Psilocybin and chronic neuropathic pain: a systematic review

David S. Jevotovsky, Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, New York, USA.
Harman Chopra, Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Daniel J. Pak, Anesthesiology, Weill Cornell Medical College, New York, New York, USA.
Shravani Durbhakula, Anesthesiology, Pain Medicine Division, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Alexander Shustorovich, Physical Medicine & Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, New Jersey, USA.
Tanya Juneja, Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mustafa Y. Broachwala, Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Tariq AlFarra, Interventional Spine & Pain, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Caroline Silver, Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, New York, USA.
Greg Kreitzer, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Philip Oreoluwa, Psychiatry, Cooper University Health Care, Camden, New Jersey, USA.
Braden B. Weissman, Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, New York, USA.
Abraham AlFarra, Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA.
Brian G. Mayrsohn, Pain Medicine, Maywell Health, New York, New York, USA.
Vwaire Orhurhu, Anesthesiology, Pain Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Trent Emerick, Anesthesiology, Pain Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Timothy Furnish, Division of Pain Medicine, University of California San Diego, San Diego, California, USA.
Joel P. Castellanos, Division of Pain Medicine, University of California San Diego, San Diego, California, USA jcastellanos@health.ucsd.edu.

Document Type

Journal Article

Publication Date

11-5-2025

Journal

Regional anesthesia and pain medicine

Volume

50

Issue

11

DOI

10.1136/rapm-2024-105532

Keywords

CHRONIC PAIN; Complementary Therapies; ETHICS; Neuralgia; Pain Management

Abstract

BACKGROUND/IMPORTANCE: Chronic pain affects many people globally, requiring alternative management strategies. Psilocybin is gaining attention for its potential in chronic pain management despite being classified as Schedule I. OBJECTIVE: This systematic review critically evaluates the evidence for psilocybin, a Schedule I substance, in the treatment of chronic pain. The exact purpose of the review is to assess the impact of psilocybin on chronic pain relief, focusing on dosing protocols, treated conditions, and patient outcomes. EVIDENCE REVIEW: A comprehensive review of PubMed, CINAHL, Web of Science, Cochrane Library, and EMBASE was conducted up to January 2024. Eligibility criteria included studies evaluating psilocybin for chronic pain management. The risk of bias was assessed using the MASTER (MethodologicAl STandards for Epidemiological Research) scale, and the strength of evidence was graded using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). FINDINGS: The review identified 28 relevant studies focusing on dosing, treated conditions, and outcomes. The majority of the included studies (76.2%) were of low or very low quality. Several studies with moderate-to-low-quality evidence utilized a 0.14 mg/kg dosing protocol. The findings suggest promise for the use of psilocybin in chronic pain relief, though the quality of evidence is generally low. CONCLUSIONS: The current research shows potential for psilocybin as a treatment option for chronic pain relief. However, methodological issues and a lack of high-quality evidence underscore the need for further investigations with standardized protocols. Despite these limitations, the potential for psilocybin in chronic pain management is encouraging. PROSPERO REGISTRATION NUMBER: CRD42023493823.

Department

School of Medicine and Health Sciences Student Works

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