Daily Archives: February 7, 2022

Diagnosis

Your provider will conduct a thorough physical exam, checking for tenderness and swelling of the testicles and epididymis. Your provider will also look for the presence of a small ball of scar tissue where your vasectomy was performed (sperm granuloma).

Other possible causes of testicle pain will need to be ruled out. Tests your provider might recommend include:

Treatment for PVPS depends on your symptoms and how much pain you have.

There is not much known about alternative medicine for the treatment of PVPS.

Your provider may consider acupuncture either alone or together with medication. Although there are no clinical trials that prove the effectiveness of acupuncture in treating PVPS, acupuncture is considered safe and noninvasive for men recently diagnosed with PVPS.

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:

Take a family member or friend along, if possible, to help you remember the information you're given.

For PVPS, some basic questions to ask include:

Don't hesitate to ask other questions.

Your provider is likely to ask you several questions, such as:

Avoid doing anything that seems to worsen your signs and symptoms.

Post-vasectomy pain syndrome care at Mayo Clinic

Feb. 03, 2022

Continue reading here:

Post-vasectomy pain syndrome - Diagnosis and treatment - mayoclinic.org

KNOX When Jessica Perrin Barcomb was in her twenties, she fell through a stairwell and landed on her head. She was in a coma and had to be resuscitated several times.

It made her angry then when people told her that things happen for a reason.

But now she realizes she learned so much, especially on the road to recovery.

Barcomb has just published her first novel, which opens with the description of a terrible car accident. The books central character, Rebecca, at age 7, survives, after a coma, but her beloved mother, a healer, dies.

Barcomb, who has wanted to be a writer her whole life, stresses in this weeks Enterprise podcast, that the book is not autobiographical. Even so, she has drawn on many of her real-life experiences to make it vivid.

The novel is at one a romance, as Rebecca works through relationships with several men to define herself, and is also a testimonial to the powers of alternative medicine for healing.

A real marker in Barcombs own recovery, she says, was going to live with her grandmother to help her after she had suffered a stroke.

We all want to help each other ., she says. Ultimately, we are all in this together.

Barcomb became a craniosacral therapist, something the books Rebecca ends up pursuing. Just as Rebecca, in the novel, says that Western medicine saved her life, Barcomb says, Western medicine is awesome and notes her twin brother holds both an M.D. and a Ph.D.

But both the author, Jessica Barcomb, and the character she created, Rebecca Carroll, believe Western medicine falls short with important aspects of healing.

One of the biggest problems we have is mental health and spiritual health in this country . recognizing the other dimensions that we have all around us, says Barcomb.

When she practices craniosacral therapy shes owned a wellness studio for more than two decades Barcomb uses a touch as light as a nickel to tap into the different craniosacral rhythms of the body. She says it can help not just with physical ailments, like a hurt knee or ankle, but with things like depression or trauma.

People have to be willing to let go and to release what it is theyre holding onto, she says.

The name of her book is Letting Go.

The novels most enduring relationship, more central to the book than the men with whom Rebecca is involved, is the friendship between Sarah and Rebecca. They were best friends since they were girls and were driven apart by Rebeccas first love but reunited by the end of the book.

Sarah has chosen a path of being a stay-at-home mother, raising three young children on a farm in the Helderberg Hilltowns.

Its important for people to recognize the challenges that women have ., says Barcomb. How they need each other for support and how oftentimes they dont get a whole lot of support . Its not easy being a mom trying to do it all.

A feminist theme runs though the book; while Rebecca studies art at New York University, Sarah, in her college years, is a womens studies major who travels to Europe to learn about the persecution of witches.

Often women who were healers and midwives were targeted as witches, says Barcomb. The novels Rebecca discovers a book dating back to her great-great-great-great-grandmother who was a healer living in Salem, Massachusetts in the 1600s.

Many of todays craniosacral therapists are women, Barcomb says, just as many of the Salem residents hanged for witchcraft in the 1600s were women.

Barcomb notes that often history is told from a male perspective. We just dont know the other half of the story that well, she says. She wants her readers to think about how women have been treated throughout history and their roles and how theyve been downplayed and often silenced.

For her research, Barcomb and her husband journeyed to Salem and stayed in the same inn where Rebecca stayed with a male friend. Just like the characters in her book, Barcomb says, There were explosions when I was there and my husband went to the window and I opened my eyes and saw a ghost.

As she was writing the book, Barcomb learned her own ancestors had lived in Salem in the 1600s, moving to Boston before the witch trials, similar to Rebeccas history.

Barcomb worked on her novel for years, taking a five-year break between the first and final draft. When her children were young like the novels Sarah, she and her husband raised them in a Hilltown farmhouse Barcomb worked on her writing in spaces and places wherever she could.

When her daughter was in ballet class, Barcomb said, she would write on her laptop in the car. When her son was at piano lessons, the teacher let her use a spare room to write in.

Barcomb hopes that Letting Go is the first of a trilogy and thinks shell have more time to write now that her children are older.

She believes women are a likely audience for Letting Go but hopes men read it too.

Im hoping, she says, it opens up a discussion about healing and about whats important about it and how we can do it better as a society.

****

Letting Go, a 308-page paperback, is available through Amazon for $16 and will soon be in local bookstores.

Jessica Perrin Barcomb will be signing her novel at the Open Door Bookstore at 128 Jay St. in Schenectady on Saturday, Feb. 5, from 1 to 2:30 p.m.

See the rest here:

Barcombs first novel tells a story of healing and hope - The Altamont Enterprise

This press release was orginally distributed by SBWire

Edison, NJ (SBWIRE) 02/02/2022 HTF MI introduce new research on Global Alternative Medicine covering micro level of analysis by competitors and key business segments (2022-2028). The market Study is segmented by key a region that is accelerating the marketization. The Global Alternative Medicine explores comprehensive study on various segments like opportunities, size, development, innovation, sales and overall growth of major players. The research is carried out on primary and secondary statistics sources and it consists both qualitative and quantitative detailing. Some of the MajorKey players profiled in the study are Herbal Hills, Thorne Research, Herb Pharma, Helio USA, Pure encapsulations, Pacific Nutritional, Nordic Naturals, Deepure Plus & Medigenics

Get Free Sample Report + All Related Table and Graphs @ https://www.htfmarketreport.com/sample-report/3619414-2020-2025-global-alternative-medicine-market-report-production-and-consumption-professional-analysis

On the off chance that you are engaged with the industry or expect to be, at that point this investigation will give you complete perspective. It's crucial you stay up with the latest sectioned by Applications [Men & Women], Product Types [Herbal supplements, Nutraceuticals Supplements & Others] and some significant parts in the business.For more data or any query mail at [emailprotected]

Which market aspects are illuminated in the report?

