Psilocybin in alcohol use disorder and comorbid depressive symptoms

Depression after alcohol detox is a big risk factor for relapse to drinking, so this study looked at psychedelic assisted psychotherapy with psilocybin (the active ingredient in magic mushrooms) to see if they could improve outcomes. Two groups were randomized; one group received a 25mg dose and the other got a placebo of 1mg which is an inactive microdose. A few different outcome measures were different between the groups: number of drinking days, craving scores, and relapse rates were all better in the 25mg group, suggesting psilocybin has a genuine effect in facilitating staying quit from drinking. Still, this is a small study, enrolling only 30 individuals, so as they say, more research needs to be done. Check out the link below for the full article. While psilocybin is still not available for medical use in the United States, it will likely be in the coming years at which point it’s worth considering. For now, ketamine assisted psychotherapy remains the only medically available psychedelic, which also has robust anti-addiction properties; confusingly, it also sometimes precipitates a ketamine use disorder, so it’s worth closely considering the risks and benefits, and working with an experienced clinician.

Luquiens A, Belahda D, Graux C, Igounenc N, Serrand C, Rochefort P, et al. Psilocybin in alcohol use disorder and comorbid depressive symptoms: Results from a feasibility randomized clinical trial. Addiction. 2025. https://doi.org/10.1111/add.70152

full text: https://onlinelibrary.wiley.com/doi/10.1111/add.70152

Genetics study develops our understanding of alcohol use disorder

Interesting news for future potential treatments of alcohol use disorder:  a study in PNAS recently came out that points to a novel gene, and particular hormone, being involved in drinking behavior, β-Klotho and FGF21, respectively.  This is particularly interesting because it elaborates on our existing understanding of alcohol use disorder, and may offer a new molecular target for medications to disrupt drinking behavior.  The mainstay of substance use disorder treatment is a combination of psychosocial (such as psychotherapy and/or 12 step meetings, lifestyle changes) and biological treatments (like existing medications including naltrexone/vivitrol, acamprosate, disulfiram/antabuse).  With the current array of medications available, one--or a combination of several--works well for many folks, but more options, with potentially a better side effect profile, is always welcome.  

NBC story: http://www.nbcnews.com/health/health-news/gene-might-affect-how-much-you-drink-n689156

Article: http://www.pnas.org/content/early/2016/11/22/1611243113.abstract