Psilocybin Update Part 3

TODAY is the third and installment of the Psilocybin Update Series I started two weeks ago. This week, we are focusing specifically on psilocybin as an alternative for treating depression. There has been a lot of new and exciting news on the subject, so tune in as we explore how PSILOCYBIN may be able to help your MOODY BRAIN issues.

LINKS TO PART ONE AND TWO of this series
Part 1- https://podcasts.apple.com/us/podcast/psilocybin-update-part-one/id1596513668?i=1000600715164
Part 2- https://podcasts.apple.com/us/podcast/psilocybin-update-part-2/id1596513668?i=1000601527443

KEY POINTS in this Episode 

[00:00] Introduction to the Genesis Zone Show
[03:26] Research done in a Naturalistic Setting
[05:37] Benefits of STACKing Nutritional Supplements and Psilocybin
[08:39] Clinical Effects of Microdosing Psilocybin
[15:53] Treatment Resistant Depression & Psilocybin

Connect with Dr Brian Brown, the Moody Brain Expert
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Transcript

 ITZ_EP109_PSILOCYBIN UPDATE - PART 3

SUMMARY KEYWORDS

psilocybin, study, depression, participants, remission, treatment resistant depression, observational study, naturalistic, clinical, neuroplasticity, depression symptoms, niacin, Lion’s mane, BDI, naturalistic observational study, bipolar disorder, placebo-controlled study, Montgomery Asberg Depression Rating Scale, MADRS, Beck Depression Inventory, BDI, full remission, treatment resistant depression, clinical dosing, functional mental health practitioner

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 entered 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 day to join us. 

Today is the third and final installment of our psilocybin update series that I started two weeks ago. This week, we are focusing specifically on psilocybin as an alternative for treatment for the treatment of depression. 

As it's shown in current studies, there's been a lot of new and exciting news on the subject. A lot of new research. So, tune in today as we're going to explore how psilocybin may be able to help you with your moody brain issues. 

Over the past couple of years, I've been sharing some of the latest information about psilocybin and how it can help with the treatment of depression symptoms. Now, when information first started coming out, it was sparse. The studies are really small, they were more anecdotal, meaning we just didn't have really good solid studies. And then about two years ago, we started seeing some really good clinical, well designed studies coming out. 

It seems like the studies that are coming out lately, especially over the past year just continue to get better over time. And today's update is no exception in this department. 

Last week, we discussed some new information with regard to psilocybin helping those who struggle with bipolar disorder. If you missed that episode, go back and listen to it. https://podcasts.apple.com/us/podcast/psilocybin-update-part-2/id1596513668?i=1000601527443

If you know somebody that's struggling with bipolar disorder, or you struggle with bipolar disorder yourself, you're gonna want to listen to that because I think there's a burgeoning field here in relationship to psilocybin and its use with bipolar patients have listened to that episode, you'll find out more about it. 

But for the sake of today's episode, the focus is only on three new studies related to psilocybin and the treatment of depression, and not to harp on an old thing, but go back and listen to part one of the series if you want to understand the foundation as it relates to neuroplasticity, and why neuroplasticity or brain's ability to lay down new nerve pathways, healthier nerve pathways is critical to understanding where we are in this arena related to psilocybin. And how it vastly differs from prescription medications that are on the market today. Go back and listen to part one for an understanding on that and for really good foundation leading into today's episode. 

https://podcasts.apple.com/us/podcast/psilocybin-update-part-one/id1596513668?i=1000600715164

Now the first study up was published in the journal Scientific Reports. That's not a well-known journal, but it's still a reputable peer reviewed journal. And this was a long term, what they call a naturalistic observational study spanning from November of 2019 to May of 2021.

What does a naturalistic model look like? A naturalistic model means that it occurs in the community where people are living. It's usually done with questionnaires, very structured questionnaires, and it's really just kind of observing and day to day life, how people are using psilocybin, what their demographics look like across a different ages, different socio economic strata, and what their responses their perceived responses to this psilocybin therapy is. 

So that's kind of what the researchers are looking at in this particular study. And you may be thinking, it's not a very powerful study, if it's a naturalistic observational study. It's definitely not a placebo-controlled study. And we'll talk more about that here in just a second. The interesting piece of this study, though, was that it appears to be the first of its kind, observing for the differences between subgroups of psilocybin microdosers. 

