Professional Documents
Culture Documents
DOI 10.1007/s00213-006-0457-5
ORIGINAL INVESTIGATION
W. A. Richards
Johns Hopkins Bayview Medical Center,
2516 Talbot Road, Introduction
Baltimore, MD 21216-2032, USA
W. A. Richards : R. Jesse
Psilocybin, a naturally occurring tryptamine alkaloid with
Council on Spiritual Practices, actions mediated primarily at serotonin 5-HT2A/C receptor
Box 460220, San Francisco, CA 94146-0220, USA sites, is the principal psychoactive component of a genus of
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page1
*****************************************************************************************************
Psychopharmacology
mushrooms (Psilocybe) (Presti and Nichols 2004). Psilocy- histories of hallucinogen use, and without family histories of
bin, in the form of these mushrooms, has been used for schizophrenia or other psychotic disorders or bipolar I or II
centuries, possibly millennia, within some cultures in disorder. The participants had an average age of 46 years
structured manners for divinatory or religious purposes (range 24 to 64) and were well educated; 97% (35 volun-
(Wasson 1980; Stamets 1996; Metzner 2004). The psycho- teers) were college graduates and 56% (20 volunteers) had
logical effects of psilocybin, which are similar to other post-graduate degrees. Eighty-three percent (30 volunteers)
classical serotonergically mediated hallucinogens [lysergic were employed full time, with the remainder employed part
acid diethylamide (LSD), mescaline, and N,N-dimethyl- time. Fifty-three percent (19 volunteers) indicated affiliation
tryptamine (DMT)], include significant alterations in with a religious or spiritual community, such as a church,
perceptual, cognitive, affective, volitional, and somates- synagogue, or meditation group. All 36 volunteers indicated
thetic functions, including visual and auditory sensory at least intermittent participation in religious or spiritual
changes, difficulty in thinking, mood fluctuations, and activities such as religious services, prayer, meditation,
dissociative phenomena (Isbell 1959; Wolbach et al. 1962; church choir, or educational or discussion groups, with
Rosenberg et al. 1964). 56% (20 volunteers) reporting daily activities and an
Early clinical research with psilocybin in the 1950s and additional 39% (14 volunteers) reporting at least monthly
early 1960s attempted to study the effects of psilocybin activities. The volunteers did not receive monetary compen-
without recognition of the powerful influences of set and sation for participation. Although most volunteers had very
setting (e.g., Isbell 1959; Hollister 1961; Malitz et al. 1960; busy personal and professional schedules, they were inter-
Rinkel et al. 1960). Subsequent research, which included ested in the study and made participation a priority. Based on
more preparation and interpersonal support during the period interviews, their motivation for participation was curiosity
of drug action, found fewer adverse psychological effects, about the effects of psilocybin and the opportunity for
such as panic reactions and paranoid episodes, and increased extensive self-reflection in the context of both the day-long
reports of positively valued experiences (Leary et al. 1963; drug sessions and the meetings with the monitors that
Metzner et al. 1965; Pahnke 1969). In response to the occurred between sessions. The Institutional Review Board
epidemic of hallucinogen abuse that occurred in the 1960s, of the Johns Hopkins University School of Medicine
clinical research with psilocybin and other hallucinogens approved the study, and all volunteers gave their informed
largely ceased and has resumed only recently. Notably, consent before participation.
Vollenweider and colleagues from Switzerland and Gouzoulis-
Mayfrank from Germany have reported a series of studies Study design
that have characterized the acute subjective, physiological,
and perceptual effects of psilocybin (e.g., Vollenweider et al. The study compared psilocybin (30 mg/70 kg) and
1998; Gouzoulis-Mayfrank et al. 1999; Hasler et al. 2004; methylphenidate hydrochloride (40 mg/70 kg) using a
Carter et al. 2005). double-blind between-group, crossover design that in-
In the present study, we sought to use rigorous double- volved two or three 8-h drug sessions conducted at 2-
blind clinical pharmacology methods to evaluate both the month intervals. Thirty-six volunteers were randomly
acute (7 h) and longer-term (2 months) mood-altering and assigned to receive either two sessions (N=30) or three
psychological effects of psilocybin (30 mg/70 kg) relative to sessions (N=6). The group of 30 volunteers were then
an active comparison compound (40 mg/70 kg methylphe- randomly assigned to receive psilocybin or methylpheni-
nidate). The study was conducted with 36 well-educated, date on the first session (15 per group), with the alternative
hallucinogen-naïve volunteers. drug administered on the second session. The other six
volunteers received methylphenidate on the first two
sessions and unblinded psilocybin on the third session.
Materials and methods The purpose of this condition was primarily to obscure
the study design to the participants and monitors (see
Participants “Expectancy” section), and data from the six participants
were not used in the statistical analyses; however, those
The participants were recruited from the local community data were generally consistent with the results described in
through flyers announcing a “study of states of conscious- this report. Outcome measures obtained throughout the
ness brought about by a naturally occurring psychoactive drug sessions included blood pressure and monitor ratings
substance used sacramentally in some cultures.” There were of participant mood and behavior. At about 7 h after drug
135 individuals screened over the telephone and 54 were ingestion (when the primary drug effects had subsided),
further screened in person. The 36 study participants (14 the participants completed several questionnaires designed
males) were medically and psychiatrically healthy, without to assess various aspects of hallucinogen experience
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page2
*****************************************************************************************************
Psychopharmacology
(described below). The longitudinal measures assessed out the session. For most of the time during the session, the
before and 2 months after each drug session included participant was encouraged to lie down on the couch, use an
measures of psychiatric symptoms, personality measures, eye mask to block external visual distraction, and use
quality of life, and lifetime mystical experiences. A 1-year headphones through which a classical music program was
follow-up assessment is still underway. played. The same music program was played for all
participants in all sessions. The participants were encouraged
Drug conditions to focus their attention on their inner experiences throughout
the session. If a participant reported significant fear or
Psilocybin and methylphenidate were administered in iden- anxiety, the monitors provided reassurance verbally or phys-
tically appearing opaque, size 0 gelatin capsules with ically (e.g., with a supportive touch to the hand or shoulder).
