Psilocybin therapy appears to be at least as effective as a leading conventional antidepressant

Authored by psypost.org and submitted by TrixyUkulele

Psilocybin, the active compound in magic mushrooms, may be at least as effective as selective serotonin reuptake inhibitors, the leading type of antidepressant medication, according to research published in the New England Journal of Medicine. The phase 2, double-blind, randomized, controlled trial compared psilocybin to the antidepressant medication escitalopram.

“Our previous research in treatment-resistant depression and as well as human brain scanning strongly suggested the therapeutic potential of psilocybin. Pitting psilocybin in a head to head versus a conventional antidepressant felt like a brave and interesting test to do,” said study author Robin Carhart-Harris, the head of the Centre for Psychedelic Research at Imperial College London and founder of MyDelica.

The researchers recruited 59 men and women between the ages of 18 and 80 years who suffered from moderate-to-severe depression for their 6-week trial. Thirty patients were randomly assigned to the psilocybin group, while the remaining 29 patients were assigned to the escitalopram group.

Patients in the psilocybin group received 25 mg of psilocybin during two sessions. Those in the escitalopram group, on the other hand, only received 1 mg of psilocybin during their sessions — a dose with negligible effects. The patients received their dose in a controlled clinical setting as they listened to a curated music playlist and were guided through their experiences by a psychological support team, which included registered psychiatrists.

The patients were also instructed to take one capsule each morning. Those in the psilocybin group took a placebo pill, while those in the escitalopram group received an active dose of the antidepressant medication.

The patients completed a standardized scale of depressive symptom severity known as the Quick Inventory of Depressive Symptomatology–Self Report. At the start of the trial, the mean score was 14.5 out of 27 for the psilocybin group and 16.4 for the escitalopram group. After six weeks, scores reduced by an average of 8.0 points for those in the psilocybin group and 6.0 points for those in the escitalopram group — a difference that was not statistically significant.

“Psilocybin therapy appears to be at least as effective as a leading conventional antidepressant and is faster acting with a reassuring safety profile when given by professional therapists,” Carhart-Harris told PsyPost.

The researchers also found that patients in the escitalopram group were more likely to report side effects such as anxiety, dry mouth, sexual dysfunction, and reduced emotional responsiveness compared to those in the psilocybin group. Patients in the psilocybin group reported greater improvements in the ability to cry and feel compassion, intense emotion, and pleasure.

“Remedicalizing psilocybin and related drugs is the most interesting project in contemporary psychiatry,” Professor Guy Goodwin, an emeritus professor of psychiatry at University of Oxford who was not involved in the study, told the Science Media Centre. “The present study is not a quantum leap: it is under-powered and does not prove that psilocybin is a better treatment than standard treatment with escitalopram for major depression. However, it offers tantalizing clues that it may be.”

While the initial findings are encouraging, the study has some limitations.

“A bigger trial with a straight placebo condition would have further helped to clarify results and our interpretation of them,” Carhart-Harris explained.

The duration of treatment could also be a factor. SSRIs like escitalopram can take several weeks to start reducing symptoms. “Had the course of escitalopram been extended, it is possible that better efficacy would have been observed among the patients in the escitalopram group,” the researchers noted.

“The next big question is ‘how will psilocybin therapy fair in a big licensing trial?’ These are needed before medicine regulators can make a decision about whether to approve psilocybin therapy as a licensed treatment for depression,” Carhart-Harris said.

The study, “Trial of Psilocybin versus Escitalopram for Depression“, was authored by Robin Carhart-Harris, Bruna Giribaldi, Rosalind Watts, Michelle Baker-Jones, Ashleigh Murphy-Beiner, Roberta Murphy, Jonny Martell, Allan Blemings, David Erritzoe, and David J. Nutt.

EdnaScott32 on June 7th, 2021 at 04:15 UTC »

Psilocybin is so hot right now.

Akihaa on June 7th, 2021 at 03:50 UTC »

I really hope that psilocybin with guided therapy sessions will become legal soon. I’ve heard people say that taking psychedelics or similar really helps clear up the fog that mental illness causes you, like depression or PTSD, in ways that current medication can’t hold a candle to. While in some states in the US (iirc) these substances are legal, it is probably rarer to find therapists who are licensed to work alongside these substances which is probably an important factor in really nailing down the root of the problem.

I had read an interesting comment regarding the effects of psilocybin: Imagine that your brain is a ski slope, and your negative thoughts are the trails that you frequent which causes you to go down them more often than you would a different trail. Psilocybin adds a new layer of snow on top of your ski slope, which will make it easier for you to develop different mentality and perspective to yourself than before.

The only problem I can see happening is that big pharma will try their hardest to lobby against the legalization of psilocybin therapy, as some psilocybin substances that come from shrooms are easily cultivated by yourself, therefore putting a plug in one of pharma’s biggest cash cow.

Regardless, I believe there is a group that are currently recruiting testers for psilocybin therapy in the states. Hopefully somewhere in the next decade or so (sooner? who knows) it will become more accessible for the sake of mental wellness.

I_Am_Coopa on June 7th, 2021 at 01:46 UTC »

It's taken us over 40 years to get back to the same point we were when scientists first started studying psychedelics. Psilocybin, LSD, and the like will revolutionize therapy.