DYING patients will be treated with synthetic “magic mushrooms” in a Melbourne medical trial that aims to ease the paralysing anxiety felt by many who are in palliative care.
It is hoped that the use of the mind-bending drug, guided by psychiatrists, will give terminally ill patients an altered perspective that will help dispel the fear and depression that for many can come to dominate their final months.
It has taken more than a year for the controversial St Vincent’s Hospital trial to be approved by ethics committees and state and federal authorities. Treatment of the first of 30 patients will begin in April.
St Vincent’s clinical psychologist Dr Margaret Ross said patients in the Melbourne study would be given a single dose of psilocybin — the psychoactive ingredient in magic mushrooms. Its effect on the brain is so powerful it can result in an alteration of outlook lasting six months or more.
US studies found psilocybin was able to overcome severe depression in about 70 per cent of cases: it was so successful the treatment was awarded breakthrough drug status.
“It is a little bit controversial because obviously we are using a psychedelic compound, and it is a compound which is a synthetic version of what is colloquially known as magic mushrooms,” Dr Ross said.
Dr Ross said: “The US study was really profound: some people were able to transcend their ideas about dying. It really relaxes those old rigid ways we have built up in the way we look at the world. They had remission of symptoms (of psychiatric distress).
“It was rapid, it was dramatic, and it was beyond impressive, because it lasted for up to six months,” she said.
Up to three in 10 palliativecare patients can experience extreme distress in their final months. Dr Ross said antianxiety medications or psychotherapies, such as talking or music therapy, could relieve that in some, but not others.
“For many people, when they are diagnosed and living with a terminal illness, it is absolutely devastating.
“People can live for months and years in palliative care, and it is a long time to live with that hanging over your head.
“People can be quite paralysed by anxiety and despair, and feel demoralised and withdrawn. It can have a profound impact on quality of life and their experiences with their precious time,” she said.
Studies at the Imperial College in London showed psilocybin relaxes a part of the brain known as the Default Mode Network, which is associated with a person’s concept of themselves and of their past.
The drug has almost no physical effects. But it can have adverse psychological impacts on patients who have a history of psychosis or conditions such as bipolar disorder, on those given too high a dose, and on those who are unprepared or who take it in an unsuitable environment.
The 25mg dose being used at St Vincent’s will have a peak effect about the 90- to 100minute mark. But patients will be accompanied by two clinicians in a safe, supported environment for at least four more hours while effects wear off.
Dr Ross said: “This could potentially help so many peo- ple, but it needs more research, and we need to understand the exact mechanisms of how psilocybin helps people and how we can optimise treatment.”
St Vincent’s director of palliative medicine Associate Professor Mark Boughey said: “There will be some degree of backlash because everyone will assume this is just about magic mushrooms. But if you look at the studies … it has minimal … serious adverse effects … it has great potential.”