What are the risks of psilocybin use during pregnancy?

From the Guidelines

Psilocybin use during pregnancy should be avoided due to the potential risks to fetal development and the lack of research on its safety and efficacy in this context. The current evidence, as noted in the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline 1, does not support the use of psilocybin for therapeutic purposes outside of clinical trials, highlighting concerns about psychotic events, harmful behaviors, and potential dependence. Given the limited understanding of how psilocybin affects pregnancy, it is prudent to prioritize caution.

Key Considerations

• The potential for psilocybin to impact fetal brain development by altering brain chemistry through serotonin receptor binding is a significant concern.
• The placenta's inability to fully protect the fetus from substances consumed by the mother increases the vulnerability of developing organs and neural systems to chemical influences.
• Established treatments for conditions like depression or anxiety, such as certain approved medications, therapy, or mindfulness practices, offer better-understood safety profiles during pregnancy.

Recommendations

• If pregnant or planning to become pregnant, individuals considering psilocybin for mental health reasons should consult with their healthcare provider about safer, evidence-based alternatives.
• Discontinuation of psilocybin use upon discovery of pregnancy is advised, with discussion of this use at the next healthcare provider appointment.
• Healthcare providers should guide patients in preparing for and undergoing treatment with psilocybin, if considered in a clinical trial setting, emphasizing the importance of supportive psychotherapy throughout the treatment process, as noted in the study 1.

Evidence Basis

The guideline recommends against the use of psilocybin, MDMA, cannabis, or other unapproved pharmacologic agents in settings outside clinical trials 1, underscoring the need for rigorous research to establish safety and efficacy before such substances can be considered for therapeutic use during pregnancy.

From the Research

Risks of Psilocybin Use During Pregnancy

There are no direct research papers to assist in answering this question. However, some studies provide information on the use of psychotropic medications during pregnancy:

• The use of psychotropic medications during pregnancy can pose risks to the fetus, such as increased risk of spontaneous miscarriage, preterm birth, and cardiac malformations 2.
• Antipsychotic medications, which are sometimes used to treat similar conditions, have been studied in pregnancy and may increase the risk of gestational diabetes, neonatal respiratory distress, and withdrawal symptoms 3.
• Psilocybin has been studied as a treatment for depression and anxiety, but its safety and efficacy in pregnancy are unknown 4, 5, 6. Some key points to consider:
• Psilocybin is a serotonin receptor agonist that can have psychedelic effects 4.
• The therapeutic potential of psilocybin for treating depression and anxiety has been explored in several studies, but none of these studies have focused on its use during pregnancy 4, 5, 6.
• More research is needed to understand the safety and efficacy of psilocybin in various populations, including pregnant women 4, 5, 6.