Improvement in advanced Alzheimer’s disease following high-dose psilocybin

11 hours ago (frontiersin.org)

Highly editorialized title. "Transient multidomain functional improvement in advanced Alzheimer’s disease following high-dose psilocybin-containing mushroom administration: a case report" This is exactly that. A case report. This is not a successful treatment. Far short of that.

  • > We report the case of an octogenarian Japanese-American woman with a 10-year history of Alzheimer’s disease, including 5 years of marked hypofunction and predominantly monosyllabic speech.

    > The patient received 5 g of orally administered psilocybin-containing mushrooms

    > Approximately 19 h post-administration, spontaneous autobiographical speech emerged. Over subsequent days and weeks, functional improvements included restoration of urinary continence, improved ambulation, autonomous dressing, increased emotional responsiveness, sustained social interaction, contextual memory retrieval, preserved working memory for social context, and spontaneous conversational engagement.

    This is exactly that, a treatment using psilocybin that was successful. It's not claiming to have developed a treatment protocol, the title is precise.

I was recently reading about a phenomenon called terminal lucidity, where a person suffering from mental decline such as Alzheimer's spontaneously improves, recognizing loved ones, retrieving memories, and being able to carry on conversations. It's called "terminal" because the person usually dies within hours or days.

If this is a real phenomenon, then it's amazing to think that at least some of the people who suffer from Alzheimer's still have their memories inside their minds, as opposed to the disease erasing the memories from existence, which means that an effective treatment might recover their identities.

https://en.wikipedia.org/wiki/Terminal_lucidity

  • If you have cared for someone with dementia, this isn't so surprising.

    It isn't a monotonic decline with memories disappearing forever. It is like wave upon wave of changing capacity at different time scales. The general trend is deterioration, but there are frequent periods that can almost seem like remission.

    There is a well known daily cycle referred to as "sundowning", where the sufferer tends to come unraveled later in the day. The next morning, they'll be more functional.

    Later in the progression, you can see much higher frequency variations. Like periods of disorientation and confusion interspersed with periods of lucidity all within a single sitting or conversation.

    In those periods of greater lucidity, recall of the past can be more accurate. General listening comprehension, speaking, and logical thought also seem more normal.

    Edit to add: I sometimes wonder if the belief in terminal lucidity is one of those logical fallacies which support lots of superstitions. Are we just fixating on the final wave in this chaotic wave train, and forgetting all the other waves that happened before it? Or is it that more caretakers are engaged and observing these waves towards the end, e.g. because the patient is known to be in the terminal phase..?

  • Same thing happens for other disease. Some kind of last honey moon period where your health improves and often followed by a catastrophic relapse.

    I'm nobody but it makes me feels there's an economic system issue, the body gradually degrades but has the ability one last time to inject a final wave of change to try restore a proper state but the resources are too short and so the attempt cannot sustain itself.

    I wonder if research is happening on this aspect.

    • I’ve heard this is because a lot of symptoms are not from the disease itself but actually side effects of mounting an aggressive immune system response to the underlying condition. Once your body gives up the fight as a lost cause, you will get a burst of relief and restored function from the lack of immune activity but it happens just before total system collapse.

  • i’m skeptical how much of a real thing this is vs particularly type of appealing story to the human psyche

    • It happened to my father, who was suffering a severe mental decline because of hydrocephalus. After weeks of trying to figure out what happened, one day he was sitting in the hospital perfectly fine, talking normally. I remember being so relieved. But then the next day he was back to not knowing anything and being half aware. He died a few weeks later.

      1 reply →

    • Lost my grandfather to it in his late 80's. He did indeed become more responsive and engaged the day (maybe two) before he died, but he was non-verbal at that point. I recalled my mother telling me he was having a surprisingly good day on Sunday and seemed to recognize people, then getting the call from her the following evening that he had passed.

    • I saw it with a family member that had glioblastoma. It was weird, one of the nurses had seen it quite a few times apparently, it's also known as rallying. Family member's situation was similar to sibling comment's family, it wasn't right before death, just in the days and weeks leading up to it. It was like a sudden burst of vitality that came of nowhere, like their condition had dramatically reversed itself.

      I'm sure it's a little different for everyone though.

Psilocybin is one of those things we don't even know the full effects of because the government had a hysterical fit and completely banned it because people who took it were more likely to oppose the Vietnam War.

  • Was that causation though? I have to imagine the kind of people who are open to psychedelics also generally oppose war.