Executive Summary: It covers a summary of the most vital studies, the Global Alternative Medicine market increasing rate, modest circumstances, market trends, drivers and problems as well as macroscopic pointers.

Study Analysis:Covers major companies, vital market segments, the scope of the products offered in the Global Alternative Medicine market, the years measured and the study points.

Company Profile: Each Firm well-defined in this segment is screened based on a products, value, SWOT analysis, their ability and other significant features.

Manufacture by region: This Global Alternative Medicine report offers data on imports and exports, sales, production and key companies in all studied regional markets

Highlighted of Global Alternative Medicine Market Segments and Sub-Segment:

Alternative Medicine Market by Key Players: Herbal Hills, Thorne Research, Herb Pharma, Helio USA, Pure encapsulations, Pacific Nutritional, Nordic Naturals, Deepure Plus & Medigenics

Alternative Medicine Market by Types: Herbal supplements, Nutraceuticals Supplements & Others

Alternative Medicine Market by End-User/Application: Men & Women

Alternative Medicine Market by Geographical Analysis: North America (Covered in Chapter 8), United States, Canada, Mexico, Europe (Covered in Chapter 9), Germany, UK, France, Italy, Spain, Others, Asia-Pacific (Covered in Chapter 10), China, Japan, India, South Korea, Southeast Asia, Others, Middle East and Africa (Covered in Chapter 11), Saudi Arabia, UAE, South Africa, Others, South America (Covered in Chapter 12), Brazil & Others

For More Query about the Alternative MedicineMarket Report? Get in touch with us at: https://www.htfmarketreport.com/enquiry-before-buy/3619414-2020-2025-global-alternative-medicine-market-report-production-and-consumption-professional-analysis

The study is a source of reliable data on: Market segments and sub-segments, Market trends and dynamics Supply and demand Market size Current trends/opportunities/challenges Competitive landscape Technological innovations Value chain and investor analysis.

Interpretative Tools in the Market: The report integrates the entirely examined and evaluated information of the prominent players and their position in the market by methods for various descriptive tools. The methodical tools including SWOT analysis, Porter's five forces analysis, and investment return examination were used while breaking down the development of the key players performing in the market.

Key Growths in the Market: This section of the report incorporates the essential enhancements of the marker that contains assertions, coordinated efforts, R&D, new item dispatch, joint ventures, and associations of leading participants working in the market.

Key Points in the Market: The key features of this Alternative Medicine market report includes production, production rate, revenue, price, cost, market share, capacity, capacity utilization rate, import/export, supply/demand, and gross margin. Key market dynamics plus market segments and sub-segments are covered.

Basic Questions Answered

*who are the key market players in the Alternative Medicine Market?*Which are the major regions for dissimilar trades that are expected to eyewitness astonishing growth for the *What are the regional growth trends and the leading revenue-generating regions for the Alternative Medicine Market?*What are the major Product Type of Alternative Medicine?*What are the major applications of Alternative Medicine?*Which Alternative Medicine technologies will top the market in next 5 years?

Examine Detailed Index of full Research Study [emailprotected]: https://www.htfmarketreport.com/reports/3619414-2020-2025-global-alternative-medicine-market-report-production-and-consumption-professional-analysis

Table of ContentChapter One: Industry OverviewChapter Two: Major Segmentation (Classification, Application and etc.) AnalysisChapter Three: Production Market AnalysisChapter Four: Sales Market AnalysisChapter Five: Consumption Market AnalysisChapter Six: Production, Sales and Consumption Market Comparison AnalysisChapter Seven: Major Manufacturers Production and Sales Market Comparison AnalysisChapter Eight: Competition Analysis by PlayersChapter Nine: Marketing Channel AnalysisChapter Ten: New Project Investment Feasibility AnalysisChapter Eleven: Manufacturing Cost AnalysisChapter Twelve: Industrial Chain, Sourcing Strategy and Downstream Buyers

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About HTF Market ReportHTF Market Report is a wholly owned brand of HTF market Intelligence Consulting Private Limited. HTF Market Report global research and market intelligence consulting organization is uniquely positioned to not only identify growth opportunities but to also empower and inspire you to create visionary growth strategies for futures, enabled by our extraordinary depth and breadth of thought leadership, research, tools, events and experience that assist you for making goals into a reality. Our understanding of the interplay between industry convergence, Mega Trends, technologies and market trends provides our clients with new business models and expansion opportunities. We are focused on identifying the "Accurate Forecast" in every industry we cover so our clients can reap the benefits of being early market entrants and can accomplish their "Goals & Objectives".

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Alternative Medicine Market to Witness Huge Growth from 2022 to 2028: Herbal Hills, Thorne Research, Herb Pharma - Digital Journal

February is Cancer Prevention Awareness Month and since today, we know more about cancer than ever before, it is no secret that early detection and treatment is the key to prevention that can save millions of lives every year - a thought backed by the World Health Organization and even Ayurveda experts. The WHO lists tobacco use, alcohol consumption, unhealthy diet, physical inactivity and air pollution as risk factors for cancer and other noncommunicable diseases.

Can Ayurveda really shrink tumours?

While scientists are making their best efforts to fight this disease, Ayurveda experts assert that the ancient Ayurvedic classics are aware of the clinical features resembling cancer with the names such as Apachi, Gulma, Granthi and Arbuda. In an interview with HT Lifestyle, Dr Vasudev Vaidya (PhD) Deputy Medical Superintendent at Sushrutha Ayurvedic Medical College and Hospital and Dr Sunitha MP (MD Ayurveda) Department of Dravyaguna Vijnana shared, Ayurveda, the oldest Indian medicine system which is still at practice is known from very early times for preventing or suppressing various tumours using these natural drugs and nowadays the scientific community has shifted the focus of research on complementary and alternative medicine for the management of cancer.