Okay, so in the psilocybin community, there's a lot of thinking around stacks. And when I say stacks, I mean combining your psilocybin micro dose with other nutritional supplements to enhance the effects make the effects cleaner, and make the response more efficient. That's all I'm talking about here. 

So, in this particular observational study, they wanted to see if there were any differences reported among these various micro dosing subgroups. So they looked at those who only took psilocybin, they looked at those who took psilocybin Plus, with a stack of Lion's Mane. 

Lion's mane is another fungi, a mushroom that has very good neuro protective and neuro activating qualities. In fact, you might call it a legal way to really stimulate your brain without having to use psilocybin, which right now is a scheduled one, and is not legally able to be prescribed. But lion's mane is a really good, like I add it to my smoothie every single morning, along with Cordyceps and Reishi, and different other different types of mushrooms that are legal because of the health benefits of those particular types of mushrooms. 

But anyway, psilocybin in some groups is combined with Lion's Mane, and there's a lot of beliefs around that and then some people take it one step further, and they combined psilocybin with Lion's Mane, and niacin. Now, I'm not talking about the no flush niacin.

Dr Brian G Brown  07:10

I'm talking about nicotinic acid, real true-blue niacin, the kind that causes skin flushing, if you take it in high enough dose, now typically people who micro dose, they're not taking doses, over 500 milligrams of niacin, some people will take 1000 milligrams, it will cause flushing, guaranteed every time. So you got to be careful with that, but with niacin, and typically they're in the 250 milligram range, in order to get the effect that they're looking for which as I said a second ago, it's a perception there that taking it with niacin, taking psilocybin with niacin, and or Lion's Mane can boost the effects, make it cleaner and make the response more efficient.

Again, that's just the belief. So, this was the first study of its kind to look at whether or not that actually had a clinical effect, or at least a perceived clinical effect at just under 1000. Participants in this particular observational study, the sample size was really healthy enough to yield some really good information. But just keep in mind that this was an observational study and the power behind it isn't as great if it stands alone. But again, we'll talk more about that in a second. 

Now for those who microdose, in this study, independent of whether they added lion's mane or niacin or both to their regimen, researchers found that those who micro dose psilocybin were more likely than non-psilocybin micro dosers, to see improvements in their mood, in their anxiety control, and in their stress tolerance. 

Now, here was an interesting finding on top of that, and this is the first time we've ever seen this separation and a study those over age 55, were also more likely to see improvement in psychomotor function. Another way of saying that is, you know that if that doesn't make sense to you, another way of saying that is,

Those 55 and older who microdose had better improvements in their:

-overall movement,

-overall coordination, 

-overall manipulation of their body, 

-dexterity, 

-grace of movement, 

-strength and 

-speed than those microdoses who were under 55. 

And then even better than those who didn't microdose at all. 

So that's the first study and in the grand scheme of things. It proved to us what other more powerful studies have already proven. Is this a weak study? Well, in the absence of other studies, meaning if it stood alone, it would definitely be a weak study. 

But when you consider the whole body, the growing body of research that we have related to psilocybin and that treatment of depression and its effect on depression and anxiety quality of life, then a naturalistic study and observational study of this nature is really a good way of saying, Okay, we recognize the studies over here that are in A, shall we say, sterile test tube like environment, controlled by the research group. We recognize those and they're good, and they're powerful, but what's actually going on in real life. So now we're starting to see these naturalistic studies come out, that's backing up all of this information that's done in this sterile testing environment of a research setting. 

Frankly, we need both types of research at this stage in the development of psilocybin research as an especially as it's related to an alternative treatment pathway for depression. This naturalistic design confirms a lot of what we already know. 

And this particular study really opened the door for further research on age related differences in psilocybin response, which we've not really seen before, such as those aged 55 and older who microdose see better improvement in their psychomotor function. We don't know the answer to that and there needs to be more research in that area. I have a feeling that has to do with neuroplasticity, and we're talking about neuroplasticity, and the neurological system as a whole, not just the brain in and of itself. 

