This Month in Psychopharmacology

Psilocybin for Treatment of Alcohol Use Disorder

Pharmacological treatments for Alcohol Use Disorder (AUD) have remained scarce throughout modern medical times, however, recent research is revisiting the old idea of treating AUD with psilocybin mushrooms (aka magic mushrooms). In a recent study by Bogenshutz and colleagues, a total of 95 participants (42 female) who met the DSM-IV diagnostic criteria for alcohol dependence were randomized to receive psilocybin (25 mg/70kg & 25-40 mg/70kg) or the placebo diphenhydramine (50 mg & 50-100 mg) at two psychotherapy sessions that included motivational enhancement therapy and cognitive behavioral therapy. Participants were monitored for the number of heavy drinking days, total number of drinking days, and the number of drinks per drinking episode over a 32-week period following the first therapy session. Overall, this study found that psilocybin-based psychotherapy outperformed placebo in reducing the number of heavy drinking days, the number of drinking days in general, and the number of drinks consumed in an episode. More specifically, participants treated with psilocybin were more likely to have no heavy drinking days and a 2-level reduction in WHO risk level during the observation period. At the end of the study 18/45 participants in the placebo group had no heavy drinking days, while almost double, 30/48 participants, in the psilocybin group experienced no heavy drinking days. Additionally, participants who received psilocybin showed moderate to large reductions in several categories of drinking-related problems at week 24 and/or week 36. Finally, adverse events associated with psilocybin administration were mostly mild, however, it must be noted that these safety findings should not be generalized to other contexts considering the careful medical and psychiatric screening occurring throughout this study.

Reference:

Bogenschutz, MP et al JAMA Psychiatry, 2022. 79(10), 953-962. Abstract.

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