They explained that in Ayurvedic concept, according to Charaka and Sushruta Samhitas, cancer is described as inflammatory or non-inflammatory swelling and mentioned either as Granthi (minor neoplasm) or Arbuda (major neoplasm). The nervous system (Vata or air), the venous system (Pitta or fire) and the arterial system (Kapha or water) are three basics of Ayurveda and very important for normal body function and in malignant tumours, all three systems get out of control (Tridoshas) and lose mutual coordination that causes tissue damage, resulting in critical condition.

Tridoshas cause excessive metabolic crisis resulting in proliferation, they said. The doctors added, The modern cancer therapy which is known to be burdened by drug-induced toxic side effects, hoping perfect cure of disease, form the complementary and alternative medicine system. The main objective of Ayurvedic therapy is to find the ultimate cause of an illness while the therapeutic approach of Ayurveda is divided into four categories as Prakritisthapani chikitsa (health maintenance), Rasayana chikitsa, (restoration of normal function), Roganashani chikitsa (disease cure) and Naishthiki chikitsa (spiritual approach).

Potential herbs for Cancer:

Dr Vasudev Vaidya and Dr Sunitha stressed that herbs help in total healing, reduce the side effects along with reduction in cancer-associated complications. They revealed that though many herbs are under clinical studies and being investigated phytochemically to understand their anti-cancer potential nowadays, some plants have scientific evidence of anti-cancer property.

These include:

1. Amorphophallus Campanulatus,

2. Oroxylum indicum,

3. Basella rubra,

4. Flacourtia ramontchi,

5. Moringa oleifera,

6. Ficus bengalensis,

7. Curcuma domestica,

8. Allium sativum,

9. Calotropis gigantea,

10. Datura metel,

11. Hygrophila spinosa,

12. Juniperus indica,

13. Moringa oleifera,

14. Nigella sativa,

15. Picrorrhiza kurroa,

16. Rubia cordifolia,

17. Andrographis paniculata,

18. Annona atemoya,

19. Phyllanthus niruri,

20. Piper longum,

21. Podophyllum hexandrum,

22. Tinospora cordifolia,

23. Semecarpus anacardium

24. Vitis vinifera,

25. Baliospermum montanum,

26. Madhuca indica,

27. Pandanus odoratissimum,

28. Pterospermum acerifolium,

29. Raphanus sativus,

30. Barleria prionitis,

31. Prosopis cineraria,

32. Catharanthus Roseus

See the rest here:

Can Ayurveda shrink tumours? Check out these 32 herbs with anti-cancer potential - Hindustan Times

The use of psychedelic compounds in the treatment of illness may appear unconventional at first glance; however, this application is not a new phenomenon. Many cultures have been using psychoactive plants for thousands of years to treat and diagnose medical ailments [1]. Evidence of the use of mescaline, a serotonin 5-hydroxytryptamine 2A (5HT-2A) receptor agonist similar to psilocybin, has been recovered by archeologists in Texas and radiocarbon dated to 5700 years ago [2]. The ability of psychoactive plants to produce both spiritual and medicinal effects has placed them in a unique category among many societies. Throughout their history, they have been considered both holy and immoral, revered and criminalized. The legality of and public opinion on these compounds have fluctuated; however, the compounds themselves have largely remained the same. Many compounds that fit this description are placed into a category called the 5HT-2A agonists, otherwise known as classic hallucinogens. While many of these chemicals share similar effects and have the same potential for medicinal value, we will focus this paper on one, namely, psilocybin, the active chemical found in psilocybe magic mushrooms.

Psilocybin-containing mushrooms can grow all over the world and appear to be ubiquitous across many cultures [1]. Evidence of the use of neurotropic fungi exists from Northwest Mexico, dating over 2000 years old. However, cave paintings from Spain depicting a bull and what appears to be neurotropic mushrooms (which commonly grow on cow and bull manure) have been dated back to between 6000 and 8000 years ago [3]. The inclusion of mushrooms in ancient cultural artifacts shows the importance that these societies placed on these fungi.

In the early 20th century, psilocybin and lysergic acid diethylamide (LSD) became an intriguing new topic to study among medical professionals in psychiatry. Albert Hofman, who famously synthesized lysergic acid diethylamide (LSD) while working for Sandoz in 1938 and then again in 1943, was also responsible for first isolating and synthesizing psilocybin in 1958, the psychoactive chemical found in psilocybe mushrooms [1]. These compounds, which are often categorized as the classic hallucinogens, were used with increasing frequency until their classification as Schedule I substances under the UN Convention on Drugs in 1967 [1]. Additionally, following the UNs classification, many countries included their own laws for restricting or regulating the use of these substances.

Since their inclusion in the Schedule I class of substances, there has been an ongoing discussion about the benefit and harm that these compounds produce and how they should be considered within the greater society. Recently, there has been a resurgence of evidence-based research and clinical trials involving these compounds. This is a wonderful, fruitful time for discovery because people are suddenly willing to consider these substances as therapeutics again, which hasnt happened in 50 years, said Jennifer Mitchell, a neuroscientist at the University of California, San Francisco. Dr. Mitchell is the lead author of a study exploring the benefits of treating patients suffering from severe post-traumatic stress disorder (PTSD) with 3,4-methylenedioxymethamphetamine (MDMA), a psychoactive chemical.

While it is certain that more research is necessary to determine how best to utilize psilocybe mushrooms and the active ingredient psilocybin, many potential uses have been proposed and experiments conducted. Among those include the treatment of addiction, depression, and end-of-life mood disorders. Throughout this paper, we will review and discuss studies conducted that test psilocybins potential ability to treat these ailments. By assessing these areas of medicine and contrasting the current treatment options with psilocybin-assisted therapy, we aim to determine how efficacious these new methods are. In addition, we will consider the secondary effects and adverse effects of all treatment options for a more holistic review.

