Mushrooms And Bipolar: A Risky Mix?

Psilocybin, the hallucinogenic compound found in psychedelic mushrooms, has been tested as a potential treatment for mood disorders such as depression. While there is growing evidence that psilocybin can improve symptoms of depression, there is limited data on its effects on bipolar disorder (BD). Some studies suggest that psilocybin may have potential benefits for BD, while others indicate risks of adverse effects, including the induction of mania and other negative outcomes. As such, further research is needed to understand the potential therapeutic use of psychedelic mushrooms in treating BD.

Potential therapeutic effects of psilocybin for bipolar treatment

Psilocybin, the primary psychoactive component of psychedelic 'magic mushrooms', has been tested as a potential treatment for mood disorders, including depression. It is theorized that psilocybin encourages the action of serotonin 5-HT2A receptors in the brain's central nervous system, similar to antidepressant and antipsychotic medications.

Research co-led by Dr. Emma Morton of the Vancouver Coastal Health Research Institute (VCHRI) examined the experiences of 541 individuals with bipolar disorder who had used psilocybin. The findings, published in the Journal of Psychopharmacology, offer a promising yet cautionary tale of the potential therapeutic use of psilocybin to treat bipolar disorder (BD). Respondents in the study gave their psilocybin trips a harmfulness rating of 1.6 out of 5 and a helpfulness rating of 4 out of 5. Despite the reported benefits, there are concerns about the potential for psilocybin to induce mania in BD patients, as approximately one-third of respondents in the study reported adverse effects, including new or increased manic symptoms.

Growing evidence suggests that psilocybin can rapidly and durably improve symptoms of depression, with one study finding that it increased emotional empathy in depressed individuals, with improvements lasting for at least two weeks after treatment. This has potential applications for bipolar disorder, as individuals with BD II have demonstrated vulnerability to developing depressive symptoms. However, there is limited scientific data on the risks of psilocybin use in people with bipolar disorder, and modern clinical trials have excluded individuals with bipolar disorder due to concerns about activating mania or worsening the illness course.

While the potential therapeutic benefits of psilocybin for bipolar treatment are encouraging, more research is needed to fully understand the risks and benefits of its use in this population. Clinical trials should incorporate careful monitoring of symptoms, as data suggest that BD symptoms may emerge or intensify following psilocybin use. Additionally, individuals with bipolar disorder who seek psilocybin treatment may be doing so in unregulated settings, further emphasizing the need for harm reduction strategies and careful guidance on access to psilocybin for this population.

Risks of psilocybin use for bipolar patients

Psilocybin, the hallucinogenic compound found in psychedelic mushrooms, has been tested as a potential treatment for mood disorders such as depression. However, there are risks associated with its use, especially for individuals with bipolar disorder.

Manic Episodes

One of the primary risks of psilocybin use for bipolar patients is the potential induction of manic episodes. Psilocybin affects similar regions of the brain as antidepressants, which can lead to the activation of mania. In a survey of 541 individuals with bipolar disorder who had used psilocybin, 32.2% reported new or increasing manic symptoms after their psilocybin trips. This was also the most common reason for seeking emergency medical services, with 3% of respondents visiting emergency departments or psychiatric wards due to new or worsening manic symptoms.

Other Adverse Effects

In addition to mania, psilocybin use can lead to other adverse effects in bipolar patients. These include difficulties with sleep, symptoms of anxiety and/or depression, delusional beliefs, hallucinations, and depressive symptoms. In the same survey, 32% of respondents reported negative or unwanted outcomes during or within two weeks after a psilocybin trip, highlighting the potential for adverse reactions.

Psychosis

Psychedelic substances, including psilocybin, can lead to an increased risk of psychosis in individuals with bipolar disorder. This vulnerability to serious adverse effects is an important consideration when assessing the risks of psilocybin use in this population.

Limited Scientific Data

Currently, knowledge about the risks and benefits of psilocybin use in bipolar disorder is limited to case studies. Bipolar individuals have often been excluded from modern clinical trials due to concerns about activating mania or worsening the illness. As a result, there is a need for further research and careful monitoring in clinical trials to understand the potential risks and benefits of psilocybin-based treatments for bipolar disorder.

Adverse effects of psilocybin use

Psilocybin, the primary psychoactive component of psychedelic 'magic mushrooms', has been tested as a potential treatment for mood disorders, such as depression, and has shown promising effects in treating bipolar II disorder. However, there are adverse effects associated with its use, particularly for those with bipolar disorder (BD).