approximately 180 ml water. The dose of psilocybin The sessions were videotaped and about 25% were reviewed
(30 mg/70 kg) was selected as a high safe dose based on by the first author to verify session procedures.
non-blind (Malitz et al. 1960; Metzner et al. 1965; Leuner
1981) and blind (Pahnke 1963, 1969) studies conducted with Expectancy
hallucinogen-naïve individuals in the 1950s–1960s. The
methylphenidate dose (40 mg/70 kg) was selected for the It is widely believed that expectancy plays a large role in
comparison condition because it is a high, discriminable but the qualitative effects of hallucinogens (Metzner et al.
safe dose, it has an onset and duration of subjective effects 1965). Some expectancy effects are unavoidable because it
similar to psilocybin, and it produces some subjective effects would be unethical not to inform both the participants and
(e.g., excitability, nervousness, and/or increased positive the session monitors about the range of possible effects
mood) overlapping with those of psilocybin (Chait 1994; with hallucinogens. In addition, it is believed by many that
Rush et al. 1998; Kollins et al. 1998). ethical hallucinogen administration requires that sessions be
monitored by individuals who are familiar with such altered
Meetings with monitor before and after sessions states of consciousness (Masters and Houston 1966;
Roberts 2001; Stolaroff 2001). Thus, the beliefs of the
The primary monitor met with each participant on four session monitors introduce another source of expectancy.
occasions before his or her first session (for 8 h total) and on While it was not possible to completely eliminate such
four occasions (for 4 h total) after each session. A major expectancy effects, it was possible to significantly reduce
purpose of the participant-monitor meetings was to develop such effects by studying participants without personal
and maintain rapport and trust, which is believed to histories of hallucinogen use, by studying only a single
minimize the risk of adverse reactions to psilocybin participant at a time, and by using an experimental design
(Metzner et al. 1965). During these meetings, the partici- and instructional sets that provided the expectation that
pant’s life history and current life circumstances were sessions could involve not only the administration of a wide
reviewed. The preparation of participants by the monitors range of psilocybin doses but also a range of novel drugs,
explicitly included the monitor’s expectation that the drug some of which could produce effects that overlap with
session experiences could increase personal awareness and those produced by psilocybin. Expectancy effects were also
insight, however, avoided even mention of the criteria used reduced because the experimental design was further
to assess mystical experiences. A male clinical psychologist obscured from both participants and monitors, who were
(W.R.) with extensive prior experience monitoring halluci- not aware of which or how many participants would have a
nogen sessions and a female clinically trained social worker final unblinded psilocybin session (see “Instructions to
(M.C.) served as primary and assistant monitors, respectively, participants and monitors”).
for all study participants.
Instructions to participants and monitors
Drug sessions
The participants and monitors were informed that the
The participants were instructed to consume a low-fat participants would have either two or three sessions and
breakfast before reporting to the research unit at 0800 hours, that, in at least one session, they would receive a moderate
about 1 h before drug administration. A urine sample was or high dose of psilocybin. They were informed that an
taken to verify drug-free status, and the participants were inactive placebo, a low dose of psilocybin or various doses
encouraged to relax and reflect before drug administration. of 11 other drugs that could produce various effects
The 8-h drug sessions were conducted in an aesthetic living- (dextromethorphan, nicotine, diphenhydramine, caffeine,
room-like environment designed specifically for the study. methylphenidate, amphetamine, codeine, alprazolam, diaz-
Two monitors were present with a single participant through- epam, triazolam, or secobarbital), could be administered in
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page3
*****************************************************************************************************
Psychopharmacology
sessions in which a moderate or high dose of psilocybin gen N,N-dimethyltryptamine (Strassman et al. 1994; Riba
was not administered. After data collection 2 months after et al. 2001), consists of six subscales assessing various
the second session, the six participants who received aspects of hallucinogen effects (intensity, somaesthesia,
methylphenidate on the first and second session were affect, perception, cognition, and volition).
informed that they would have a third session that would
involve administration of a moderate or high dose of APZ The APZ is a 72-item yes/no questionnaire designed
psilocybin. These six sessions were the only unblinded to assess altered states of consciousness induced by drug
sessions. To help focus the participants on their experiences (e.g., DMT or psilocybin) or non-drug (e.g., perceptual
during the sessions, they were not asked to guess whether deprivation, hypnosis, and sensory overload) manipulations
or not they received psilocybin. However, the monitors (Dittrich 1998). The three major scales on the APZ are the
completed a rating form which recorded their guesses about OSE (oceanic boundlessness, a state common to classic
the contents of capsules approximately 7 h after capsule mystical experiences including feelings of unity and tran-
administration but before the participant completed detailed scendence of time and space), the AIA (dread of ego dis-
questionnaires describing his or her experiences. The solution, dysphoric feelings similar to those of some “bad
participants were given no information about these or any trips” described by hallucinogen users), and the VUS
other monitor ratings. (visionary restructuralization, which includes items on
visual pseudo-hallucinations, illusions, and synesthesias).
Measures assessed throughout the session The data on each scale were expressed as a proportion of
the maximum possible score.