A group of compounds that have recently sparked interest for their treatment potential is psychedelic drugs including psilocybin, dimethyltryptamine (DMT), mescaline, and lysergic acid diethylamide (LSD), among others [4]. These drugs are currently controversial for their hallucinogenic effects and recreational use; however, their resemblance to tryptophan enables them to act as serotonin agonists and activate 5HT receptors, mainly the 5HT-2A receptor [5]. This effect makes them promising candidates in the treatment of substance abuse disorders as well as mood disorders [6]. This is due to the fact that substance use disorder (SUD) is the manifestation of several neurophysiological mechanisms including the dopaminergic pathways of the striatum (reward center), 5-HT pathways connecting with the striatum, and the corticotropin-releasing hormone (CRH) pathway, which drives the hypothalamic-pituitary-adrenal (HPA) axis [7].

One of the hallucinogens of interest in the treatment of mental health disorders is tryptamine: psilocybin. This compound can be isolated from over a hundred species of mushroom and is thus a naturally occurring alkaloid [8]. Most of the psilocybin-containing species of mushrooms come from the Psilocybe genus [8]. In its natural form, psilocybin or 3-[2-(dimethylamino) ethyl]-1H-indol-4-yl dihydrogen phosphate is a prodrug that is converted in the body to psilocin or 4-hydroxy-N,N-dimethyltryptamine [9]. The structure of psilocybin is such that it cannot cross the blood-brain barrier. Its metabolite psilocin, however, is more lipophilic and therefore more active [6]. The active metabolite can be found 20-40 minutes after ingestion as psilocybin is quickly converted to its metabolite in the stomach acid or via first-pass metabolism with a bioavailability of around 50% and a half-life of 2.5 hours [6].

This metabolite is the active form of psilocybin and closely resembles the structure of serotonin [10]. The psychedelic is, therefore, able to activate 5HT receptors as mentioned, ultimately leading to their downregulation [4]. In such instances, there is a compensatory upregulation in the metabotropic glutamate receptors (mGluR2/3) due to the inverse relationship between mGluR2/3 and 5HT-2A receptors [5]. The stimulation of 5HT-2A receptors on pyramidal cells in levels V and VI in the cortex by psilocin, a metabolite, leads to the release of glutamate in the prefrontal cortex [6].

The significance of the upregulation of the mGluR2/3 pathway is the result of the receptors abundance in the route from the medial prefrontal cortex to the nucleus accumbens where these receptors play a role in the mediation of craving and addiction, as well as cognitive function [5]. It has been found that persons with an alcohol addiction have a deficiency or downregulation in their mGluR2 pathway in the infralimbic region of the medial prefrontal cortex [5].

On the other hand, psilocybins effects at the 5HT receptors are responsible for decreased depression and suicidal behaviors, as well as increased memory and learning [11]. Further, it is believed that psilocins activation of the 5HT-2A receptor is responsible for increased release of dopamine from the striatum, which is capable of regulating the defective reward pathway in patients who suffer from depression and with suicidal ideation [6].

In addition to its effects on the serotonin receptors, psilocybin is able to activate G protein-coupled receptors via brain-derived neurotrophic factor (BDNF) and enable downstream effects such as signal transduction and gene expression [9]. These changes are potentially responsible for plasticity, regeneration, and neurogenesis. Psilocybin-mediated BDNF is also responsible for the activation of N-methyl-D-aspartate (NMDA) and -amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors in the prefrontal cortex, leading to increased plasticity (Figure 1)[9].

Use in Addiction Treatment

Among the proposed therapeutic applications of psilocybin is its use in the treatment of substance use disorders. The current FDA-approved pharmacotherapies for substance use disorder (SUD) have modest effect sizes, and patients often relapse [12]. Psychedelic therapy models for addiction treatment were heavily researched between 1950 and 1970. However, research in this field came to a halt with the restriction of the classic psychedelics (LSD, psilocybin, DMT, etc.) as Schedule I controlled substances in 1970 [13]. A renewed enthusiasm for this area emerged in the past decade with early clinical trials of psilocybin showing promising results in treating nicotine dependence and alcohol dependence. Additional phase II trials are currently underway.

A number of characteristics distinguish psilocybin as a useful pharmacotherapy in the treatment of substance use disorders. First, psilocybin has a low abuse potential despite its classification as a Schedule I controlled substance. Tolerance to the reinforcing effects builds rapidly in users who take psilocybin repeatedly [13]. However, signs of physical dependence on psilocybin and withdrawal have not been documented [7]. Second, the half-life of psilocin, the active metabolite, is three hours [14]. The peak effect typically occurs within 60-90 minutes of oral ingestion, which subsides over the following six hours after ingestion [15]. This pharmacokinetic profile makes psilocybin more attractive as a pharmacologic treatment than other psychedelics with slower elimination and longer durations of action [13]. Third, psilocybin is associated with few adverse effects, most of which are mild, including mild, transient hypertension and tachycardia, mild headaches, and rarely prolonged psychosis [16]. Fourth, the duration of therapeutic effect in the context of SUD is such that only two or three administrations of psilocybin may have long-term or even permanent beneficial effects [17].

Nicotine Addiction

The enduring personal meaning and spiritual awakening effects of psilocybin have been put to use in the context of smoking cessation. A small, open-label study conducted through Johns Hopkins University incorporated two to three psilocybin administrations to examine its utility in smoking cessation [16]. This study enrolled 15 participants for the 15-week course of treatment. The participants received cognitive behavioral therapy (CBT) for smoking cessation as well as preparation for psilocybin administration weekly for the first four weeks. The participants target quit date (TQD) coincided with their treatment session for week 5 in which they received their first dose of psilocybin of 20 mg/70 kg. The subjects continued to meet with study staff weekly and received a second psilocybin dose in the seventh week and a third optional dose in the 13th week. The second and third doses were higher at 30 mg/70 kg, but the participants could repeat the initial 20 mg/70 kg dose instead if they preferred [16]. The biological markers of smoking abstinence were employed throughout the study and at long-term follow-up in the form of breath CO and urine cotinine [16]. Each marker served as biological verification of abstinence. The participants also completed a Mysticism Scale questionnaire at intake, one week after the second psilocybin session, and one week after the third psilocybin session when applicable [16].

The study found that 12 of 15 participants (80%) were abstinent at the six-month follow-up [16]. Three of these 12 had suffered lapses between the end of the 15-week course and the six-month follow-up, but all three resumed smoking abstinence prior to the follow-up meeting as verified by biological markers. The participants also indicated that the psilocybin experiences changed their orientation toward the future, so that long-term benefits outweighed immediate desires (73%) and that psilocybin strengthened participants belief in their ability to quit (73%) [16].

