Key takeaways:

  • Why does PTSD occur?

    Some scientists believe that it is a survival mechanism of the individual to replay the traumatic event to be "better prepared" next time it happens. Others believe it is caused by constantly elevated levels of adrenaline that is triggered by the initial traumatic event.

  • What's the rationale behind psilocybin and other psychedelics?

    Because psychedelics are able to promote the creation of new neurons and promote neuroplasticity, they may have a role to play in PTSD. Psilocybin has also been shown to reduce many of the symptoms associated with PTSD such as anxiety and depression.

  • What's the first-ever psilocybin treatment for PTSD?

    Silo Wellness has developed a psilocybin nasal spray that can be used by war veterans to reduce the severity and symptoms of PTSD.

The unfortunate reality for many PTSD sufferers is that conventional treatment isn’t effective or is only partially effective. Post-traumatic stress disorder (PTSD) has baffled the medical world for pretty much... forever. Those therapies that are available for people with PTSD 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?

painting of somebody in anguish for article on psilocybin and 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.

Image of multicolored brain for an article on ptsd and psilocybin

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 treatment options for PTSD.

Image of woman in distress being offered pills for an article on psilocybin and ptsd

There are two main approaches to treating PTSD.

The first is psychotherapy, which uses psychological methods that involve regular, one-on-one interactions to help individuals make desired changes. Cognitive processing therapy, a common form of psychotherapy, is often used for people with PTSD.

The goal of this therapy is to teach individuals with PTSD how to assess and change their distressing thoughts following a traumatic event. Therapists believe that by altering thought patterns, a person can change how they feel. In the case of a traumatic event, psychotherapy can help individuals reevaluate and see the world differently, particularly if they tend to blame themselves.

The second way to treat PTSD is through antidepressant medication. Antidepressants affect the hippocampus, a part of the brain associated with memory, to counteract the effects of stress.

There are two types of antidepressants used: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). The four main antidepressants effective for treating PTSD are sertraline (Zoloft®), paroxetine (Paxil®), fluoxetine (Prozac®)—all SSRIs—and venlafaxine (Effexor®), an SNRI. In addition to antidepressants, three antipsychotic drugs—olanzapine, quetiapine, and risperidone—are used to help treat PTSD.

Read: The Truth About Mushrooms & Meds: Are They Safe to Mix?

Modern medicine treats PTSD using a combination of both 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.

Can Psilocybin Help Treat PTSD?

Photograph of psilocybin mushrooms for an article on ptsd and psilocybin

While therapy, antidepressants, and antipsychotics help many patients, these methods often fall short. Studies have suggested that antidepressants do not work well for people who have had multiple traumas over the course of years or chronic PTSD. A new study found that the antipsychotic risperidone worked no better than a placebo in alleviating typical PTSD symptoms in patients who had the disorder long-term or who continued to experience symptoms after being treated with antidepressants.

Read: Is It Safe to Mix Magic Mushrooms and Antidepressants?

Because these drugs can also cause intolerable side effects, many patients are left to experience PTSD with no sign of relief. Many of these patients turn to substance abuse, develop anger management issues, or commit suicide. A study analyzing data from the National Comorbidity Survey showed that out of six anxiety diagnoses, PTSD was significantly associated with suicide attempts.

There is some evidence in animal studies to show that psilocybin, the psychedelic compound found in “magic mushrooms,” may act by stimulating nerve cell regrowth in parts of the brain responsible for emotion and memory.

2013 study on psilocybin and fear in mice.

2013 study from the University of South Florida found that psilocybin stimulates neurogenesis—the growth and repair of brain cells in the hippocampus, which is the brain’s center for emotion and memory. In the study, mice that were given psilocybin overcame fear conditioning far better than mice that were given a placebo. The study supported the hypothesis that psilocybin can help break the traumatic cycle that occurs in patients with PTSD.

2016 clinical trial on psilocybin and relief of distress in cancer patients.

Stephen Ross, MD, a psychiatrist at NYU Langone, conducted a study 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.

In Dr. Ross’s study, 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.

Dr. Ross says that the findings “…have the potential to transform the care of cancer patients with psychological and existential distress, but beyond that, it potentially provides a completely new model in psychiatry of a medication that works rapidly as both an antidepressant and anxiolytic and has sustained benefit for months.” Dr. Ross has hope that the drug will become legal in the next five years.

“If larger clinical trials prove successful, then we could ultimately have available a safe, effective, and inexpensive medication—dispensed under strict control—to alleviate the distress that increases suicide rates among cancer patients.”

2021 survey on psilocybin and PTSD.

Child maltreatment is significantly linked to post-traumatic stress symptoms and internalized shame. Specifically, emotional abuse and neglect are most strongly associated with complex trauma symptoms and internalized shame.

Interestingly, according to a survey involving 166 participants, individuals with a history of intentional therapeutic psychedelic use report lower complex trauma symptoms and internalized shame, despite having similar histories of maltreatment. Notably, these differences are most pronounced in those with a history of more than five instances of intentional therapeutic psychedelic use.

