LONDON — Could a psychedelic “trip” be the best medicine to cure depression? A new study reveals magic mushroom-based compounds could be twice as effective as the leading antidepressant medication.
Psilocybin, the active compound in magic mushrooms, appears to work faster and cause a more significant reduction in depressive symptoms than a leading drug, according to researchers from Imperial College London.
Results reveal the compound caused “marked improvements” in patients’ ability to feel pleasure and express emotions. Participants taking psilocybin experienced greater reductions in anxiety, suicidal thoughts, and increased feelings of well-being.
The study finds remission rates were twice as high over a six-week course in comparison to taking the best available antidepressant.
Researchers examined 59 people with moderate-to-severe depression, guiding them through hallucinogenic experiences. Clinical staff played specially selected music and offered psychological support during the treatments.
Despite the promising results, study authors say their results are not “statistically significant” due to the size of the patient group. They are looking to carry out their experiments in larger studies to verify their findings.
How do normal antidepressants work?
Doctors commonly treat depression and anxiety with a family of drugs called SSRIs – selective serotonin re-uptake inhibitors. As the name suggests, these medications work by increasing the amount of the neurotransmitter serotonin in the brain by stopping nerve cells from reabsorbing the chemical.
U.K. doctors typically prescribe one of eight different SSRIs for depression. This includes escitalopram, which the team tested against psilocybin in the study.
“These results comparing two doses of psilocybin therapy with 43 daily doses of one of the best performing SSRI antidepressants help contextualize psilocybin’s promise as a potential mental health treatment,” says study leader Dr. Robin Carhart-Harris, head of the Centre for Psychedelic Research, in a university release. “Remission rates were twice as high in the psilocybin group than the escitalopram group.”
Government officials classify mushrooms containing psilocybin as Class A drugs. The maximum penalties are seven years behind bars for possession or life in prison for supplying them. Researchers say this makes research incredibly difficult and expensive.
“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 favorably in this head-to-head,” Dr. Carhart-Harris adds.
Finding the right dose to treat depression
Patients treated with the psilocybin medicine — named COMP360 by its developers COMPASS Pathways PLC — received either a high dose of psilocybin and a placebo, or a very low dose of psilocybin and escitalopram.
In the psilocybin arm of the trial, 30 people received an initial 25mg dose of psilocybin at the start of the study, followed by a second 25mg dose three weeks later.
The team also gave participants six weeks of daily placebo capsules to take; one per day after the first dosing session and two per day after the second dosing session.
In the escitalopram arm of the study, 29 people received 1mg of psilocybin at the dosing sessions. This dose is so low researchers classify it as being non-active and unlikely to have an effect.
This group also received six weeks of daily escitalopram treatments at a dose of one 10mg capsule per day after the first dosing session. That increased to two capsules per day after the second dosing session, the maximum recommended dose for this SSRI.
The team then assessed each patient using standardized scales of depressive symptom severity, giving scores ranging from zero to 27. At the start of the trial, the average score was 14.5 for the psilocybin group. After six weeks, those scores fell by an average of eight points. In fact, seven out of ten participants who took the psilocybin dose saw their scores cut by at least half.
Over half of the psilocybin group (57%) experienced a remission of symptoms, with scores measuring between zero to five at week six of the trial. In comparison, only 28 percent of the escitalopram group had the same outcome.
Are there side-effects to taking these drugs?
The team notes that, while the findings are generally positive, the lack of a placebo-only group and the small number of participants limits what conclusions they can draw about the effect of either treatment alone. They add the trial sample was comprised of largely white, mostly male, and relatively well-educated individuals — meaning they can’t say the drug would work for everyone.
It is also important to note, researchers say, the psilocybin group reported fewer cases of common SSRI side-effects like dry mouth, anxiety, drowsiness, and sexual dysfunction than the escitalopram group. However, psilocybin patients had a similar rate of unpleasant side-effects overall. In particular, headaches experienced one day after dosing sessions were the most common side-effect of psilocybin.
Don’t try this at home
The authors also warn against people trying to medicate themselves. Taking mushrooms which have not been properly processed into the drug, making precise dosing possible, outside of a clinical setting without support or safeguards, could have negative consequences.
“Context is crucial for these studies and all volunteers received therapy during and after their psilocybin sessions,” says Dr. Rosalind Watts, clinical lead of the trial and formerly based at the Centre for Psychedelic Research. “Our team of therapists were on hand to offer full support through sometimes difficult emotional experiences.”
“These findings provide further support for the growing evidence base that shows that in people with depression, psilocybin offers an alternative treatment to traditional antidepressants,” adds Professor David Nutt, the Edmond Safra Chair in Neuropsychopharmacology at Imperial College London. “In our study, psilocybin worked faster than escitalopram and was well tolerated, with a very different adverse effects profile. We look forward to further trials, which if positive should lead to psilocybin becoming a licensed medicine.”
“These latest finding build on our previous research testing psilocybin therapy for treatment resistant depression, and offer the most compelling evidence yet to support efforts towards licensing psilocybin therapy as a regulated mental health intervention,” Dr. Carhart-Harris concludes.
The findings appear in the New England Journal of Medicine.
SWNS writer William Janes contributed to this report.