Exploring Psilocybin as a Potential Treatment for Refractory CRPS Pain

Complex Regional Pain Syndrome (CRPS) is a debilitating condition characterized by chronic pain, often following an injury. Traditional treatments frequently fall short, leaving patients in search of alternative therapies. A recent case report published in Clinical Case Reports sheds light on the potential of psilocybin, a naturally occurring psychedelic compound, in alleviating refractory CRPS pain.

Case Overview

The report details the experience of a 54-year-old female patient who developed CRPS following a subacromial decompression surgery in 2003. Despite undergoing various treatments, including spinal cord stimulation and intravenous ketamine infusions, her pain remained unmanageable. In 2023, she turned to psilocybin therapy, consuming doses of 2g, 5.5g, and 3.5g of dried Psilocybe cubensis mushrooms over several days.

Results and Observations

One month post-treatment, the patient's pain levels significantly decreased, as measured by the Brief Pain Inventory (BPI), from a baseline of 4 to 0–1. Additionally, improvements were noted in mood and mental health assessments, including the Montgomery–Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), and Clinician-Administered PTSD Scale (CAPS). Notably, her frequency of falls decreased by 75%, and the intensity and duration of glossodynia attacks reduced by 75%. These positive outcomes persisted for nine months without the need for ketamine therapy.

Discussion

This case underscores the potential of psilocybin as a treatment for CRPS, particularly in cases resistant to conventional therapies. The mechanisms by which psilocybin may alleviate pain are not fully understood but are believed to involve serotonergic pathways and neuroplasticity. Unlike ketamine, which acts as an NMDA receptor antagonist, psilocybin's effects on the 5-HT2A receptor may offer a different approach to managing chronic pain.

The patient's decision to combine psilocybin therapy with adjunctive neuromechanical and neurovisual techniques appears to have contributed to the positive outcomes. This integrated approach highlights the importance of comprehensive treatment strategies in managing complex pain conditions.

Conclusion

While this single case report is promising, it is essential to approach the findings with caution. The study's limitations, including its small sample size and lack of controlled conditions, necessitate further research to establish the efficacy and safety of psilocybin for CRPS. Nonetheless, this report adds to the growing body of evidence suggesting that psychedelics may play a role in chronic pain management.

For more detailed information, refer to the original article: Refractory CRPS pain treated with psilocybin: A case report.