The Psilocybin Strips Changing Medicine
The promise of psychedelics glows brighter with every research breakthrough. Take for instance MDMA therapy for patients with PTSD, or microdosing psilocybin to combat depression and anxiety. And remember when Canada allowed psilocybin use for end-of-life care?
There’s also the flurry of huge, well-respected universities launching their own hubs for psychedelic research, namely UC Berkeley’s Center for the Science of Psychedelics last month, Johns Hopkins’ 2019 opening, and NYU Langone Health’s own upcoming division, all in search of psychedelic medicine’s next big discovery.
Exciting news, right? Wait till you hear about Cybin’s new crusher: a high-dose psilocybin film strip that melts in your mouth… quite literally. These are the psilocybin strips changing medicine…
Oral vs. Sublingual Intake of Psilocybin
Cybin Corporation has partnered with IntelGenx , an oral drug delivery tech company, to make Psilotonin™ — the first-ever quick-dissolving strips with pharmaceutical-grade psilocybin. The 25mg psilocybin film strips are designed to be sublingual (or placed “under the tongue”) unlike most clinical trials and psychedelic therapies that use capsules.
Via the standard route of administration, psilocybin needs to pass through the digestive system so it can turn into psilocin – the bioactive compound which acts on the brain’s “happy hormone” receptors.
(Side note: This is why it usually takes at least 30 minutes for a trip to materialise. Now you know!)
It’s also worth noting that 50-60% of a 25mg dose is lost when taken orally, which means it never enters the bloodstream… or reaches the brain, for that matter. This is because a large chunk of the psilocin is first metabolised in the liver — not in the mouth or the stomach.
On the other hand, when a psilocybin film strip melts under your tongue, it can skip the usual route it takes to be “bioavailable” (or absorbed and used by the body), entering the bloodstream right away.
Cybin’s Chief Medical Officer, Jukka Karjalainen, said:
“With the oral film dosing, bioavailability goes to 100%. The dose that is being given is the dose available to the clinical effect.”
Is Your Gut Required for Psilocybin’s Full Effect?
Hold up. If a dose given by an orally-dissolving film is only a fraction of the one required for capsules, then what role does your gut still play when it comes to psilocybin? Dr. Alan Davis, an adjunct assistant professor of Johns Hopkins University’s Psychedelic Research Unit, offers some insight:
“There’s also some question about the importance of the gut in the disruption of mental health processes.”
Dr. Davis also said that the gut microbiome —or the totality of bacteria, protozoa, and fungi present inside you — may play a role in mental health. This is largely due to the abundance of serotonin transporters (which brings psilocin to your brain) inside the gut.
What This Could Mean for Patients
IntelGenX’s wafer-thin VersaFilm technology — which allows for rapid disintegration without the need for water — has a lot of implications not just for psychedelics, but for medicine in general.
A versatile drug delivery platform such as film strips could provide patients with a host of other potential benefits, such as:
- Faster buccal absorption (which refers to when a drug is placed between your gums and cheek.)
- Speedier sublingual absorption (“under the tongue.”)
- Faster onset of action + increased bioavailability.
- More convenience for patients due to its small and thin size.
Also, by skipping first-pass metabolism, “what you dose is what you get” – so there is more medicine to absorb in the bloodstream (unlike capsules).
Film strips are also perfect for patients who have trouble swallowing, are afraid of choking, or blanketed with nausea from chemo or radiotherapy.
There is also the potential for unlimited flavor options, since the entirety of the intake happens in your taste buds (Mint chocolate-flavored film strips? Cybin would be crazy not to experiment).
Clinical Trials in Jamaica
Cybin intends to conduct its trials in Jamaica, one of the lucky places where psilocybin is legal, with 2 phases in total: Phase2A and Phase2B. Phase 2A should figure out exactly how many milligrams of pure psilocybin (taken sublingually via film strips) are equivalent to the standard dose of 25mg in a capsule. Doses of 1, 3, 5, and 7mg will be tested specifically. Phase 2B will then test the correct sublingual dose against placebo in 120 participants with major depressive disorder (MDD).
Easier Times Ahead for Patients and their Caregivers?
Ease, convenience, and comfort.
These are things that we might sometimes take for granted. We enjoy life’s simple pleasures, such as quarter-pounder with cheese, or an icy cold pint of beer. We get the luxury of time, a luxury that patients in palliative care may not be afforded.
This is why it’s so important for scientists to innovate, for psychedelic research (or just medical research, in general) to strive to make these patient’s experiences more bearable. Simple things, like shortening the waiting time, could save precious seconds from a patient’s daily routine— which should be spent in comfort.
This new psilocybin strip technology is another step towards both legitimacy and efficiency in psychedelic treatment … this will play an important role in future medicine, especially for end-of-life care.