Potential Benefits of Psilocybin for Lupus Pain: A Case Report

A 67-year-old man with lupus and chronic joint pain unrelieved by standard treatments experienced dramatic, lasting pain relief after a single 6-gram dose of psilocybin mushrooms. Twelve months later, he remained free of debilitating joint pain. The authors suggest that psilocybin's activation of serotonin-2A receptors may disrupt neural pathways associated with chronic pain and promote neuroplastic changes, though this mechanism is not fully understood. This is the first reported case of psilocybin benefiting lupus-related pain, and the authors call for further research on macro-dosing psilocybin for this condition.

Study at a glance

Abstract

Introduction: Outcomes of treatment for patients with Lupus have shown overall improvement and benefit from the more aggressive use of immunosuppressants and biological agents through a treat-to-target approach. However, chronic musculoskeletal pain can be refractory to treatment despite the use of non-steroidal anti-inflammatory drugs, corticosteroids, and other analgesic agents, leading to patient dissatisfaction. The concept of new neural pathways from psilocybin usage has been proposed in a variety of pain syndromes; however, it is not trialed for patients with Lupus pain. Case Presentation: The patient was a 67-year-old male with positive anti-dsDNA antibody Lupus with a predominance of chronic polyarticular joint pain treated with hydroxychloroquine and non-steroidal anti-inflammatory drugs without pain relief. Pain dramatically improved after a one-time macro-dosing of 6 grams of Psilocybin cubensis in Oregon, which he expected would only provide a sense of enlightenment. After 12 months, he continued without debilitating joint pain. Conclusion: The serotonin-2A receptor’s activation triggers an array of neurophysiological reactions that disrupt the functional connections in areas of the brain that are associated with chronic pain. These neuroplastic effects can generate healthy connections, resulting in long-lasting pain relief. However, this is a process that has not been fully analyzed. While there is anecdotal evidence to suggest the therapeutic benefits for autoimmune diseases, including rheumatoid arthritis and psoriasis, there is no specific research that explores its use for lupus-related pain. Since this is the first case that shows the benefit of psilocybin in a patient with Lupus, further studies on macro-dosing psilocybin to treat Lupus pain are warranted.