are some people who need to escape from a false/negative reality (e.g. depression) or come to terms with a traumatic one (e.g. PTSD), which is where psilocybin treatment can work. Others, meanwhile, need to be drawn back to reality (e.g. conditions involving hallucinations), which is where psilocybin treatment may be less useful and potentially even harmful.
Compass Pathways, a U.K.-based company that researches and develops mental health treatments, announced the FDA granted them what’s called a “breakthrough therapy designation” for their trials into psilocybin, the psychoactive ingredient in psychedelic mushrooms.
The idea of using psychedelics for mental health problems is not new. In fact, psychedelics and mushrooms of various types have been used for their medical and spiritual applications for thousands of years, before even cannabis use. Co-founder of Alcoholics Anonymous Bill Wilson was a proponent of psychedelic therapy (LSD in his case) for alcoholism.
Here’s why Bill Wilson may have been right …
Why Does Psilocybin Work?
There are a few good reasons why psilocybin works for the above conditions. These include:
- Disruption of the Default Mode Network (DMN) – the DMN is a network of interacting brain regions that is active when a person is not focused on the outside world. In depressed people, the default mode is one of persistent, ruminating negative thoughts. Psilocybin essentially breaks this cycle – it “breaks the script”.
- For those who are addicted to a particular substance or activity, psilocybin can act as a prompt to start thinking differently and beating negative patterns of behavior.
- Psilocybin can promote structural and functional neural plasticity – it can help increase brain flexibility and foster a new way of seeing things.
- Psilocybin can help one connect and reconnect with nature and others, as well as one’s self.
- Can help one face and come to terms with past traumas.
- A single dose can have long-lasting effects – this is not the case with antidepressants, which must be taken daily, can come with serious side-effects and sometimes do not even work.
The effects of classic hallucinogens like psilocybin on serotonin 2A and 5-HT2C receptors are thought to give them anti-addictive properties.
The duration of the trip is between four and eight hours, which is far more tolerable than the 12+ hours of LSD.
Other psychedelics, like ibogaine from the iboga root, may be particularly useful for opioid addiction, as ibogaine works on opioid receptors and can even inhibit or block opioids from attaching to the dopamine and opioid receptors! A single dose of ibogaine can increase Glial Cell Derived Neurotrophic Factor (GDNF) expression, which can reduce drug-seeking behavior. Psilocybin, however, is generally much safer and more therapeutically useful than ibogaine for conditions such as depression or PTSD. Ibogaine treatment for opioid addiction still needs more research, although the initial results are promising.
How Does Psychedelic-Assisted Therapy Work? What Does a Session Look Like?
While there is certainly more research that needs to and is actively being done, using psilocybin effectively requires more than the ingestion of a few grams of mushrooms on a single occasion. Early research on the benefits of psilocybin has been so promising that many medical professionals and therapists expect magic mushroom therapy treatments to be more commonly used in 2021.
Effective psychedelic therapy will likely include:
- Extensive therapy before and after the psychedelic experience (“trip”) in order to allow the patient to integrate and talk about their experiences into everyday life, including discussions on planning how they intend to use what they have learned.
- Group therapy and discussion with others about their experiences, if the patient feels they can do so.
- Having a guide or a trip sitter – someone who is not using psilocybin – keeping watch and providing support is of immense importance.
- Some would recommend 2 trip-sitters for each patient – ideally one male and one female.
- Sensory deprivation – headphones with music (usually Western or Indian Classical, jazz or ambient music) and blindfolded – will also be incorporated in many types of psychedelic-assisted therapy sessions. Others involve a group setting and a guide or even a shaman with experience of the process.
- Some would suggest using a high dose of 2 – 5 grams is required for the true therapeutic effects. The intensity of the psychedelic experience can be the thing that makes it potentially very useful.
- Microdosing psilocybin (i.e. using small amounts that do not have psychedelic effects) can be useful for their mood-boosting (and possibly neurogenic) effects. However, some believe that it is the large dose/s that are thought to be truly therapeutic for long-term benefits, whilst microdosing is better as a maintenance dose. Microdosing psilocybin mushrooms is usually done with low doses (under 0.5 g), and once every 2 – 4 days.
How Long Does It Work For?
The initial experience after ingestion lasts for between four and eight hours for most people. If high doses (4g +) are consumed, then experiences can last up to 14 hours. Some have reported an “afterglow” effect as well.
Long-term, psychedelic-assisted therapy’s efficacy depends on the individual, but some would say around 3-6 months on average. Some have reported positive effects for a year or even longer afterward, others less than three months. It’s also worth noting that psilocybin lingers in your blood and urine for up to 24 hours after initial dosage and up to 90 days in your hair, so keep that in mind before your next drug test at work!
What is a Psychedelic Experience Like?
