Psilocybin in neuropsychiatry: A review of its pharmacology, safety, and efficacy

Seetal Dodd, Trevor R. Norman, Harris A. Eyre, Stephen M. Stahl, Arnie Phillips, André F. Carvalho, Michael Berk

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Psilocybin is a tryptamine alkaloid found in some mushrooms, especially those of the genus Psilocybe. Psilocybin has four metabolites including the pharmacologically active primary metabolite psilocin, which readily enters the systemic circulation. The psychoactive effects of psilocin are believed to arise due to the partial agonist effects at the 5HT2A receptor. Psilocin also binds to various other receptor subtypes although the actions of psilocin at other receptors are not fully explored. Psilocybin administered at doses sufficient to cause hallucinogenic experiences has been trialed for addictive disorders, anxiety and depression. This review investigates studies of psilocybin and psilocin and assesses the potential for use of psilocybin and a treatment agent in neuropsychiatry. The potential for harm is also assessed, which may limit the use of psilocybin as a pharmacotherapy. Careful evaluation of the number needed to harm vs the number needed to treat will ultimately justify the potential clinical use of psilocybin. This field needs a responsible pathway forward.

Original languageEnglish (US)
Pages (from-to)416-426
Number of pages11
JournalCNS spectrums
Issue number4
StatePublished - Aug 11 2023


  • Psilocybin
  • adverse events
  • anxiety
  • depression
  • neuroscience
  • posttraumatic stress disorder
  • psychiatry
  • safety
  • treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health


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