Psilocybin

Question 1

what is the C-SSRS?

Answer 1

1) columbia suicide severity rating scale
2) score from 0-25, higher score = more severe

Question 2

what is the BPRS?

Answer 2

1) brief psychiatric rating scale
2) measures 18 items including mood disorder symptoms and psychotic symptoms

Question 3

what is the MADRS?

Answer 3

1) montgomery-asberg depression rating score
2) Scored as 0-60
6 or less is normal
7-19 mild
20-24 moderate
>35 severe depresion
3) 10 item scoring system with each item rated 0-6

Question 4

what is the mechanism of action of psilocybin?

Answer 4

1) psilocybin converted to psilocin in the liver (ALP dephosphorylates psilocybin)
2) psilocin enters the bloodstream and crosses blood-brain barrier (lipophylic)
3) binds to 5-HT2A receptors to enhance serotonin transmission (improve mood); stimulate neuroplasticity (reorganise maladaptive patterns of thinking; form and reorganise synaptic connections), and reduce DMN activity (=decreased depressive rumination and increased flexible thinking)

Question 5

what have the existing trials in psilocybin shown?

Answer 5

1) phase I
- generally well tolerated, common side effects included nausea, headache, temporary anxiety

2) phase II
- significant reduction in depressive sx at one week mark and sustained up to 3 months, better than placebo

patients reported feeling more connected to themselves and some had breakthrough moments of self-reflection, clarity, and insights

Question 6

how long do the psychedelic effects of psilocybin last?

Answer 6

tend to last 4-6 hours with peak effects at 60-90 minutes

Question 7

how is psilocybin metabolised?