How long do you have? Those who have experienced a psychedelic experience can report profound changes in their lives, and many describe it as one of the most important experiences in their lives. Some can describe the experience as beautiful, but it is not always so! Set and setting also make a huge difference, as can one’s mood prior to ingestion.
Unfortunately, a “bad trip” can occur. The first port of call is usually to help the patient “ride out” the experience in a comfortable environment, ensuring them that it will pass. Chamomile tea, fresh fruit, and fruit juice, and even CBD can help calm nerves. In some instances, sedatives like diazepam (Valium) will be used to reduce or stop a bad experience. In severe cases, antipsychotics such as haloperidol can reduce or stop hallucinations.
There is also a difference between a “bad” and difficult psychedelic experience. Sometimes, difficult experiences can be important for learning as well. Some people have reported both beautiful and difficult experiences during the same experience!
Another interesting effect is one of no effect at all, or perhaps a “flat” effect where the participant is “tripping without tripping”. This is a unique effect and could arise from a number of reasons.
In some instances ego death or ego dissolution occurs. Ego death is a “complete loss of subjective self-identity”, and can be either a transcendent or frightening experience, but is more often than not a very profound experience.
More About Fungi and Mushrooms
Fungi contain chitin, a cellulose-like derivative of glucose that is the building block of insect exoskeletons, fish scales, fungi cell walls, and more. Fungi seek out food and do not photosynthesize. Fungi are nature’s decomposers and are responsible for nutrient cycling and exchange, a criminally undervalued and vital part of the circle of life. Fungi form vast mycorrhizal networks under the ground, connecting individual plants together (and, interestingly, allowing plants to communicate with each other). The fruiting bodies of these networks can display as mushrooms that we see above ground.
Fungi can contain all sorts of compounds, from the harmful to the innocuous to the extremely useful. Yeast, bread leavening, detergents, natural pesticides, bioremediation, antibiotics and antivirals, and many immune- and brain-boosting properties. Fungi can be symbiotic to plant and animal species, as well as parasitic. Fungi and their fruiting bodies can also produce extremely toxic effects if consumed.
The study of fungi is called mycology. Mycology was once a subset of botany, but as the two are entirely different kingdoms (fungi are closer to mammals than plants), they require a different understanding. They could therefore be seen as different areas of study entirely. However, the two areas share some interesting overlaps with regards to how the two kingdoms interact on top of the historical association.
What Are Magic Mushrooms or Psilocybin Mushrooms?
These are essentially mushrooms that contain the compound psilocybin, which we have mentioned above. There are various kinds of mushrooms that contain psilocybin from across the world.
The following genera contain psilocybin: Psilocybe (116 species), Gymnopilus (14), Panaeolus (13), Copelandia (12), Hypholoma (6), Pluteus (6) Inocybe (6), Conocybe (4), Panaeolina (4), Gerronema (2), Agrocybe (1) and Galerina (1). Psilocybe cubensis (“Golden Teacher”), Psilocybe subcubensis and Psilocybe semilanceata (“Liberty Caps”) are the world’s most widely distributed psilocybin mushrooms.
Other widely-distributed kinds include Psilocybe azurescens (“Flying Saucers”), Psilocybe cyanescens (“Wavy Caps”), Psilocybe baeocystis (“Knobby Tops”) and Psilocybe mexicana (“teonanacatl”). Panaeolus cyanescens, aka Copelandia cyanescens (“Blue Meanies”), are another potent type of psilocybin mushroom that is not in the psilocybe family. Psilocybin-containing species are dark-spored, gilled mushrooms that usually grow in meadows and woods of the subtropics and tropics, most often in soils rich in humus and plant debris.
There are four main active alkaloids in psilocybin mushrooms:
The most potent variety of mushroom is thought to be Psilocybe azurescens, but potency can vary amongst different genus and species, and can only be described in generalities rather than specifics. Yes, there is an entourage effect between these different compounds, and synthesized psilocybin will likely have a different effect compared to the mushroom itself. It is thought that about 4 mg of baeocystin produces mild psychedelic effects, and 10 mg effects similar to the same dose of psilocybin.
Psilocybin is rapidly dephosphorylated in the body to psilocin by the liver, which is a partial agonist for several serotonin receptors. Psilocin binds with high affinity to 5-HT2A receptors and low affinity to 5-HT1 receptors, including 5-HT1A and 5-HT1D. Effects are also mediated via 5-HT2C receptors. 5-HT2A antagonists like ketanserin block psilocin’s effects. Psilocin is rapidly metabolized by MAO-A and MAO-B.
Serotonin receptors are located in numerous parts of the brain, including the cerebral cortex. Serotonin is involved in a wide range of functions, including regulation of mood, motivation, body temperature, appetite, and sex.