    On the other hand I heard a single dose does permanently increase your trait openness by a standard deviation, which is nuts. So maybe there is causation there too.

    • It definitely wasn't causation, the causation flows the other way (criminalizing a proxy for a political belief as an end run around the first amendment).

  • What’s exciting though is that this administration recently signed an executive order directing the agency to speed up the development and approval process for psychedelics.

    • Yup. Not sure which particular stopped-clock struck right within the generally anti-science MAHA movement but I think everybody is happy to take the win.

      11 replies →

  • >>the government had a hysterical fit and completely banned it because people who took it were more likely to oppose the Vietnam War.

    If you are to believe the Brave New World (https://en.wikipedia.org/wiki/Brave_New_World) worldview of Huxley (who topically was on loads of LSD himself), you'd think the government would want to flood the public with psychedelics -- low to zero toxicity, allows people to zone out, not addictive, allows people to focus inwards rather than focus on civic mismanagement.

    Any ideas on why the US government is so opposed Psychedelics? Clearly the government is for Bread and circus. In fact, the establishment left and right want desperately for us to believe everything is indeed fine regardless of the facts our eyes see (e.g. Annie Lowrey on https://www.theatlantic.com/ideas/2026/05/americans-depresse...)

    • Psychededics are unpredictable. We know the government looked into their use as thought- and behavior-manipulating tools (MKUltra) but the results proved too chaotic. You might get a manchurian candidate...or the unabomber. But most likely just a renewed outlook on life.

      Psyches basically raise the "temperature" (in machine learning parlance) of the brain, increasing crosstalk. This can jostle folks out of a mental rut. But it can also create positive feedback loops of upheaval.

      Soma would only work as it did in BNW if society controlled essentially all sources of information - which is essentially the whole premise.

  • Psilocybin is harder to get research approvals for than many things, but it’s not “completely banned”. There are studies every year being completed with psilocybin, many of which get posted here on HN.

    There is a growing tension between the extraordinary pop culture claims of psilocybin curing everything (now extending to Alzheimer’s due to this 1 low-quality report from Brazil) and the actual studied effects, though. A lot of the published outcomes are surprisingly low quality, like this case report or all of the studies that neglect to include a control group. Mental health studies without a control group are basically useless because even a control group that doesn’t receive a placebo (that is, people you simply monitor and interact with) will get better.

    Just look at this comment section: People raising suspicions about the obvious problems in the study are being downvoted. The top voted comments are citing a Joe Rogan podcast with a guy hyping his startup. People really, really want to believe this is a magic cure and the usual guardrails of suspicion for extraordinary claims are seemingly suspended for this one topic.

    • When you take it, you understand, that if taken with the right approach it can lead to profound insights in changing your life and the effects described: helping with depression, addiction and accepting death are not far fetched at all. Yet it can also, if not guided or done on someone with anxiety have the opposite effect.

      The more biological effects I agreed are not conclusion that can be drawn from that.

      5 replies →

    • > A lot of the published outcomes are surprisingly low quality, like this case report or all of the studies that neglect to include a control group. Mental health studies without a control group are basically useless because even a control group that doesn’t receive a placebo (that is, people you simply monitor and interact with) will get better.

      Honest question, does a control group really matter that much when it's not possible to do a blinded study? Unless it's some incredibly small microdose, I would assume most study participants are able to tell if they're tripping or not.

    • In defense of the comment you replied to: Research into treatments with Psilocybin or LSD was in quite a hiatus for decades after the substances were banned in the 1960s or 70s.

      4 replies →

    • >There is a growing tension between the extraordinary pop culture claims of psilocybin curing everything (now extending to

      That's the playbook that got marijuana (more or less) legalized. So of course they're going to use the same exact strategy with each drug in turn.

This exact case study came up on a recent Rogan episode with Dean Radin, PhD. While the result is very interesting and perhaps illuminating about the unexpected biological mechanisms, apparently the effects were very short lived.

Even more interesting, Dr. Radin discussed one of his companies is working on a new drug that uses the same brain receptors as psilocybin, that has the potential to induce similar effects (with no psychedelic side effects) with a nasal delivery system that crosses directly into the brain. The benefit of that, he says, is the effect would last for much longer, months perhaps, and patients would only have to take it a few times per year.

  • I am immediately skeptical of anyone who goes on Rogan's show. Looking him up the guy has a PhD in education psychology, and his masters was in electrical engineering. I'm curious how much expertise he truly has on the subject and whether this was just spin for his company's work vs the natural option of psilocybin.

