Psilocybin-assisted Therapy for Phantom Limb Pain

NCT ID: NCT05224336

Last Updated: 2025-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE1

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-03

Study Completion Date

2026-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This double-blind placebo-controlled pilot study seeks to investigate whether psilocybin can be safely administered to people with chronic phantom limb pain (PLP) in a supportive setting with close follow-up, and its effects on pain symptoms and other moods, attitudes, and behaviors. The investigators' primary hypotheses are that psilocybin is safe to administer in people with PLP and that it will reduce scores on measures of pain. The investigators will also assess a number of secondary measures related to the behavioral and neural responses to pain after psilocybin treatment.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Phantom Limb Pain

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Phantom Limb Pain Psilocybin Psychedelic Therapy fMRI Pain Chronic Pain Psychedelics Hallucinogens Physiological Effects of Drugs Psychotropic Drugs

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participants and outcome assessor will not be made aware if participants are receiving psilocybin or placebo niacin.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Psilocybin

Participants will receive 25mg oral psilocybin one day to two weeks after baseline psychophysical and fMRI testing. Psychophysical and fMRI testing will then be employed one day to two weeks after drug administration.

Group Type EXPERIMENTAL

Psilocybin

Intervention Type DRUG

25mg oral psilocybin

Niacin

Participants will receive 100mg oral niacin one day to two weeks after baseline psychophysical and fMRI testing. Psychophysical and fMRI testing will then be employed one day to two weeks after drug administration.

Group Type PLACEBO_COMPARATOR

Placebo Niacin

Intervention Type DRUG

100mg oral niacin

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Psilocybin

25mg oral psilocybin

Intervention Type DRUG

Placebo Niacin

100mg oral niacin

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Between 18 and 75 years of age
* Amputation of one extremity
* Experience phantom limb pain of at least one month's duration and intensity of at least 3 out of 10 on the VAS
* Able to fluently communicate in English
* Agree to sign the consent and HIPPA authorization
* Willing to refrain from taking serotonergic antidepressant medication during the study period
* Willing to refrain from using any non-prescribed psychoactive drugs, including alcohol, within 24 hours before and after study drug administration
* Agree not to use any nonprescription medications, herbal medications, or supplements during the week prior to each drug session unless an exception is approved by the study investigators
* Willing to refrain from smoking or use of nicotine during the period from 8:00 am on the morning of the drug sessions until they are discharged to go home at the end of the end of the session
* Able to remain in an MRI machine without sedation
* Women of childbearing potential must agree to practice an effective means of birth control throughout the study, from screening to the final visit
* Have a relative or friend who can provide/accompany transportation after the drug session
* If pain is currently being treated with analgesic medications, the analgesic regimen must be stable for at least 2 weeks prior to enrollment, and the participant must agree not to change their use of analgesic medication without first consulting with the study investigators \[permissible analgesic medications are as follows: aspirin, acetaminophen, celecoxib, diflunisal, etodolac, fenoprofen, flubiprofen, gabapentin, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, meloxicam, nalbumetone, naproxen, pregabalin, proxicam, sulindac, tolmetin, and valdecoxib. PRN use of OTC analgesic medications by participants is also permissible\]
* Participants who are taking other medications acting as serotonin antagonists (e.g., cyclobenzaprine, odansetron), dopamine antagonists (e.g., metoclopramide, promethazine, prochlorperazine), dopamine agonists (e.g., levodopa, pramipexole, apomorphine), psychostimulants (e.g., modafinil, armodafinil, solriamfetol, methylphenidate, dexmethylphenidate, atomoxetine, dextroamphetamine, mixed amphetamine salts, lisdexamphetamine), anticholinergics (e.g., benzotropine, trihexyphenidyl, scopolamine, hypscyamine), or N-methyl-D-aspartate receptor antagonists (e.g., amantadine, memantine, ketamine) must be willing to discontinue those medications 1 week prior to each drug session

