Managing Medical Risk in Patients Seeking Psilocybin Therapy with Reid Robison, MD, MBA
In this episode of the Psychedelic Medicine Podcast, Dr. Reid Robison joins to discuss managing medical risk in patients seeking psilocybin therapy. Dr. Robison is a board-certified psychiatrist and Chief Clinical Officer at Numinus, overseeing the company's psychedelic and mental health services across the US and Canada. He has led over 200 clinical trials in neuropsychiatry, including the MAPS-sponsored MDMA-assisted therapy for eating disorders study, and several other psychedelic studies with psilocybin, LSD and DMT.
In this conversation, Dr. Robison begins by sharing how researchers have been determining guidelines for managing medical risks associated with psilocybin and how this guidance may shift as research continues in real-world settings at larger scales. He also discusses the intricacies of psilocybin’s pharmacokinetics and how the substance interacts with common psychiatric medications such as SSRI antidepressants. In closing, Dr. Robison emphasizes the importance of keeping a close eye on potential psychological risks of psilocybin and other psychedelics, especially amid the excitement stemming from the incredible potential of these medicines.
In this episode:
- The emerging medical indications for psilocybin therapy
- How the research into psilocybin has developed in the past few years
- The pharmacokinetics of psilocybin
- Medication interactions with psilocybin
- Risks of serotonin syndrome
- Absolute vs relative contraindications
- Psilocybin’s effect on QT interval and heart valves
- The Psychedelic Medicine Association’s “Psilcobyin-Informed Clinicians” database comprised of practitioners who have completed the course
Quotes:
“There’s a lot to learn [about the interaction of psilocybin and SSRIs] and it's a little bit unpredictable. And some people anecdotally would say that their SSRI interfered with their trip or diminished the experience and others would say it did not.” [26:22]
“Psychological risks are nontrivial, including the risk of a difficult experience—something that may even need some mental health treatment afterwards, something that may be meaningful, nontrivial for the individual for a while, and can coexist with the mystical experience. And having the most meaningful experience of your life can coincide with the most difficult.” [40:43]
Links:
Course: Managing Medical Risk in Patients Seeking Psilocybin Therapy
Previous episode: Psychedelics for Eating Disorders with Reid Robison