Patients with major depressive disorder ( MDD) who were given two doses of psilocybin along with psychotherapy saw a decline in depressive symptoms in a small clinical trial. The psychedelic therapeutic effects, with limited side effects, lasted for up to 4 weeks.
Psychedelics are known for their hallucinogenic properties, but individuals with depression can also benefit from their mind-altering effects.
In the United States , approximately 17.3 million people have experienced at least one depressive episode, according to the National Institute of Mental Health.
Presently, psychotherapy or antidepressant medicine is the gold standard for treating MDD. A 2014 research in World Psychiatry found that antidepressant-combined psychotherapy was more effective than the former alone.
Replacing antidepressants with mushrooms that are hallucinogenic
Ketamine-like drugs that display a high therapeutic response are novel antidepressants. In Psychopharmacology, a 2014 meta-analysis states that approximately 0.5 milligrams per kilogram of ketamine effectively reduced depressive symptoms. After surgery, these results also lasted 2-3 days. There are some disadvantages, however.
Although currently approved by the Food and Drug Administration ( FDA), when using ketamine, there are some short-term side effects to remember, such as feeling odd or bizarre, numbness, and speaking difficulties.
Ketamine is particularly responsible for addiction and may have a high potential for misuse. A 2018 research in Neurobiology of Stress found that prolonged low-dose treatments with ketamine for treatment-resistant depression resulted in cognitive decline and violence potential.
Alternative therapies to complement psychotherapy are required to discourage people from abusing their medicine, entering psilocybin.
There is growing proof of the antidepressant properties of psilocybin. A research in the Journal of Psychopharmacology found that a single dose of psilocybin created an antidepressant and anxiolytic response that lasted for 5 years in cancer patients.
Psilocybin has lower addictive effects compared with ketamine, which would be useful for existing therapies as a possible add-on. Clinical studies testing this substance in combination therapy, however, are minimal.
Researchers at Johns Hopkins University have recently released an article contributing to studies exploring the efficacy of psilocybin-assisted depression therapy.
“These findings extend the results of previous studies involving cancer and depression patients as well as treatment-resistant depression patients by indicating that psilocybin could be beneficial in the far larger MDD population,” the authors of the study write.
Their clinical trial results appear in JAMA Psychiatry.
Johns Hopkins clinical trial
The researchers of the present study recruited adults with MDD from August 2017 to April 2019 who did not take antidepressant drugs and had no history of psychotic illness, suicide attempts, or hospitalizations. A total of 24 participants were randomly allocated by the scientists to an immediate or delayed treatment group.
The psychedelic-assisted therapy lasted for 8 weeks, with 18 in-person visits and 2 days of treatment with psilocybin.
During an 11-hour supportive psychotherapy session , participants in the immediate treatment community started psilocybin treatment. The researchers permitted a break of 1.6 weeks between the first and second doses. The delayed therapy group, by comparison, waited 8 weeks before obtaining psilocybin-assisted therapy.
Reduction of depression severity
Participants had a score of 23 on the GRID-Hamilton Depression Rating Scale (GRID-HAMD) at the time of registration, which suggests moderate depression. Participants in the immediate care group fell to a score of 8 after 1 week and 1 month of follow-up, suggesting moderate depression.
In the entire cohort, 1 week after treatment with psilocybin, 67 percent decreased the severity of their depressive symptoms. When researchers followed up after 4 weeks, this percentage rose to 71 percent.
After 1 week, the researchers found that 58% were no longer listed as clinically depressed in the cohort. By week 4, 54 percent of the participants were no longer classified as depressed, they found.
Limitations from the clinical trial design
There are some constraints that may challenge the usefulness of the findings of the analysis. As recruiting was leaning towards non-Hispanic whites, the sample had inadequate minority representation.
Although white people usually report more cases, this is significant because the American Psychiatric Association states that for longer periods, black and Hispanic Americans are more likely to experience depression. In response, the researchers recognize the need to test this proof of concept in more representative populations for future studies.
The research also fails to discuss the long-term consequences of therapy with psilocybin. The current study followed up after just 1 month, unlike the investigation on cancer patients, which had a 5-year follow up.
The research design also had variables that could challenge the efficacy of psilocybin as an antidepressant drug. Each of these comes from the absence of a placebo community. In deciding whether an individual has actually benefited from the medication and not from outside causes, placebos are important. The efficacy of using psilocybin for this purpose remains uncertain.
Overall , the authors find that the use of psilocybin-assisted therapy for MDD supports their clinical trial.
“Although psilocybin ‘s rapid antidepressant effects are similar to those reported with ketamine, there are different therapeutic effects. Usually, ketamine effects last for a few days to 2 weeks, although the current study found that clinically significant antidepressant response to psilocybin therapy continued for at least 4 weeks, with 71 percent of participants continuing to show clinically significant response at week 4 of follow-up (about 50 percent decrease in GRID-HAMD score).