Psilocybin Increases Positive Behaviours in those Suffering from Alcohol Use Disorder

Die Studie, published January 1st, in the American Journal of Psychiatry, noted that previous research had shown that serotonergic psychedelics (wie z.B. Psilocybin or LSD) can encourage significant shifts in personality and improve mental health.

This led the researchers to hypothesize that, as those who suffer from alcohol use disorder (AUD) often display atypical personality structures (such as heightened neuroticism, reduced conscientiousness, and impulsiveness) which hinder treatment while driving the addiction cycle, positive changes stemming from psilocybin therapy could be greatly beneficial.

Could Psilocybin Help Addicts to “Remain Resilient”?

Broc Pagni, PhD, a cognitive neuroscientist in the department of psychiatry and NYU Grossman School of Medicine said in a press release;

“Since impulsiveness has long been linked to both excessive drinking and relapse after treatment, the personality changes brought about by psilocybin-assisted psychotherapy may help those recovering from alcohol dependence remain resilient to internal and external stressors known to trigger relapse,”

With this in mind, Pagni and colleagues decided to carry out a secondary analysis of a randomized, double-blind, placebo-controlled trial to discover how psilocybin therapy impacts the personality traits of patients with AUD.

*Psilocybin is the psychoactive ingredient in magic mushrooms (Original public domain image from Wellcome Collection)*

Wie hat die Studie funktioniert?

The trial consisted of 84 participants (approx. 77% white) who received two doses of psilocybin or an active placebo (in this case diphenhydramine) four weeks apart alongside 12 weeks of psychotherapy. The participants were followed for 36 weeks.

Using the self-report NEO Personality Inventory, the researchers measured personality changes from the established baseline of each volunteer to week 36. The NEO Personality Inventory is based on the 5-factor model of personality. This includes neuroticism, extraversion, conscientiousness, agreeableness, and openness. They quantified drinking-related behaviours using the Timeline Followback.

The participants, on average, reported being alcohol-dependent for 31.56 years and met 5.25 of seven criteria for alcohol dependence. They also reported an average of 52.57% heavy drinking days within the past month.

The two treatment groups (psilocybin and placebo), appeared similar in age, gender, weight, ethnicity and annual income at baseline. However, at baseline, the psilocybin group was on average higher in conscientiousness while the placebo group was higher in openness.

An Increase in Extraversion and Openness / A Decrease in Neuroticism

After the treatment period, Pagni and colleagues found that the psilocybin group experienced decreased neuroticism and increased extraversion and openness. These changes were significant in relation to the placebo group. Notably, agreeableness and conscientiousness were not significantly affected by the treatment.

When they compared these results to normative personality scores (of individuals without AUD), these changes showed the participants were growing towards normalization. The exception was for openness, which actually exceeded normal scores at baseline and at 36 weeks.

Interestingly, women experienced significant increases in openness and conscientiousness, whereas men reported a notable increase only in extraversion. Further research is needed to uncover the reasons behind these gender-based differences, and their potential clinical implications, the authors note.

Additionally, the researchers conducted secondary analyses, which found that reductions in neuroticism were induced by decreases in depression, impulsiveness and vulnerability. Conversely, the increases in openness were prompted by increases in “fantasy” and “feelings”.

A Decrease in Impulsivity Is Linked To Reduced Drinking

Perhaps most importantly, decreased impulsivity was linked to a reduction in alcohol consumption after treatment, for all the participants. This association was most dramatic among participants who exhibited moderate to high levels of drinking before the first psilocybin session.

There were some notable limitations to the study; including their reliance on self-reported data, baseline group differences, and also the fact most participants were able to guess whether they had been given psilocybin or the placebo.

All the same, “Our findings suggest that psilocybin-assisted therapy could serve as a valuable adjunct to conventional treatments for AUD and other psychiatric disorders,” schrieben die Autoren.

“While these relationships warrant further exploration, it is conceivable that psilocybin-induced changes in specific personality domains may heighten awareness of maladaptive behaviors and bolster the therapeutic alliance, thereby enhancing patients’ receptivity to feedback and their ability to engage in other evidence-based psychotherapies.”

Next, the researchers plan to study whether the psilocybin-induced personality changes observed in participants with AUD will also occur among those with opioid-use disorder. It is also notable that New Zealand is currently exploring psilocybin for meth-addiction.