    Not that I doubt the benefit of a non-psychoactive treatment. Just the adjacency of this idea to Rogan makes me immediately suspicious.

    • I’m a skeptical person to, you should be skeptical, it’s healthy! I just find guys like this super interesting and it was a really fun listen.

      He talked about how his whole career he just followed whatever was most interesting to him at the time, hence the different disciplines. He also talked about programs he ran at universities where he was in charge of bringing different disciplines together & the challenges of that since academia is incredibly siloed. Departments don’t talk to each other.

      So I think people like him are very valuable, since they aren’t afraid to think it if the box, work on taboo subjects like “psychic” abilities, and see the universe in novel ways.

      He mentioned they’ve done trials in mice and chimpanzees with very positive results. I’m not saying it’s some crazy breakthrough or anything, but it’s interesting and something worth keeping an eye on. It sounded also like the killer feature is the nasal delivery tech. I don’t think the are the first ones to study non psychoactive psilocybin like compounds, but the nasal delivery that can cross into the brain directly seemed important.

  • The problem with this study though is that it doesn’t really illuminate anything. Psychedelics restoring the default mode network in the brain is already somewhat understood (*that it happens, not the mechanism of how), so it’s not that strange a temporary reversion of the symptoms of Alzheimer’s would happen.

    And it’s not even suggestive of eg making an actual medicine that could be taken long term, because Alzheimer’s physically destroys your brain. The restorative effect of psychedelics is just a bandage over not understanding why that damage is happening in the first place.

    • And it's a single case which could simply be an anomaly. You'd need a serious controlled study to get any meaningful info about the effectiveness.

      Very curious exactly who made the decision/gave permission to take granny on a shroom trip.

  • What does "the effects were very short lived" mean in this context? If it's hours then it seems useless, but if it's months that is short for us normies that expect to live decades more, but for someone who is 90+ that's a pretty nice percentage that is absolutely acceptable if it just means repeating the treatment.

  • Wow, if that turns out to work, that would alleviate lots of suffering for both the patient and her or his relatives and caretakers.

    This would be pretty amazing.

    • This is crackpot stuff - there's no scientific evidence of any of this, it's pure grifting. The individual cited above has a phd in educational psychology and runs a pseudoscience "institute"

So, I'm not making any accusations or decelerations of "bad science", I've only read the abstract and this isn't my field.

That said, some relevant context here is that:

(1) Case studies are some of the most easily fabricated journal outputs

(2) This is published in Frontiers in Neuroscience, which is listed by some as being a predatory journal [0]. The Frontiers publishers are the fine folk who published an AI generated anatomical figure of a rat that not only was obviously incorrect to anyone you'd stop on the street, it'd give them nightmares [1].

So I'm not saying this paper is bunk, but that I reserve a healthy degree of skepticism pending some clinical trials or replication in animal models.

[0] https://www.predatoryjournals.org/news/list-of-all-frontiers...

[1] https://arstechnica.com/science/2024/02/scientists-aghast-at...

  • They do add:

    > Generative AI statement

    > The author(s) declared that Generative AI was not used in the creation of this manuscript.

    > Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

    Which is good.

    But it makes me wonder about “wherever possible”. In which case wouldn’t it be possible and why would it remain if it’s not possible?

    edits: formatting

  • I would not trust predatoryjournals.org. Beside the site looking much like the worst predatory journals, they have no transparency in who they are and how they evaluate journals. It seems just to be Beall's old list, with some newer things thrown in.

    I'm not saying that Frontiers in Neuroscience is not predatory, but its not a proper argument for it to be predatory, to point to a random list as proof. As Beall couldn't understand being crap publisher is not predatory in it self.

    • That's totally fair, and I'm often reminded not to paint all "Frontiers" journals with the same brush (although it's difficult for me sometimes).

If it was my grandma I would treat her to some shrooms, I've taken them many times and I find them quite safe, I can't see harm in trying. If it would really works I don't know, but I would find value in the experience and consider it safe. Though the challenge would be explaining it to her and potentially dealing with her tripping.

This case report is being shared widely across social media but it’s full of red flags from top to bottom.

It’s a case report (n=1) that a group of 3 people from Brazil wrote up and pushed into the publishing world. The report is full of big words and tables, but barely says anything more than the abstract: It’s basically “an 80 year old Japanese women received mushrooms and was better afterward” expanded with as much medical jargon as they could apply without accidentally getting too specific. No mention of how the Alzheimer’s disease history was documented or diagnosed or even if she was a patient of one of the authors.