Psilocin also indirectly increases the concentration of the neurotransmitter dopamine in the basal ganglia. Some psychotomimetic symptoms of psilocin are reduced by haloperidol, a non-selective dopamine receptor antagonist.
Psilocin antagonizes H1 receptors with moderate affinity, compared to lysergic acid diethylamide (LSD) which has a lower affinity for H1 receptors. Unlike LSD, psilocybin and psilocin have no affinity for dopamine receptor D2.
The effects of psilocybin/psilocin begin 10–40 minutes after ingestion and can last anything between 2 and 12 hours depending on dose, species, and individual metabolism.
A typical recreational dosage is 10–50 mg psilocybin, which is roughly equivalent to 10–50 grams of fresh mushrooms, or 1–5 grams of dried mushrooms. A dosage of 4–10 mg, or roughly 50–300 micrograms per kilogram (µg/kg) of body weight, is required to induce psychedelic effects.
A Johns Hopkins study found the ideal dose for long-term positive effects to be 20 mg per 70 kg of body weight. This is usually around 2 – 3 grams of dried magic mushrooms of standard potency, which can last between four and eight hours depending on individual metabolism.
Psilocybin is a tryptamine, a monoamine alkaloid. Tryptamine is a neurotransmitter found in trace amounts naturally in mammals. Tryptamine binds to human trace amine-associated receptor 1 (TAAR1) as an agonist. Tryptamine acts as a non-selective serotonin receptor agonist and serotonin-norepinephrine-dopamine releasing agent (SNDRA), with a preference for evoking serotonin and dopamine release over norepinephrine release.
Effects of psilocybin – both positive and negative – can include:
- Spiritual awakening
- Quickly changing emotions
- Derealization – the feeling that your surroundings are not real
- Depersonalization – a dream-like sense of being disengaged from your surroundings
- Distorted thinking
- Visual alteration and distortion, such as halos of light and vivid colors
- Dilated pupils
- Impaired concentration
- Muscle weakness
- Lack of coordination
- Unusual body sensations
- Visual and auditory hallucinations
- Fatigue & “brain fog” – in particular the next day, which may be partially attributable to a lack of sleep. Your brain is also using a lot of energy, so this can contribute
Psilocybin may induce a psychotic episode in those who are prone to hallucinations. Some have likened the psilocybin experience to one of “temporary psychosis”, but as the experience is often significant for many people and not necessarily harmful in healthy people, it is simplistic to liken the psilocybin experience to psychosis.
Tolerance to psilocybin is built rapidly and is also diminished quickly. Ingesting more than once a week can lead to diminished effects, and tolerance can dissipate after three to four days. There is also cross-tolerance to other tryptamines, like LSD, as well as phenethylamines such as mescaline.
Psilocybin is not addictive. In fact, many have claimed that psilocybin could be anti-addictive! Due to its spiritual uses, psilocybin is often described as being an “entheogen” in order to differentiate it from other kinds of psychedelics.
There are reports of “flashbacks” – the effects of psychedelics being felt or “revisited” months or even years after the initial experience. Such experiences are often triggered by a certain visual pattern or occurrence of a type of event. This could be compounded by polydrug use or could be caused by a shift in pattern processing or recognition. Such experiences are often brief, and for some can be unusual or uncomfortable.
How Successful Is Psychedelic Therapy?
Although most of the studies so far are small in scale, it does seem that psychedelic-assisted therapy is very effective for treating depression, anxiety and addiction. Another issue is that many sessions are usually done in informal, unstructured environments outside of the views of a healthcare professional. A large-scale study had this to say:
“Past-year suicidal thinking and planning were lower in the psilocybin group compared to the psilocybin and other psychedelics group .. the odds of past-month psychological distress were lower in the psilocybin group relative to the other psychedelics-only group … This further supports the idea that psilocybin may play a role in reducing suicidality and improving mood although these patients did not necessarily have a diagnosis of major depressive disorder. It also highlights the potential safety of the substance in such a large population.”
While it’s true that we don’t yet have an overwhelming data-set when it comes to psilocybin-based therapy, the early results have been promising. Cognitive-behavioral therapy and PTSD treatments have been the two most promising thus far.
How Does Cannabis and CBD Interact with Magic Mushrooms?
The combination of cannabis and magic mushrooms is popular, but not well-studied. THC and high amounts of THCV are thought to intensify the experience, but can also make one more prone to anxiety, depersonalization, disassociation, and paranoia. CBD and terpenes like linalool, myrcene, and humulene may help calm an overly intense trip.
At what stage of the mushroom experience a person decides to use cannabis matters as well. Some may prefer to use at the beginning to reduce nausea and anxiety often associated with the initial stages of the psilocybin experience. Others prefer during the end to help get to elongate the trip, or to help get to sleep if low-THC varieties are used. Some may use cannabis throughout to intensify or calm the experience, depending on what cannabinoids are used. Some people prefer to keep the ingestion of the two substances separate entirely.
