Skip to main content

Psilocybin for the Treatment of Obsessive-Compulsive Disorders

  • Chapter
  • First Online:
Disruptive Psychopharmacology

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 56))

Abstract

Obsessive-compulsive disorder (OCD) is a highly prevalent and disabling condition for which currently available treatments are insufficiently effective and alternatives merit priority attention. Psilocybin may represent a safe and effective avenue for treatment of individuals affected by this condition. In this chapter we briefly introduce OCD symptoms, epidemiology, as well as relevant hypotheses on the mechanism of disease that may inform treatment interventions. We briefly describe currently available treatments, mechanisms of action, and efficacy limitations, as preamble to the potential use of psilocybin and perhaps similar compounds in the treatment of OCD and related conditions. Although much is reviewed throughout this book about the mechanisms of action of psychedelic agents, a focused discussion of psilocybin effects as they pertain to OCD is also included. Our experience with incidental observation, prospective research, and current explorations of psilocybin in OCD are also described.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Andrews-Hanna JR, Smallwood J, Spreng RN (2014) The default network and self-generated thought: component processes, dynamic control, and clinical relevance. Ann N Y Acad Sci 1316(1):29

    Article  Google Scholar 

  • Carhart-Harris RL (2019) How do psychedelics work? Curr Opin Psychiatry 32(1):16–21

    Article  Google Scholar 

  • Carhart-Harris RL, Friston KJ (2019) REBUS and the anarchic brain: toward a unified model of the brain action of psychedelics. Pharmacol Rev 71(3):316–344

    Article  CAS  Google Scholar 

  • Carhart-Harris RL, Nutt DJ (2017) Serotonin and brain function: a tale of two receptors. J Psychopharmacol 31(9):1091–1120

    Article  CAS  Google Scholar 

  • Chlebowski S, Gregory RJ (2009) Is a psychodynamic perspective relevant to the clinical management of obsessive–compulsive disorder? Am J Psychother 63(3):245–256

    Article  Google Scholar 

  • Delgado PL, Moreno FA (1998) Hallucinogens, serotonin and obsessive-compulsive disorder. J Psychoactive Drugs 30(4):359–366

    Article  CAS  Google Scholar 

  • Foa EB (2010) Cognitive behavioral therapy of obsessive-compulsive disorder. Dialogues Clin Neurosci 12(2):199–207

    Article  Google Scholar 

  • Foa EB, Goldstein A (1978) Continuous exposure and complete response prevention in the treatment of obsessive-compulsive neurosis. Behav Ther 9(5):821–829

    Article  Google Scholar 

  • Foa EB, Kozak MJ (1985) Treatment of anxiety disorders: implications for psychopathology. In: Tuma AH, Maser JD (eds) Anxiety and the anxiety disorders. Lawrence Erlbaum Associates, Hillsdale, pp 421–452

    Google Scholar 

  • Freud A (1966) Obsessional neurosis: a summary of psycho-analytic views as presented at the congress. Int J Psychoanal 47:116–122

    CAS  PubMed  Google Scholar 

  • Gonçalves ÓF, Soares JM, Carvalho S, Leite J, Ganho-Ávila A, Fernandes-Gonçalves A, Pocinho F, Sampaio A (2017) Patterns of default mode network deactivation in obsessive compulsive disorder. Sci Rep 7(1):1–7

    Article  Google Scholar 

  • Gosmann NP, Costa MDA, Jaeger MDB, Motta LS, Frozi J, Spanemberg L, Manfro GG, Cuijpers P, Pine DS, Salum GA (2021) Selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors for anxiety, obsessive-compulsive, and stress disorders: a 3-level network meta-analysis. PLoS Med 18(6):e1003664

    Article  CAS  Google Scholar 

  • Lugo-Radillo A, Cortes-Lopez JL (2021) Long-term amelioration of OCD symptoms in a patient with chronic consumption of psilocybin-containing mushrooms. J Psychoactive Drugs 53(2):146–148

    Article  Google Scholar 

  • Madsen MK, Fisher PM, Stenbæk DS, Kristiansen S, Burmester D, Lehel S, Páleníček T, Kuchař M, Svarer C, Ozenne B, Knudsen GM (2020) A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding. Eur Neuropsychopharmacol 33:71–80

    Article  CAS  Google Scholar 

  • Mahjani B, Bey K, Boberg J, Burton C (2021) Genetics of obsessive-compulsive disorder. Psychol Med 51(13):2247–2259

