Summary: A research comparing psilocybin and the SSRI monotherapy found that while both medications improved depressive symptoms also over the course of six months, psilocybin also had more behavioral benefits. People taking psilocybin reported a greater sense of meaning, mental closeness, and improved cultural working.
These findings suggest that mushroom might be a more holistic approach to treating depression, taking into account both the signs and general well-being. While tempting, serotonin remains empirical and is only administered in handled conditions.
Important Information:
- Over the course of six weeks, SSRIs and Psilocybin both reduced melancholy symptoms.
- Psilocybin improved meaning in life, mental closeness, and social working.
- Psilocybin remains an experimental care, administered under tight control.
Origin: Western College of Neuropsychopharmacology
Similar improvements in depressive symptoms are observed in a direct comparison between the empirical psychedelic medicine psilocybin and a typical SSRI antidepressant, but psilocybin offers more longer-term benefits.
The comparison, between , psilocybin , ( the active ingredient in “magic mushrooms” ) and the SSRI escitalopram gave similar long-term improvements in , depressive symptoms , over a 6-month period, however, patients taking psilocybin also reported better psychosocial functioning, including experiencing a greater sense of meaning in life and psychological connectedness.
The work is presented for the first time at the , ECNP Congress in Milan. A related document will look in the journal , eClinicalMedicine , to coincide with the event display.
Direct scientist Mr. Tommaso Barba ( Ph. D. candidate from Imperial College, London ) said,” This is the first work to compare the long-term effects of these two drugs in the context of overall well-being, not just freedom from depression.
At the 6-week mark, we had previously found that both treatments had similar effects on reducing symptoms of depression, including sadness and bad emotions.
” But, this work shows that mushroom outperformed methylphenidate in various methods of well-being, meaning in life, work and social functioning. These findings appeared to be maintained over a 6-month follow-up time.
In addition, we previously discovered that mushroom also increases sexual push, in contrast to SSRIs, which frequently lower libido in some patients. Overall, it seems as though psi may offer more beneficial mental health benefits.
SSRI drugs ( selective serotonin reuptake inhibitors ), such as Prozac, Paxil and Zoloft, are one of the major types of drugs used to treat despair. However, around a third of patients do n’t respond to SSRI treatment, so for them psilocybin may offer an alternative, although this was not studied in this trial.
Barba continued,” Antipsychotics work well, but not for all. Additionally, they have some negative results. But this work implies that psilocybin usually seems to offer a genuine alternative, and perhaps more benefits, to people who are worried about taking regular antidepressants”.
The researchers, from Imperial College in London, undertook a 6-month research ( step 2, double-blind, randomized controlled trial ) with 59 people with moderate to severe depression. 30 were treated with a second dose of mushroom, 29 people were given a six-week program of methylphenidate. Each party received roughly 20 days of equivalent mental support overall.
Both groups showed significant improvement in depressive symptoms, even up to six months after receiving treatment ( the researchers stopped monitoring at six weeks ). However, those given mushroom reported greater enhancements in social functioning and internal closeness, with big impact sizes.
Co-first artist Dr. David Erritzoe, Clinical Director and Deputy Head of the Centre for Psychedelic Research, Imperial College, London, commented,” This is important because improving closeness and having greater meaning in life can tremendously increase a person’s quality of life and long-term mental wellbeing.
The study suggests that mushroom treatment may be a more systematic treatment option for melancholy, taking into account both the depression’s symptoms and general well-being. By combining these two factors, there might be a significant difference in the overall quality of life and routine activities for those who suffer from depression.
The researchers note that the people received just six weeks of treatment and that many of the patients received additional therapies over the 6-month follow-up.
Dr. Erritzoe cautioned”, Psilocybin is still an exploratory substance, it has not yet been approved for public use. These measures are not present in outdoor psychedelic use, which is known to have unexpected and potentially harmful results, especially for vulnerable people who struggle with mental health issues. It is administered in very controlled and protected environments.
Commenting, Johan Lundberg ( Adjunct Professor of Psychiatry at the Department of Clinical Neuroscience, Karolinska Institute, Stockholm ), was not involved in this work, said”, This report is an important attempt to compare the clinical value of psilocybin compared to a state-of-the-art treatment of major depressive disorder.
The findings come with a number of drawbacks, including the lack of a non-inferiority research and the failure to report additional interventions made during the follow-up time. That said, as a thesis generating element it may benefit the industry considerably.