The results of this open-label study were remarkable when contrasted with those of the current FDA-approved smoking cessation pharmacotherapies. One such therapy, sustained-release bupropion, yields seven-day point prevalence abstinence rates of 24.9% at six months post-target quit date, while varenicline shows 33.5% abstinence rates at six months post-target quit date [18], both of which are less than half the rates seen in this psilocybin study. Another method of smoking cessation treatment that consisted of a combination of bupropion, nicotine replacement, and cognitive behavioral therapy (CBT) for 12 weeks duration yielded a 40% abstinence rate at six months [19]. This multipronged approach, while more effective than pharmacotherapy alone, does not boast the 80% six-month abstinence rate seen with this small psilocybin study.

A long-term follow-up study was performed on the original participants of the study. At the 12-month follow-up, 10 of the 12 participants who returned were smoking abstinent as confirmed by biological marker tests. Of these 10, eight reported continuous abstinence since their target quit date (TQD) (60%) [17]. The most effective smoking cessation medications demonstrate about 30% abstinence at 12 months post-TQD [19]. At long-term follow-up (mean: 30 months post-TQD), nine participants were biologically confirmed abstinent with seven of them reporting having not smoked since TQD [17]. The results of this study led to a larger clinical trial examining the efficacy of single-dose psilocybin versus an eight- to 10-week course of nicotine replacement therapy with both groups receiving the same CBT smoking cessation treatment [17]. This trial is currently underway.

Alcohol Use Disorder

A small, open-label study with 10 participants was conducted to examine the utility of psilocybin in the treatment of alcohol use disorder [20]. All 10 individuals had a diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)criteria. The participants underwent a 12-week course of treatment consisting of seven sessions of motivational enhancement therapy (MET). The first psilocybin administration consisted of a 0.3 mg/kg dose. The participants received a dose of 0.4 mg/kg for the second psilocybin administration with the exception of one participant who repeated the same initial dose [20].

The percent heavy drinking days (defined as five or more drinks in one day for males and four or more in one day for females) of the participants decreased a mean of 26% compared to their baselines in the remainder of the study following the first psilocybin session [20]. Additionally, the percent of days when subjects consumed any alcohol decreased a mean of 27% compared to their baseline following the first psilocybin session. Another notable result from this study was a statistically significant decrease in Penn Alcohol Craving Scale (PACS) values from weeks 8-12 compared to baseline values [20]. The PACS is a widely used assessment tool to measure craving for alcohol. Its validity and reliability have been well demonstrated [21]. The adverse effects of psilocybin treatment consisted of five participants reporting mild headaches lasting less than one day and one participant reporting nausea with one episode of vomiting. None of the participants required pharmacologic intervention for adverse effects [20]. Although this study was small and lacked a control group, the findings are encouraging, and an adequately powered, double-blind trial is currently underway [22].

Applications in Other Substance Use Disorders

The potential benefits of psilocybin in the area of substance use disorders and addiction are currently being examined in several clinical trials. The encouraging results of small, open-label studies revealed that there is a promise with nicotine and alcohol addiction. This concept has been extrapolated to methamphetamine use disorder with a small clinical trial comparing therapy and two psilocybin sessions versus the standard rehabilitation treatment with a total of about 30 participants [23]. Another current clinical trial is comparing the benefits of one psilocybin session versus diphenhydramine as a control for the treatment of cocaine use [24]. This trial is unique in that it is placebo-controlled, an invaluable component of pharmaceutical research that is difficult when dealing with psychedelic substances. Another application of psilocybin in a small clinical trial is examining the effect of psilocybin with guided counseling in addition to buprenorphine/naloxone maintenance therapy in patients with opioid use disorder [25]. The results of these small studies (Table 1), in addition to the larger phase II studies regarding nicotine and alcohol addiction previously mentioned, may have large implications for the field of substance abuse therapy.

Use in Major Depression

Major depressive disorder is a growing problem within our society, with roughly 20% of people experiencing some form of depression within their lifetime [26]. The current first-line treatment for major depressive disorder is a treatment with a class of medications called SSRIs [27]. However, these drugs can take weeks to begin working, have adverse side effects, and often have limited efficacy, with 30%-50% of patients being unresponsive to treatment and 10%-30% considered resistant to treatment entirely [28]. Due to the inconsistent efficacy in some individuals of current treatment options, alternative methods are constantly being investigated.

Psilocybin, an agonist acting on the serotonin 5-hydroxytryptamine 2A (5HT-2A) receptor, has been implicated as a potential treatment option for a variety of illnesses, depression being one of them [27]. In this approach, the patient consumes psilocybin in a therapeutic setting, guided by a trained professional referred to as a therapist. Psilocybin-assisted therapy is a unique form of treatment because it does not require daily administration. Rather, it consists of two or three doses given several weeks apart. Research is currently underway to determine the long-term efficacy of this approach to treatment.

An experiment conducted at the Center for Psychedelic and Consciousness Research at Johns Hopkins Bayview Medical Center tested the efficacy of psilocybin in treating major depressive disorder. The team used a randomized, waiting list controlled trial to assess their patients results. Twenty-four patients were included in the study; 13 patients were in the immediate treatment group, receiving 20 mg/70 kg of psilocybin during session one and 30 mg/70 kg during session two, at week 3 and 4, respectively, and 11 patients were in the delayed group, receiving the same dosage as the immediate groups, at weeks 11 and 12, respectively. The delayed group allowed for the comparison between two otherwise similar groups, one having undergone the psilocybin therapy sessions and one not having completed it yet [28].

Using the GRID-Hamilton Depression Rating Scale (GRID-HAMD), researchers were able to compare the effects of psilocybin on the immediate treatment group compared with that of the delayed group, with the higher score indicating more severe depression. They found that while the delayed treatment groups scores did not change significantly within the first 11 weeks, the immediate treatment groups scores dropped significantly following the psilocybin therapy, measured in week 5. The mean GRID-HAMD scores one week after psilocybin treatment and four weeks after treatment were significantly lower for the immediate group (8.0 at week 1 and 8.5 at week 4) than that of the delayed group (23.8 at week 5 and 23.5 at week 8, which had yet to undergo treatment.

