Taking psilocybin is associated with a fast acting and lasting antidepressant effect for people with major depressive disorders, according to a recent study.
Psilocybin, a psychedelic which naturally occurs in more than 200 species of fungi, has gained significant attention amongst researchers in recent years as a possible therapeutic treatment for major depressive disorders (MDDs).
This importance is also driven by current approved pharmacological treatments for MDD being limited and the antidepressant effect of psilocybin having been demonstrated to outlast the presence of psilocybin in the body.
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There is currently insufficient evidence regarding the effectiveness of psilocybin treatment for MDD due to factors such as small sample sizes and study design issues. Large studies have only assessed the short-term effects of psilocybin and therefore, the long-term effects are unknown.
The randomised, placebo-controlled, six-week trial took place across 11 sites in the United States between December 2019 to June 2022 and involved 104 participants aged between 21 and 64. Participants were medically healthy, met the diagnostic criteria for MDDs and had at least one episode of a depressive disorder within the two months prior.
Other participant requirements included a central rater–assessed Montgomery-Asberg Depression Rating Scale (MADRS) score of at least 28, no personal or first-degree family history of psychosis or mania, no moderate or severe alcohol or drug use disorder and no active suicidal ideation with intent or plan.
Researchers used the phase two clinical trial to assess the outcomes of 25-milligrams of psilocybin and compare it to 100-milligrams of active placebo niacin by examining the timing, safety, scale and permanence of antidepressant effects.
The researchers said: “A 25-mg dose of psilocybin administered with psychological support was associated with a rapid and sustained antidepressant effect, measured as change in depressive symptom scores, compared with active placebo. No serious treatment-emergent adverse events occurred.
“The primary outcome was change in central rater–assessed MADRS score from baseline to day 43. The key secondary outcome measure was change in MADRS score from baseline to day 8. Other secondary outcomes were change in Sheehan Disability Scale score from baseline to day 43 and MADRS-defined sustained response and remission. Participants, study site personnel, study sponsor, outcome assessors (raters) and statisticians were blinded to treatment assignment.”
These findings suggest that treating MDDs with psilocybin is a safe and effective way to continually and substantially reduce functional disability and depressive symptoms, with no reported severe negative reactions.
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Researchers observed significant improvements in depressive symptoms for participants taking psilocybin within the first eight days which continued throughout the next six weeks.
Noticeable benefits of psilocybin also included reduced anxiety, lower disease severity, improved depressive symptoms and a better overall quality of life.
Additionally, emotional blunting which is linked to other standard antidepressant medications was not observed in those who took psilocybin.
There were very little mild to moderate severity adverse reactions reported and the number of adverse reactions in this trial was lower than those in other trials exploring psilocybin.
The study, which was published in the journal JAMA, concluded: “These findings add to increasing evidence that psilocybin—when administered with psychological support—may hold promise as a novel intervention for MDD.”