Ten minutes before and 30, 60, 90, 120, 180, 240, 300, and
360 min after capsule administration, monitor ratings, blood Addiction research center inventory (ARCI) The ARCI was
pressure, and heart rate were obtained. developed to differentiate subjective effects among several
classes of psychoactive drugs including hallucinogens
Blood pressure and heart rate Blood pressure (systolic, (Haertzen 1966). The short form of the ARCI consists of
diastolic, and mean arterial pressure using oscillometric method 49 true/false questions and contains five major scales:
with the blood pressure cuff placed on the arm) and heart rate lysergic acid diethylamide (LSD, a hallucinogen-sensitive
were monitored using a Non-Invasive Patient Monitor Model scale that is often interpreted as providing a measure of
507E (Criticare Systems, Waukesha, WI, USA). dysphoric changes); pentobarbital, chlorpromazine, and
alcohol group (PCAG, a sedative sensitive scale); benzedrine
Monitor rating questionnaire At the same time-points at group (BG); amphetamine (A) scales (amphetamine-
which the physiological measures were taken, the two sensitive scales); and morphine-benzedrine group (MBG,
session monitors completed the Monitor Rating Question- often interpreted as a measure of euphoria) (Martin et al.
naire, which involved rating or scoring 20 dimensions of 1971; Jasinski 1977). The participants were instructed to
the participant’s behavior or mood (Table 1). The dimen- answer the questions on the ARCI with reference to the
sions expressed as peak scores in Table 1 were rated on effects they experienced after they received the capsules that
a five-point scale from 0 to 4. The dimensions expressed morning.
as total duration in Table 1 were rated as the estimated
number of minutes since the last rating. The data were States of consciousness questionnaire This 100-item ques-
the mean of the two monitor ratings at each time-point. tionnaire is rated on a six-point scale [0=none, not at all;
1=so slight, cannot decide; 2=slight; 3=moderate; 4=strong
(equivalent in degree to any previous strong experience or
Measures assessed 7 h after drug administration expectation of this description); and 5=extreme (more than
ever before in my life and stronger than 4)]. Forty-three
At about 7 h after capsule administration, when the major items on this questionnaire comprised the current version of
drug effects had subsided, the participants completed three the Pahnke–Richards Mystical Experience Questionnaire
empirically derived (i.e., via factor analysis) questionnaires (Pahnke 1969; Richards 1975), which was designed to
assessing subjective drug effects and two questionnaires assess mystical experiences, used as a primary outcome
assessing mystical experience, as described below. The measure in the Good Friday Experiment (Pahnke 1963;
participants typically completed these questionnaires in Doblin 1991), and has been shown to be sensitive to other
about 40 min. hallucinogens (Turek et al. 1974; Richards et al. 1977). This
questionnaire is based on the classic descriptive work on
Hallucinogen rating scale This 99-item questionnaire, mystical experiences and the psychology of religion by Stace
which was designed to show sensitivity to the hallucino- (1960), and it provides scale scores for each of seven
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page4
*****************************************************************************************************
Psychopharmacology
domains of mystical experiences: internal unity (pure mood, and spirituality. The participants typically completed
awareness; a merging with ultimate reality); external unity these questionnaires in about 75 min.
(unity of all things; all things are alive; all is one); tran- At about this same time, community observer ratings of
scendence of time and space; ineffability and paradoxicality participants’ attitudes and behavior were obtained by
(claim of difficulty in describing the experience in words); telephone. The outcome measures at this time-point are
sense of sacredness (awe); noetic quality (claim of intuitive described below.
knowledge of ultimate reality); and deeply felt positive mood
(joy, peace, and love). The specific items in each of the Persisting Effects Questionnaire This 89-item question-
scales of the Pahnke–Richards Mystical Experience Ques- naire sought information about changes in attitudes, moods,
tionnaire are available online as Electronic Supplementary behavior, and spiritual experience that, on the basis of prior
Material, Table 1. The data on each scale were expressed as research (Pahnke 1963, 1969; Doblin 1991; Richards et al.
a proportion of the maximum possible score. Based on prior 1977), would possibly be sensitive to the effects of
research (Pahnke 1969), the criteria for designating a psilocybin 2 months after the session. Eighty-six of the
volunteer as having had a “complete” mystical experience items were rated on a six-point scale (0=none, not at all;
were that the scores on each of the following scales had to be 1=so slight, cannot decide; 2=slight; 3=moderate; 4=strong;
at least 0.6: unity (either internal or external, whichever was and 5=extreme, more than ever before in your life and
greater), transcendence of time and space, ineffability, sense stronger than 4). Sixty-six of the items were from Pahnke
of sacredness, noetic quality, and positive mood. The (1963, 1969) and 20 items were new. For purposes of
remaining 57 items in the questionnaire served as distracter summarizing the results before data analysis, 61 of the 86
items. items were judged as likely to be unambiguously divided
into six categories: positive attitudes about life and/or self,
Mysticism scale This 32-item questionnaire was developed negative attitudes about life and/or self, positive mood
to assess primary mystical experiences (Hood et al. 2001; changes, negative mood changes, altruistic/positive social
Spilka et al. 2005). The Mysticism Scale has been exten- effects, and antisocial/negative social effects. Six raters
sively studied, demonstrates cross-cultural generalizability, independently sorted the 61 items into the six categories.
and is well regarded in the field of the psychology of Three items were excluded because fewer than five of the
religion (Hood et al. 2001; Spilka et al. 2005) but has not six raters agreed on the categories. For the remaining 58
previously been used to assess changes after a drug experi- items, at least five of the six raters agreed with the
ence. A total score and three empirically derived factors are assignment of each item to each category, suggesting the
measured: interpretation (corresponding to three mystical appropriateness of the category descriptors. The category
dimensions described by Stace (1960): noetic quality, descriptors and the number of items associated with each
deeply felt positive mood, and sacredness); introvertive category were: positive attitudes about life and/or self (17
mysticism (corresponding to the Stace dimensions of items), negative attitudes about life and/or self (17 items),
internal unity, transcendence of time and space, and positive mood changes (four items), negative mood changes
ineffability); and extrovertive mysticism (corresponding to (four items), altruistic/positive social effects (eight items),
the dimension of the unity of all things/all things are alive). and antisocial/negative social effects (eight items). Two
The items were rated on a nine-point scale (−4=this additional categories were comprised of one item each:
description is extremely not true of my own experience or positive behavior change and negative behavior change.
experiences; 0=I cannot decide; and +4=this description is For scoring purposes, the eight category scores based on
extremely true of my own experience or experiences). For a total of 60 items were expressed as the percentage of
the version of the questionnaire used 7 h after drug the maximum possible score. The items in each of the
administration, the participants were instructed to complete categories of the Persisting Effects Questionnaire are
the questionnaire with reference to their experiences after available online as electronic supplementary material,
they received the capsules that morning. Table 2. The remaining 23 items in the questionnaire
that did not readily fit into the categories predominately
reflected aspects of spirituality and mystical experience;
Measures assessed 2 months post-session these domains were characterized by other outcome
measures.
