Psilocybin Update Part 2

In Part Two of the Psilocybin Update, we’ll continue our exploration of the updated information about psilocybin and what this means for your brain health… and ultimately your moody-brain issues. Today’s show will focus on psilocybin’s role in helping those with bipolar disorder.

Here is a link to the study that DR Brian referenced:
https://journals.sagepub.com/doi/full/10.1177/02698811221131997

👉Key Points from this Episode
 [02:31]   Bipolar Disorder = 90% Depressive State!
 [03:15]   Psilocybin Treatment for Bipolar Disorder?
 [04:13]   Research Studies for Psilocybin and Bipolar Disorder
 [11:00]   Adverse results in Pharmacological clinical trials VS Psilocybin Clinical Trials

Connect with Dr Brian Brown, the Moody Brain Expert

🌎https://DrBrianGBrown.com
👍https://www.facebook.com/drbriangbrown
IG:@drbriangbrown
LinkedIn: @company/dr-brian-g-brown

🧬Find more information about genetics, epigenetics and how they impact your overall health and performance🧬 in Dr Brian's FREE Master Class on Gene Hacking https://drbriangbrown.com/genehack/bootcamp

Transcript

 PSILOCYBIN UPDATE - PART TWO

SUMMARY KEYWORDS

psilocybin, bipolar disorder, study, bipolar patients, depression, dose, side effects, treatment, bipolar,  anxiety 

Dr Brian G Brown  00:55

The mission is simple to help high achievers naturally eliminate emotional and physical obstacles, so they can optimize their life for higher achievement. 

Welcome, you just enter the Genesis zone. Good day. Good day, and welcome to the Genesis zone show. This is Dr. Brian Brown, thank you for taking time out of your busy schedule to join us today. 

Today is part two of the psilocybin update that I started last week. Now we are continuing our exploration of the updates and information around psilocybin and what that means for brain health, and ultimately, your moody brain issues. 

Now in today's show, we're specifically focusing on the risks and benefits of psilocybin use, and those with bipolar disorder. Now, last week, you may recall that we discussed a benchmark study on psilocybin and one of its key mechanisms of actions. In other words, how it actually helps people overcome moody brain issues. Now, if you missed last week's episode, I encourage you to go back and listen to it. https://youtube.com/live/J8VjGIv1s34

In the comments, I've got the link to the actual article that I'm talking about there.

Then you can listen to the show and find out what I'm talking about. And it'll lay out the foundation for this week's episode and next week's episode, I'll talk more about that in a minute. In the world of psilocybin research, there have been very few articles written or studies conducted and published with regard to those who have bipolar disorder. Now in the grand scheme of things, especially in relation to all mood disorders, bipolar disorder, is reported in approximately 2.5% of the population worldwide. Now, although manic episodes and psychotic episodes, garner the most attention among mental health professionals, as well as patients when it comes to treating and managing bipolar disorder. Research shows that bipolar patients spend over 90% of their life in the depressed phase. 

Now, hear me when I say that I'm gonna repeat this. Even though mania and psychosis related to bipolar disorder, get a lot of attention. Most bipolar patients will spend about 90% of their life cycle in the in the Depression phase. 

I personally think this is why it's worth taking a look at psilocybin as a treatment alternative for those who have bipolar disorder, because psilocybin is proving to be very, very effective antidepressant treatment for depression. 

2 Fears for Bipolar Treatment 

Whether that holds true for bipolar disorder remains to be seen, and I think the reason there's been a hesitation in the research community is because of two main fears that mental health professionals especially have regarding psilocybin and treating bipolar disorder. 

-Number one is the question always comes up will psilocybin therapy in the bipolar patient trigger a psychotic break? 

-Number two will psilocybin therapy in the bipolar patient trigger a manic episode? 

Having practiced psychiatry since 1998, these are very valid concerns as their concerns that we have with any medication, whether you know, pharmaceutical or otherwise, that we're prescribing for bipolar patient, we were always on the watch for that. 

All that being said, when we are analyzing new clinical treatments for bipolar disorder, we want to look at a new treatment alternative from a little bit different point of view. And I would propose is that we want to look at it from a little bit more positive. I'll talk about that here in just a second. 

3 Questions to Ask About Treatment for Bipolar Disorders

So, there are actually three questions we as researchers, as mental health clinicians need to ask. 

-Number one is, does the treatment that we're using we're studying reduce the incidence of psychotic episodes? 

-Number two, does the treatment that we're using in this research or an actual clinical practice, reduce the incidence of manic episodes? 

