Psilocybin & PTSD: Revolutionising the Role of Psychedelics in Therapy

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The unfortunate reality for many PTSD sufferers is that conventional treatment isn’t effective or is only partially effective. Post traumatic stress disorder has baffled the medical world for pretty much...ever. Those therapies that are available for PTSD sufferers include medication and psychotherapy, although few therapies are demonstrably effective. For most people with PTSD, it becomes a chronic and lifelong condition.

Enter psilocybin therapy.

Psilocybin, along with MDMA, have been granted “breakthrough therapy” designation by the FDA in the USA for their potential to treat the broad population affected by PTSD. Rather than this being in light of evidence, the move is bound to open doors for evidence, as this status enables the medical world to study psilocybin in the clinical context.

And that’s exactly what’s happening at Leiden University in the Netherlands and at Urona in Wisconsin.

In this article, we’re talking about PTSD, who it affects, and the research going on in the Americas that are putting psilocybin in the spotlight as a potential alternative treatment.

What is PTSD?

PTSD is short for Post Traumatic Stress Disorder, and as its name suggests, it is a disorder that follows an extremely traumatic event. It’s because of this that PTSD is most common among war veterans. It can occur after a single, isolated traumatic event, or can occur after prolonged exposure to trauma such as sexual abuse victims or domestic violence.

PTSD sometimes presents in a person immediately after the trauma, but can also be latent for a number of years before it manifests clinically. A person with PTSD experiences repeated recollection of the event, typically avoids stimuli that arouse the memory, and has negative thoughts and moods. It’s very common for patients with PTSD to experience anxiety disorder and depressive disorder as comorbidities.

Theories about why PTSD occurs.

Nobody quite understands why PTSD occurs in some people but not in others. It has been hypothesized that there is a genetic factor in PTSD risk, as those whose parents have a mental health disorder may be more likely to develop PTSD.

Aside from this, there are three main theories.

The first is the “survival mechanism” theory. The constantly recurring memories may be the person’s subconscious way of being “prepared” for the next time such an event occurs, making them better fit for survival.

The second is the “adrenaline” theory. In this theory, the traumatic event triggers a chronic dysregulation of the fight-or-flight response, causing constantly elevated levels of adrenaline, norepinephrine and dopamine. This causes hyperarousal, or an inability to switch off. Essentially, it puts a person in a constant mode of fight-or-flight.

Finally, the third is that constant stress causes changes to the hippocampus. In those with PTSD, ongoing stress is a major factor. In some studies, evidence shows that hippocampal size is reduced in those with PTSD, suggesting that stress has major consequences on brain function. This may explain the symptoms associated with PTSD and its resistance to treatment.

Conventional therapy for PTSD.

Modern medicine treats PTSD using a combination of pharmaceutical drugs and psychotherapy. Drugs are only typically given for comorbidities or physical illnesses arising as a result of PTSD. For example, many PTSD sufferers receive medication for reducing blood pressure as high blood pressure is a common symptom in PTSD.

However, trauma focused psychotherapy is, to date, the best indicated treatment for PTSD. There are still major barriers to healing using this form of psychotherapy. The very nature of PTSD makes it difficult to commit to long-term psychotherapy because avoidance is one of the primary psychological indicators of PTSD. This starts to shed a light on what makes psilocybin such a potent therapeutic for PTSD.

Trauma focused psychotherapy and cognitive behavioural therapy essentially allow the person to access that memory in a safe place, process it, and move on from it. This is typically a long-term therapy that for some, isn’t effective or is only partially effective.

The rationale behind psilocybin and other psychedelics.

The clinical rationale behind using psilocybin and other psychedelics in the treatment of PTSD involves the neurobiological changes that occur in the brain. It’s hypothesised that psilocybin facilitates fear extinction and promotes neurogenesis and neuroplasticity.

There are also the more obvious emotional effects from using psychedelics such as increased empathy, increased mindfulness and insightfulness, increased acceptance, and increase in personality trait openness. 

Arguably, the most important rationale behind psilocybin and other psychedelics is the emotional breakthrough experience. Some people call this the mystical experience or the sudden realisation experience. It’s very difficult to define, and it’s probably for this reason that clinical medicine finds it very difficult to pinpoint why psychedelics might work for PTSD. The sudden realisation of why a certain thing occurs is a common effect from psilocybin, and is sometimes all a person needs to move forward from that phenomenon.

Psilocybin nasal spray being developed and researched.

In Oregon, Silo Wellness is developing a world-first psilocybin nasal spray especially targeted at those with PTSD. The philosophy behind this product is a simple delivery system of psilocybin that bypasses the associated nausea with high-dose psilocybin. Silo Wellness also says that a the nasal spray delivery method lets patients self-titrate for the perfect sub-psychedelic or psychedelic dose.

Essentially, the nasal spray lets you microdose or macrodose, depending on your needs. And there’s no nausea that comes with higher doses.

As of February 2023, Mydecine, a U.S. biotechnology company that creates new drugs and treatments for addiction and mental health, is getting ready to conduct a Phase 2A clinical trial on PTSD among veterans, first responders, and front-line employees. Global test sites have been approved at Leiden University in the Netherlands, the University of Alberta, the Royal Ottawa Hospital, and Western Ontario University. In addition, they are nearing completion on numerous US locations, including Boston, Los Angeles, and San Francisco. Mydecine is hosting the research in conjunction with NeuroPharm Inc., a Canadian veteran-focused healthcare company. Together, they have been developing a psilocybin protocol that addresses some of the unmet needs of the most high-risk individuals.

In 2016 , researchers at NYU conducted a Phase 1 clinical trial on terminally ill cancer patients and found that one-time treatment with psilocybin very quickly brought relief from distress that had lasted more than 6 months in 80% of study subjects.

half of the participants were randomly assigned to receive psilocybin. The rest received a control drug of niacin, which is known to produce a “rush” similar to that associated with a hallucinogenic drug experience. Halfway through the seven-week study period, all of the participants switched treatments. Neither the researchers nor the patients knew which patients had first received psilocybin or which received the control. All of the patients, mostly women, had advanced gastrointestinal, blood, or breast cancers and had been diagnosed as having serious psychological distress related to their disease.

Patients noted that after being treated with psilocybin, they felt their quality of life improve. They noted that they wanted to engage more with external activities, had more energy, experienced improved relationships with their family members, and performed better at work. The researchers concluded that if psilocybin could reduce psychological distress in terminally ill cancer patients, it could apply to less extreme medical conditions related to psychological distress as well.

Alongside this clinical trial are others for the effect of psilocybin therapy on clinical depressive disorder, which is the leading cause of disability in the world.

Breakthrough therapy.

The potential of psilocybin for PTSD has already been discovered by many brave pioneers, but only on an anecdotal level. Nonetheless, the discovery of an effective, safe therapeutic for conditions as complex as depressive disorder, clinical anxiety, and PTSD is a breakthrough. For many with PTSD, there’s no clear light at the end of the tunnel, and for that, alternative therapies are welcomed.

Given that the FDA has approved psilocybin for breakthrough therapies, we can only assume that we will be seeing the results of clinical trials in the very near future. This should give the medical world a better idea of the place psilocybin has in the clinical context, how it should be administered, and the best dose for treating PTSD.

Read: The Benefits of Microdosing Psilocybin — Without the Fluff

Read: How Psilocybin Improves Your Brain's Neuroplasticity

Read: The Ultimate Guide to Magic Mushroom Microdosing

Read: Microdose Cycling: What It Is, and Why You Should Be Doing It

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