I’m surprised how much it’s getting people to let their guard down and accept the result. Normally when studies get posted with only 100 to 500 participants the comments everywhere are full of doubters calling out the small sample size. For some reason this n=1 story written vaguely about extraordinary claims with a complete absence of pre-treatment documentation or standardize testing/scoring hits all the right notes to convince a lot of people that mushrooms can reverse Alzheimer’s disease.

I know it’s something that a lot of people would like to be true, but this is a domain where anyone in the world can make any claims they want and find a journal who will publish it if you pay them. People write and publish papers like this all the time claiming to have treated major diseases in a single patient or group of patients with different drugs or herbs.

  • Sure, It’s a single case study so obviously take it with a grain of salt. Actual scientists understand this. People on social media don’t ands that’s annoying I get it.

    On the other hand, it’s interesting and perhaps illuminating to people working in that field. A field mind you, that has made a little to no progress in decades. Arguments could be made they’ve made some errors and went down the wrong path. It’s a field that could probably use some new ideas.

    • > On the other hand, it’s interesting and perhaps illuminating to people working in that field

      People in medicine or research have seen hundreds of extraordinary case reports like this. They’re everywhere on different topics and they’re not hard to get published.

      They know that extraordinary claims require extraordinary evidence and it’s easy to see that this paper is completely devoid of evidence, just some extraordinary claims written in formal medical language, minus the usual process, methodology, and assessments one would expect in a paper like this.

      1 reply →

Reminder that the American federal government classifies psilocybin as a Schedule I drug "no currently accepted medical use and a high potential for abuse". Along with marijuana. And heroin. Who else but the DEA thinks those three things make sense to put in the same bucket?

Meanwhile fentanyl is Schedule II. The government is often the biggest barrier to psilocybin research despite its positive effects being acknowledged for decades. Depending on the administration (which will sometimes signal they won't actually enforce the law) these research efforts are often terminated, meaning it is often safer/cheaper to just never start them in the first place.

https://www.dea.gov/drug-information/drug-scheduling

https://www.nature.com/articles/nrn3530

https://www.cato.org/blog/trumps-psychedelic-order-speeds-re...

Good riddance - this kind of thing needs to be experimented with more. But 5 grams! This reads like witch doctor science; I’m surprised it passed ethics

  • The Johns Hopkins studies have been administering high doses for 20+ years now. The difference is that they use synthesized psilocybin instead of mushrooms (which makes the dosing more consistent since potency can vary a lot across strains and individual mushrooms).

  • It's not just 5 grams of some random cubensis, it's 5 grams of the enigma strain, which is ridiculously potent.

    • Yeah and when they give it in experiments they also give participants an eye mask, which doesn't allow you to quickly snap back to reality. I enjoy Psilocybin, but that would be scary for me.

  • While it’s a fairly good sized dose, it’s not one that would typically produce a nightmare trip scenario.

    As far as ethics go, I would absolutely sign a document that gives the right for experimentation in the event I become incapacitated to some degree.

    • I wouldn't, or put constraints into it - you may be incapacitated but you may also still be aware, and you wouldn't want to get I-have-no-mouth'd.

    • 5+ grams is considered a "heroic dose", i.e. the one that is needed for ego death and subsequent therapeutic effects.

  • Yeah this story was on HN before a few weeks ago and I raised similar - it’s nuts to give that to someone who probably doesn’t have the mental state to be able to comprehend what is going on. Don’t understand how it is possibly ethical to do.

    Especially with the effects being temporary - can you imagine how awful it must be to regain lucidity outside of your control and then lose it again for the sake of an experiment like this? Awful experiment.

> n=1

> pay to publish journal

> no clear Alzheimers diagnosis ("[...] were considered clinically most compatible with advanced Alzheimer’s disease")

> administration of a heroic dose of street-quality drugs vs. a controlled sample

> no university or hospital affiliation?

Extraordinary claims require extraordinary evidence, hence I remain skeptical

  • I think it’s funny to describe a drug as “street-quality” while using a slang term “heroic dose” in the same sentence.

  • It’s a single case study so obviously take it with a grain of salt. On the other hand, it’s interesting and perhaps illuminating to people working in that field. A field mind you, that has made a little to no progress in decades. Arguments could be made they’ve made some errors and went down the wrong path. It’s a field that could probably use some new ideas.

    • > On the other hand, it’s interesting and perhaps illuminating to people working in that field

      I responded to your other comment with this exact text, but to repeat:

      This paper is not illuminating to people in the field. This is 3 unaffiliated people who paid to publish an anecdote without any supporting evidence. Paid medical journals are full of these.

