Psilocybin, the active compound in ‘magic mushrooms’, could be at least as effective in treating depression as a leading antidepressant medication, according to a study by Imperial College. Researchers compared a six-week course of escitalopram – a widely available selective serotonin reuptake inhibitor (SSRI) – with two sessions of psilocybin therapy in 59 people with moderate to severe depression, and found that reductions in depression scores happened more quickly and were more pronounced in the psilocybin group. The psilocybin group also reported fewer cases of side effects such as anxiety, dry mouth, drowsiness or sexual dysfunction.
The study is the ‘most rigorous trial to date’ assessing the potential of psychedelic compounds in mental health treatment, says Imperial College’s Centre for Psychedelic Research. Volunteers either received a high dose of psilocybin and a placebo, or a very low, ‘non-active’ dose of psilocybin plus escitalopram. All volunteers on the study received the same level of psychological support, the researchers stress, with people receiving an oral dose of psilocybin while listening to music and being guided by a support team including psychiatrists. The report’s authors also warn against people with depression attempting to self-medicate with psilocybin in an unsupported, non-clinical setting.
There have been increasing levels of research in recent years into the potential of psychedelic compounds to treat depression without side effects, but the Imperial College team acknowledges that longer trials involving more patients will be needed to determine if psilocybin can perform more effectively than established drugs. Magic mushrooms were re-classified as a class A substance in the UK in 2005.
‘These results comparing two doses of psilocybin therapy with 43 daily doses of one of the best performing SSRI antidepressants help contextualise psilocybin’s promise as a potential mental health treatment,’ said head of the Centre for Psychedelic Research, Dr Robin Carhart-Harris. ‘Remission rates were twice as high in the psilocybin group than the escitalopram group. One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment in the same study. Psilocybin performed very favourably in this head-to-head.’
Trial of psilocybin versus escitalopram for depression, published in the New England Journal of Medicine, at https://www.nejm.org/doi/full/10.1056/NEJMoa2032994