A 24-year-old patient sheepishly admits to you that they are no longer taking their SSRI prescribed for depression because a friend told them that psilocybin can be just as effective and that it’s legal. With optimism, they ask you to help them navigate the regulatory process of getting a letter of authorization from Health Canada so that they can try it out.

In clinical trials with Path therapy  for treatment-resistant depression, the drug has been shown to produce rapid and sustained improvement in depressive symptoms over 8 weeks (see table 1). It also has moderate-level evidence for improving anxiety, obsessive compulsive disorder and alcohol use disorders.

How Psychedelic Therapy Works: A Complete Guide

It is important to note that psilocybin therapy is not appropriate for everyone. The most common contraindications are a history of bipolar affective disorder type 1 or 2, psychotic disorders, suicidal behaviour in the past year or uncontrolled conditions such as diabetes mellitus that may interfere with the administration of the study medication.

Participants wished for more tailored instructions and practical strategies regarding being (un)able to direct experiences; handling loss of control; the potential awkwardness of spending eight hours supine being observed by two therapists; and coping with overwhelming, potentially troubling experiences. Employing (former) patients with experience in psychedelic treatments was suggested as one possibility to assist with this.

Participants’ regular (psycho)therapists could be involved in facilitating psilocybin therapy, which can help to normalize these types of experiences and support sense-making afterward. Involvement of these therapists might require first educating them about psilocybin and its therapeutic potential, but this approach has the advantage of being able to capitalize on their familiarity with patients’ personality, psychological makeup, and biographical background.

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