Dementia is a degenerative disease that, despite decades of research, no known drug can completely stop or reverse.
Now, the historically reviled psychedelic is being seen as a potential new way to manage the symptoms of Alzheimer's disease.
Neuroscientists around the world are beginning to explore whether psilocybin, the psychoactive component of hallucinogenic mushrooms, can help protect the aging brain.
A recent study from Brazil hints at this tantalizing possibility.
The report says that after an 80-year-old patient with advanced Alzheimer's disease took a high dose of psilocybin-containing mushrooms, she temporarily regained bladder control and the ability to speak in more than monosyllables.
Unfortunately, the article, written by neurobiologists from Brazil, lacks details.
However, it does indicate significant improvements in the patient's cognitive and physical functions that persisted for several weeks after taking the drug.
«"These results should not be interpreted as a reversal of Alzheimer's disease pathology," warn the study's authors, led by neurobiologist Marcos Lago of the University of São Paulo.
«"Rather, they raise the question that latent functional capacities may persist during progressive neurodegeneration and become temporarily accessible under certain neuromodulatory conditions.".
In other words, psilocybin may help target areas of the brain affected by dementia, temporarily alleviating symptoms, although this idea remains speculative.
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The experimental treatment with psilocybin was carried out under clinical supervision in Brazil with written informed consent from the patient's legal guardian.
An elderly woman suffering from dementia was initially treated with an incredibly high dose of 5 grams of psilocybin-containing mushrooms, which induced a prolonged state similar to deep sleep.
Before the experimental treatment, the patient could only speak in monosyllables, rarely initiated communication with others, and was highly dependent on assistance to perform basic daily activities.
Approximately 19 hours after ingestion, the woman suddenly began talking to herself. She continued this behavior for several hours.
Over the next few days, the elderly patient reportedly became able to independently control her bladder, dress and walk, and engage in conversation by maintaining eye contact and smiling back.
«"The preservation of urinary control after more than 5 years of chronic urinary incontinence is particularly remarkable given that control depends on integrated interoceptive perception, executive inhibition, and frontoinsular network functioning," write the researchers describing the case, including neurologists Mariana Cerveira and Joe Xavier Simone.
An elderly patient received an incredibly high dose—5 grams of psilocybin-containing mushrooms. (James MacDonald/Bloomberg Creative/Getty Images)
Due to the woman's promising and long-lasting response to psilocybin, she was given an additional 3 grams of mushrooms a month after the first session. This dosage was also strictly controlled.
During the second session, the patient didn't fall asleep but continued to express her thoughts freely. She described emotional scenes, such as surfing with her son on a quiet island.
«"Facial expressiveness, emotional responsiveness, spontaneous humor, and gait agility improved markedly," the case report states.
During the second session, the woman, without any prompting, said, «I enjoy coming here.».
It's important to note that the researchers in Brazil did not track the woman's sleep or brain activity during her trip, nor did they use standardized cognitive scales to assess her cognitive state.
«"This report should be understood primarily as a detailed description of observations intended to formulate hypotheses for future controlled studies," the authors write.
«"A systematic investigation is needed," they add.
Researchers around the world are already studying the effects psilocybin might have on older people with cognitive impairment or mental illness.
A recent study of more than 3,000 US adults aged 42 to 92 found that those who reported using hallucinogens in the past year had fewer depressive symptoms and also showed more favorable changes in certain brain functions.
The first clinical trials of psilocybin showed that just a single dose of 25 mg can cause lasting changes in the brain. But this is very small compared to what the elderly woman in Brazil took.
Its recreational dose is known as a "heroic dose." Such doses of psilocybin are said to be life-changing, though not without risks.
«"The chosen mushroom dose was relatively high compared to dosing approaches commonly used in contemporary clinical trials and was chosen based on previous observations of the depth and duration of neurobehavioral effects induced by psychedelics," the authors explain in the case study.
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Future randomized clinical trials are needed to determine whether psilocybin is truly capable of enhancing brain function, and to determine the safest and most effective dose.
In fact, one pilot study has already begun on cognitive impairment. It is evaluating whether psilocybin, administered under specialist supervision, can reduce depression and improve quality of life in people with mild cognitive impairment or early-stage Alzheimer's disease.
On the topic: Psilocybin "restored" the brains of rats after mild traumatic brain injury.
«"In certain patient populations, psilocybin is very useful for reducing depression, reducing anxiety, and improving quality of life," explained neuroscientist Albert Garcia-Romeu, who studies psychedelic therapies at Johns Hopkins University, in 2023.
«"These kinds of benefits could be really helpful for people with Alzheimer's disease.".
Only time will tell. Many dementia drugs have shown great promise but failed in clinical trials.
Perhaps with psilocybin it will be different.
The results of the study were published in the journal Frontiers in Neuroscience.
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