At 7 to 8 weeks after each session and before any additional The questionnaire also included these three questions:
session, the participants returned to the research facility and (1) How personally meaningful was the experience (rated
completed a series of questionnaires to assess possible 1= no more than routine, everyday experiences; 2= similar
persisting changes in attitudes, mood, or behavior as well as to meaningful experiences that occur on average once or
possible changes in standardized measures of personality, more a week; 3=similar to meaningful experiences that
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page5
*****************************************************************************************************
Psychopharmacology
occur on average once a month; 4=similar to meaningful the questionnaire used instructed the participants to
experiences that occur on average once a year; 5=similar answer questions based on how they feel on the
to meaningful experiences that occur on average once average. This questionnaire was completed at screening
every 5 years; 6=among the 10 most meaningful experi- and at 2 months after each session.
ences of my life; 7=among the 5 most meaningful
experiences of my life; and 8=the single most meaningful Community observer ratings of changes in participants’
experience of my life)? (2) Indicate the degree to which behavior and attitudes After acceptance into the study,
the experience was spiritually significant to you (rated each participant designated three adults who were
1=not at all, 2=slightly, 3=moderately, 4=very much, expected to have continuing contact with the participant
5=among the 5 most spiritually significant experiences (e.g., family members, friends, or coworkers/colleagues at
of my life, and 6=the single most spiritually significant work) such that they would be likely to observe changes
experience of my life). (3) Do you believe that the in the participants’ behavior and attitudes that might occur
experience and your contemplation of that experience during the study. Ratings by the designated individuals
have led to change in your current sense of personal well- were conducted via a structured telephone interview
being or life satisfaction (rated +3=increased very much, approximately 1 week after the participant had been ac-
+2=increased moderately, +1=increased slightly, 0=no cepted into the study and 7 to 8 weeks after each of the
change, −1=decreased slightly, −2=decreased moderately, drug sessions. The interviewer provided no information
and −3=decreased very much)? to the community volunteer about the participant. Fur-
This questionnaire was developed after the initiation of thermore, most of the interviews (60%) were conducted
the study and was completed by all 24 of the 30 participants by a research assistant who had never met the participant
who thereafter received psilocybin and methylphenidate in and had no knowledge about the participant’s experiences
counterbalanced order in the first two sessions (12 partici- during drug sessions. The structured interview consisted
pants in each of the two drug orders). of asking the rater to rate the volunteer’s behavior and
attitudes using a ten-point scale (from 1=not at all to
Mysticism Scale-Lifetime The Lifetime version of this 10=extremely) on 11 dimensions that were identified from
previously described questionnaire instructed the partici- prior research (Pahnke 1963; Richards et al. 1977; Doblin
pants to answer questions with reference to their total life 1991) as possibly sensitive to the effects of psilocybin.
experiences. This questionnaire was completed at screening The rated dimensions were: inner peace, patience, good-
and at 2 months after each session. natured humor/playfulness, mental flexibility, optimism,
anxiety, interpersonal perceptiveness and caring, negative
Spiritual Transcendence Scale This 24-item questionnaire expression of anger, compassion/social concern, expression
assesses a construct that reflects an individual’s effort to of positive emotions (e.g., joy, love, appreciation), and
create a broad sense of personal meaning in his or her life self-confidence. On the first rating occasion, which
and has been shown to demonstrate cross-cultural general- occurred soon after acceptance into the study, the raters
ity (Piedmont 1999, 2005, 2006; Piedmont and Leach were instructed to base their ratings on observations of and
2002). A total score and three empirically derived factors conversations with the participant over the past 3 months.
are scored: prayer fulfillment, universality, and connected- On subsequent ratings, which occurred 7 to 8 weeks after
ness. This questionnaire was completed at screening and at each session, the raters were told their previous ratings and
2 months after each session. were instructed to rate the participant based on interactions
over the last several weeks. The data from each interview
NEO Personality Inventory (NEO PI-R) This 241-item with each rater were calculated as a total score, with
questionnaire, which was completed on a computer, per- anxiety and anger scored negatively. The changes in
mits the assessment of five major personality factors: participants’ behavior and attitudes after drug sessions
neuroticism, extraversion, openness, agreeableness, and were expressed as a mean change score from the preceding
conscientiousness (Costa and McCrae 1992). This ques- rating across the raters.
tionnaire was completed at screening and at 2 months after A failure to interview all three of the raters after one of
each session. the drug sessions resulted in elimination of 4 of the 30
participants who received psilocybin and methylphenidate
PANAS-X (Positive and Negative Affect Schedule Expanded in counterbalanced order on the first two sessions. Of the
Form) This 60-item questionnaire permits the assessment 52 rating occasions in the 26 participants, the majority
of two broad general factors (positive affect and negative (83%) involved interviews with all three raters on each
affect) accounting for most of the variance in self-rated rating occasion, with all of the remaining interviews con-
affect (Watson and Clark 1994, 1997). The version of ducted with two raters.