    Article  Google Scholar 

  • March JS, Liebowitz M, Carpenter D, Kahn DA, Francis A (1997) The expert consensus guideline series: treatment of obsessive-compulsive disorder. J Clin Psychiatry 58(4):2–72

    Google Scholar 

  • Moreno FA, Delgado PL (1997) Hallucinogen-induced relief of obsessions and compulsions. Am J Psychiatry 154(7):1037–1038

    CAS  PubMed  Google Scholar 

  • Moreno FA, Wiegand CB, Taitano EK, Delgado PL (2006) Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry 67(11):1735–1740

    Article  CAS  Google Scholar 

  • Moreno JL, Holloway T, Albizu L, Sealfon SC, González-Maeso J (2011) Metabotropic glutamate mGlu2 receptor is necessary for the pharmacological and behavioral effects induced by hallucinogenic 5-HT2A receptor agonists. Neurosci Lett 493(3):76–79

    Article  CAS  Google Scholar 

  • Nichols DE (2004) Hallucinogens. Pharmacol Ther 101(2):131–181

    Article  CAS  Google Scholar 

  • Öst LG, Havnen A, Hansen B, Kvale G (2015) Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clin Psychol Rev 40:156–169

    Article  Google Scholar 

  • Pittenger C, Bloch MH, Williams K (2011) Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment. Pharmacol Ther 132(3):314–332

    Article  CAS  Google Scholar 

  • Pokorny T, Preller KH, Kraehenmann R, Vollenweider FX (2016) Modulatory effect of the 5-HT1A agonist buspirone and the mixed non-hallucinogenic 5-HT1A/2A agonist ergotamine on psilocybin-induced psychedelic experience. Eur Neuropsychopharmacol 26(4):756–766

    Article  CAS  Google Scholar 

  • Raines AM, Oglesby ME, Allan NP, Mathes BM, Sutton CA, Schmidt NB (2018) Examining the role of sex differences in obsessive-compulsive symptom dimensions. Psychiatry Res 259:265–269

    Article  Google Scholar 

  • Stein DJ, Costa D, Lochner C, Miguel EC, Reddy Y, Shavitt RG, van den Heuvel OA, Simpson HB (2019) Obsessive-compulsive disorder. Nat Rev Dis Primers 5(1):52

    Article  Google Scholar 

  • Stern ER, Fitzgerald KD, Welsh RC, Abelson JL, Taylor SF (2012) Resting-state functional connectivity between fronto-parietal and default mode networks in obsessive-compulsive disorder. PLoS One 7(5):e36356

    Article  CAS  Google Scholar 

  • Tang W, Zhu Q, Gong X, Zhu C, Wang Y, Chen S (2013) Cortico-striato-thalamo-cortical circuit abnormalities in obsessive-compulsive disorder: a voxel-based morphometric and fMRI study of the whole brain. Behav Brain Res 313:17–22

    Article  Google Scholar 

  • Taylor S, Asmundson GJ, Jang KL (2016) Etiology of obsessions and compulsions: general and specific genetic and environmental factors. Psychiatry Res 237:17–21

    Article  Google Scholar 

  • Vaidya VA, Marek GJ, Aghajanian GK, Duman RS (1997) 5-HT2A receptor-mediated regulation of brain-derived neurotrophic factor mRNA in the hippocampus and the neocortex. J Neurosci 17(8):2785–2795

    Article  CAS  Google Scholar 

  • Van der Straten AL, Denys D, Van Wingen GA (2017) Impact of treatment on resting cerebral blood flow and metabolism in obsessive compulsive disorder: a meta-analysis. Sci Rep 7(1):1–8

    Article  Google Scholar 

  • Vulink NC, Denys D, Westenberg HG (2005) Bupropion for patients with obsessive-compulsive disorder: an open-label, fixed-dose study. J Clin Psychiatry 66(2):228–230

    Article  CAS  Google Scholar 

  • Wilcox JA (2014) Psilocybin and obsessive compulsive disorder. J Psychoactive Drugs 46(5):393–395

    Article  Google Scholar 

  • Zambrano-Vazquez L, Allen JJB (2014) Response monitoring in obsessive-compulsive, worrying, and anxious individuals. Neuropsychologia 61:197–209

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francisco A. Moreno .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ehrmann, K., Allen, J.J.B., Moreno, F.A. (2021). Psilocybin for the Treatment of Obsessive-Compulsive Disorders. In: Barrett, F.S., Preller, K.H. (eds) Disruptive Psychopharmacology . Current Topics in Behavioral Neurosciences, vol 56. Springer, Cham. https://doi.org/10.1007/7854_2021_279

Download citation

Publish with us

Policies and ethics