Psilocybin, the active ingredient in magic mushrooms, could potentially be used to treat depression, according to new research published on Wednesday, the latest evidence suggesting psychedelics could play a role in psychiatry as firms and campaigners push to introduce the controversial substances into mainstream medicine.
Psilocybin could potentially be used to treat depression, research suggests.
High doses of psilocybin appear to have a similar effect on depression symptoms as a popular antidepressant drug escitalopram, according to the peer reviewed study published in the BMJ medical journal.
Escitalopram, sold under the brand names Lexapro and Cipralex, belongs to a class of drugs widely used to treat depression and other mental health problems called selective serotonin reuptake inhibitors (SSRIs) and it is one of the most prescribed medicines in the United States.
Evidence supporting the use of psychedelics like psilocybin to treat mental health problems is often flawed, inconsistent and shows small effect sizes, the researchers said, and they reviewed and analyzed data from nearly 3,000 people across 20 trials studying the drugs to get a more accurate understanding on their ability to treat depressive symptoms.
The studies included around 800 people across 15 psychedelics trials and around 2,000 from five escitalopram trials—some of which compared psilocybin and escitalopram directly—to see how the drugs impacted depression symptoms measured on a widely-used scale compared to a placebo.
The researchers said that while most psychedelics performed better than placebo in the psychedelic trials, only high doses of psilocybin outperformed placebo in escitalopram trials, where they showed a small effect.
The effect was “similar to that of current antidepressant drugs,” the researchers said, concluding high dose psilocybin could “have the potential to treat depressive symptoms.”
Psychedelics are closer to entering mainstream clinical practice than ever before after decades of work from advocates, researchers and biotech and pharma firms, but despite their promise, there are significant hurdles that must be overcome before they can be used outside of clinical trials. Psychedelics are a broad grouping of drugs that can alter mood, thoughts and perception and include the likes of LSD, psilocybin, ketamine and MDMA, or ecstacy. Psychedelics are criminalized in many parts of the world—often under the harshest classification of illegal drugs available—which has complicated scientists’ efforts to rigorously examine growing reports they could potentially be used to treat a wide array of psychiatric problems and raises the bar companies must clear when hoping to bring a treatment built around a controlled substance to market. Many mental health conditions, including depression, PTSD, anxiety, schizophrenia and bipolar, can be difficult to treat or resist available treatments and experts say progress developing new drugs “has been slow and disappointing” despite the desperate need for new and improved treatments. Psychedelics offer promise here, though are also difficult to assess using typical clinical trials as the mind-altering nature of the drugs often means participants are aware of whether they have received a placebo or active substance in a trial.
In August, the Food and Drug Administration set back hopes to usher in a new age of psychedelic medicine when it rejected Lykos Therapeutics' application to use MDMA and psychotherapy to treat post-traumatic stress disorder. The decision dashed what many had hoped would be a landmark moment for medicine and the regulator requested an additional late-stage trial from the company to further study the treatment’s safety and efficacy. This could take years to complete and Lykos has said it plans to meet with the FDA and ask it to reconsider the decision with a view to resubmitting an application for the treatment. Lykos said PTSD affects approximately 13 million Americans, who it says could potentially benefit from its treatment. The condition disproportionately affects women and disadvantaged or marginalized groups, as well as military personnel and veterans.
The researchers said none of the interventions studied were associated with higher rates of serious adverse events, including death, hospital admission or suicide attempts.
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