- Researchers have studied whether the psychedelic compounds found in magic mushrooms can help with depression.
- A single dose of psilocybin reduced symptoms of major depression better than placebo.
- The study improved on previous studies, but experts say longer-term trials are needed to know if the effects last beyond six months.
- Psilocybin is administered with psychological support such as pre-dose preparation and subsequent consolidation sessions.
A single dose of the hallucinogen psilocybin, along with psychological support, reduced symptoms of major depression, and the effects lasted for up to six weeks, a new study shows.
The research
Researchers found that people who took psilocybin had greater improvements in depression scores than those who took a placebo substance without psychedelic properties.
Psilocybin is a psychedelic compound found in magic mushrooms.
People who took psilocybin also saw a reduction in overall disease severity, an improvement in anxiety symptoms and quality of life.
Also, unlike standard antidepressants, psilocybin use did not cause “emotional blunting,” a paralysis of positive and negative emotions.
This study adds to the evidence that psilocybin, along with psychological support, may offer an alternative treatment to antidepressants for people with major depressive disorder.
“Although this trial was relatively small, a single dose of psilocybin within a 6-week period that included active psychotherapy provided rapid, strong, and sustained relief of symptoms of depression. has been demonstrated,” writes Dr. Rachel Yehuda. and Dr. Amy Lehner, Icahn College of Medicine at Mount Sinai,Accessory
Major depressive disorder, or clinical depression, is a serious medical condition that can affect mood and behavior, as well as physical functions such as appetite and sleep.
It is commonly treated with antidepressants, and symptoms improve within 6 to 8 weeks.
However, these drugs have many side effects, such as headaches, dizziness, and sexual problems, that can cause people to stop treatment.
In recent years, researchers have investigated the use of psychedelics, such as psilocybin, the active compound in magic mushrooms, as treatments for depression and other mental health conditions.
Announced August 31 in Phase 2 clinical trials
The new study included 104 participants aged 21 to 65 who met criteria for major depressive disorder but were otherwise healthy.
About half of the participants were female and the majority were white. Most people were experiencing ongoing depression rather than the first episode of depression.
The study was conducted at 11 US centers from 2019 to 2022.
Potential participants must have a moderate or severe alcohol use disorder, have used hallucinogens within the past 5 years, have had suicidal ideation or behavior in the past 1 year, and have undergone deep brain stimulation. They were excluded from the study for certain reasons, such as being treated for depression.
The researchers randomly assigned people to receive a single oral dose of either 25 milligrams of psilocybin or 100 milligrams of niacin. This dose was administered after participants slowly reduced and then discontinued their usual antidepressant medication.
Niacin has no psychedelic effects but causes harmless redness on the skin, so it was used as an effective placebo. This makes it less likely that participants or researchers will be able to guess which compounds they have ingested.
The researchers assessed people’s symptoms of depression when they started taking psilocybin or niacin and after 2, 8, 15, 29, and 43 days. Participants were also asked about their anxiety symptoms, side effects experienced, and quality of life.
These assessments were made over the phone. Again, this is to reduce the risk of researchers knowing which group a participant belongs to.
The study sponsor, Usona Institute Inc., a non-profit medical research institute, provided psilocybin for the trial, designed the study, and helped interpret the study data and write the scientific paper.
After six weeks, those who took psilocybin had, on average, significantly improved their symptoms of depression compared to those who took niacin.
The average size of improvement in the psilocybin group corresponds to “substantial clinical improvement” in patients with treatment-resistant depression, the researchers wrote.
These “Depression Improvements” [in the psilocybin group] It was evident within 8 days after psilocybin administration,” the researchers added, “this was consistent with a rapid onset of action and was maintained throughout the 6-week follow-up period.”
However, not all participants benefited from psilocybin at this level.
“It appears from this study that psilocybin does not work for everyone,” he said. Manish Supraa psychiatrist and executive director of behavioral health services at Northwell Health.
But “even the best antidepressants we have are effective in about two-thirds of the population, so any more is an improvement,” he told Healthline.
But given the study’s small sample size, it’s difficult to know how many people would benefit from psilocybin in the real world, he added.
The researchers also found that psilocybin was “generally well tolerated” and that most of the negative side effects were “mild or moderate” in severity and short-lived.
The most common side effect was headache, followed by nausea and hallucinations. Visual effects occurred primarily on the day of dosing and were experienced by a minority thereafter. These had disappeared by the end of the study.
While the researchers were able to overcome some of the limitations of previous studies, the new study had its own drawbacks. One is the lack of ethnic and racial diversity, making it difficult to know if other groups experience the same benefits.
Furthermore, the study did not show whether the effects of psilocybin lasted longer than 6 weeks.However, the previous study It suggests that the effects may last for at least a year after administration.
“The results are very encouraging,” Sapra said. “But what we really need are long-term trials to see how long this improvement in patients lasts.”
Longer studies, such as one year, may also reveal whether patients need repeat or maintenance treatment with psilocybin to maintain its effects, he told Healthline.
Once psilocybin is approved by the Food and Drug Administration for the treatment of major depression, ongoing research will provide additional data on the substance’s safety and efficacy in real-world settings, he said. added.
As with other psychedelics, psilocybin treatment involves more than just administering psilocybin to patients and sending them home.
“Psychedelics … can cause difficult and difficult experiences,” write Yehuda and Lehner.
Therefore, these substances “need to be used with caution and in the presence of a trained facilitator or therapist who works with people experiencing extraordinary states of consciousness,” the researchers added. .
In the new study, participants spent six to eight hours with research staff preparing for the experience before receiving psilocybin (or niacin).
Dosing sessions lasted 7-10 hours and were conducted in a comfortable room under staff supervision. Participants were encouraged to wear eyeshades and listen to relaxing music on headphones.
This was followed by a 4-hour integration session with staff where participants discussed their experiences.
Yehuda and Lehrner wrote that additional research is needed to identify which patients benefit most from psychedelics, whether repeated treatments are beneficial and safe, and what the optimal doses and treatment approaches are. ing.
If psychedelic treatments prove to have lasting effects after one or a few treatments, they “may offer not only a new approach to mental health care, but an entirely new paradigm of care.” said the researchers.
In a six-week clinical trial, researchers found that a single dose of psilocybin with psychological support improved symptoms of depression more than a nonpsychedelic placebo.
Psilocybin was generally well tolerated, with headache, nausea, and hallucinations being the most common side effects. Most visual effects occurred on the day of dosing and were all gone by the end of the study.
Psilocybin reduced symptoms of depression on average more than placebo, but not all participants benefited from the psychedelic treatment.
