'Magic Mushrooms' Possible Tx in End-Stage Cancer

[Guest guest]

'Magic Mushrooms' Possible Tx in End-Stage Cancer

The active ingredient in "magic mushrooms" -- psilocybin -- may be useful to treat the anxiety and stress associated with end-stage cancer, researchers suggest.

In a small placebo-controlled randomized trial, the drug was safe both physiologically and psychologically, according to Grob, MD, of Harbor-UCLA Medical Center in Torrance, Calif., and colleagues.

And -- despite a low dose -- the drug appeared to have some beneficial effect on mood, they reported online in Archives of General Psychiatry.

Psilocybin is an hallucinogen with some effects similar to those of lysergic acid diethylamide (LSD), but its effects are considered to be more visual and euphoric, as well as less emotionally intense and less likely to cause panic reactions and paranoia.

From the late 1950s to the 1970s, drugs such as psilocybin were studied as possible treatments for what the researchers called "the existential anxiety, despair, and isolation often associated with advanced-stage cancer."

In many cases, critically ill people had "psychospiritual epiphanies, often with powerful and sustained improvement in mood and anxiety as well as diminished need for narcotic pain medication," the researchers wrote.

But follow-up research was not conducted, despite promising initial results, because of "political and cultural pressures," they continued. The current study is the first in 35 years to examine the effect of the drug in advanced cancer patients.

Grob and colleagues enrolled 12 patients -- 11 of them women -- with end-stage cancer and associated anxiety. Each patient acted as his or her own control, getting either 0.2 milligrams per kilogram of psilocybin or 250 milligrams of niacin in six-hour treatment sessions separated by several weeks.

Before and during the sessions, patients wore a heart monitor to track changes in rhythm; blood pressure and heart rate were measured before drug administration and at regular intervals for six hours afterwards. Mood changes were measured on several psychological instruments, including the Beck Depression Inventory, the State-Trait Anxiety Inventory anxiety subscale, and the Profile of Mood States.

The drug was physiologically safe, the researchers reported, accompanied by only mild -- although statistically significant -- elevations in heart rate and blood pressure, but no clinically significant adverse events including arrhythmias or heart block. Specifically:

Heart rate peaked two hours after administration of the drug, with an average increase of 11 beats per minute compared with the placebo sessions. The difference was significant at P<0.007.

Blood pressure also peaked two hours after the drug was given, with an average increase in systolic pressure of 21 millimeters of mercury and an average increase of 6.3 millimeters in diastolic pressure. The difference from placebo for the systolic pressure was significant at P<0.01, but the difference for diastolic pressure did not reach significance, possibly because of a physiological effect of the niacin at that time.

It was also safe physiologically, the researchers reported. "All subjects tolerated the treatment sessions well," they wrote, "with no indication of severe anxiety or a 'bad trip.'"

There were hints of efficacy, the researchers reported, including:

A significant reduction in anxiety at one and three months after psilocybin treatment on the State-Trait Anxiety Inventory trait anxiety subscale (at P<0.001 and P=0.03, respectively)

An improvement in mood on the Beck Depression Inventory that reached significance (at P<0.03) after six months

Mood improvement on the Profile of Mood States that approached but did not reach significance

"These results support the need for more research in this long-neglected field," Grob and colleagues concluded.

They cautioned that, despite efforts at blinding, the drug order was "almost always apparent" to both patients and investigators. Future studies, they wrote, will need to find ways to improve blinding techniques.

The investigators also noted that variability in the number and intensity of contact with patients was another study limitation.

