Psilocybin and chronic neuropathic pain: a systematic review

Area of Science:

• Neuroscience and Pharmacology
• Pain Management Research
• Psychedelic Studies

Background:

• Chronic pain is a global health issue requiring novel therapeutic approaches.
• Psilocybin, a psychedelic compound, is emerging as a potential treatment for chronic pain conditions.
• Despite its therapeutic potential, psilocybin remains a Schedule I controlled substance.

Purpose of the Study:

• To systematically review and critically evaluate existing evidence on psilocybin for chronic pain management.
• To assess the efficacy of psilocybin in alleviating chronic pain, considering various dosing regimens and patient outcomes.
• To identify gaps in the current research landscape regarding psilocybin's role in pain relief.

Main Methods:

• A comprehensive systematic literature search was performed across major databases (PubMed, CINAHL, Web of Science, Cochrane Library, EMBASE) up to January 2024.
• Studies evaluating psilocybin for chronic pain management were included based on predefined eligibility criteria.
• Methodological quality was assessed using the MASTER scale, and the strength of evidence was graded using the GRADE framework.

Main Results:

• Twenty-eight studies were identified, providing data on dosing, treated conditions, and patient outcomes.
• The majority of included studies (76.2%) were assessed as having low or very low methodological quality.
• Preliminary findings suggest potential benefits of psilocybin for chronic pain, with some studies using a 0.14 mg/kg dose showing promise, despite the overall low quality of evidence.

Conclusions:

• Current evidence indicates a potential role for psilocybin in managing chronic pain.
• Significant limitations exist due to methodological issues and the predominantly low quality of available research.
• Further rigorous, high-quality studies employing standardized protocols are essential to validate psilocybin's efficacy and safety for chronic pain treatment.