Furthermore, a history of more than five occasions of intentional therapeutic psychedelic use significantly changed the relationship between emotional abuse and neglect and complex trauma symptoms. However, there were no observed associations between maltreatment, psychedelic use, and the recognition of facial emotions.

In conclusion, these findings suggest that using psychedelic drugs for therapeutic purposes is linked to reduced levels of complex trauma symptoms and internalized shame in individuals who have experienced child maltreatment. Psychedelic use may hold promise as a therapeutic approach for addressing the aftermath of childhood maltreatment.

2022 open-label study on psilocybin and PTSD.

In an open-label study involving AIDS survivors who had experienced trauma, psilocybin-assisted psychotherapy (PAP, also known as PAT) was found to reduce PTSD symptoms, attachment anxiety, and feelings of demoralization.

Several PAP trials have also shown initial promise in helping individuals confront traumatic memories, reduce emotional avoidance, alleviate depression and anxiety, foster a more positive outlook, enhance interpersonal connections, and promote self-compassion and forgiveness, all of which are relevant to PTSD recovery.

2023 clinical trial on psilocybin and PTSD in U.S. veterans.

Psilocybin-assisted therapy has displayed considerable potential in addressing the array of mood and anxiety symptoms associated with post-traumatic stress disorder (PTSD). Moreover, existing pharmacological and psychotherapeutic treatments for PTSD, especially among the US Military Veteran (USMV) population, are often challenging to endure and have limited effectiveness.

This clinical trial aims to evaluate the safety and effectiveness of two psilocybin administration sessions (15 mg and 25 mg) when combined with psychotherapy for individuals with severe, treatment-resistant PTSD among USMVs.

2023 clinical trial on psilocybin and PTSD.

The impact of PTSD can be profoundly debilitating, and existing treatments often fall short in providing effective relief. In partnership with COMPASS Pathways as part of a multi-center trial, researchers at King's College London and Icahn School of Medicine at Mount Sinai are exploring the safety and tolerability of psilocybin for individuals dealing with PTSD.

The study will include 20 participants, and is taking place at The Institute of Psychiatry, Psychology & Neuroscience at King's College London and Icahn School of Medicine at Mount Sinai.

This phase 2, open-label study will involve participants receiving a single 25mg dose of COMP360 psilocybin, administered alongside specialized psychological support. The study will span a 12-week period, with a primary focus on safety and an evaluation of changes in PTSD symptoms and overall quality of life.

This groundbreaking research will offer participants the opportunity to engage in at least six sessions of talk therapy combined with the 25mg psilocybin treatment. Additionally, there is an option to partake in the neuroimaging (brain scan) component of the trial. Your involvement in this study can contribute to advancing our understanding of this innovative approach to addressing PTSD.

Both sites are currently recruiting patients to join the study—for more information on how to join, click here.

2023 clinical trial on psilocybin and PTSD.

The Mydecine trials are exploring psilocybin-assisted psychotherapy to treat chronic PTSD in veterans and Emergency Medical Services (EMS) personnel. The purpose of the trials is to explore how the brain responds to psychedelics and to develop a better understanding of the biological underpinnings created by the psychedelic experience.​

The research will take place at Leiden University Medical Centre in the Netherlands; the University of Western Ontario; and the University of Alberta, with other clinical sites on the horizon in the USA, Europe, and Australia.

Mydecine hopes the trials will help to establish the safety and efficacy of psychedelic-administered psychotherapy in a safe and supervised setting.

Chief Medical Officer, Dr Jetly, a prominent voice in the fight against PTSD and other mental health issues facing vulnerable populations like veterans and first responders, said: “The choice of working with veterans as our first subjects in our clinical trials was made for a variety of reasons. Along with my experience, and that of our Scientific Advisory Board, we have devoted our professional lives to the treatment of soldiers and veterans suffering from a variety of mental health conditions including PTSD.

“Those who have treated veterans and connected research in the same group have come to the realization that, although many evidence-based treatments exist for PTSD, they are built largely on the ‘fear-based model,’ and sadly a significant proportion of those suffering do not respond positively. In fact, veterans tend to respond less often to evidence-based therapies compared to other types of trauma.”

The rationale behind psilocybin and other psychedelics.

A collage art of magic psilocybin mushrooms in someone's mouth for an article on psilocybin for ptsd

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 hypothesized 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 developed.

Image of psilocybin nasal spray designed to help those with PTS and treatment-resistant conditions

A magic mushroom nasal spray has been designed to make microdosing easier for people trying to treat their PTSD or depression.

Silo Wellness, an Oregon company with a team with roots in cannabis delivery modalities, has developed a magic mushroom nasal spray in Jamaica – where psilocybin is legal – for controlled, metered-dosing known as microdosing.

Magic mushroom nasal spray​.

