Depression Improves Following Single Dose of Psilocybin
Psychiatric News December 26, 2022 DOI: 10.1176/appi.pn.2023.01.1.50 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 233 |
| Population | Adults with treatment-resistant depression |
| Intervention | Psilocybin |
| Dose | 1 mg, 10 mg, or 25 mg |
| Duration | Three-week follow-up |
| Topics | Psilocybin Depression |
| Keywords | Depression economics Randomized controlled trial Significant difference Hallucinogen |
| Key findings | A single 25-mg dose of psilocybin with psychological support significantly reduced depression symptoms for at least three weeks compared with a 10-mg or 1-mg dose, but severe adverse events including suicidal ideation were more common at the higher dose. |
Abstract
Back to table of contents Previous article Next article Clinical & ResearchFull AccessDepression Improves Following Single Dose of PsilocybinNick ZagorskiNick ZagorskiPublished Online:26 Dec 2022https://doi.org/10.1176/appi.pn.2023.01.1.50AbstractPatients with treatment-resistant depression who receive a single dose of psilocybin may experience a reduction in depression symptoms.iStock/Rich TownsendPatients with treatment-resistant depression who receive a single 25-mg dose of psilocybin coupled with psychological support may experience a reduction in depression symptoms for at least three weeks. Similar results were not seen in patients who received a single 10-mg dose of psilocybin. The findings were published in the New England Journal of Medicine.The trial—conducted at 22 sites in 10 countries—included 233 adults with treatment-resistant depression; 90% of the participants had no prior experience with psilocybin. The participants were randomized to receive one of three doses of psilocybin (1 mg, 10 mg, or 25 mg) followed by a six-to-eight-hour therapy session. The participants also received two shorter follow-up therapy sessions one day and one week after receiving psilocybin.After three weeks, the participants’ scores on the Montgomery–Åsberg Depression Rating Scale (MADRS) dropped by 12.0 points in the 25-mg group, 7.9 points in the 10-mg group, and 5.4 in the 1-mg group; the difference between the 25-mg and 10-mg groups was statistically significant whereas the difference between the 10-mg and 1-mg groups was not. In addition, 37% of adults taking the 25-mg dose experienced a treatment response (at least 50% reduction in MADRS score), compared with 19% taking the 10-mg dose and 18% taking the 1-mg dose.From day 2 to week 3, severe adverse events were reported by 9% of the participants in the 25-mg group and 7% in the 10-mg group, compared with 1% of those in the 1-mg group, the researchers noted. The adverse events included a few instances of suicidal ideation or self-injury.“[S]uicidality demands clinical vigilance in future trials of psilocybin for depression,” they wrote. ■Goodwin GM, Aaronson ST, Alvarez O, et al. Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. N Engl J Med. 2022; 387(18): 1637-1648. ISSUES NewArchived
Comparable studies
Other randomized controlled trials on psilocybin for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety | 2016 | Randomized controlled trial | n = 51 |
| Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression | 2016 | Double-blind, placebo-controlled, crossover trial | n = 29 |
| Trial of Psilocybin versus Escitalopram for Depression Selected group of patients with depression | 2021 | Randomized controlled trial | |
| Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder Adults aged 21 to 75 years with major depressive disorder, not currently using... | 2020 | Randomized controlled trial | n = 24 |
| Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. Adults with treatment-resistant depression | 2022 | Phase 2 double-blind randomized controlled trial | n = 233 |