Primary source: Archives of General PsychiatrySource reference:Grob CS, et al "Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer" Arch Gen Psych 2010; DOI: 10.1001/archgenpsychiatry.2010.116.

http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/22042

[Guest guest]

Well gang - imagine looking forward to these things LEGALLY !! First, it's pot for medicinal purposes and now it's magic mushrooms at end stage. Hmmm does one pick the pot instead of legal narcotics?? But, we already know that we have to be careful, in case you might have to face a live transplant; because the Dr's there, can remove you from the list for using it. Then, that poor patient that is living with end-stage liver disease - you wanna eat a few mushrooms and go

tripping??Seems to me that this really will be the "Baby Boomer" health issue after all!!!!!!!Gloria

'Magic Mushrooms' Possible Tx in End-Stage Cancer

The active ingredient in "magic mushrooms" -- psilocybin -- may be useful to treat the anxiety and stress associated with end-stage cancer, researchers suggest.

In a small placebo-controlled randomized trial, the drug was safe both physiologically and psychologically, according to Grob, MD, of Harbor-UCLA Medical Center in Torrance, Calif., and colleagues.

And -- despite a low dose -- the drug appeared to have some beneficial effect on mood, they reported online in Archives of General Psychiatry.

Psilocybin is an hallucinogen with some effects similar to those of lysergic acid diethylamide (LSD), but its effects are considered to be more visual and euphoric, as well as less emotionally intense and less likely to cause panic reactions and paranoia.

From the late 1950s to the 1970s, drugs such as psilocybin were studied as possible treatments for what the researchers called "the existential anxiety, despair, and isolation often associated with advanced-stage cancer."

In many cases, critically ill people had "psychospiritual epiphanies, often with powerful and sustained improvement in mood and anxiety as well as diminished need for narcotic pain medication," the researchers wrote.

But follow-up research was not conducted, despite promising initial results, because of "political and cultural pressures," they continued. The current study is the first in 35 years to examine the effect of the drug in advanced cancer patients.

Grob and colleagues enrolled 12 patients -- 11 of them women -- with end-stage cancer and associated anxiety. Each patient acted as his or her own control, getting either 0.2 milligrams per kilogram of psilocybin or 250 milligrams of niacin in six-hour treatment sessions separated by several weeks.

Before and during the sessions, patients wore a heart monitor to track changes in rhythm; blood pressure and heart rate were measured before drug administration and at regular intervals for six hours afterwards. Mood changes were measured on several psychological instruments, including the Beck Depression Inventory, the State-Trait Anxiety Inventory anxiety subscale, and the Profile of Mood States.

The drug was physiologically safe, the researchers reported, accompanied by only mild -- although statistically significant -- elevations in heart rate and blood pressure, but no clinically significant adverse events including arrhythmias or heart block. Specifically:

Heart rate peaked two hours after administration of the drug, with an average increase of 11 beats per minute compared with the placebo sessions. The difference was significant at P<0.007.

Blood pressure also peaked two hours after the drug was given, with an average increase in systolic pressure of 21 millimeters of mercury and an average increase of 6.3 millimeters in diastolic pressure. The difference from placebo for the systolic pressure was significant at P<0.01, but the difference for diastolic pressure did not reach significance, possibly because of a physiological effect of the niacin at that time.

It was also safe physiologically, the researchers reported. "All subjects tolerated the treatment sessions well," they wrote, "with no indication of severe anxiety or a 'bad trip.'"

There were hints of efficacy, the researchers reported, including:

A significant reduction in anxiety at one and three months after psilocybin treatment on the State-Trait Anxiety Inventory trait anxiety subscale (at P<0.001 and P=0.03, respectively)

An improvement in mood on the Beck Depression Inventory that reached significance (at P<0.03) after six months

Mood improvement on the Profile of Mood States that approached but did not reach significance

"These results support the need for more research in this long-neglected field," Grob and colleagues concluded.

They cautioned that, despite efforts at blinding, the drug order was "almost always apparent" to both patients and investigators. Future studies, they wrote, will need to find ways to improve blinding techniques.

The investigators also noted that variability in the number and intensity of contact with patients was another study limitation.

Primary source: Archives of General PsychiatrySource reference:Grob CS, et al "Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer" Arch Gen Psych 2010; DOI: 10.1001/archgenpsychiatry.2010.116.

http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/22042