Friday, November 10, 2006

Mushrooms for Monk?

Monk

The most recent Journal of Clinical Psychiatry has an article about using the active ingredient in psilocybin mushrooms (which is a potent specific serotonin receptor agonist) to treat OCD. I wonder if anyone knows of folks with OCD who have tried LSD or other hallucinogens. The study suggests that, whereas traditional medications for OCD may take 3 months to work, this drug worked same day, and its effects lasted beyond 24 hours.

13 comments:

Sarebear said...

SWEET, sweet relief.

Ahhhh . . . .

really, I wish someone could turn off all these things I "have" to do in my head, and often not in my head.

IT'S DRIVING ME BATTY!

Lol. Ah, well, so many problems, so little therapy time (1 hr a week seems hardly enough, and at that the ins. only pays 20 visits a year, altho my church paid for all before we just recently got insurance, and is picking up the rest of it, when the 20 visits are up and all too, but I am uncomfortable being on charity)

ClinkShrink said...

The world may be coming to an end---Dinah is linking successfully but Roy isn't. Is this a Freaky Friday thing?

dinah said...

hmm, love the foto, roy... will you be posting blogs on a plane, or just dodging snakes?

Roy said...

I guess we are all regressing to the mean. I like the new pic better anyway.

NeoNurseChic said...

FYI: Clusterbusters Psilocybin has been successfully used to treat cluster headaches for a long time now - years, really. Reesearch has also been done (and is being done) on this therapy by Dr. Andrew Sewell out of Harvard.

However, psilocybin is contraindicated to those who have a tendency towards certain mental illness - such as psychosis, schizophrenia, and severe depression - if I recall correctly.

Unfortunately, it is illegal - and this dissuades me from trying it - even though I'd do almost anything to get rid of clusters... There has been recent discussion about certain seeds such as rivea corymbosa (I think?) that may work in a very similar way but without the worries of some of the issues with psychedelics. I know some people who have gotten complete relief from the seeds.

It's an interesting field...for sure...

DrivingMissMolly said...

I have oft looked at little sis who has had issues with addiction for years. She was clean for over a year and has relapsed. I think of her drug use and am frightened that the only difference between me and her is that my drugs are legal. We all know Freud employed cocaine in his practice and now the info on ketamine as a potent antidepressant really is blurring the lines.

Is it just that we shouldn't self-medicate because there is an industry that owes its existence to medicating us legally?

New shrink expressed concern at my use of Benadryl as potential vulnerability to addiction. I don't even drink and he uses the word 'addiction' because I take Benadryl? WTF?

Color me confused and suspicious.

Lily

OMG! OMG! The last two letters on my word verification were "rx" a sign of a definite conspiracy! j/k

Sarebear said...

I'd rather regress to the nice (I knew what you mean, though (grammatically incorrect, but oh so punny!)

Anonymous said...

I have OCD. It's now held more or less at bay with the help of citalopram and quetiapine, but for sixteen years I kept it hidden- with the result that I kept myself mostly hidden too.

I first tried psilocybe mushrooms six years ago. I elected to take a cautious dose- maybe an eigth of a gram. My boyfriend and I walked to Queen Elizabeth park at dawn and sat under a tree, enjoying a slight euphoria. That's when he decided to light up a joint and teach me how to take a puff. For a few minutes all was sweetness and light. Then...

It hit me like a body slam. I felt myself simultaneously expanding- all boundaries between myself and the rest of the world being brutally smashed- and shrinking- being pressed into the ground, feeling myself trapped in a tiny, dirty, mean, isolated little body. Somewhere in there I had thrown my body forward into the bushes, sobbing with more no-holds-barred emotion than I'd ever allowed. Somewhere in there I realized that I'd done something truly hateful to my mind, fearfully erecting such high barriers between myself and other people that I could no longer experience either them, or myself, as real. Somewhere in there the crying turned to relief, a massive weight was lifted.

It was a cardinal experience, if not the cardinal experience, in my life.
It effected a permanent change in my personality: I became more relaxed, less anxious about maintaining facades, more open to newness.

The terrible thoughts that usually plagued me were exorcised for a brief time; I had happier fish to fry.

