For years, researchers have been interested in psilocybin – the active principle of certain hallucinogenic mushrooms – for its therapeutic virtues, in particular thanks to its potential for “neuronal rewiring” which, repeatedly demonstrated, has been shown to be effective in treating the disease. depression resistant to treatment in the past. In a new clinical trial, researchers have shown that psilocybin is at least as effective as a conventional antidepressant in treating depression, with fewer reported side effects.
The compound would thus be at least as effective as selective serotonin reuptake inhibitors (the main type of antidepressant). This phase 2, double-blind, randomized, controlled trial compared psilocybin with escitalopram, a conventional antidepressant. The results were published in the New England Journal of Medicine.
” Our previous research on treatment-resistant depression as well as analysis of the human brain has strongly suggested the therapeutic potential of psilocybin. Psilocybin opposed to a conventional antidepressant was a brave and interesting test Said lead author of the study Robin Carhart-Harris, director of the Center for Psychedelic Research at Imperial College London.
Similar effectiveness, but faster action
The trial lasted 6 weeks, and involved 59 men and women between the ages of 18 and 80 with moderate to severe depression. 30 patients were randomly assigned to the psilocybin group, while the remaining 29 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, received only 1 mg of psilocybin during their sessions (a dose with negligible effects). All candidates received their dose in a controlled clinical setting while listening to (carefully selected) music and were guided through their experiences by a psychological support team, which included licensed psychiatrists.
” Psilocybin therapy appears to be at least as effective as a leading conventional antidepressant and works faster with a reassuring safety profile when administered by professional therapists Carhart-Harris told PsyPost.
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. They also completed a standardized questionnaire on the severity of depressive symptoms, 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 decreased by an average of 8 points for people in the psilocybin group and 6 points for those in the escitalopram group. A difference that was not statistically significant.
Fewer side effects than standard treatment
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 than those in the psilocybin group. Patients in the psilocybin group reported greater improvements in their ability to cry and to feel compassion, intense emotions, and pleasure.
” Remédicaliser psilocybin and related drugs is the most interesting project of contemporary psychiatry », Told the Science Media Center Professor Guy Goodwin, professor emeritus of psychiatry at Oxford University, who was not involved in the study. ” The present study is not a quantum leap: it does not prove that psilocybin is a better treatment than standard escitalopram treatment for major depression. However, she offers tantalizing clues that she might be. “.
Study limits to consider
Although the first results are encouraging, the study has certain limitations. ” A test larger with direct placebo control would have to further clarify the results and interpretation of these “Says Carhart-Harris.
The length of treatment could also be an important factor. SSRIs such as escitalopram may take several weeks to start reducing the symptoms. ” If escitalopram treatment had been prolonged, it is possible that better efficacy would have been observed in patients in the escitalopram group. The researchers noted. ” The next big question is, ‘How will psilocybin treatment behave in a large licensing trial?’ These are needed before medical regulatory authorities can make a decision on whether to approve psilocybin therapy as an approved treatment for depression. “Says Carhart-Harris.
” Secondary results generally favored psilocybin over escitalopram, but analyzes of these results were not corrected for multiple comparisons. Larger and longer trials are needed to compare the established psilocybin antidepressants », Write the researchers.