The difference in depression scores between the two groups can be attributed to the psilocybin therapy and is further supported by the secondary measures using the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). Using the QIDS-SR depression rating scale, they found that the levels of depression fell from 16.7 (which was the baseline for the immediate group) to 6.3 one week after the treatment with psilocybin (Cohen d = 2.6; 95% confidence interval (CI): 1.8-3.5; P < 0.001) [28]. The conclusion of the study found that 71% of the participants had a significant reduction in their depression, measured as a greater than 50% reduction in the GRID-HAMD score at week 1 and 4 following treatment, and 58% and 54% of the participants were considered in remission (GRID-HAMD < 7) after week 1 and 13, respectively [28].

In a study conducted at the British National Institute for Health Research (NIHR) Imperial Clinical Research Facility, psilocybin was tested against escitalopram, an SSRI used for the treatment of moderate to severe major depressive disorder. Using a double-blind, randomized, controlled trial, the team found that there was no statistically significant difference in the antidepressant effects of psilocybin versus escitalopram after administering both for six weeks, two 25 mg doses of psilocybin three weeks apart, and daily escitalopram [27]. This trial used the QIDS-SR-16 as the primary method to assess a participants level of depression. The scale ranged from 0 to 27, with higher numbers indicating higher levels of depression. Both treatment options lead to a decrease in the QIDS-SR-16 score. The psilocybin group had a reduction of 8 1 points, and the escitalopram group had a reduction of 6 1 points. The difference was 2 points, with a 95% CI of -5.0 to 0.9 and a P value of 0.17 [27].

The trial included several secondary measures of depression such as the Beck Depression Inventory 1A (BDI-1A), 17-Item Hamilton Depression Rating Scale (HAM-D-17), and the Montgomery and Asberg Depression Rating Scale (MADRS). These measures tended to support the use of psilocybin over escitalopram; however, the confidence intervals were not corrected for these comparisons [27]. While they were unable to suggest that one treatment was superior to the other, they established that they both decreased the depression scores in their respective cohorts. The conclusion that there was no significant difference between the two treatments reflects the potential for psilocybin as a treatment option. Additional research is required to correct for secondary factors, and future studies will be better able to provide more inclusive comparisons.

Use in Cancer/End-of-Life Mood Disorders

It is common for patients with a terminal diagnosis such as cancer to develop mood disorders such as depression and anxiety [29]. The current treatment options for these patients are limited, complicated by the long list of medications the patient is on, and often do not produce adequate results. Psilocybin was initially investigated as a potential treatment for mood disorders in terminally ill patients from the 1950s to the 1970s; however, due to its addition to the list of scheduled substances, most research halted in the 1970s [30]. In recent years, psilocybin research has been renewed and shown as a potential therapeutic for end-of-life depression and anxiety.

In a recent double-blind, placebo-controlled study, psilocybin was tested in 12 patients with various forms of cancer, to reduce the psychological burden of a terminal diagnosis [30]. Each patient had advanced-stage cancer and a clinical diagnosis of at least one of the following: acute stress disorder, generalized anxiety disorder, anxiety disorder due to cancer, or adjustment disorder with anxiety. In this study, each patient underwent both the placebo and active treatment administered several weeks apart. The order of which was randomized. The placebo consisted of 250 mg of niacin, due to its ability to cause mild flushing, but no psychological effects, and the active treatment consisted of a relatively small dose of 0.2 mg/kg psilocybin [30]. The results were calculated using various types of self-questionnaires. The Beck Depression Inventory (BDI), Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were measured the day before each session, the day after each session, two weeks after each session, and once per month for six months following the final session. In addition, the POMS, STAI, Five-Dimension Altered States of Consciousness profile (5D-ASC), and Brief Psychiatric Rating Scale were given directly following the session. The intervals at which these tests were given helped identify the cause of any potential changes in scores.

The mean BDI score of the psilocybin group dropped 6.1 points after the treatment, from 16.1 one day before treatment to 10.0 at the two-week follow-up. A reduction in the BDI by roughly 30% was shown at the one-month follow-up after the psilocybin treatment, and this trend continued and was shown to be significant at the six-month follow-up(P = 0.03) [30]. This represents a significant decrease in self-reported depression among the participants. The placebo group did not show any significant reduction between one day before and at the two-week follow-up.

The POMS showed a similar decrease in mean scores between one day before psilocybin and the two-week follow-up, demonstrating significant improvement in mood after a psilocybin treatment. No differences in mean scores were observed one day before the placebo and the two-week follow-up. A paired post hoc test showed that the mean scores one day before the psilocybin treatment were significantly higher than that of the placebo, regardless of the order of the two treatments. This aberration may account for some of the differences; however, the results were sustained for the six-month follow-up period, so it is unlikely to be entirely due to this anomaly [30]. The STAI did not show any significant decrease in anxiety in the two weeks following either treatment. However, at the one-month follow-up, there was a sustained decrease in anxiety scores, which persisted through the six-month follow-up.

A separate study, consisting of 51 individuals, used a double-blind crossover design with two sessions to compare the efficacy of a small dose of psilocybin versus a larger dose in treating patients withcancer with clinical depression and anxiety [29]. The participants received either a large dose of psilocybin (22 or 30 mg/70 kg) or a low dose (1 or 3 mg/70 kg). The low dose was expected to have negligible psychoactive effects. The study utilized a selection of self-questionnaires and community observer questionnaires completed by family, friends, or colleagues.

The outcomes of this study showed that the larger dose of psilocybin contributed to a greater reduction of depression and anxiety during the five-week period prior to the crossover. At the six-month interval, the STAI, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and BDI all demonstrated a sustained decrease in the score, indicating less severe symptoms. Of the participants,80% had a clinically significant reduction in their depression and anxiety at the six-month follow-up, and 60% of the participants were in remission, meaning they no longer qualified as having a diagnosis [31].

It is not fully understood how psilocybin achieves these results; however, it is proposed that the consciousness-altering properties are partly responsible due to the correlation between larger doses and more substantial outcomes. However, the authors found that a dose greater than 30 mg/70 kg more often led to psychologically challenging experiences and were thus not beneficial [29]. The exact mechanism by which psilocybin achieves these favorable outcomes requires additional study.