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page6
*****************************************************************************************************
Psychopharmacology
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page7
*****************************************************************************************************
Psychopharmacology
about 10 bpm for both drugs and remained significantly showed differences between psilocybin and methylpheni-
elevated over the pre-drug value throughout the session. date (Table 2). All six scales of the Hallucinogen Rating
The volunteers were rated as showing very low sleepiness/ Scale, all three scales on the APZ Questionnaire, and the
sedation and restlessness during sessions, with no differ- LSD scale of the ARCI were significantly higher after
ences between the psilocybin and methylphenidate con- psilocybin than after methylphenidate. These differences
ditions (Table 1). The volunteers had a significantly greater reflect the fact that, after psilocybin, the participants
number of minutes talking with the monitors after methyl- experienced alterations in mood, affect, and cognition
phenidate than psilocybin (72 vs 51 min, during the 6 h typical of hallucinogenic drugs. These included perceptual
after capsule ingestion), although after psilocybin they had changes (e.g., visual pseudo-hallucinations, illusions, and
more physical contact (e.g., handholding) with the monitor synesthesias), labile moods (e.g., feelings of transcendence,
(24 vs 58 min) and higher peak ratings of stimulation/ grief, joy, and/or anxiety), and cognitive changes (e.g.,
arousal and spontaneous motor activity (Fig. 2; Table 1). It sense of meaning and/or ideas of reference).
is noteworthy that, during psilocybin sessions, the partic- A mixed pattern of results occurred on the other scales of
ipants were rated as being less responsive to questions, the ARCI. The PCAG subscale, which is sensitive to
further from ordinary reality, and showing greater emotion- sedative drugs, was higher after psilocybin. It is interesting
ality as reflected in peak ratings of tearing/crying, anxiety/ to note that the two stimulant scales showed opposite
fearfulness, joy/intense happiness, and peace/harmony effects. The amphetamine scale (A), which was designed to
(Fig. 2; Table 1). show dose-related sensitivity to amphetamine, was signif-
icantly higher after psilocybin than after methylphenidate.
Drug effect and mysticism measures assessed 7 h after drug However, the benzedrine group scale (BG), which measures
administration amphetamine-induced increases in self-control, efficiency,
and concentration, was significantly higher after methyl-
Hallucinogen-sensitive questionnaires The three question- phenidate than after psilocybin. Finally, the morphine-
naires developed for sensitivity to hallucinogenic drugs benzedrine group (MBG) scale, which is considered a
Table 1 Monitor ratings of volunteer behavior and mood throughout the session
Data are mean scores with one SEM shown in parentheses (N=30)
N.S. not significant
a
For example, humming, sighs, laughter
b
For example, reassuring touch
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page8
*****************************************************************************************************
Psychopharmacology
Table 2 Volunteer ratings on three drug-sensitive questionnaires completed 7 h after drug administration
Hallucinogen Rating Scale (4=maximum) Intensity 1.38 (0.14) 2.79 (0.12) <0.001
Somaesthesia 0.91 (0.10) 1.92 (0.11) <0.001
Affect 1.16 (0.10) 2.16 (0.10) <0.001
Perception 0.54 (0.11) 2.07 (0.14) <0.001
Cognition 1.03 (0.14) 2.54 (0.15) <0.001
Volition 1.39 (0.06) 1.77 (0.07) <0.001
APZ Questionnaire OSE (oceanic boundlessness) 3.30 (0.50) 8.00 (0.45) <0.001
AIA (dread of ego dissolution) 1.03 (0.21) 5.03 (0.74) <0.001
VUS (visionary restructuralization) 3.70 (0.59) 8.87 (0.47) <0.001
Addiction Research Center Inventory (ARCI) PCAG (sedative) 4.83 (0.41) 7.27 (0.58) <0.001
BG (amphetamine/self-control) 5.83 (0.38) 4.57 (0.32) <0.05
A (amphetamine) 3.80 (0.44) 5.13 (0.41) <0.05
MBG (euphoria) 6.77 (0.73) 8.60 (0.67) N.S.
LSD (hallucinogen/dysphoria) 4.33 (0.37) 7.33 (0.40) <0.001
Data are mean ratings with one SEM shown in parentheses (N=30)
N.S. not significant
measure of drug-induced euphoria, did not differ signifi- Measures assessed 2 months post-sessions
cantly between the drug conditions.
Persisting Effects Questionnaire As shown in Table 4,
Measures of mystical experience At 7 h after capsule compared to methylphenidate, psilocybin produced signif-
administration, the volunteers also completed two ques- icantly greater elevations in ratings of positive attitudes,
tionnaires designed to assess primary mystical experiences mood, social effects, and behavior; the negative ratings of
based on classic phenomenological descriptions from the these same dimensions were very low and did not differ
psychology of religion (Table 3). The total score and all across the drug conditions. This questionnaire also included
three empirically derived factors of the Mysticism Scale ratings of the personal meaningfulness and spiritual
and all seven scales on States of Consciousness Question- significance of the experience and whether the experience
naire were significantly higher after psilocybin than after changed their sense of well being or life satisfaction.
methylphenidate. Based on a priori criteria, 22 of the total Table 4 shows that these ratings were significantly higher
group of 36 volunteers had a “complete” mystical experi- after psilocybin than after methylphenidate. It is remarkable
ence after psilocybin (ten, nine, and three participants in the that 67% of the volunteers rated the experience with
first, second, and third session, respectively) while only 4 psilocybin to be either the single most meaningful
of 36 did so after methylphenidate (two participants each in experience of his or her life or among the top five most
the first and second sessions). meaningful experiences of his or her life (Fig. 3). In written
Psilocybin
145 90 3 Methylphenidate
Psilocybin
140 85 Methylphenidate
135 80 2
130 75
125 70 1
120 Psilocybin 65
Methylphenidate
115 60 0
0 30 60 90 120 180 240 300 360 0 30 60 90 120 180 240 300 360 0 30 60 90 120 180 240 300 360
Minutes Minutes Minutes
Fig. 1 Within-session time-course of psilocybin and methylphenidate significant difference (Tukey HSD) from pre-administration of the
effects. Blood pressure (systolic and diastolic) and monitor ratings drug (time 0). The figure shows that, compared to methylphenidate,
(mean of overall drug effect) as a function of time since capsule psilocybin produced modestly higher elevations in blood pressure but
ingestion (time 0=before drug administration). Data points are means substantially higher monitor rating of overall drug effect
with brackets showing ±1 SEM (N=30) Filled data points indicate a
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page9
*****************************************************************************************************
Psychopharmacology
MINUTES (TOTAL)
PEAK SCORE
70
PEAK SCORE
2 2
* *
60
1 * 1
50
0 40 0
Methp Psilocybin Methp Psilocybin Methp Psilocybin
*
PEAK SCORE
PEAK SCORE
PEAK SCORE
2 2 2 *
*
1 1 1
0 0 0
Fig. 2 Monitor ratings during sessions. Bars are mean ratings with 1 SEM shown in brackets (N=30). Asterisks indicate a significant difference
between the methylphenidate (Methp) and psilocybin conditions. Maximum possible rating=4
comments, the volunteers judged the meaningfulness of the After methylphenidate, in contrast, 8% of volunteers rated
experience to be similar, for example, to the birth of a first the experience to be among the top five (but not the
child or death of a parent. Thirty-three percent of the single most) spiritually significant experiences. Seventy-
volunteers rated the psilocybin experience as being the nine percent of the volunteers rated that the psilocybin
single most spiritually significant experience of his or her experience increased their current sense of personal well
life, with an additional 38% rating it to be among the top being or life satisfaction “moderately” (50%) or “very
five most spiritually significant experiences. In written com- much” (29%), in contrast to 17 and 4%, respectively,
ments about their answers, the volunteers often described after methylphenidate. No volunteer rated either the
aspects of the experience related to a sense of unity without psilocybin or methylphenidate experience as having
content (pure consciousness) and/or unity of all things. decreased their sense of well being or life satisfaction.