Okay, so all that said, let's move on to the second study, which was published in The Lancet journal, which is a very reputable journal, researchers looked at 52 study participants who had been officially diagnosed with major depressive disorder. Now in a double blind, placebo-controlled fashion. The study participants were given blindly given a single dose of psilocybin based on their body weight, which kind of placed people in the category of 25 to 75 milligrams based on their body weight, or they were given placebo. Now, the measurement tools that they use; they actually use two depression measurement tools, which you see commonly used in depression studies all the time. Sometimes you'll see the Montgomery-Asberg Depression Rating Scale, or Madras used in a lot of studies. 

And then sometimes you'll see the Beck Depression Inventory, the BDI used in a lot of studies, this particular study, they used both; little redundant if you ask me, because there have been correlative studies that show they correlate very well. But anyway, they used both of them. And what they did:

They measured their MADRS and BDI scores at the beginning prior to taking the single dose, and then 14 days after the single dose.

Researchers found that participants in the psilocybin group, not the placebo group, but the psilocybin group had a 13 and a 13.2. Drop in their MADRS and BDI scores respectively. Again, there's that correlation. And we typically see this in other correlation studies. So, in the case, in the case, that sounds like Greek to you, this is a huge improvement. 

In fact, it was greater than 54% of the participants in this study, met the criteria for full remission of major depressive symptoms at 14 days. 

Now, I can tell you after 25 years of clinical psychiatric practice, this never happens with prescription medications. And this is very, very, I'm going to add another very significant, okay, and a really good way. Now, besides telling us how effective psilocybin is and treating major depression, what else did this study show us?

 Dr Brian G Brown  13:51

Well, I think the biggest thing is that it showed us that there needs to be a larger study with the same major depressive population, and the same double-blind placebo controlled design. I would personally love to see this study replicated with about 1000 people, 1000 participants who have major depressive disorder. My hunch is we're going to see the exact same results, as we saw at this study. But I'd like to see the power of a larger number of people so that we're able to extrapolate that into clinical practice. And I would like to say that see the demographics of this particular group of people be very broad across the world. We need a large sampling of a lot of different populations to kind of see what kind of clinical effect we can actually get with this particular model. 

Now, the third study up for discussion today was published in the New England Journal of Medicine. As far as journals go, it's not one of my favorites. It's kind of a freebie type journal that you can get. I call it a coffee table journal in the medical world, but it does garner some respect among research. 

This particular study looked at 233 participants who had get this treatment resistant depression. And they were blindly randomized into one of three groups:

-either a single dose of 25 milligrams of psilocybin, 

-a single dose of 10 milligrams of psilocybin or 

-single dose of one milligram of psilocybin, which was actually their control group. 

So instead of giving placebo a sugar pill that gave them one milligram of psilocybin, which we know from other studies doesn't do a thing. Okay. 

One of three groups 25 milligram group 10 milligram group, one milligram group, and we're dealing with treatment resistant depression. And this particular study had a pretty good amount of power behind it, and that had 233 participants. 

Now a sidebar here. If you don't hear anything else about this study here, this treatment resistant depression is one of the most difficult types of depression. In fact, it's one of the most difficult types of conditions in psychiatry to treat. So needless to say, this was a tough crowd. 

Now, let's get into the results. measurements in depression, only use the MADRS score that Montgomery Asper depression rating scale, which I was glad to see that they didn't use too, but they did use one and it was the MARDS and the study questionnaire, the MADRS questionnaire was obtained at the beginning of the study before study participants received the psilocybin dose. It was repeated again at 21 days, and then it was repeated again at 12 weeks. 

And here's what the researchers found among those with treatment resistant depression:

-The 25 milligram and 10 milligram group showed good clinical responses at the three week mark. 

-The 25 milligram group had a 30% reduction in depression, which placed them in the remission category. 

-The 10-milligram group had a 25% reduction in depression symptoms, which was just outside the remission category, or classification. 

What ended up happening when the measurement was completed at 12 weeks?

-The 10-milligram group fell out, it was just way, way out of parameters. The dose was too low, it wasn't a great clinical impact. 

-And the 25 milligram fell to about where the 10-milligram group was previously around 25%. We saw a reduction and we fell out of remission at that point. So slipping out of remission at 12 weeks, with a single dose of 25 milligrams is it because of the population being a treatment resistant population, because we've actually got other studies that show that people continue to stay in remission, but they weren't treatment resistant depression patients. 

So, does this paint a grim picture for psilocybin therapy in treating those with treatment resistant depression? I don't think so. In fact, I think it's quite the opposite. I think they're painting a very promising picture. Now remember, these were single doses, 25, 10, and one milligram. 