Analysis of recent and ongoing studies show that psilocybin has promising therapeutic effects. Psilocybin has been implemented as a potential therapy for hard-to-treat disorders such as addiction, depression, and end-of-life anxiety. There are still questions about how best to proceed with psilocybin-assisted therapy, and further studies are necessary. However, if it was determined to effectively and safely treat these diseases, it would benefit millions of people and greatly reduce suffering throughout the world.

Relationship With Therapy

Clinical trials involving psilocybin have shown promising results in reducing the burden of many psychiatric conditions. However, psilocybin and other psychoactive chemicals currently being studied require more than simply administering a capsule and waiting for the beneficial effect. This often includes weeks of therapy leading up to the first dose of psilocybin and again directly following. In a recent paper describing the goals and challenges of psychedelic therapists, Phelps identifies three core phases of treatment: preparation for the medicine-assisted session, the medicine session itself, and integration of the psychological material that arises during preparation and the medicine session [32].

Another important aspect to control for is set and setting. Set refers to the patients and therapists goals for the session, often discussed in detail during therapy beforehand. It includes the motivating factors, intentions, and expectations. In addition, it includes the specific type of guidance the therapist will use throughout the experience. The setting is used to describe the physical, mental, and emotional environment of the patient before and during the treatment [32]. There are differing opinions on how best to prepare an individual for a psychedelic-assisted therapy session; however, most recent studies use similar environments. These often include a quiet room with the patient lying down, a choice of preset music to listen to, and a blindfold, which is often encouraged.

As more studies are being conducted and clinical trials begin, developing these ancillary procedures will become an essential part of the overall treatment. There will be a growing demand for trained therapists able to administer psilocybin therapy. It will be prudent to continue to research and understand the supporting measures that lead to the most effective outcomes.

Relationship Between Mechanism of Action and Efficacy

Much has been learned about psilocybin in the past few decades; however, the mechanism of action responsible for the therapeutic results is still not completely understood. Promising new studies are using MRI technologies in order to understand the effects of psilocybin on resting neurological pathways [31]. During an interview in 2019, Dr. Griffiths, who is a lead researcher of psilocybin at Johns Hopkins, stated, Neuroimaging studies have shown that at the time psilocybin is given, theres a lot of neural connectivity among areas of the brain that usually dont talk to one another. He also said, And this occurs for the duration of time that the psilocybin is in the system. It has led to a hypothesis that this may open a window of neuroplasticity in which there may be a rewiring going on. This is a striking difference in mechanism of action to the majority of therapeutics currently in use, suggesting that the beneficial effects are a result of rewiring of the brain and that the altered consciousness experience of the individual leads to lasting durable changes after minimal treatments.

Various studies demonstrate that a greater level of mystical experiences was associated with and predicted better outcomes [28]. This strengthens the assertion that psilocybin works in part by changing the way we think and view the world. The ability of psilocybin to alter an individuals perception may be linked to changes in mood and behavior that last longer than the duration of the drug itself and thus lead to longer-lasting changes. This could provide patients with an alternative to daily medications and allow them to seek treatment at much longer intervals.

Observable Changes in Personality After Psychedelic Administration

Psilocybin has been shown to change ones personality. In a small study, participants with moderate to severe treatment-resistant depression were administered a 10 mg and 25 mg dose of psilocybin one week apart. Using the Revised NEO Personality Inventory (NEO-PI-R), a baseline personality score was assessed pretreatment and then assessed again three months posttreatment. When assessing the five personality traits, it was found that there was a significant increase in openness and extraversion scores with a significant decrease in neuroticism scores. Conscientiousness scores showed trend-level increases with no change to agreeableness scores. The positive personality changes were correlated with the patients degree of insightfulness during the psilocybin-induced experience [33].

The positive changes seen in personality with psychedelics are not limited to patients with preexisting mental conditions. In one study, 20 healthy participants were assessed at baseline with a Revised Life Orientation Test (LOT-R) and a NEO-PI-R personality test. Two weeks post-administration of 75 g LSD, patients reported a significant increase in optimism with LOT-R and openness with NEO-PI-R. The study also shows a trend toward an increase in the personality trait agreeableness [34].

These studies, along with others, illuminate a growing body of evidence that psychedelic compounds cause positive personality modification. It was found that healthy participants benefit from the use of these compounds, as well as participants with preexisting cognitive conditions. This finding further broadens the discussion about the potential use of psychedelic compounds, both for treating diagnosed conditions and in healthy individuals.

Adverse Effects

As research opens to explore the therapeutic options for these compounds, it is equally important to explore the potential downsides. Psilocybin is considered a Schedule I controlled substance, categorized as a drug that has high abuse potential with no clinical application. When administering psilocybinor any psychoactive compound, there is a potential to elicit psychologically challenging situations, sometimes referred to as a bad trip. These can include delirium, panic attacks, depersonalization, extreme distress, and other symptoms similar to schizophrenia [35]. In controlled settings, some participants experienced elevated blood pressure and gastrointestinal distress including nausea and vomiting [29]. It is important to note that these side effects are transient. One of the more serious concerns when using psilocybin is eliciting the onset of schizophrenia. In the majority of test subjects, there is little evidence to support that symptoms of psychosis persist after psilocybin use. When psychotic illness does occur, it is thought to be due to the expression of a predisposition rather than the drug creating the disorder [36]. Due to this, patient screening is important to reduce the occurrence of adverse drug effects.

Limitations With Testing Psychedelic Compounds

Performing strict scientific research on psychedelics comes with many challenges. First comes the problem of performing an effective double-blind study. In a study using a self-controlled blinding system, it was discovered that most patients and facilitators were able to assess which treatment options were administered due to the consciousness-altering nature of psilocybin [30]. Some studies use placebos such as niacin, which have mild flushing effects, or intravenous saline [34]. However, even with these placebos, more research and testing are required to find a suitable and effective form of blinding.

Expectations of what will happen during the drug-induced experience may affect the efficacy of the compounds being studied. When gaining informed consent, the participants are made aware that they may experience out-of-body sensations, depersonalization, or severe anxiety. This, in combination with prior expectations and environmental factors, may make the participant more sensitive to the context of the experience [34]. Biases are likely to occur in some of these studies due to the relatively small sample size as well as selection bias when using participants willing to take a Schedule I drug [37].