Table 3 Volunteer ratings on two mystical experience questionnaires completed 7 h after drug administration
Data are mean scores with one SEM shown in parentheses (N=30)
N.S. not significant
a
For States of Consciousness Questionnaire, data are expressed as a proportion of the maximum possible score
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page10
*****************************************************************************************************
Psychopharmacology
Table 4 Volunteer ratings and community observer ratings completed 2 months after sessions
Persisting Effects Questionnaire Positive attitudes about life and/or self and/or self 22.8 (4.5) 55.0 (5.0) <0.001
(volunteer ratings)a Negative attitudes about life and/or self 0.3 (0.1) 0.5 (0.3) N.S.
Positive mood changes 16.0 (3.5) 39.2 (5.3) <0.001
Negative mood changes 0.6 (0.5) 1.5 (0.7) N.S.
Altruistic/positive social effects 17.3 (4.4) 46.6 (5.5) <0.001
Antisocial/negative social effects 0.3 (0.2) 0.7 (0.5) N.S.
Positive behavior changes 29.2 (6.5) 60.0 (4.8) <0.001
Negative behavior changes 1.7 (1.2) 0 (0) N.S.
How personally meaningful was the experience? 3.42 (0.35) 6.54 (0.22) <0.001
How spiritually significant was the experience? 2.63 (0.22) 4.79 (0.26) <0.001
Did the experience change your sense of well +0.79 (0.18) +2.04 (0.17) <0.001
being or life satisfaction?
Community observer ratings of changes in Positive change score −0.03 (0.68) 2.42 (0.70) <0.01
participants’ behavior and attitudesb
Personality and affect None of the factors on the two did not decrease after the second session in the group that
widely used questionnaires assessing five factors of received psilocybin on the first session.
personality (NEO and PI-R) and measures of general
positive and negative affect (PANAS-X) was differentially Community observer ratings of changes in participants’
affected by psilocybin. At screening and at 2 months after and behavior and attitudes Table 4 shows that, compared
session 1, there were no significant differences between the to methylphenidate, psilocybin sessions were associated
group that received psilocybin on the first session (N=15) with small but significant positive changes in the par-
and the group that received methylphenidate on the first ticipants’ behavior and attitudes.
session (N=15). Furthermore, within the latter group, there
were no significant changes from post-session 1 to post- Fear, anxiety/dysphoria, and ideas of reference/paranoia
session 2.
According to monitor ratings, post-session ratings and
Lifetime assessment of mystical experience and spirituali- written comments by the monitors and the participants,
ty Two additional questionnaires completed 2 months after and post-session interviews with the participants, many
each session provided lifetime measures of mystical participants reported mild or moderate anticipatory anxiety
experiences (Mysticism Scale) and spirituality (Spiritual at the beginning of sessions. In post-session ratings, 11 of
Transcendence Scale). As with the measures of personality the 36 total volunteers after psilocybin and none after
and affect, there were no significant differences at screening methylphenidate rated on the States of Consciousness
between the group that received psilocybin on the first Questionnaire their “experience of fear” sometime during
session (N=15) and the group that received methylpheni- the session to be “strong” or “extreme.” Four volunteers (all
date on the first session (N=15). As shown in Fig. 4, at of whom had high post-session fear ratings) reported that
2 months after the first session, lifetime mystical experience their entire session was dominated by anxiety or unpleasant
and spiritual transcendence scores were significantly higher psychological struggle (i.e., dysphoria). Four others (again,
in the group that received psilocybin on the first session all of whom had high post-session fear ratings) reported
than the group that received methylphenidate on the first that a significant portion of their session was characterized
session. At 2 months after the second session, the scores in by anxiety/dysphoria. Although the onset of episodes of
the group that received psilocybin on the second session notable anxiety/dysphoria was most likely to occur shortly
increased significantly on both measures. As expected, after onset of drug effect, there were occasions on which
because these scores reflect lifetime measures, these scores onset occurred later in the session when drug effects were
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page11
*****************************************************************************************************
Psychopharmacology
Once a Year
Once a Month
Psilocybin
Once a Week Methylphenidate
Everyday Experience
0 10 20 30 40 50 60
Percentage of Volunteers
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page12
*****************************************************************************************************
Psychopharmacology
190
Methp 1st Psil 1st Methp 1st Psil 1st
Psil 2nd Methp 2nd Psil 2nd Methp 2nd
2 Months after 1st Session 2 Months after 2nd Session
*
110 *
105
100
95
90
Methp 1st Psil 1st Methp 1st Psil 1st
Psil 2nd Methp 2nd Psil 2nd Methp 2nd
2 Months after 1st Session 2 Months after 2nd Session
Rigorous attempts to prospectively experimentally manip- 30 mg psilocybin (ten participants) or 200 mg nicotinic acid
ulate such experiences have generally been associated with (ten participants) in a group setting during a religious
only modest effects (e.g., Hood et al. 1990; Spilka et al. service (the Good Friday Experiment, Pahnke 1963; 1967;
2005). Although there are anecdotal reports from the Doblin 1991). The participants who received psilocybin
clinical research in the 1960s of hallucinogens occasioning showed significant elevations on the Pahnke Mystical
religious experiences, even when administered in a secular Experience Questionnaire and reported positive changes in
setting (Smith 1964; Masters and Houston 1966; Dobkin de attitudes and behavior at 6 months and at 25-year follow-
Rios and Janiger 2003), a systematic study of such effects up. Those results are consistent with the present study,
has been almost nonexistent. The most relevant study was which also demonstrated sustained increases on two closely
one in which theological seminary students received either related outcome measures (Pahnke–Richards Mystical
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page13
*****************************************************************************************************
Psychopharmacology
Experience Questionnaire and Persisting Effects Question- the novelty of the experience in hallucinogen-naïve individ-
naire). Significant limitations of the Pahnke study were that uals enhanced both the intensity and the personal and
the participants were explicitly told that some would spiritual significance of the experience.
