By Karen Kier
Pharmacist on behalf of the ONU HealthWise team
In the 1960s, social upheaval related to wars and political issues about race and gender fueled political activism. This decade also brought about a psychedelic drug-using counterculture that believed there was better living through chemistry. These psychedelic drugs included lysergic acid diethylamide commonly referred to as LSD and magic mushrooms containing psilocybin.
Various songs in the ‘60s and ‘70s referred to the use of drugs including hallucinogens. Jefferson Airplane was formed in 1965 in the San Francisco bay area at the height of the counterculture and quickly rose in popularity. The band disbanded around 1973 but members formed other groups such as Jefferson Starship, which maintained the distinct vocals of Grace Slick. The band was inducted into the Rock and Roll Hall of Fame in 1996 and was awarded a Lifetime Achievement Grammy in 2016. Consider their song White Rabbit with the well-known lyrics, “And you've just had some kind of mushroom, And your mind is moving low, Go ask Alice, I think she'll know.”
Research in the 1950s led to the understanding of the basic chemistry and action of hallucinogenic drugs used in the 1960s. In 1956, psychiatrist Humphry Osmond coined psychedelic from the Greek words psyche meaning mind or soul and delos meaning to show. Dr. Osmond had been conducting research on LSD. Psychedelic drugs belong to a class of medications known as hallucinogens. This class of drugs produces a mind-altering or reality-distorting effect and they can trigger emotional swings, delusions, and feelings of being detached from reality.
Many common medications still used today started from natural products such as digoxin from the foxglove plant and aspirin substances from the bark of the willow tree. These substances have valuable benefits for diseases such as heart failure to inflammation and pain management. Researchers continue to study and evaluate natural products for their benefit to society in managing various disease states. Scientists and healthcare professionals have taken interest in the possibility of clinical benefit with magic mushrooms.
Magic mushrooms is a term used to describe a naturally occurring group of fungi that produce a psychedelic prodrug that is chemically known as psilocybin. Over 200 species of fungi produce psilocybin with the most potent members coming from the genus Psilocybe. Psilocybin is a Schedule I controlled substance by the Drug Enforcement Agency (DEA) because of the definition of high potential for abuse with no currently accepted medical use in treatment in the United States. Some newer research may refute this classification.
A prodrug is a drug that is not the active compound or causes the actual change in the body. A prodrug like psilocybin needs to be orally ingested and the body then converts the prodrug to the active form causing the effect on the body. After being eaten, psilocybin is converted into the active drug psilocin.
Psilocybin is a tryptamine compound related to the amino acid tryptophan, which is structurally similar to serotonin. Serotonin is a neurotransmitter that can be found in the brain and is part of the mechanism for mental health conditions and migraines. Due to psilocybin’s chemical relationship to serotonin, researchers have a renewed interest in evaluating its potential to help manage certain disease states including depression.
After six decades of being considered a drug with no medical benefit, psilocybin is back in clinical studies evaluating its use in conditions such as depression, substance abuse disorders, and post-traumatic stress disorders (PTSD). Both the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) have published research showing positive benefits of psilocybin in patients with long-standing, moderate to severe depression. Some of the studies have compared psilocybin to standard depression therapy such as escitalopram (Lexapro). The Department of Veterans Affairs has recently announced clinical studies within many of their clinics. This will provide more research in much needed areas including PTSD, substance abuse, and refractory depression.
Clinical trials or studies are the basis for evidence to understand the effectiveness and safety of drugs. One might wonder how to find clinical trials such as psilocybin in the United States especially if they know of someone who is not responding to current medical therapy? Interestingly, the government provides free access to information through a website known as www.clinicaltrials.gov. This website is searchable by drug or condition. It provides information on where research is being done by facility and if the study is enrolling individuals. If a study has been completed or stopped due to issues, then the site will report this information as well. It is a valuable resource and I often refer to it to gather important data.
The good news is studies are showing benefit for psilocybin and continued research will help us understand its use better.
There really might be some magic in those mushrooms.
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