Psychiatry Investigation
October 10, 2021
Chia‐ling Yu, Fu-Chi Yang, Szu‐nian Yang et al.
57 citations
A meta-analysis of five clinical trials found that psilocybin is superior to placebo for reducing end-of-life anxiety symptoms. Psilocybin reduced state anxiety at 1 day and 2 weeks after treatment, and trait anxiety at 1 day, 2 weeks, and 6 months after treatment. Psilocybin caused a temporary increase in systolic and diastolic blood pressure compared with placebo. There were no significant differences between psilocybin and placebo in rates of stopping treatment, serious adverse events, or heart rate. The authors conclude that psilocybin-assisted therapy can improve end-of-life anxiety without serious side effects, but note the small sample sizes and high heterogeneity in long-term outcomes.
Journal of Clinical Medicine
February 11, 2022
Chia‐ling Yu, Chih-Sung Liang, Fu-Chi Yang et al.
37 citations
A meta-analysis of ten studies found that one or two doses of psilocybin produce rapid and sustained antidepressant effects lasting up to six months. Depressive symptoms decreased substantially, with the largest effect at one week (standardized mean difference -1.74) and a still-large effect at six months (-1.12). Higher doses and two sessions were linked to greater improvement. Psilocybin raised systolic blood pressure by 19.00 mmHg and diastolic by 8.66 mmHg, but discontinuation rates and heart rate changes were similar to placebo. The findings suggest psilocybin has favorable cardiovascular safety and acceptability for treating depression.
BMJ
August 21, 2024
Trevor Thompson, Ping-Tao Tseng, Chih-Wei Hsu et al.
24 citations
A systematic review and network meta-analysis of randomized controlled trials compared oral psychedelics (MDMA, LSD, psilocybin, ayahuasca) and escitalopram for depressive symptoms. Placebo responses were lower in psychedelic trials than in antidepressant trials. Only high-dose psilocybin outperformed placebo from antidepressant trials, with a mean difference of 6.45 on the Hamilton depression rating scale. However, when the reference arm shifted from psychedelic-trial placebo to antidepressant-trial placebo, the effect size dropped from large (0.88) to small (0.31). High-dose psilocybin showed a larger relative effect than escitalopram at 10 mg and 20 mg. No intervention caused higher discontinuation or severe adverse events than placebo.
Frontiers in Psychiatry
August 13, 2024
Mu-Hong Chen, Shu-Li Cheng, Yu-Chen Kao et al.
8 citations
A Bayesian meta-analysis of 10 clinical trials involving 515 adults with diagnosed depression found that psilocybin-assisted therapy produced a pooled mean reduction of 10.08 points on the 17-Item Hamilton Depression Rating Scale. The psychological protocols used alongside psilocybin varied: manualized directive psychotherapy, manualized nondirective psychological support, non-manualized nondirective psychological support, and non-manualized supportive psychotherapy. Compared with manualized nondirective psychological support, the other three approaches did not differ significantly in their effect on depressive symptoms. The improvement in depressive symptoms was not associated with the type of psychological protocol employed.
Journal of Affective Disorders
January 15, 2025
Jia-Ru Li, Kuo-Tung Chiang, Yu-Chen Kao et al.
1 citation
The antidepressant effects of psychedelics may be overestimated in trials using pre-post single-arm, non-active-drug-as-placebo, and waitlist-control designs. A systematic review of 19 trials found that psilocybin and MDMA showed large to medium effect sizes in non-active-placebo designs (psilocybin: Hedges' g = 0.87; MDMA: g = 0.65), but effects were not statistically significant in active-placebo designs. Psilocybin effect sizes were very large in pre-post (g = 2.51) and waitlist-control (g = 2.88) designs. Ayahuasca also showed large effects in pre-post (g = 1.88) and non-active-placebo (g = 1.60) designs. LSD was significant only in non-active-placebo design (g = 1.49). Limited sample sizes, difficulty maintaining participant blinding, and high expectancy likely inflate apparent efficacy.