Assessing the risk of symptom worsening in psilocybin-assisted therapy for depression: A systematic review and individual participant data meta-analysis
Otto Simonsson, Per Carlbring, Robin Carhart-Harris, Alan K. Davis, David Nutt, Roland R. Griffiths, David Erritzøe, Simon B. Goldberg
Psychiatry Research July 23, 2023 DOI: 10.1016/j.psychres.2023.115349 (opens in new tab) via OpenAlex
Summary
AI-generated from the abstractIn a meta-analysis of three psilocybin trials for depression involving 102 participants, clinically significant symptom worsening occurred for a minority of those receiving psilocybin or escitalopram (about 10%) and for a majority of those in the waitlist condition (63.6%). The psilocybin arm showed a lower likelihood of symptom worsening compared to waitlist and no difference compared to escitalopram. The authors note the limitation of a relatively small sample size.
Study at a glance
| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Sample size | 102 |
| Population | Participants in psilocybin trials for depression |
| Interventions | psilocybin escitalopram waitlist |
| Dose | two-dose |
| Topics | Depression Psilocybin |
| Keywords | Meta-analysis Psilocybin therapy Clinical depression treatment Psychedelic medicine Mental health research |
| Citations | 24 |
| Key finding | Clinically significant symptom worsening occurred for about 10% of participants in the psilocybin and escitalopram conditions and for 63.6% in the waitlist condition, with psilocybin showing a lower likelihood of worsening versus waitlist and no difference versus escitalopram. |
Abstract
We conducted a meta-analysis using individual participant data from three, two-dose psilocybin trials for depression (N = 102) with the aim of assessing the risk of symptom worsening. Clinically significant symptom worsening occurred for a minority of participants in the psilocybin and escitalopram conditions (∼10%) and for a majority of participants in the waitlist condition (63.6%). Using data from the two trials with control arms, the psilocybin arm showed a lower likelihood of symptom worsening versus waitlist, and no difference in the likelihood of symptom worsening versus escitalopram. The limitation of a relatively small sample size should be addressed in future studies.