Set and setting also act as an important factor in the experience of the participant. Early experiments on psychedelics were performed in sterile laboratory rooms with minimal interaction with the patient in an attempt to control for variables. These experiments often had poor outcomes due to the elicitation of psychologically challenging situations brought on in part by the environment. Recent experiments have built upon these past models and modified the environment to provide a more suitable setting. The creation of an ideal set and setting is subject to ongoing research and may change from patient to patient and also as researchers continue to learn more about the best practices for administration.

Research on the classic psychedelics originally focused on treating end-of-life cancer-related distress [31]; however, recent studies have expanded the therapeutic scope of psilocybin to include major depressive disorder and addiction, among others. Recent studies have demonstrated that psilocybin is efficacious at lowering the reported levels of depression in individuals with and without a terminal diagnosis. This would prove beneficial to millions of people who suffer from depression and are unresponsive or resistant to treatment. Self-reported levels of depression show significant reductions following psilocybin treatments when compared to that of placebos. In addition, when compared to escitalopram, a commonly prescribed SSRI for major depression, psilocybin showed no statistical difference in efficacy and improvements in some nonsignificant secondary measures.

The use of psilocybin in the treatment of addiction could alter the landscape of an area of medicine that has evolved incrementally [7]. A national survey performed in 2017 found that nearly 50 million Americans aged 12 or older were current cigarette smokers, with nearly 28 million of those smoking daily [38]. While the percentage of smokers in the United States has declined in the past several decades, tobacco use still accounts for a large portion of morbidity, as well as an economic burden in the United States [39]. Similarly, alcohol use is associated with a large degree of morbidity and economic burden as well [40]. The same national survey from 2017 found that 16.7 million Americans were heavy drinkers, defined as binge drinking on five or more days in the past month [38]. For those individuals with substance use disorders and tobacco addiction who wish to decrease or eliminate their behavior, psilocybin-assisted therapy may become a useful asset for medical professionals attending to these individuals. Furthermore, the use of a substance with a low risk of dependence and toxicity on a limited, supervised basis in the pharmacologic treatment of individuals predisposed to addiction is ideal. The results of current clinical trials are likely to enhance the understanding of the efficacy of psilocybin-assisted addiction treatment(Table 2).

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Analysis of Psilocybin-Assisted Therapy in Medicine: A Narrative Review - Cureus

Gerry and Kathy Huspek had a plan for COVID-19.

After a year of doing their own research online, the couple from Cottage Grove decided if either one of them ended up in the hospital, they would ask to be treated with the controversial drug Ivermectin. Its an unproven therapy the federal government warns against using as a coronavirus treatment.

We have the right to try, Kathy Huspek said.

Their plans were put into motion when Gerry, who is unvaccinated, fell ill on Thanksgiving. The 66-year-olds condition deteriorated quickly and he remains on a ventilator today.

Shortly after being admitted to the intensive care unit late last year, Kathy asked doctors to administer the drug that has been occasionally used to treat parasites in humans but is primarily used on pets and livestock.

The doctors refused.

But Kathy was so convinced that Ivermectin could save her husbands life, she hired a lawyer and asked a Ramsey County judge to force the doctors at St. Johns Hospital in Maplewood to use the drug.

Judge Leonardo Castro refused, too, calling it a very slippery slope.

It is a very slippery slope this court is not prepared to, and should not, venture down.

The familys demand for the unproven treatment is part of a growing push around the country in which patients lean on lawyers instead of doctors to obtain treatments not approved or authorized by the FDA or CDC.

Demand for Ivermectin began to soar late last year as controversial doctors, politicians, and popular podcast hosts promoted it as an alternative treatment for COVID-19. All of them tout anecdotes or foreign studies that are not widely recognized.

Dr. Jacob Lyons, who works in the intensive care unit at Centracares St. Cloud Hospital, says they are pushing snake oil to desperate families.

It doesnt help. Its been tested again and again. None of the trials we have so far have shown benefits, Dr. Lyons said. Unless someday Ivermectin is proven to be effective in a large, randomized clinical trial, I cant respect those folks.

More research is expected to be released later this month. The University of Minnesota is conducting a placebo-controlled trial considered the gold standard in the U.S. to see if Ivermectin is actually effective in treating COVID-19.

Until then, Dr. Lyons says he has no choice but to keep denying the almost daily requests he receives for Ivermectin.

There are often polite requests, said Lyons, who is not involved in Gerry Huspeks care. Other times that conversation can become more tense, veiled threats of lawsuit.

The Huspeks launched their legal fight in December with the help of a self-described patient advocate from Plymouth.

Many people need to know what to do, said Jackie Schroeder. If they need to get legal help, Ive researched that. So I have connections to them. Thats how Kathy and I met.

Schroeder does not claim to be a medical expert but, she too insists shes done the necessary research.

However, most of Schroeders research comes from controversial sources labeled as fringe doctors who are accused of creating the Myth that Ivermectin is the miracle cure.

But Schroeder continues to relay the information she collects to her network of desperate families seeking unproven treatments.

Im just putting it into a format that people can understand, she said.

The Huspeks obtained a prescription after a telemedicine visit with a doctor from out of state.

We have a right to give him something that was prescribed to him, Kathy Huspek said.

But as the fight against COVID-19 moves from hospital rooms to courtrooms, judges are making it clear that a patient doesnt mean patients can demand unproven treatments.

In the Huspeks case, Judge Castro ruled he could not force the hospital to use a drug that is not in the standard of care.

I can empathize with the folks who look at their loved one on a ventilatorthose people arent at fault. Its the snake oil salesman that are pushing unproven therapies that shoulder the blame.

A spokesperson for M Health Fairview, the hospital group that owns St. Johns Hospital, said in a statement that patients will continue to receive care grounded in proven, evidence-based medicine.

But as front-line doctors head into the third year of the pandemic, Dr. Lyons says they continue to face an overwhelming amount of misinformation.

I can empathize with the folks who look at their loved one on a ventilator those people arent at fault, Dr. Lyons said. Its the snake oil salesmen that are pushing unproven therapies that shoulder the blame.

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Denied by doctors, COVID-19 patients turn to lawyers to force ivermectin treatment - KSTP