Manic Episodes

The most common adverse effect of psilocybin use in people with BD is the emergence or intensification of manic symptoms. One survey found that 32.2% of respondents with BD experienced new or increasing manic symptoms after psilocybin trips. This is a significant concern, as manic episodes can be severe and require hospitalization.

Sleep Disturbances

Sleep difficulties, including trouble falling or staying asleep, were also commonly reported after psilocybin use, affecting around 32% of respondents in one survey. Sleep disturbances can exacerbate other mental health issues, so this is a notable adverse effect.

Anxiety and Depression

Some individuals with BD reported increased symptoms of anxiety and depression following psilocybin use. These symptoms, along with sleep difficulties, were among the reasons a small percentage of respondents (3%) in one survey visited emergency departments after psilocybin trips.

Psychosis

Psilocybin's impact on similar regions of the brain as antidepressants raises concerns about its potential to induce mania and psychosis in vulnerable individuals. People with BD may be at higher risk of experiencing psychosis or a treatment-emergent affective switch into mania due to the action of psilocybin on serotonin 5-HT2A receptors in the brain.

While psilocybin has shown potential therapeutic benefits for BD, particularly in treating depressive symptoms, the adverse effects highlight the need for caution and careful monitoring in clinical trials.

Psilocybin's effect on serotonin 5-HT2A receptors in the brain

Psilocybin, the primary psychoactive component of psychedelic 'magic mushrooms', has been tested as a potential treatment for mood disorders, such as depression. It has also been tested for its potential to treat bipolar disorder (BD). However, there is limited scientific data on the risks and benefits of psilocybin use in people with bipolar disorder.

Psilocybin affects similar regions of the brain as antidepressants, and there has been concern about its potential to induce mania among patients. Research has shown that psilocybin affects serotonin 5-HT2A receptors in the brain. The psychedelic 5-HT2A receptor agonist psilocybin (or its active metabolite psilocin) has emerged as a potentially useful drug for various neuropsychiatric diseases, with a rapid onset of therapeutic activity.

Psilocybin is theorized to encourage the action of serotonin 5-HT2A receptors in the brain's central nervous system. It is believed that when the primary psychoactive ingredient in magic mushrooms binds with 5-HT2A receptors, it triggers psilocybin-induced psychedelic experiences. Psilocybin exhibits a similar pharmacological profile in rodent and human brain tissue. It modulates temperature by central 5-HT2AR and 5-HT1AR dependent mechanisms.

Psilocybin induced a dose-dependent head-twitch response (HTR) that was completely suppressed by the 5-HT2AR antagonist MDL11939. Higher doses of psilocybin induced a lower HTR. Brain regions demonstrating the greatest 5-HT2A receptor occupancy by psilocybin (between 63.12% and 74.72% occupancy) included the bilateral angular gyrus, bilateral intraparietal sulcus, precentral gyrus, and subgenual anterior cingulate cortex.

Overall, psilocybin has shown preliminary efficacy as a treatment for mood and substance use disorders. However, more research is needed to understand the risks and benefits of psilocybin use in people with bipolar disorder.

Psilocybin's potential to induce mania

Psilocybin, the primary psychoactive component of psychedelic 'magic mushrooms', has been found to be an effective treatment for treatment-resistant depression, depression associated with terminal illnesses, certain substance use disorders, and obsessive-compulsive disorder. However, its potential to induce mania in patients with bipolar disorder has been a concern, leading to their exclusion from many studies.

In a review of the literature, 18 cases were found involving the incidence of mania, five of which involved psilocybin. There have been 17 cases suggesting that there is a potential risk for activating a manic episode, warranting caution. A web-based survey of people with self-reported bipolar disorder who used psilocybin reported that a third of respondents experienced adverse effects, including new or worsening manic symptoms.

Psilocybin affects similar regions of the brain as antidepressants, and it is theorized that it encourages the action of serotonin 5-HT2A receptors in the brain's central nervous system. Activation of these receptors likely increases the release of dopamine, resulting in psychomimetic effects. This action is similar to that of serotonergic antidepressants, which have been found to increase the risk of a treatment-emergent affective switch into mania in patients with bipolar disorder.

The potential risk of inducing mania with psilocybin in patients with bipolar disorder needs to be carefully considered. Future research may assess whether pre-treating these patients with an antipsychotic or mood stabilizer prior to using psilocybin could decrease the risk of inducing mania. Additionally, meticulous dosing and monitoring may be necessary to mitigate the risk of adverse effects.

Frequently asked questions