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Psilocybin in the treatment of obsessive-compulsive disorder: What do we know so far?

Published online by Cambridge University Press:  13 August 2021

N. Descalço ,
A.B. Medeiros ,
C. Fernandes Santos  and
G. Borges
N. Descalço*
Affiliation:
Psychiatry And Mental Health Department, Hospital Garcia de Orta, E.P.E., Almada, Portugal, Portugal
A.B. Medeiros
Affiliation:
Psychiatry And Mental Health Department, Hospital Garcia de Orta, E.P.E., Almada, Portugal, Portugal
C. Fernandes Santos
Affiliation:
Psychiatry And Mental Health Department, Hospital Garcia de Orta, E.P.E., Almada, Portugal, Portugal
G. Borges
Affiliation:
Psychiatry And Mental Health Department, Hospital Garcia de Orta, E.P.E., Almada, Portugal, Portugal
*
*Corresponding author.

Abstract

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Introduction

Psilocybin is a naturally occurring plant alkaloid in mushrooms and a prodrug of psilocin. It is a serotonin receptor (5-HT2A) agonist and known psychedelic, with similar hallucinatory properties to lysergic acid diethylamide (LSD). It has been identified as a safe and effective option in treatment-resistant depression. Literature focus mainly on its use on depressive but its interest in other psychiatric disorders such as obsessive-compulsive disorder (OCD) has grown.

Objectives

To review the clinical evidence for the use of hallucinogens such as psilocybin in OCD.

Methods

Non-systematic review of literature found on PubMed/MEDLINE, Web of Science and Google Scholar, using the keywords “obsessive-compulsive disorder”, “psilocybin” and “hallucinogens”. Articles may include clinical trials, case report or case series. Articles found were admitted according to their relevance for the topic in review; only articles in English were included. Ongoing research trials on this topic were checked on ClinicalTrials.gov.

Results

So far, only one open-label non-randomized study directly assessed the effects of psilocybin on OCD patients that found acute reductions of obsessive-compulsive symptoms. Case reports of patients improving with off-label use of psilocybin are reported. There are two ongoing phase I research trials, aiming to explore the effect of the substance on symptomatology, hypothesizing that psilocybin will normalize cerebral connectivity and thus correlate with clinical improvement.

Conclusions

More research to establish the usefulness of psilocybin in OCD patients is needed; the collected data is encouraging are there may be a role for its use on this disorder.

Keywords

Obsessive-Compulsive disorderPsilocybinHallucinogens
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S417
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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