Psilocybin-assisted psychotherapy for Parkinson's disease without depression: A case-report.

A 43-year-old woman with a two-year history of Parkinson's disease who struggled with accepting her diagnosis, anxious rumination, and pessimism received four sessions of high-dose psychedelic-assisted psychotherapy (psilocybin) within one year. The treatment was well tolerated and significantly improved her pessimistic outlook, reduced anxious worries about future disability, and enhanced general well-being. Psychometric scores for depression, anxiety, and optimism improved, though apathy did not change. Motor symptoms remained stable. The patient's greater acceptance of Parkinson's disease allowed her to accept adjustments to her medication. The authors suggest psychedelic-assisted psychotherapy could be a safe, useful option for Parkinson's patients with dispositional pessimism and difficulty accepting their disease, but note that controlled trials are needed to confirm these results.

Study at a glance

Abstract

BackgroundPsychedelic assisted psychotherapy (PAP) can improve treatment-resistant depression. Its usefulness in Parkinson's disease (PD) is unknown. PD patients may have problems adjusting to their chronic progressive neurological disease. A change from emotional avoidance to acceptance has been reported following psilocybin administration in patients with treatment-resistant depression.ObjectiveTo report for the first time the effect of psilocybin in a PD patient.MethodsA non-depressed 43-year-old female with a 2-year history of PD presented with difficulty adjusting to PD, anxious ruminations and pessimism. The patient declined an increase in dopaminergic medication or the introduction of an anxiolytic. Therapeutic patient education was not beneficial. The patient received four sessions of high-dose PAP within one year. Neurological and psychiatric assessments were performed before and at one year follow-up using qualitative interviews and quantitative assessment of motor status, dispositional optimism, depression, anxiety, apathy, and well-being.ResultsPAP was well tolerated. It significantly improved the patient's overall pessimistic outlook on her future and decreased her anxious ruminations and worries about potential handicap due to PD. Her general well-being improved, as well as all psychometric scores except for the apathy scale. Motor status remained unchanged. Better acceptance of PD allowed her to accept pharmacological treatment adjustment.ConclusionsPAP could be a safe and useful treatment for PD patients with dispositional pessimism and difficulties accepting their disease by promoting profound decentration from habitual thoughts and emotions, improving mood and PD acceptance. Randomized, controlled studies are needed to confirm this result.