Ask the Doctors - How risky are 'magic mushrooms'?

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Dear Doctors: I see that psilocybin mushrooms – what we used to call magic mushrooms – are being studied now as a possible treatment for PTSD and depression. I’ve struggled with severe depression my whole life. Would it be risky for me to give magic mushrooms a try?

In a word – yes. Although emerging research into the potential benefits of psilocybin for people with depression and anxiety disorders is encouraging and intriguing, we absolutely recommend against self-experimentation.

First and foremost, psilocybin, which is the compound in certain mushrooms that gives them their hallucinogenic quality, is illegal in the United States. It is a Schedule I substance under the Controlled Substances Act and carries the same legal penalties as heroin. But even more to the point, the studies you are reading about are complex and multi-layered. They use specialized drugs in standardized doses. Participants take them under rigorously monitored conditions. Results are evaluated every step of the way.

Experimenting on yourself with unverified drugs in uncontrolled doses can be dangerous and lead to unforeseen consequences. Side by side with the research suggesting the beneficial applications of psilocybin mushrooms, recreational users are self-reporting significant challenges as well.

In an online survey completed last year, researchers at Johns Hopkins asked 1,993 individuals about their experiences with psilocybin mushrooms. Close to 40 percent said it was the most challenging experience of their lives. Eleven percent of respondents said they put themselves or someone else at risk while under the influence. Another eight percent went on to seek treatment for psychological symptoms that didn’t go away.

The researchers found that the difficulties users experienced were associated with taking too large a dose, and with being in an environment that felt unsafe. Both of these variables are hard to control in a real-world setting.

Treating depression – and living with it -- is challenging. Finding the right combination of existing drugs to alleviate symptoms can take months of trial and error. In the interim, patients suffer. That’s why the potential benefits of psilocybin mushrooms have fascinated researchers for some time.

In the 1950s and ‘60s, researchers in Europe began to explore the use of psychoactive drugs in mental health therapy. Their promising results encouraged similar research in the U.S. Between 2004 and 2008 scientists at UCLA did groundbreaking research into the effects of psilocybin on cancer patients who were gravely ill. The results showed that it significantly relieved their extreme anxiety.

In another study last year, researchers at Johns Hopkins administered psilocybin to cancer patients who were gravely ill. The sessions took place in pretty and comfortable settings, with two monitors present. Participants were encouraged to lie down, listen to music on headphones, and focus their attention inward on ideas, thoughts and emotions.

As with previous experiments, the outcomes were encouraging. Participants reported a substantial decrease in depression and anxiety, a result that endured for at least six months.

How psilocybin works, and why it is effective against depression is not yet known. But with so much promise, the research continues.

Eve Glazier, MD., MBA, and Elizabeth Ko, MD., are internists at UCLA Health. Dr. Glazier is an associate professor of medicine; Dr. Ko is an assistant professor of medicine.

Ask the Doctors is a syndicated column first published by UExpress syndicate.