The psilocybin nasal spray passes the gut, going directly to the bloodstream through the nasal mucus membranes and eventually the liver for metabolising. This saves the patient from feeling nauseous, as commonly experienced when taking psilocybin.

Board Advisor and Silo Wellness investor Becky Rotterman, a Missouri pharmacist, stated: “Many psilocybin patients, particularly women, complain of upset stomach or vomiting when taking high-doses of mushrooms.

“We want to bring this wonderful natural medicine first to Oregon and then the flyover states – to those who would be afraid to eat a handful of fungi and who feel more comfortable seeing their medicine in a familiar delivery modality, such as a metered-dose nasal spray.”

The correct dose.

When a patient takes psilocybin the dosage is vital. Many people end up ‘stacking’, whereby the first dose takes some time to take effect so the patient consumes more, only to find they have taken too much later on. Microdosing alternatives with faster uptake speed are important in order to prevent accidental high-dosage experiences.

Silo Wellness founder, Mike Arnold, said he created the medicine dispenser after his first experience with psilocybin after he was advised by a doctor to try it.

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He said: “I couldn’t help to think how fortunate I was to have an actual physician take me on my first trip rather than ‘some guy’ I know, but I realised that most first-time users don’t have that luxury.

“I reached out to my long-time colleague from the marijuana space, brilliant inventor Michael Hartman, and we agreed that we need to be able to give patients predictable dosing so they can self-titrate into the desired levels of sub-psychedelic or psychedelic treatment.”

“We solved the age-old problem with plant- and fungus-based medicine: How do you know how much is a dose?” Hartman explained. “How do you avoid taking too much, like the cannabis edibles dilemma? We also managed to solve one of the common complaints of some mushroom users: taste and upset stomach.”

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

Breakthrough therapy.

A collage art of a woman breaking through with psilocybin mushrooms, peyote, morning glory, and cannabis for an article on psilocybin for PTSD

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

Psilocybin for PTSD FAQs.

  • What is PTSD, and who does it affect?

    PTSD, or Post-Traumatic Stress Disorder, is a condition that follows extremely traumatic events, often affecting war veterans or victims of abuse and violence. It can manifest immediately after the trauma or remain latent for years.

  • What are the main theories behind why PTSD occurs?

    Three main theories include the "survival mechanism," the "adrenaline" theory, and the impact of constant stress on the brain's hippocampus, which can explain the symptoms and resistance to treatment in PTSD.

  • What are the conventional treatment options for PTSD?

    Conventional treatment includes psychotherapy, like cognitive processing therapy, and antidepressant medication, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Antipsychotic drugs may also be used for treatment.

  • Why is psilocybin therapy being explored for PTSD?

    Psilocybin and other psychedelics show promise in promoting fear extinction, neurogenesis, and neuroplasticity in the brain. They can also lead to emotional breakthrough experiences, providing potential benefits for PTSD.

  • How do psilocybin's effects on the brain offer hope for PTSD treatment?

    Psilocybin can stimulate the growth and repair of brain cells in the hippocampus, the brain's emotional and memory center. It may help break the cycle of trauma seen in PTSD. Psilocybin may also offer emotional breakthrough experiences, providing new insights or realizations, which can be therapeutic for individuals with PTSD.

  • Are there other methods of administering psilocybin for PTSD treatment?

    A nasal spray for controlled, metered dosing of psilocybin is being developed, providing a more predictable and comfortable dosing method, with faster uptake and fewer side effects.

  • What's the significance of psilocybin therapy as a "breakthrough therapy"?

    Psilocybin has been granted "breakthrough therapy" status by the FDA, opening doors for further clinical research and potentially transforming the care of individuals with conditions like PTSD.

  • How are clinical trials investigating psilocybin therapy for PTSD progressing?

    Numerous studies and trials worldwide are exploring the safety and efficacy of psilocybin for PTSD, with some showing promise in reducing symptoms and improving quality of life.

  • Can I get psilocybin-assisted therapy for trauma in Canada?

    Yes. You can visit our Trusted Psychedelic Therapists portal for a shortlist of therapists that can assist you, or browse or directory of clinics in Canada that offer psychedelic-assisted therapy.

  • Does the choice of psilocybin mushroom strain matter when using them therapeutically for conditions like PTSD?

    The choice of psilocybin mushroom strain can matter in therapeutic use to some extent. Different strains may contain varying levels of psilocybin and other compounds, which can influence the intensity and duration of the experience.

    For therapeutic purposes, some may prefer milder strains for a gentler introduction to the process. However, therapeutic efficacy primarily depends on factors like the individual's mindset, setting, and the guidance of trained professionals.

    Research and clinical trials often use standardized doses to ensure consistency and safety in therapeutic settings. Therefore, while strain choice may have some impact, it's not the most critical factor in therapeutic outcomes. Always consult with healthcare professionals or researchers for guidance on strain selection in therapeutic contexts.

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