In brief
- An open-label pilot study at Johns Hopkins provided two psilocybin sessions to 20 people with persistent symptoms following Lyme disease treatment.
- At six months, the total symptom burden was 40% lower than at baseline, with improvements in mood, sleep, pain, and fatigue.
- Because there was no control group, these changes cannot be definitively attributed to psilocybin; the results serve as a signal for further research, not proof.
Some individuals continue to experience fatigue, pain, and cognitive impairment for months or years after completing antibiotic treatment for Lyme disease. A team at Johns Hopkins has tested psilocybin for the first time in this condition, known as post-treatment Lyme disease syndrome, and preliminary results suggest sustained improvement.
A condition without clear treatment
Post-treatment Lyme disease affects a portion of those who have recovered from an infection by the tick-borne bacteria. Clinical tests show no active infection, yet symptoms persist that significantly impact daily life. There is no approved specific treatment, a gap that explains why researchers are exploring unconventional avenues.
The underlying premise is not that psilocybin acts directly on the bacteria. The hypothesis is that it may influence how the brain processes pain, mood, and fatigue—symptoms that have already been studied with this compound in other contexts.
Methodology and measurements
The study, published on October 3, 2026, in Scientific Reports and led by Albert Garcia-Romeu, is an open-label pilot trial: all participants received the compound and were aware of it. The study included 20 patients with a mean age of 44 and a median illness duration of 5.7 years. Five participants met the criteria for major depression.
Over eight weeks, there were two sessions with psychological support. In week 4, all participants took 15 mg of psilocybin; in week 6, 18 participants increased to 25 mg, while two remained at 15 mg due to the intensity of their first experience.
At the six-month mark, the overall symptom burden was approximately 40% lower than at the start. Depressive symptoms decreased by 50% to 60%, sleep and pain improved by 40% to 50%, and fatigue improved by 25% to 30%. Health-related quality of life increased by nearly 13%.
There were no serious adverse events attributed to the treatment. Transient effects were common: temporary increases in blood pressure (in 90% of participants), headache (65%), and tachycardia (35%). There were two serious events during the follow-up period that the authors consider unrelated to the drug.
Implications
Caution is mandatory. Without a control group, it is impossible to isolate the effect of psilocybin from the natural progression of the disease, the psychological support, or the expectations of those receiving a novel treatment. The sample size is small and predominantly white, and the authors note that cognitive functions were not measured, despite being a central feature of the condition.
Even so, the work fulfills its purpose as a pilot: it demonstrates that the protocol is feasible and safe in this group and justifies a randomized, placebo-controlled trial. To understand how these results are evaluated within the broader body of research, you can consult our Psychedelics Guide on science and therapy, and the general context in our section dedicated to psychedelics.
Source
- Garcia-Romeu A. et al. Psilocybin-assisted treatment for post-treatment Lyme disease (open-label pilot study). Scientific Reports, October 3, 2026.
Educational content written from a harm reduction perspective and with respect for individual freedom. It is not a substitute for advice from a healthcare professional and is not intended to encourage or condemn any drug use.