So that's my contribution, skewed and trite as it is. No doubt the psylocybin works, though I'd be scared as hell to repeat the experience!

foreva said...

What do you think about this ketamine research? For me, frankly, it was quite disturbing. Ketamine is a highly addictive drug, so if the shots worked for a week, the person would have to get their shots every week to keep the effect. Than their tollerance would increase and they would have to get their shots more often. Before you know, you have a ketamine addict. At least they are not depressed, duh! I mean, why not start giving crack cocain to people with depression? I'm sure it would alleviate their mood instantly...

By the way, I am not a psychiatrist. I am a psychologist ("psychology associate" in Ontario, sigh), fresh out of university. I came to Canada from Poland a few months ago and I'm still fighting the bureaucracy before I can start working, blah.

Anyways, I don't know much about pharmacotherapy, so please let me know what you think about this ketamine business.

Great blog, guys! I am SO happy to have found you...

Roy said...

Hey, Foreva. Thanks for the kind words.

The recent Archives article used a dose about half that of the usual anesthetic dose.

"Of the 17 subjects treated with ketamine, 71% met response and 29% met remission criteria the day following ketamine infusion. Thirty-five percent of subjects maintained response for at least 1 week."

Given that the anesthetic and dissociative effects of ketamine typically last only for a half-hour or so, a positive response lasting a day or a week is rather remarkable.

Cocaine's acute effects are also short-lasting, but afterwards depression gets worse, not better. I'm not certain, but I don't think ketamine is nearly as addictive as is cocaine, heroin, or nicotine.

I have seen patients who do not respond to *anything*, not even ECT. This is something I'd consider trying in these treatment-resistant patients, particularly if they are severely nonfunctional.

NeoNurseChic said...

In June 2005, when I went to the AHS meeting in Philly, my jaw dropped when I saw the one poster presentation by my former neurologist who now lives in Singapore. He was using Ketamine inpatient. I was like, "Are you kidding??" And he went on to explain it to me and in reality, it wasn't all that different than the other crazy things we've tried! I've been treated with just about everything the headache center uses inpatient, and been the guinea pig for many of them - these things include: DHE, Reglan, Benadryl, Haldol, Thorazine (they do first as push and then hang it in a bag), Magnesium, Droperidol, and I can't think of any others right now. Memory issues...! Oh - just remembered a few others. Continuous IV lidocaine, propofol infusions - up to 200mg in a push that is only about 5mg at a time done every few minutes with a reassessment of the pain level after each push (they also do thorazine like that, but the propofol has to be done in the PACU) - but the propofol seems similar to how they use the ketamine for headache anyway.

Ketamine, as I understand, is used in a one-time infusion sense and wouldn't be given as a chronic med...at least, I think that's how it is used for headache. And as it IS used as an anesthesia adjunct, it isn't an illegal or completely unused drug for these purposes...

Roy - correct me if I'm wrong - not thinking very clearly tonight! Very bad migraine, myself!

Foreva said...

Ok, I've done some research and, true, ketamine isn't highly addictive. Comparing it to cocaine wasn't quite fair. I also didn't understand the part about small dosage. All things considered, administering it to treatment-resistant patients may be a really good idea, especially if it's done in controlled environment. I guess what I'm afraid of is that, because it works immediately, there may be a temptation to prescribe it to everyone who suffers from depression, or just feels depressed, as a sort of 'instant happiness pill'. Especially, since antidepressants are overprescribed anyways.

Thank you very much, Roy, for casting some light onto the issue for me! It was very helpful.

NeoNurseChic said...

Foreva,

If it truly is handled in the way propofol infusions were handled for headache (they aren't done anymore really), then it won't be done unless as a last resort type thing. With the propofol, the patient had to have met criteria for admittance to the hospital (pretty strict...had to have failed multiple outpatient therapies, failed 3 days of outpatient IV infusions, and severe enough to warrant aggressive treatment - and to think I've met those criteria about 7 times! oy vey...) and then once in the hospital, had to go through the conventional meds for about 5 days....and then - if things STILL weren't going well, the propofol was considered.

It's expensive and uses time and resources - not to mention carries more risks than prescribing your average antidepressant. It has to be done in a controlled PACU or OR setting...so I doubt people will ever rush to it like they sometimes rush to antidepressants.

My .02