receive psilocybin and some would be controls, and that it An important finding of the present study is that, with
was conducted in a group setting. These features resulted in careful volunteer screening and preparation and when
the double-blind being quickly broken during the session, sessions are conducted in a comfortable, well-supervised
which presumably contributed to the assessed differences setting, a high dose of 30 mg/70 kg psilocybin can be
between the groups (Doblin 1991; Wulff 1991; Smith administered safely. It is also noteworthy that, despite
2000). The present study represents an important extension of meetings and prior sessions with monitors ranging from
the Pahnke study using better blinding and comparison 8 h (when psilocybin was administered on the first session)
control procedures, assessment of effects in individual up to 24 h (when psilocybin was administered on the third
participants unconfounded by group interactions, empirically session) of contact time, 22% (8 of 36) of the volunteers
validated measures of mystical experience (the Mysticism experienced a period of notable anxiety/dysphoria during the
Scale and the Spiritual Transcendence Scale), and assessment session, sometimes including transient ideas of reference/
of effects by community observers. The credibility of the paranoia. No volunteer required pharmacological interven-
blinding procedure is reflected in the facts that the debriefing tion and the psychological effects were readily managed with
interviews with the monitors at the end of the study indicated reassurance. The primary monitor remained accessible via
that they remained unaware of the study design and that some beeper/phone to each volunteer for 24 h after each session,
volunteers rated their experience during the methylphenidate but no volunteer called before the scheduled follow-up
session as being among the most personally meaningful meeting on the next day. The 1-year follow-up is ongoing
experiences of their lives (Fig. 3). but has been completed by most volunteers (30 of 36). In
The proportion of volunteers who fulfilled Pahnke’s criteria that follow-up, an open-ended clinical interview reflecting
for having a “complete” mystical experience (61%, 22 of 36) on the study experiences and current life situation provides a
is somewhat higher than the 30–40% reported by Pahnke in clinical context conducive to the spontaneous reporting of
the Good Friday Experiment (cf. Pahnke 1967, p 67). It seems study-associated adverse events. To date, there have been no
likely that the greater preparation time (at least 8 versus 3 h in reports of persisting perceptional phenomena sometimes
the Pahnke study) and the differences in context (individual attributed to hallucinogen use or of recreational abuse of
sessions with an eye mask and music in an aesthetic room hallucinogens, and all participants appear to continue to be
verses the Pahnke study conducted in a group setting with 30 high-functioning, productive members of society.
individuals, some of whom were acting bizarrely) likely The results of the present study have implications for
contributed to this difference. The present study provides no understanding the abuse of hallucinogens. Although psilo-
evidence that preparation beyond that given before the first cybin is regulated by the federal government under the
session produced an increase in the incidence of a mystical most restrictive category (Schedule I) of the Controlled
experience (i.e., on the first, second, and third session, Substances Act, the National Institute on Drug Abuse
respectively, 67, 60, and 50% of participants who received (2001, 2005) does not consider psilocybin and the other
psilocybin met the criteria for a complete mystical experi- classical hallucinogens to be drugs of “addiction” because
ence) or a decrease in the incidence of anxiety/dysphoria. they do not produce compulsive drug-seeking behavior as
The extent to which the study population limits the do classic addicting drugs such as cocaine, amphetamine,
generalizability of the results is unknown. The participants in heroin, and alcohol. This conclusion is consistent with
this study were hallucinogen-naïve, well educated, psycho- observations that psilocybin and other classic hallucinogens
logically stable, and middle-aged adults, who reported do not maintain reliable drug self-administration in animal
regular participation in religious or spiritual activities. In laboratory models of drug abuse (Griffiths et al. 1980;
particular, it seems plausible that the religious or spiritual Fantegrossi et al. 2004) and that most recreational users of
interest of the participants may have increased the likelihood classical hallucinogens decrease or stop their use over time
that the psilocybin experience would be interpreted as (National Institute on Drug Abuse 2001). In the present
having substantial spiritual significance and personal mean- study, psilocybin did not produce a classic euphorigenic
ing. It is also unknown how the hallucinogen-naïve status of profile of effects: measures of anxiety and dysphoria
the participants affected either the intensity or qualitative (monitor ratings of anxiety: AIA scale on the APZ
interpretation of the experience. Recruiting volunteers Questionnaire, LSD scale on the ARCI) were significantly
without histories of use avoided the problem of participant greater after psilocybin than after methylphenidate. How-
selection bias in which individuals who had previously had ever, the present study also shows that, in some people
positive experiences with hallucinogens would have been under some conditions, psilocybin can occasion experien-
most likely to participate. However, it is also possible that ces that are rated as highly valued. This seems a likely
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page14
