Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction

J Psychopharmacol. 2014 Nov;28(11):983-92. doi: 10.1177/0269881114548296. Epub 2014 Sep 11.

Abstract

Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.

Keywords: Hallucinogen; addiction; nicotine; psilocybin; psychedelic; smoking cessation; tobacco.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude
  • Behavior, Addictive / drug therapy
  • Biomarkers / metabolism
  • Biomarkers / urine
  • Carbon Monoxide / metabolism*
  • Cognitive Behavioral Therapy
  • Combined Modality Therapy / adverse effects
  • Cotinine / urine*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotinic Agonists / therapeutic use
  • Pilot Projects
  • Psilocybin / adverse effects
  • Psilocybin / therapeutic use*
  • Serotonin Receptor Agonists / adverse effects
  • Serotonin Receptor Agonists / therapeutic use*
  • Smoking Cessation / methods*
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / psychology
  • Tobacco Use Disorder / therapy
  • Treatment Outcome

Substances

  • Biomarkers
  • Nicotinic Agonists
  • Serotonin Receptor Agonists
  • Psilocybin
  • Carbon Monoxide
  • Cotinine