Exclusion Criteria

* Under the age of 18 or over the age of 75
* Pregnant or nursing females
* Females of childbearing age who are sexually active but not using birth control
* Phantom limb pain intensity \<3 out of 10 on the VAS
* Presence of another type of chronic pain that cannot be differentiated from phantom limb pain by the participant
* Amputation of more than one extremity
* MRI related contraindications including pacemakers, metal implants, spinal cord stimulators etc.
* Meet DSM-V criteria for bipolar disorder, schizophrenia, or other psychotic disorder
* Have a first-degree relative (parent or full-sibling) with a history of bipolar disorder, schizophrenia, or other psychotic disorder
* Judged to present a suicide risk
* Not able to complete an MRI scan
* Active substance use disorder (excluding tobacco and caffeine)
* Subjects prescribed methadone or buprenorphine for any indication
* Require concomitant treatment with efavirenz
* Participants who are prescribed antidepressants or antipsychotics for an axis I diagnosis
* Participants who are taking a serotonergic dietary supplement (e.g., 5-hydroxytryptophan, St. John's wort, SAM-e)
* Participants with any neurological conditions resulting in altered perception or cognition (e.g., dementia, traumatic brain injury, mild cognitive impairment) \[with the exception of phantom limb syndrome and its sequelae (depression or anxiety)\]
* Participants with a positive urine drug screen for amphetamines, barbiturates, buprenorphine, cocaine, methamphetamine, MDMA, methadone, opiates (morphine, oxycodone), or phencyclidine (PCP)
* Have used psilocybin, psilocybin-containing mushrooms, or another serotonergic hallucinogen (e.g., LSD, mescaline, ayahuasca) for recreational purposes within the last 12 months
* Require concomitant treatment with anti-psychotic medications (aripiprazole, asenapine, brexpiprazole, cariprazine, chlorpromazine, clozapine, fluphenazine, haloperidol, iloperidone, loxapine, mesoridazine, molindone, olanzapine, paliperidone, perphenazine, pimavanserin, pimozide, prochlorpromazine, quetiapine, risperidone, thioridazine, thiothixene, trifluperazine, or ziprasidone)
* Require concomitant treatment with an antidepressant medication or other medications that act as MAO inhibitors or serotonin reuptake inhibitors (amitriptyline, amoxapine, bupropion, citalopram, clomipramine, desipramine, doxepin, duloxetine, escitalopram, fluoxetine, fluvoxamine, imipramine, isocarboxazid, levomilnacipram, maprotiline, milnacipram, mirtazapine, nefazodone, nortriptyline, paroxetine, phenelzine, protriptyline, selegiline, sertraline, tramadol, tranylcypromine, trazodone, trimipramine, venlafaxine, vilazodone, vortioxetine) \[trazodone ≤50mg/24hr for insomnia is allowed, but not within 48hr of the psilocybin session\]
* Require concomitant treatment with medications known to inhibit UGT1A9 and UGT1A10 (e.g., diclofenac, probenecid, valproic acid)
* Severe hearing or visual impairment
* History of seizure disorder or epilepsy
* History of migraine or other severe recurring headaches necessitating treatment by a neurologist or headache specialist
* History of adverse reactions or intolerance to niacin or the rescue medications used in the study (benzodiazepines, antipsychotics, labetalol, nitroglycerin)
* Presence of uncontrolled cardiovascular disease or uncontrolled hypertension (SBP \> 140 mmHg or DBP \> 90 mmHg)
* Require concomitant treatment with an antihypertensive medication
* QTc prolongation (QTc \> 0.045 for man, QTc \> 0.047 for women)
* Subjects with history of stroke, angina, clinically significant ECG abnormality (e.g. atrial fibrillation), or artificial heart valve
* Participants with severe renal impairment (GFR \< 30 mL/min/1.73 m2)
* Participants with any clinically significant lab abnormalities as determined by a physician on the study team
* Myocardial infarction within the last 12 months
* Participants who meet criteria for Child-Pugh class B or higher
* Participants who are prescribed opioid medications
* Participants taking other medications that may be associated with serotonin syndrome: carbamazepine, dextromethorphan, lithium, linezolid, buspirone
* Evidence of severely compromised hepatic function
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Fadel Zeidan

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of California, San Diego

San Diego, California, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Morgan Gianola, PhD

Role: CONTACT

Phone: 619-800-2455

Email: [email protected]‬‬

Yasmeen Esshaki, MA

Role: CONTACT

Phone: (619) 786-0375

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Fadel Zeidan, PhD

Role: primary

Morgan Gianola, PhD

Role: backup

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

200626

Identifier Type: -

Identifier Source: org_study_id