*****************************************************************************************************
Psychopharmacology
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page15
*****************************************************************************************************
Psychopharmacology
Leuner H (1981) Halluzinogene psychische grenzzustande in for- Richards WA, Rhead JC, DiLeo FB, Yensen R, Kurland AA (1977)
schung und psychotherapie. Hans Huber, Bern The peak experience variable in DPT-assisted psychotherapy
Malitz S, Esecover H, Wilkens B, Hoch PH (1960) Some observations with cancer patients. J Psychedelic Drugs 9:1–10
on psilocybin, a new hallucinogen, in volunteer subjects. Compr Rinkel M, Atwell CR, Dimascio A, Brown J (1960) Experimental
Psychiatry 1:8–17 psychiatry. V. Psilocybine, a new psychotogenic drug. N Engl J
Martin WR, Sloan JW, Sapira JD, Jasinski DR (1971) Physiologic, Med 262:295–297
subjective, and behavioral effects of amphetamine, methamphet- Roberts TB (2001) Psychoactive sacramentals: essays on entheogens
amine, ephedrine, phenmetrazine, and methylphenidate in man. and religion. Council on Spiritual Practices, San Francisco, CA
Clin Pharmacol Ther 12:245–258 Rosenberg DE, Isbell H, Miner EJ, Logan CR (1964) The effect of N,
Masters REL, Houston J (1966) The varieties of psychedelic N-dimethyltryptamine in human subjects tolerant to lysergic acid
experience. Holt Rinehart & Winston, New York diethylamide. Psychopharmacologia 5:217–227
Metzner R (2004) Teonanacatl: sacred mushroom of visions. Four Rush CR, Kollins SH, Pazzaglia PJ (1998) Discriminative-stimulus
Tree, El Verano, CA and participant-rated effects of methylphenidate, bupropion,
Metzner R, Litwin G, Weil G (1965) The relation of expectation and and triazolam in D-amphetamine-trained humans. Exp Clin
mood to psilocybin reactions: a questionnaire study. Psychedelic Psychopharmacol 6:32–44
Rev 5:3–39 Smith H (1964) Do drugs have religious import? J Philos 61:517–530
National Institute on Drug Abuse (2001) Hallucinogens and dissocia- Smith H (2000) Cleansing the doors of perception: the religious
tive drugs. National Institute on Drug Abuse research report significance of entheogenic plants and chemicals. Tarcher/
series, NIH publication, volume 01-4209 Putnam, New York
National Institute on Drug Abuse (2005) LSD NIDA infofacts. Spilka B, Hood RW, Hunsberger B, Gorsuch R (2005) The
National Institute on Drug Abuse, Rockville, MD, February 2005 psychology of religion: an empirical approach, 3rd edn. Guilford,
Pahnke W (1963) Drugs and mysticism: an analysis of the relationship New York
between psychedelic drugs and the mystical consciousness. Ph.D. Stace WT (1960) Mysticism and philosophy. Lippincott, Philadelphia
thesis, Harvard University Stamets P (1996) Psilocybin mushrooms of the world: an identification
Pahnke WN (1967) LSD and religious experience. In: DeBold RC, guide. Ten Speed, Berkeley, CA
Leaf RC (eds) LSD man & society. Wesleyan University Press, Stolaroff MJ (2001) A protocol for a sacramental service. In: Roberts
Middletown, CT, pp 60–85 TB (ed) Psychoactive sacramentals: essays on entheogens and
Pahnke WN (1969) Psychedelic drugs and mystical experience. Int religion. Council on Spiritual Practices, San Francisco, CA
Psychiatry Clin 5:149–162 Strassman RJ, Qualls CR, Uhlenhuth EH, Kellner R (1994) Dose–
Piedmont RL (1999) Does spirituality represent the sixth factor of response study of N, N-dimethyltryptamine in humans. II.
personality? Spiritual transcendence and the five-factor model. Subjective effects and preliminary results of a new rating scale.
J Person 67:985–1013 Arch Gen Psychiatry 51:98–108
Piedmont RL (2005) Aspires assessment of spirituality and religious Turek IS, Soskin RA, Kurland AA (1974) Methylenedioxyamphet-
sentiments. Technical Manual, Loyola College in Maryland, amine (MDA) subjective effects. J Psychedelic Drugs 6:7–14
Columbia, MD Vollenweider FX, Vollenweider-Scherpenhuyzen MFI, Babler A,
Piedmont RL (2006) Cross-cultural generalizability of the Spiritual Vogel H, Hell D (1998) Psilocybin induces schizophrenia-like
Transcendence Scale to the Philippines: spirituality as a universal. psychosis in humans via a serotonin-2 agonist action. Neuroreport
Ment Health Relig Cult (In press) 9:3897–3902
Piedmont RL, Leach MM (2002) Cross-cultural generalizability of the Wasson RG (1980) The wondrous mushroom: mycolatry in Meso-
spiritual transcendence scale in India. Am Behav Sci 45:1886–1899 america. McGraw-Hill, New York
Presti DE, Nichols DE (2004) Biochemistry and neuropharmacology Watson D, Clark LA (1994) The PANAS-X manual for the positive
of psilocybin mushrooms. In: Metzner R, Darling DC (eds) and negative affect schedule—expanded form. The University of
Teonanacatl. Four Trees, El Verano, CA, pp 89–108 Iowa, Iowa City, Iowa
Riba J, Rodriguez-Fornells A, Strassman RJ, Barbanoj MJ (2001) Watson D, Clark LA (1997) Measurement and mismeasurement
Psychometric assessment of the Hallucinogen Rating Scale. Drug of mood: recurrent and emergent issues. J Pers Assess 68:
Alcohol Depend 62:215–223 267–296
Richards WA (1975) Counseling, peak experiences and the human Wolbach AB Jr, Miner EJ, Isbell H (1962) Comparison of psilocin
encounter with death: an empirical study of the efficacy of DPT- with psilocybin, mescaline and LSD-25. Psychopharmacologia
assisted counseling in enhancing the quality of life of persons 3:219–223
with terminal cancer and their closest family members. Ph.D. Wulff DM (1991) Psychology of religion; classic and contemporary
thesis, Catholic University of America, Washington, DC views. Wiley, New York
*****************************************************************************************************
NEWS EMBARGOED FOR RELEASE UNTIL 12:01 a.m. ET, Tuesday 11 July 2006 - Page16
*****************************************************************************************************