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)
Study at a glance
AI-extracted from the abstract| 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 Therapeutic efficacy |
| Citations | 24 |
| Key findings | 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.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... | 2020 | Systematic review | n = 188 |
| The experimental effects of psilocybin on symptoms of anxiety and depression: A meta-analysis People with elevated symptoms of anxiety and depression | 2020 | Meta-analysis | n = 117 |
| Psychedelics in the treatment of unipolar mood disorders: a systematic review Patients with broadly defined unipolar mood disorders | 2016 | Systematic review | n = 423 |
| Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Participants in studies of psychedelic therapy for depressive symptoms (Major... | 2023 | Systematic review with meta-analysis | n = 14 |
| Serotonergic hallucinogens in the treatment of anxiety and depression in patients suffering from a life-threatening disease: A systematic review. Patients with life-threatening diseases and symptoms of anxiety or depression | 2018 | Systematic review | n = 445 |