Does Psilocybin Therapy Work? Science, Uses, and Risks - Neuropedia

Does Psilocybin Therapy Work? Science, Uses, and Risks

Psilocybin therapy is a special type of psychotherapy that shows promise in treating addiction, depression, and anxiety. It involves taking psilocybin (the active compound in psychedelic mushrooms) under the care of a licensed therapist, who then guides you through a therapy session.

Studies show that psilocybin-assisted therapy can help patients access and process difficult emotions and that it may speed up your progress as compared to standard talk therapy.

Here’s how psilocybin therapy works, as well as its benefits, risks, possible side effects, and more.

What Is Psilocybin?

Psilocybin is the active compound in the family of Psilocybe mushrooms, also called magic mushrooms or psychedelic mushrooms.

Psilocybin is a potent psychedelic. It can cause:[1][2][3]

  • Euphoria
  • Spiritually meaningful experiences
  • Increased access to emotions
  • Improved mood
  • Visual and auditory hallucinations
  • Altered sense of time and space

Used without proper supervision, it can also cause negative or frightening experiences.

What Is Psilocybin Therapy?

Psilocybin therapy started back in the 1950s, when researchers began exploring the therapeutic value of psychedelics like psilocybin, MDMA, and LSD.

Psychiatrists would give patients psychedelics, then guide them through a talk therapy session. Patients were often more open to therapy and more capable of deep insight while under the influence of psychedelics, and in many cases, psychedelic therapy led to meaningful long-term positive changes in patients’ psychology.

Early studies found that psychedelic-assisted therapy was particularly beneficial for patients with:[4]

  • Addiction
  • Major depression
  • Anxiety
  • Fear of death related to terminal illness

Psychedelics were made illegal in 1971 under the Controlled Substances Act,[5] and psychiatrists and researchers stopped administering them to patients.

In the last few years, however, scientists have begun studying psychedelic therapy again, and they’ve uncovered a number of benefits with few to no side effects.

A Typical Psilocybin Therapy Session

Because psilocybin therapy is still new, there’s no standardized method when it comes to dosage or number of treatments. The approach will vary depending on your therapist.

That said, there is a basic three-part framework for psilocybin therapy.

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The first step is a consultation with a licensed psychiatrist. The psychiatrist will take your medical history to make sure you don’t have any contraindications or prescriptions that would interact with psilocybin therapy.

The consultation may also include an interview and emotional assessment to see if you’re a good fit for psilocybin therapy and predict how much it may help you.

Finally, the consultation is a chance for you to ask questions and share any concerns you may have about taking psilocybin.


Therapy starts with you ingesting psilocybin, usually orally, under the supervision of your therapist. Your therapist will choose the right dose and timing to ensure that your experience is safe and as effective as possible.


After you begin to experience the effects of psilocybin, you and your therapist will talk. Your therapist will likely ask you to describe what you’re thinking about or experiencing, possibly following up with questions that prompt you to consider your thoughts and emotions more deeply.

Your therapist will also help you integrate your experiences, deriving meaning and applying your discoveries to your life going forward.

With psilocybin, you will likely undergo multiple therapy sessions (at least two), spaced out over time and based on your therapist’s judgment.

Benefits of Psilocybin Therapy

In the last few years, a wave of new research has found several benefits to psilocybin therapy.


Emerging research shows that psilocybin therapy seems to be particularly good for depression.

In a 2021 study, researchers administered two psilocybin therapy sessions to patients with major depressive disorder. The sessions were spaced four weeks apart.

By the end of the trial:[6]

  • 71% of patients saw at least a 50% decrease in their depression score
  • 54% of patients were in full remission— they no longer had depression

When it comes to depression, psilocybin therapy seems to cause long-term positive changes to brain function.

A 2020 study found that after a single psilocybin therapy session, patients experienced a significant increase in positive emotion and a significant decrease in reactivity to negative emotion, and that their brain function was still different a month after their initial dose.[7] Patients also showed increased emotional access and increased brain plasticity—the brain’s ability to change and reorganize behavior.

A third study found that psilocybin therapy caused significant decreases in depression and anxiety in patients with life-threatening cancer, and that the benefits remained in 80% of patients at a 6-month follow-up.[8]

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A 2021 review of four studies found that people showed a significant decrease in anxiety after one or two psilocybin therapy sessions.[9]

A study in patients with terminal cancer found that a single session of psilocybin therapy led to “rapid and sustained symptom reduction for anxiety and depression” and that the decrease in anxiety remained at a 6-month follow-up.[10] Patients also reported a decreased fear of death, a decrease in existential dread, and a large increase in quality of life.


Psilocybin therapy may also be beneficial for addiction.

In a 2014 study, alcoholics received normal talk therapy for 4 weeks, followed by two psilocybin therapy sessions—one at week 8 and one at week 12.

Patients saw no decrease in alcoholism after normal talk therapy. After psilocybin therapy, they saw a dramatic decrease in alcohol consumption, with an average ~50% decrease in drinking and a significant number of participants quitting alcohol entirely.

The benefits remained at a 6-month follow-up, suggesting a long-term, sustainable decrease in alcohol addiction after only two psilocybin therapy sessions.[11]

In another 2014 study, smokers received either two or three psilocybin therapy sessions. At a 6-month follow-up, biological analysis confirmed that 80% of them had stopped using nicotine entirely.[12]

As an interesting side note, a large percentage of the patients who stopped smoking credited a mystical or spiritual experience while on psilocybin, saying it helped them beat their addiction.

A 12-month follow-up of the same patients found that a full year after treatment, 67% were still nicotine-free, and 87% rated psilocybin therapy as among the 5 most meaningful and spiritually significant experiences of their lives.[13]

Risks and Side Effects of Psilocybin Therapy

A comprehensive 2017 review found no negative long-term side effects from psilocybin therapy.[14] The most common reported side effects were headaches or nausea that resolved within 24 hours.[15]

However, screening for psilocybin therapy is extensive. Most psychiatrists won’t accept people with a history of psychosis, due to case reports of psychedelics triggering psychotic episodes. In addition, there’s also a small risk of psilocybin causing panic attacks, although you’re less likely to panic when in a safe setting under a therapist’s supervision.[16]

These risks highlight the importance of working with a licensed therapist if you choose to try psilocybin therapy.

Final Thoughts

Psilocybin therapy is a promising new approach to psychotherapy. It seems particularly useful for helping people with addiction, depression, or anxiety, and research suggests that it can cause long-term improvement after one or two sessions.

Side effects of psilocybin therapy are minimal. The most common are headache and nausea that resolve within 24 hours. However, part of the lack of side effects could be because therapists are careful about screening potential patients.

For that reason, if you want to try psilocybin therapy, it’s crucial to work with a licensed therapist.

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