-Number three, does the treatment improve the depression phase of this mood disorder? 

Although it's very nuanced, asking the questions in a positive way, regarding positive outcomes for any bipolar therapy, psilocybin or otherwise, is essential. So, when we consider psilocybin therapy for bipolar patients, it's best if we consider the same three questions that we would consider for any pharmaceutical therapy. And those are the questions I just asked. The study that I'm highlighting today is from the Journal of Psychopharmacology, not a lightweight journal by any stretch of the imagination is a very, very key journal in the medical world. I'll provide the link to the full length article that I'm discussing today in the comments below after the show. 

Limitations in the research

Now, before I begin reviewing this article, let's discuss some major limitations. Okay. 

-Firstly, there's very little research information about the use of psilocybin in the bipolar population, as I've already discussed. 

-Secondly, this study that I'm presenting today is a survey study. Okay? 

Keeping these two things in mind, it simply means that we don't have enough data from other studies to draw comparisons from. And only other data we have is from what we know that pharmaceutical medications do. And I don't think that's comparing apples to apples, I think it's comparing apples and oranges. 

As we've seen from psilocybin studies and depression, we see how powerful they are and how clean they are compared to antidepressant medications. Hold another topic for another day, you can go back and listen to last week's episode. I touch on that a lot in that episode, but again, this this particular these two things that I have don't my issues here, as we just don't have enough data to compare to when we're comparing apples to apples. 

In other words, do we have other psilocybin studies for bipolar disorder patients? And the answer is no, we just don't have that data right now.

And the second thing is, you know, this is a survey type of study. And survey type studies are certainly not the weakest of study types by any stretch of the imagination, but they are on the lower end of power, when compared to say, a double-blind placebo controlled study, okay? Or even a meta-analysis of multiple placebo-controlled studies. It's also a very high-powered study. 

Now, don't let this make you anxious or upset or make you tune out by any stretch of the imagination because there's some really good information here. We are at a time in history, where there's so little information regarding the use of psilocybin period, much less than bipolar disorder, that a survey study is a great first place to start. It's a door opener, if you will, into this particular positive population. And it's also the way a lot of studies start, they start with survey type studies like this. 

Now that we have a bit of background through which to filter this information, let's dive in. And this particular study in the Journal of Psychopharmacology there were 541 participants, not a lightweight study, if you ask me, I mean, even though it was a survey, it's fairly easy to get people to participate in surveys, and they had 541 participants. Now the average age was 34 years and one month, okay, so relatively young population, and 46.4% of those were female. So, what did the survey reveal? That's a great question. 

Before we jump into the results of the study, though, the actual doses were not discussed in the survey. Participants were by and large believed to be taking recreational or what we call hero doses of psilocybin known to have more side effects than micro dosing. 

In other words, they were taken doses and upwards of 2000 plus milligrams, 2000, 3000, 5000, even 10,000 milligrams, super high doses, compared to say, a micro dose of 25 to 200 milligrams. Now, we don't know the data on that because they didn't ask, or at least it wasn't published in the study. So that's one big question mark, that we have. So, I wanted you to know this before we talk about these results. It does matter because like I said, people who take the higher doses tend to have more side effects. 

With this in mind, approximately a third of the survey participants reported some sort of side effects. Now 214 participants out of 541 rated their experience in general, quote unquote, largely positive, and only 25 out of 541 rated their experience, quote, unquote, negative.

Side Effects Reported

-Difficulty sleeping

-Anxiety and 

-Manic symptoms were the top three. 

Now manic symptoms represented the number one side effect. But in the grand scheme of things, it was about 14% of the population or 77 people out of the 541. Insomnia was number number two, and we even see insomnia in some cases with micro dosing.

 Dr Brian G Brown  10:55

And interestingly enough, it follows about the same numbers, about 10% of people are going to have that. And that's what it was in the study.

And just for the purposes of seeing if there were any major issues that required more intensive type of care, medical care, they asked the question, did you have to go to the emergency room after you used your dose of psilocybin? And the answer was about 3.3% of people did have to go to the ER, they didn't say what it was for. But they had to go to the ER, and I thought that was a huge question more like, we don't know why these people went, where are they on other medications, prescription or illicit? Why did they have to go there? Or were they having chest pain? Did they have a heart condition, we just don't know the answer to these. Probably because of the age it was related. It was not related to physical health, although it could be and that's a huge assumption. 

