Psilocybin May Have Similar Benefits to Antidepressants

Psilocybin may be as good as standard SSRI antidepressants for treating depression without causing side effects like reduced libido, according to a new study. However, researchers warn against using recreational psilocybin for alleviating mental health disorders.

Psilocybin, the active ingredient in "magic mushrooms," has been long used in religious ceremonies around the world and is a common recreational drug, classified as a Schedule I substance in the United States.

Despite the controversy that comes with the classification, there has been growing interest in investigating psilocybin as a potential medication for mental health disorders. Some trials showed promising results for psilocybin's use in the treatment of addiction, depression, post-traumatic stress disorder, and end-of-life mood disorders.

Australia has already authorized psilocybin for treatment-resistant depression. The approval was based on a study that found that a single dose of 25 mg reduced depression scores over a period of three weeks. However, most participants experienced side effects like headache, nausea, and dizziness.

A new study presented at the ECNP Congress in Milan that will be published in Lancet eClinicalMedicine compared the effects of psilocybin and the SSRI escitalopram on depressive symptoms.

SSRIs, short for selective serotonin reuptake inhibitors, are widely used antidepressant medications. However, not all individuals respond to the treatment with SSRIs, which can cause side effects like decreased sex drive or changes in appetite leading to weight gain.

The study involved 59 patients with moderate to severe depression. Of those, 30 were treated with a single dose of psilocybin, and 29 patients were given a six-week course of escitalopram. Each group received similar psychological support of around 20 hours in total.

Both groups experienced significant improvement in depressive symptoms, even up to six months after treatment. However, the psilocybin group saw greater improvements in social functioning and psychological connectedness.

"The study suggests that psilocybin therapy might be a more holistic treatment option for depression, addressing both the symptoms of depression and overall well-being. This could make a substantial difference in the overall happiness and daily activities of those suffering from depression, providing a more joined-up approach to mental health treatment," said a co-first author Dr. David Erritzoe, clinical director and deputy head of the Centre for Psychedelic Research at Imperial College.

Johan Lundberg, an adjunct professor of psychiatry at the Karolinska Institute, Stockholm, who was not involved in the study, says it comes with several limitations, including failure to report other interventions given during the follow-up period.

It is still unknown if psilocybin will be approved for the treatment of major depression. And even if it is authorized, psilocybin won't be for everyone.

Lundberg says, "Some future patients might prefer psychedelic treatment over SSRI, but some patients may be intimidated by the dramatic alterations in perception and confrontations with challenging emotions that psychedelic drugs promote."