Psilocybin: Physiological effects

Last modified: Saturday, 20. June 2009 - 3:02 pm

Psilocybin is a neurotoxin that bears close resemblance to the human brain neurotransmitter serotonin. Psilocybin is a specific central nervous system (CNS) serotonin (5-HT) receptor activator. It causes disruption in the normal serotonin levels in the brain. This disruption causes dilated pupils, a feeling of numbness throughout the body, nausea, blurred vision, exaggerated reflexes, tremors, loss of appetite, sleeplessness, and hallucinations. It also causes an increase in body temperature, blood pressure, and heart rate. A large amount of psilocybin, or psilocybin ingested by people with sensitivities to the drug, or by small children, can cause seizures, coma, and death. Ingesting psilocybin also interferes with the transmission and processing of external stimuli. The most common reasons for people who have ingested psilocybin to go to the hospital are hallucinations, hyperexcitability, panic attacks, coma, and convulsions.
Psilocybin is not considered to be addictive. However, there is a high risk of tolerance that leads to increased doses. Tolerance occurs when a person repeatedly uses psilocybin in a short period of time. The user’s body will change the way it processes the drug. To recapture the effect from an earlier use, the person experiencing tolerance would have to use increasing amounts of the drug. Using psilocybin more often and in larger quantities increases the chances of experiencing serious side effects requiring medical attention.
Psilocybin is activated in the body by first being converted to psilocin by the enzyme alkaline phosphatase. Psilocin is then metabolized and inactivated by monoamine oxidase to form 4-hydroxyindole-3-acetic acid. This is then excreted in the urine.
Harmful side effects
The most common harmful side effect from ingesting psilocybin mushrooms is a panic attack caused by a “bad trip.” A “bad trip” is often described as terrifying hallucinations, unwanted thoughts, frightening visions, serious distress, and paranoia. Some reported “bad trips” include hallucinations of skin turned to liquid, worms crawling inside the users body, sinking into the ground, or being suffocated by someone. In a 2000 study that examined 161 acute psilocybin mushrooms exposures reported to the Swiss Toxicological Information Center (STIC), 31% of the users were admitted to the hospital for panic attacks. The loss of self-control, aggressive response to others, and general psychosis generally lasts fewer than 24 hours, though long-term side effects are possible. Panic attacks and “bad trips” are not preventable or predicable, and often happen to users who have experienced “good trips” in the past.
Other reasons listed for hospitalization of Psilocybe mushroom users are hallucinations, hyperexcitability, tachycardia (excessively rapid heart rate), incontinence of urine, coma, and convulsions. Severe complications arise when users mix psilocybin with other drugs such as alcohol, opioids, or LSD. The International Programme on Chemical Safety Poisons Information Monograph (INCHEM) on fungi reports that some people are allergic to psilocybin mushrooms with fatal results. Others accidentally ingest poisonous mushrooms, which results in serious adverse side effects or death. Users who have ingested mushrooms several days consecutively or who are sensitive to other naturally occurring substances in the mushrooms such as phenylethylamine can experience serious heart problems.
Overdoses of psilocybin may cause intense side effects that require medical attention. Overdoses can happen easily because there are over a dozen common species of Psilocybe mushrooms, and one mushroom of one species can have the equivalent potency of 20 mushrooms of another strain. Also, because LSD is usually cheaper than Psilocybe mushrooms, grocery store mushrooms are often injected with LSD and then sold as Psilocybe mushrooms. As LSD is 100 times more potent than psilocybin, this greatly increases the chances of an overdose.
When unsuspecting individuals accidentally ingest psilocybin mushrooms, it is common for them to conclude that they are going insane because of the hallucinations and psychosis that occurs.
The effect of psilocybin on pregnant women is not known yet. In studies of LSD, which has a similar structure to psilocybin, it has been shown that large doses can cause spontaneous abortion. Studies also indicated increased risk for birth defects, such as malformed limbs, heart defects, and eye lens defects associated with LSD use during pregnancy. Central and South American natives have used psilocybin for thousands of years, but generally this was done during rare religious rituals and usually women and children did not partake. Therefore, this history offers little insight to the effects of psilocybin during pregnancy.
Long-term health effects
Ingesting Psilocybe mushrooms has been known to precipitate long-term mental illness including paranoia, depression, and psychosis. It is uncertain as to whether the user would have eventually developed these conditions in the absence of psilocybin. However, there does appear to be an increased risk of developing chronic mental problems after the use of psilocybin if the user has a family history of mental illness.
Another long-term side effect is called flashbacks. Flashbacks are recurrences of the drug’s effects when the drug is not being used. Sometimes several months after last use, persons who ingested Psilocybe mushrooms will unexpectedly experience hallucinations or mood swings. Often flashbacks occur when the past user is tired, anxious, uses another drug, or moves from a lighted environment into a dark one. Over 15% of people who use psilocybin experience this delayed effect. Users unaware of this side effect have sometimes sought medical attention fearing they were going insane.
Long term and sometimes lethal side effects also come in the form of self-inflicted injuries due to poor judgement while under the influence of psilocybin. As sensitivity to pain is decreased, the users may not know they are hurting themselves until later. In other instances, the users can overestimate their abilities and attempt something like trying to jump from extreme heights or walk on water. Occasionally, users under the influence of psilocybin become distressed to the point of committing suicide.

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