The accepted clinical dosing schedule for psilocybin, when you're treating depression, in general, is around 25 milligrams, three to five times per week. And that's just based on other studies and other study designs that showed that clinical response was the most effective. 

So, this study done with patients who quite frankly, are some of the most clinically difficult clients to help those with treatment resistant depression, was quite significant, and tells us that we need a better design study, to look at this same population, with the exception of taking a more clinically appropriate stance on the dosing intervals. 

In other words, instead of one time over a 12 week period, we probably need to dose three times a week over a 12 week period, and measure the results out to 52 weeks to see what happens because I guarantee you, because of the neuroplasticity that I explain in part one of this series three weeks ago, I think what you're going to see when you do a long term study like that, and you actually get the dosing right, you're going to see that neuroplasticity by week 12 takes over to the point that if you were to stop dosing at that point, you're going to see continued effect somewhere that's going to fall off between 12 weeks and 52 weeks. 

I don't know that data. I haven't seen any studies like that. But if I were designing a study, that's what this study would look like, on follow up. 

So what does all this mean?

It just means that we're making some amazing progress when it comes to psilocybin therapy and treating depression of all kinds, whether it be depression symptoms or anxiety symptoms or major depressive disorder. Whatever our treatment resistant depression, we are making major strides towards getting people the help that they need. Because when you look at the economic impact that mental health disorders, especially depressive disorders have on the world economy, it's in the trillions and trillions and trillions of dollars, whether it be lost wage earners, whether it be cost of health care, in and of itself for caring with people. For people with these types of issues. The list goes on and on and on. It's a trickle-down economics in this particular case, and it's in the multiple trillions of dollars. And we need to get a handle on this. 

Therefore, we're going to have to see a decriminalization of psilocybin. And hopefully, with the studies coming out, we're going to see that in the coming. In the coming years, we're already seeing it in spotty areas across the United States, where it's being decriminalized in certain cities, and in certain states like Oregon, because they see the clinical effectiveness of these types of therapies and quite frankly in Oregon, being one of those states with some of the highest rates of depression, I think it's going to be one of the best things that could have ever happened to the Oregon mental health population, to be quite honest with you. 

We are on the cusp of some major changes. These are revolutionary studies. And this is revolutionary data that we're getting right now that we're going to be able to apply clinically. So that's why I want to keep you up to date, even though we can't prescribe this right now. I want to keep you up to date so that when that time comes, you are aware, and you're informed. 

So, what do you do until that time? 

Well, I highly recommend that you work with a functional mental health practitioner, who can start with the genetics and work their way up. I have learned that if we can impact the genome by nutritionally supporting the gene to function the way it was designed to function in the first place, then we can change a person's clinical course, seemingly overnight, in comparison to using prescription medication. 

It is like almost overnight, what I see clinically when I work with a client who's struggling with depression or severe debilitating anxiety, when we get them in, we do their genetics, we established where they are. And we established the pathway forward. And what we need to do. Once we implement that plan, we're seeing changes in as early as two, three weeks by simply nutritionally supporting the genes. Versus and I'm talking about changes where a person wasn't working, now they're going back to work, a person wasn't attending college, now they're going back to attending college. It makes people go from non-functional to functional. 

It isn't a miracle cure, it's not a miracle cure, is it a small portion of a larger piece of the treatment protocol, it definitely is do advocate for people to come off of their antidepressants when they initiate this level of care. Absolutely, not until the time is right. And it has to be done under coordination with the mental health prescriber who's been prescribing the psychiatric medications. And on the functional psychiatric side, it takes good communication, so that we know how to slowly taper or back off of those medications. While at the same time, we're keeping an eye on those things that we can nutritionally support and modify, to get the genes to function at their highest peak level.

Dr Brian G Brown  23:49

So, if you want to know more about that, I encourage you to reach out to me I'm open and available. In my free time what little I have, but I do answer messages on Messenger, Facebook Messenger on Instagram or LinkedIn. 

Reach out to me, even on YouTube if you message me there, I'm gonna answer you back. You have a question. Don't sit there on it. The best thing you can do for yourself is get the answers you deserve. So most informed, most trust and most grateful you spent this time with us today. Until next time, I'm Dr. Brian Brown. Stay in the zone.