Use of psilocybin for chronic pain: a scoping review with current evidence and prospection of literature and technology for future applications

Chronic pain affects millions of people and remains one of the greatest clinical challenges due to limited response to conventional therapies. Psilocybin, a psychedelic found in mushrooms of the Psilocybe genus, has sparked interest due to its potential to modulate serotonergic receptors and promote neuroplasticity, suggesting analgesic and psychotherapeutic effects. The objective of this scoping review was to map and synthesize the available evidence on the use of psilocybin in the management of chronic pain. The protocol was registered on the OSF platform (DOI: 10.17605/OSF.IO/MQ36X) and gathered evidence from seven databases and gray literature, including clinical and preclinical studies, and patents. Twenty studies were included: nine published, eleven ongoing clinical trials, and five filed patents. Doses ranged from 5 to 25 mg, administered in single or multiple sessions, with or without associated psychotherapy, and showed reduced pain intensity and improved mood and quality of life. In animal models, the results were heterogeneous, ranging from significant analgesia to no effect. The analyzed patents indicate industrial interest in microdosing protocols and controlled-release formulations aimed at fibromyalgia, neuropathic pain, and phantom pain. Taken together, the evidence pointed to psilocybin as a promising alternative for chronic pain management, although robust and standardized clinical trials are needed to confirm its efficacy and safety.