” For now, we do n’t know if psilocybin will be approved for the treatment of major , depression, but if so, it wo n’t be for everyone. Some potential patients may choose psychedelic , treatment , over SSRI, but some patients may become intimidated by the extraordinary alterations in understanding and confrontations with challenging emotions that kaleidoscopic drugs promote.”
About this study in psychiatry
Author: Tommaso Barba
Source: European College of Neuropsychopharmacology
Contact: Tommaso Barba – European College of Neuropsychopharmacology
Image: The image is credited to Neuroscience News
Original Research: Start entry.
” Impact of mushroom and methylphenidate on melancholy symptom severity in patients with moderate-to-severe major depressive disorder: observing 6-month follow-up of a phase 2, double-blind, randomised, controlled trial” by Tommaso Barba et al. EClinicalMedicine
Abstract
Effect of psilocybin versus escitalopram on depression symptom severity in patients with moderate-to-severe major depressive disorder: observational 6-month follow-up of a phase 2, double-blind, randomised, controlled trial
Background
Major depressive disorder ( MDD ) patients receive rapid and persistent antidepressant effects from peptidoybin therapy ( PT ). However, there has never been a comparison of the long-term effects of PT with gold-standard MDD treatments like pharmacotherapy or psychotherapy alone or in combination.
Methods
This is a 6-month follow-up study of a phase 2, double-blind, randomised, controlled trial involving patients with moderate-to-severe MDD. Participants were chosen from a hospital in the UK.
Male or female patients with major depressive disorder ( DSM-IV ), moderate to severe depression ( HAM-D , ≥17 ), no MRI or SSRI contraindications, confirmed diagnosis by a GP or mental healthcare professional, aged 18–80, and competent in English were eligible.
Patients were given either two 25 , mg doses of the psychedelic drug psilocybin (‘psilocybin therapy’ or PT ) or two 25 , mg doses of the drug escitalopram (administered daily at 10 , mg for three weeks and 20 , mg for the subsequent three weeks ) and matched psychological support (‘escitalopram treatment’ or
The primary outcome measure was change from baseline in the score on the 16-item Quick Inventory of Depressive Symptomatology–Self-Report ( QIDS-SR-16 ) at week 6, which has been reported previously.
Herein, we present results at the 6-month follow-up time point. Measures of social functioning, connectedness, and meaning in life constituted the study’s secondary outcomes during follow-up. Safety in the follow-up period was not assessed.
This trial is registered at , ClinicalTrials. gov,  , NCT03429075.
Findings
Between January 15th, 2019 and March 20th, 2020, 59 patients were enrolled and 30 ( 11 females]37 % ] and 19 males]63 % ] ) were assigned to the psilocybin group and 29 ( 9 females]31 % ] and 20 males]69 % ] ) to the escitalopram group. 25 participants in the PT group and 21 in the ET group completed the 6-month follow-up.
Both PT and ET conditions at the 6-month follow-up showed continued improvements in depressive symptom severity. The mean between-condition difference in QIDS-SR-16 scores at 6-months was 1.51 (95 % CI:  , −1.35, 4.38, p , = , 0.311 ).
Secondary outcomes demonstrated that PT had greater mean between-condition differences in functioning ( WSAS:  , −7.46, 95 % CI:  , −12.4,  , −2.47, p , <,  , 0.001 ), psychological connectedness (WCS: 11.02, 95 % CI: 1.25, 20.83, p , = , 0.033 ), and meaning in life ( MLQ: 4.86, 95 % CI: 0.67, 9.05, p , = , 0.021 ) compared to ET.
Interpretation
Long-term improvements in depressive symptom severity were correlated with six-week intensive MDD treatments using either psilocybin or escitalopram ( with psychological support ). The greater degree of improvement in the PT arm at follow-up on psychosocial functioning, meaning in life, and psychological connectedness suggests warrant future research. However, these results are descriptive and should be interpreted with caution.
The study’s key drawbacks include its suboptimal ability to detect subtle but discernible differences between treatments, insufficient data, the possibility of additional interventions during the follow-up period, and reliance on self-reported treatment assessments. These variables should be taken into account when interpreting the study’s conclusions and how they are perceived.
Funding
The Alexander Mosley Charitable Trust was founded by the Center for Psychedelic Research at Imperial College London in partnership with the founding partners of the Alexander Mosley Charitable Trust.
