Psilocybin in neuropsychiatry: a review of its pharmacology, safety, and efficacy

Psilocybin is a tryptamine alkaloid found in some mushrooms, especially those of the genus Psilocybe. Psilocybin has four metabolites including the pharmacologically active primary metabolite psilocin, which readily enters the systemic circulation. The psychoactive effects of psilocin are believed t...

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Veröffentlicht in:CNS spectrums Jg. 28; H. 4; S. 416 - 426
Hauptverfasser: Dodd, Seetal, Norman, Trevor R., Eyre, Harris A., Stahl, Stephen M., Phillips, Arnie, Carvalho, André F., Berk, Michael
Format: Journal Article
Sprache:Englisch
Veröffentlicht: New York, USA Cambridge University Press 01.08.2023
Schlagworte:
Drug dosages
Hallucinogens - adverse effects
Hallucinogens - pharmacology
Hallucinogens - therapeutic use
Humans
Mental Disorders - drug therapy
Metabolism
Metabolites
Mushrooms
Oral administration
Pharmacokinetics
Pharmacology
Plasma
Psilocybin - adverse effects
Psilocybin - analogs & derivatives
Psilocybin - pharmacology
Psilocybin - therapeutic use
Psychedelic drugs
Review
treatment
anxiety
neuroscience
safety
Psilocybin
psychiatry
depression
adverse events
posttraumatic stress disorder
ISSN:1092-8529, 2165-6509
Online-Zugang:Volltext
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Beschreibung
Zusammenfassung:Psilocybin is a tryptamine alkaloid found in some mushrooms, especially those of the genus Psilocybe. Psilocybin has four metabolites including the pharmacologically active primary metabolite psilocin, which readily enters the systemic circulation. The psychoactive effects of psilocin are believed to arise due to the partial agonist effects at the 5HT2A receptor. Psilocin also binds to various other receptor subtypes although the actions of psilocin at other receptors are not fully explored. Psilocybin administered at doses sufficient to cause hallucinogenic experiences has been trialed for addictive disorders, anxiety and depression. This review investigates studies of psilocybin and psilocin and assesses the potential for use of psilocybin and a treatment agent in neuropsychiatry. The potential for harm is also assessed, which may limit the use of psilocybin as a pharmacotherapy. Careful evaluation of the number needed to harm vs the number needed to treat will ultimately justify the potential clinical use of psilocybin. This field needs a responsible pathway forward.
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ISSN:1092-8529
2165-6509
DOI:10.1017/S1092852922000888