Health and Medicine
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A patient with advanced dementia appears to have had a significant improvement in some symptoms following a fairly hefty dose of "magic mushrooms", the psilocybin-containing mushrooms currently being explored as a treatment for a range of other conditions.
The rest of this article is behind a paywall. Please sign in or subscribe to access the full content.First off, we should go right ahead and explain that this is a case report on an individual, so while it is intriguing, this is far from saying that psilocybin could be used as a treatment for diseases like Alzheimer's. The team themselves note that the mechanism for such improvements remain unclear, and that the case report is more of a detailed description, which could be used to inform further work.
Nevertheless, it is an intriguing case report, and may be an area worth exploring in the future, especially given the results outlined by the team. Those important caveats out of the way, let's dive in.
The team describes the case of a Japanese-American woman in her 80s, who had been diagnosed with Alzheimer’s disease 10 years previously. Over the most recent five years, the unnamed woman was in the latter stages of the disease and was capable only of producing monosyllabic speech, while her movements were pretty limited.
"Baseline features included chronic urinary incontinence, executive dysfunction, dysphagia, dependent mobility, flat affect, and severe reduction in spontaneous communication," the team explains in their paper.
It is unclear from the paper who administered the psilocybin mushrooms, though the team notes that it took place at a private clinical practice, and did not violate local laws. But we do know that dosing-wise they went in fairly hard, giving the woman 5 grams of enigma mushrooms, a large dose of a strain already known for its high potency. The initial effects were fairly predictable. During the acute phase, the woman experienced profuse sweating, suspected hyperthermia, and a long sleep-like state, fairly typical of someone taking what is sometimes referred to as a "heroic dose" of magic mushrooms. But after the dose was over, things got a little more interesting.
"Approximately 19 h after administration, the patient spontaneously initiated autobiographical conversation lasting several hours," the team explains in their report.
Over the course of the next month, the patient's symptoms appeared to have improved significantly, with the team adding that she experienced sustained urinary continence, mobility, emotional reciprocity, and spontaneous communication during this time.
After that, a second dose – this time of 3 grams of mushrooms – was given to the woman. During this session, she showed "greater verbal expressivity, improved facial mimicry, spontaneous humor, emotionally valenced autobiographical imagery, and increased agility while walking," as well as describing "emotionally positive imagery involving surfing with her son on a peaceful island". Though patient follow-up was difficult given her condition, she spontaneously said “it is pleasant to come here" of the sessions.
So, what can we take away from this? As stated by the authors, not a huge amount, given that it is a single person. There has been some interest in trialing psilocybin on patients with forms of dementia, though largely this has focused on secondary anxiety and depression that comes with it.
"The active metabolite of psilocybin, psilocin, elicits its effects through the modulation of the 5-hydroxytryptamine 2A receptor (5-HT2A receptor). This modulation causes heightened neural plasticity, diminished inflammation, and improvements in cognitive functions such as creativity, cognitive flexibility, and emotional facial recognition," a paper on the topic explains.
"Noteworthy is psilocybin’s promising role in mitigating anxiety and depression symptoms in AD patients."
Trials may follow for treating other symptoms of dementia, but in this single-patient study in a real-world setting, it is not possible to even establish causality, even if it is highly suspected.
"The findings should not be interpreted as reversal of Alzheimer’s pathology," the team adds. "Rather, they raise the possibility that latent functional capacities may persist in advanced neurodegeneration and become temporarily accessible under specific neuromodulatory conditions."
Nevertheless, they believe that further investigation is certainly warranted, given the effects seen in the patient.
"Residual functional capacity may persist in advanced Alzheimer’s disease and may become transiently accessible following psilocybin-induced modulation of large-scale brain networks," they conclude. "Systematic investigation is warranted."
The study is published in Frontiers in Neuroscience.
