Pubdate: Wed, 20 Dec 2006
Source: Arizona Daily Star (Tucson, AZ)
Copyright: 2006 Arizona Daily Star
Contact:  http://www.azstarnet.com
Details: http://www.mapinc.org/media/23
Author: Eric Swedlund

UA STUDY POSITIVE ON PSYCHEDELIC SUBSTANCE

In a small-scale preliminary study, a UA psychiatrist has found that 
psilocybin, the active agent in psychedelic mushrooms, is effective 
in relieving the symptoms of people who suffer from severe obsessive 
compulsive disorder.

Dr. Francisco A. Moreno and his colleagues conducted the first 
FDA-approved clinical study of psilocybin since it was outlawed in 
1970. The results are published in the latest edition of the Journal 
of Clinical Psychiatry.

Moreno cautions that the study was simply to test the safety of 
administering psilocybin to OCD patients. The effectiveness of the 
drug is still in question until a larger controlled study can be conducted.

Still, in each of the nine patients in the study, psilocybin 
completely removed OCD symptoms for a period of generally four to 24 
hours, with some patients remaining symptom-free for days.

"What we saw acutely was a drastic decrease in symptoms," he said. 
"The obsessions would really dissolve or reduce drastically for a 
period of time." People would report that it had been years since 
they had felt so good, he said.

Provisions and policies for scientific research of controlled 
substances like psilocybin were included in the 1970 Comprehensive 
Drug Abuse Prevention and Control Act, which outlawed psilocybin.

New research into psilocybin does not reflect any change in 
government policy, said Rogene Waite, a spokeswoman for the Drug 
Enforcement Administration. The same review process has governed such 
research the entire time although researchers may have been hesitant 
to consider using psilocybin in the past, she said.

Currently, there is no treatment in the medical literature that eases 
OCD symptoms remotely as fast, Moreno said. Other drugs take several 
weeks to show an effect, but the psilocybin was almost immediate.

Still, it's not a drug patients could take daily and in any case, 
doctors don't know what would happen with repeated use: Would the 
effects be additive and longer-lasting over time? Or would the 
effects dissipate as the patient developed a tolerance?

Moreno, who is in "grant-seeking mode," said the next step is to 
conduct an expanded study. The findings would be far more convincing 
on the effectiveness of psilocybin in OCD patients, he said.

"We're very cautious about making too much of the early results," 
Moreno said. "I don't want to characterize it as psychedelics are the 
way to go. Although it seemed to be safe, this was done in the 
context of supervision by trained professionals in a medical setting. 
This is not ready to be used by the public just because nine people 
tolerated it."

A spokeswoman for the Food and Drug Administration declined to 
comment on the research, citing "confidentiality."

Moreno, whose specialty is in treatment resistance, started thinking 
about the psilocybin study in the mid-1990s after a patient said the 
only time he was ever free of OCD symptoms was a decade earlier in 
college when he experimented with psychedelic mushrooms. Psilocybin 
and other drugs in that family work by activating certain serotonin 
receptors, in some ways similar to the mechanisms of anti-depressants 
used to treat OCD.

Moreno examined the medical literature on psilocybin and LSD and 
found some other cases in which OCD patients reported improvement 
under similar conditions. He started the study in 2001, gradually 
recruiting patients through 2004.

Under strict rules to guard against complications, Moreno gathered 
nine OCD patients who had treatment with the typical medications and 
had prior positive experience with psychedelic drugs. The patients 
were tested between one and four times, with 29 sessions in all.

They were administered one of four dose levels of psilocybin in the 
morning and were monitored in a modified office for eight hours. The 
patients were given eye shades and listened to music, with 
instructions to turn their attention inward.

They were each interviewed at the end of the day about their 
experiences and kept in the hospital overnight to make sure they had 
no drug complications.

The patients had a range of obsessions and compulsions, including 
fear of being contaminated, elaborate cleaning rituals, tapping or 
touching rituals and mental rituals. One patient wouldn't touch the 
floor with anything but the soles of his shoes. Others would shower 
for hours or put on pants over and over again until they felt right.

"They know it's senseless. They know it doesn't do anything for them, 
but if they don't do it they become very distraught and very 
uncomfortable and have a very difficult time functioning," Moreno said.

OCD symptoms develop as early as childhood but typically in the teen 
years. Over time the mental barriers make it hard for patients to 
lead normal, day-to-day lives.

Leslie Tolbert, UA vice president for research, graduate studies and 
economic development, said the university's Human Subjects Protection 
Program sets the rules for all research involving people to ensure 
the safety of participants and maximize the usefulness of the study. 
Psilocybin, like any other controlled substance, is heavily monitored.

Any further study of psilocybin at the UA would be federally funded 
and subject to review and oversight at that level as well, she said.

"We don't have great treatments out there for OCD and any indication 
that there is a path to explore for something that would be effective 
seems an important thing to respond to," Tolbert said. "It's 
important that if psilocybin, perhaps in lower doses than are 
hallucinogenic, really has an impact, it's known. It's not a trivial 
question. There is a huge number of people who could benefit."

A few other researchers across the country have been involved in 
psilocybin research in the last several years, with some looking at 
the mystical experiences or sense of well-being associated with the 
drug, others examining its effect on patients with post-traumatic 
stress disorder and others examining it as a possible treatment for 
cluster headaches.

"Our study goes a little bit more in line with the use of 
pharmaceuticals to treat a bona fide clinical condition," Moreno said.

Read more about OCD causes, symptoms and treatments at go.azstarnet.com/ocd

"I don't want to characterize it as psychedelics are the way to go. 
Although it seemed to be safe, this was done in the context of 
supervision by trained professionals in a medical setting."

Dr. Francisco A. Moreno

UA psychiatrist
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