So, we just don't know we have to make assumptions. And this never get to do in situations like this. But if you look how this compares to clinical trials and emergency type of situations that occur from pharmaceutical clinical trials, 3.3% is a very low number in comparison. So obviously, we don't want anybody to have to go to the ER, but it is a low number when you look at other pharmaceutical clinical trials. 

Now very interesting, though, when participants were asked what their overall experience was like, even if they had side effects, and even if they had to go to the emergency room, participants reported that psilocybin was “more helpful than harmful”. 

And 86 out of the 541 said that there was a significant reduction in depression and anxiety for them. 

Okay, well, is this because you know, 86 is a fairly low number in my book, okay, when you look at the grand scheme of other psilocybin numbers when it comes to treating depression, but the numbers we have in treating depression are low dose microdose actually, types of dosing. 

So, is there a loss and the curve? When we go up on the dose? Do we lose the effect for depression and anxiety? Because we're causing more side effects? That's the big question here. And if we actually had a study where we were micro dosing bipolar patients, would we see more than 86? out of 541? Would we see closer to 300 or 400, out of 541, saying that they had a specific significant reduction in depression or anxiety? I don't know. Those are questions that need to be answered and should be answered in the future. 

Now, what does all this mean? Well, from a purely clinical standpoint, we are far from ready to begin recommending psilocybin as a viable treatment for bipolar. There are more questions from this survey, quite frankly, than answers. But it's a good starting place. And it provided us with enough positive data to proceed with further studies.

Survey Limitations in What We Don’t Know

Sure, from this survey analysis, 

-We don't know whether participants in the survey were taking other illegal drugs that resulted in side effects. 

-We don't know whether they were taking prescription medications that resulted in side effects. 

-So, drug interactions, we just don't know. 

-We don't know why they had the trips to the ER, 

-We don't know what how their perceived clinical benefit or effect was determined. What they were basing that on. We just don't know these things. 

But here's the main question I have at this point. 

-What is the lowest most effective dose of psilocybin for those with bipolar disorder? 

That's the key question.

What’s Needed Now?

-And we need to we need to have a well-designed study with bipolar patients, similar to the one that we discussed last week in part one of this series, 

-The focus of that study or any future study needs to center around the depressive phase, since that's where bipolar patients spend most of their time anyway. 

-We also need to focus on the impact that the psilocybin is having on psychosis or mania, is it a positive impact or negative impact? Those are critical questions. 

This and I believe it's the new bar that needs to be set moving forward. And mark my word, clinical trials have already begun in this area. And in the coming months, we should start seeing some data trickling out related to psilocybin use in bipolar disorder. 

And this particular survey type study is actually plays an important role in moving us in that direction. For now, my recommendation is that if you have bipolar disorder, and you're thinking about using psilocybin, I personally would stay away from psilocybin therapy if you have bipolar disorder, until we have some more quality high powered studies behind us to make those decision.

Next week, I'm going to be focusing on some amazing research studies related to depression, major depression, and treatment resistant depression. And in general, in relationship to psilocybin use, you're not going to want to miss that because this is updated information. And the studies keep getting better and better and better, more powerful, cleaner. And they're just proper studies that should have been done from the beginning. 

But it's the evolution of studies. That's the way studies evolve, we get better and better and better in the way we collect the data over time with one particular treatment modality because one study generally builds on the next. 

And the meantime, here's what I found, and working with clients who struggle with mood disorders period, whether they're bipolar disorder, or whether they're major depression, or anxiety or panic, whatever the case may be, if we can correct the underlying genetic imbalances, and yes, it can be done, I do it every single day, we get amazing results. And we get rapid results. I've got a client, relatively younger client than I've typically seen before, not a child by any stretch dimension, stretch the imagination, just a person in their 20s. And this particular person had become nonfunctional because of their depression and anxiety. And I get them in do genetic profile. And we start working on the genetics and just with a few simple changes, this person becomes functional almost overnight. Within a few short weeks, this person's back to work. They're participating in graduate school again, and it's been amazing for this person. 

That's not the only case study I have. I have tons of case studies exactly like that. It makes a difference when you can understand your genetic imbalances and start to work on balancing them very quickly. You get very rapid results. 

And so, if you want to know more about what I'm talking about relationship to genetics and mood and how that helps and, and everything. Just reach out to me on LinkedIn, Facebook, Instagram, at Dr. Brian G. Brown, and I'll be glad to answer any questions that you might have, as always, most informed, most trusted and most grateful that you spent this time with us today. 

Until next time, stay in the zone. I'm Dr. Brian Brown.