      Medical professionals know how to spot these claims because they’ve seen a hundred of them over the years that went nowhere. This was published not for the medical establishment, but for news media and social media and maybe to boost the author’s visibility to get funding for something they want to do.

  • That's fair, but research into psychoactive substances remains difficult due to legal constraints; N=1 but it will have piqued interest by others, they may want to repeat the tests on a larger scale.

    That, or individuals will science on the ones they care for. I for one would write something like that down if I were to start developing dementia/alzheimers.

  • Good criticism but be aware that acreditated authors and institutions are a bunch of crooks on the whole who cook their results, do p-hacking to the death, badly document their protocols, don't release their datasets not their analysis, and have no problems getting paid by big pharma and not disclosing it fully. The field is more joke than science at this stage.

    • Yeah, and a cure for cancer exists, but big pharma keeps it in a secret vault because treatments are more profitable than cures /s

      I recently lost a family member to cancer, and had to go through this conspiracy bullshit from evil pieces of shit peddling snake oil to desprate people. Whatever rabbit holes your social media algorithms have led you down aren't healthy, friend. Clear your cookies and go touch grass.

The key are the post-synaptic serotonin receptors. If the drug is able to reach them, these receptors trigger axons making new connections to other neurons.

Psychedelics are one of my favorite classes of drug. I used to take LSD recreationally every few weeks or months, until one bad vomiting episode caused me upper-esophageal sphincter dysfunction somehow. Ever since then, I can't seem to take any without throwing up (and generally having a terrible time due to stomach contents backing up into my throat constantly). Nobody can seem to figure out why my throat stopped working properly all of a sudden or how to fix it. :(

I'm glad that psilocybin research is picking up. I really think its potential benefits deserve to be more widely known and available. Hopefully without the spontaneously appearing dysfunction though

  • >upper-esophageal sphincter dysfunction

    If you've never read a Pulitzer Prize Winner, Confederacy of Dunces would be a personally-relatable disaster (to start with; it's great).

    >Psychedelics are one of my favorite classes of drug.

    Your initial description of usage was probably a bit wreckless, but I do maintain that most people would probably benefit from a single (or few) psilocybin experiences (preferably an initial high-dosage with a well-trained sitter).

    Microdosing is a fantastic long-term strategy, before starting more-prescribed methodologies towards happiness. Probably not useful without an initial high-dosage, first (or much cloudier/ineffective).

    YMMV £¢¢£

    • I certainly have been reckless with it, but it helped me a lot to cope with constant high stress without resorting to more immediately harmful things. It also gave me a lot of nice experiences, unique insight and other things like that. Before this dysfunction started, bad experiences were pretty rare rather than practically every time...

      2 replies →

  • It might be coincidence. Hiatal hernia affects more than 50% of the population over age 50, though not everyone shows symptoms.

    • Ever since that episode I've had difficulty swallowing; sometimes when clearing my throat the air will unexpectedly blow out my mouth instead of my nose; and I also have to be doing that constantly because my throat never actually feels clear now; it sucks.

      I used to be able to swallow gummy bears whole for fun. Or any medication, even huge pills (1g magnesium glycinate, for example -- those pills are not small) -- I didn't even need water. Now, even with water it's hard to swallow any medication, and it's hard to even swallow food half the time. Something definitely went wrong and is now wrong, compared to before.

      1 reply →

Not quite a "successful treatment":

> This case documents transient multidomain functional improvement in advanced Alzheimer’s disease following psilocybin administration. The findings do not imply disease reversal but suggest that residual functional capacity may persist in late-stage neurodegeneration and may become transiently accessible under specific neuromodulatory conditions.

Very interesting nonetheless.

> One month after the initial session, the patient remained continent and functionally improved compared with baseline. A second supervised psilocybin session using 3 g was subsequently performed and was associated with greater verbal expressivity, improved facial mimicry, spontaneous humor, emotionally valenced autobiographical imagery, and increased agility while walking.

> The patient spontaneously stated: “It is pleasant to come here.

This is just wonderful.

  • AFAIK psychedelics are thought to stimulate neurons into connecting with each other more than they normally do - both temporarily (which explains the short-term sensations) and also permanently (they stimulate neuroplasticity).

  • I'd love to see a before / after video of this or similar experiments, I'm really curious. I've seen similar ones for e.g. giving parkinsons' patients a dose of weed.