How Psilocybin Can Rewire Our Brain, Its Therapeutic Benefits & Its Risks

Main Takeaways

1. The primary effect of psilocybin is its ability to mimic serotonin in a highly specific manner, leading to neuroplasticity—reshaping the brain's neural connections to facilitate adaptive changes.

2. The goal of psilocybin is not merely to rewire the brain but to rewire it in a way that promotes new and innovative ideas, fostering creative and transformative thinking.

3. Clinical trials involving psilocybin for the treatment of depression are surpassing the effectiveness of standard therapy and selective serotonin reuptake inhibitors (SSRIs) and other antidepressant medications.

4. The combination of psilocybin and talk therapy has shown the most compelling evidence for producing long-lasting positive results in individuals with depression.

5. Psilocybin increases communication and connectivity throughout the brain, reducing hierarchical organization and allowing for a broader flow of information, encompassing interoception (internal body sensations) and exteroception (perception of the external environment).

6. During a psilocybin journey, individuals have the opportunity to develop new associations between sensory and emotional states, and these new relationships tend to persist long after the psychedelic experience concludes.

7. Best practices for an effective guided psilocybin journey include being comfortably seated or lying down with eyes closed or using an eye mask, emphasizing the importance of music throughout the experience, having at least one person present who is not under the influence of psilocybin, refraining from eating for at least four hours prior to the journey, and maintaining a calm and supportive environment.

8. Key features of a positive psilocybin experience, as reported by individuals who have had positive outcomes, include a sense of unity, spirituality, moments of bliss, gaining insights, and learning about one's own life.

9. Current clinical studies and areas of promise for psilocybin use include the treatment of treatment-resistant depression, depression related to cancer, and anxiety disorders. Emerging research is also exploring its potential benefits in addressing alcohol abuse, tobacco addiction, obsessive-compulsive disorder (OCD), and other conditions.

10. Psilocybin should not be solely consumed by ingesting mushrooms, as it becomes challenging to accurately dose. In clinical settings, psilocybin is often administered orally or in its synthetic form.

11. Proper set (mindset) and setting (environment and people present) play crucial roles in biasing the psilocybin experience towards positive therapeutic outcomes. Eye masks or closed eyes are recommended to minimize distractions from visual hallucinations. Having one or more individuals present who are not under the influence of psilocybin helps ensure safety. Music is a vital component, starting with calm tones and transitioning to more percussion-heavy rhythms during the peak of the journey.

12. Psilocybin journeys typically last 4-6 hours, during which there is a blending of perception and emotions. It is contraindicated for pregnant or breastfeeding women. The peak of the experience often involves heightened anxiety, which diminishes after 2-3 hours, leading to a more serene conclusion.

13. Psilocybin enhances functional connectivity in the brain, expanding communication networks even after its effects have subsided. The objective is to facilitate adaptive rewiring of the brain, promoting the formation of new neural connections that lead to novel and improved ideas and enhanced overall functioning.

14. Positive psilocybin experiences have demonstrated effects on creativity within specific contexts, allowing individuals to think more expansively and generate innovative ideas. Psilocybin also influences emotional responses to music, increasing joy when listening to it and dulling feelings of sadness when exposed to sad music.

15. The clinical applications of psilocybin are most strongly supported by evidence in the treatment of cancer-related depression, cancer-related anxiety, and treatment-resistant depression. Moderate evidence exists for alcohol use disorder and tobacco addiction, while low evidence supports its potential use in addressing OCD, demoralization resulting from an AIDS diagnosis, cluster headaches, and migraines. Optimal therapeutic results are often achieved through the integration of psilocybin sessions with psychotherapy.