There is little research into how the combination of the two substances works together. There are some anecdotal reports on websites like Erowid, but that is all.
Why Magic Mushrooms and Not Other Psychedelics?
Actually, there is a lot of interest in LSD and mescaline as well, as well as others like ibogaine and ayahuasca. However, these other substances either a) have a long duration of effect – 12 hours or more in some instances, b) require lots of preparation and proper supervision, c) have slightly different effects that may make them more suitable for different conditions or types of problems, and/or d) are metabolized by the body differently, so we need to take negative interactions with other substances into account. Magic mushrooms, meanwhile, can last around a more manageable four to eight hours or even more, depending on the dosage.
With states like Oregon recently decriminalizing the use of drugs, however, we’re likely to see interesting research on the role of all psychedelics, including magic mushrooms in healing people.
Can I Use Magic Mushrooms If I Am Using Antidepressants?
This depends on which types of antidepressants. SSRIs (e.g. Citalopram (Celexa, Cipramil), Sertraline (Zoloft, Lustral)) prevent the clearance of excess serotonin from the brain, meaning that serotonin levels are temporarily boosted. In rare cases, this can lead to serotonin syndrome, which can be fatal. Those who are undergoing clinical trials for psilocybin may be required to taper off of SSRIs to prevent the likelihood of serotonin syndrome. Serotonin syndrome is where there is an excess of serotonin that can cause anything from mild to fatal effects.
Mild and moderate symptoms include high blood pressure, fast heart rate, high body temperature, agitation, sweating, dilated pupils, increased reflexes, and diarrhea. In severe cases, body temperatures can reach deadly levels and can be accompanied by seizures and extensive muscle breakdown.
SNRIs (e.g. Desvenlafaxine (Pristiq, Khedezla), Duloxetine (Cymbalta)) could possibly reduce the effects of psychedelics, but there is little definitive evidence in this area. As both psilocybin and classes of antidepressant-like SSRIs work on serotonin receptors, there is some overlap between the two. In general, though, there are few negatives when combining mushrooms with SSRIs or SNRIs.
Monoamine Oxidase Inhibitors (MAOIs), e.g. Bifemelane (Alnert, Celeport), Selegiline (Eldepryl, Zelapar, Emsam) – MAOIs are a class of substances sometimes used as antidepressants. They are also used as an anti-anxiety medication. They work by preventing the breakdown of monoamine neurotransmitters, including dopamine, serotonin, and norepinephrine by interfering with the action of the MAO enzyme. The result is a boost in the levels of these neurotransmitters in the brain. This can also lead to serotonin syndrome. Ayahuasca (Banisteriopsis caapi vine) is an MAOI, and the combination of the two can prove deadly. When it comes to DMT, MAOIs prevent oxidization of DMT in the digestive tract, which renders it biologically inert.
What’s the Overall Verdict?
We here at Leafwell are always intrigued by the uses of whole-plant (or whole-fungi in this instance) medications as a treatment for all sorts of health problems. When non-toxic, naturally-occurring mushrooms are generally very well-tolerated by the human body, have low addiction potential, and do not usually cause death via overdose. Psilocybin mushrooms are no different in this regard, and the evidence so far suggests very strongly that they can be used for the treatment of depression and addiction – perhaps in a better way than ever.
As to whether or not psychedelic therapy will become more commonplace and become the next cannabis is hard to say. While the early results have been promising, it’s entirely possible that other methods will be far more effective than psilocybin. Or, on the other hand, it could turn out that psilocybin has the potential to be a miracle compound for those seeking relief from depression, PTSD symptoms, and anxiety or stress disorders. Simply put, the only way to find out is to legalize, normalize, and research how it impacts people.
The endocannabinoid system (ECS) is involved in homeostasis and could be said to have a broad range of therapeutic effects for many different conditions that arise from endocannabinoid deficiency. Psilocybin mushrooms, meanwhile, work on a different set of serotonin receptors. The two perhaps share more of a spiritual and cultural connection with each other than s strict biological one (although there is some overlap). The cannabis industry is also used to working with an illegal plant, so it would not be surprising to see their skills and expertise transferred to mycology as well! The two worlds, although different in many respects, will likely enmesh and be used in combination for mental health therapy in the future.
- Multidisciplinary Association for Psychedelic Studies
- Imperial College London Psychedelic Research Centre
- The Vaults of Erowid
- Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca
- Treatment of acute opioid withdrawal with ibogaine
- Psychedelic drugs—a new era in psychiatry?
- Microdosing psychedelics: More questions than answers? An overview and suggestions for future research
- Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin
- The Brain’s Default Mode Network
- Psychedelics Promote Structural and Functional Neural Plasticity