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Psilocybin use in bipolar disorder: A comprehensive review
André Do1, Laurence Cloutier2, Lydia Hébert-Tremblay1
1Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.
Journal of Affective Disorders
|November 2, 2025
Summary
Psilocybin shows promise for bipolar depression treatment, with early trials indicating safety and effectiveness. However, further research is needed to confirm its therapeutic value and fully understand potential risks in bipolar disorder patients.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Bipolar disorder (BD) is a severe mental illness with high burden from depression.
- Current treatments like mood stabilizers and antipsychotics have limited efficacy and side effects.
- Novel, safe, and effective treatments for bipolar depression are urgently needed.
Purpose of the Study:
- To review the clinical outcomes of psilocybin use in bipolar disorder (BD).
- To assess the safety and efficacy of psilocybin as a potential treatment for BD depression.
Main Methods:
- Comprehensive narrative review of existing literature.
- Focus on clinical trials and reported outcomes of psilocybin in BD patients.
Main Results:
- Two small trials suggest psilocybin with psychotherapy is safe and effective for BDII depression.
- No serious adverse events like mania or increased suicidality were reported in these trials.
- Other studies indicate potential risks including manic symptoms, sleep issues, and anxiety; patient experiences vary with context.
Conclusions:
- Psilocybin shows potential for treating bipolar depression but its efficacy and safety are not yet clear.
- More research is essential to determine the therapeutic value of psilocybin in bipolar disorder.
- Understanding contextual factors is crucial for safe and effective psilocybin administration in BD.
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