Personality change in a trial of psilocybin therapy v. escitalopram treatment for depression.
Brandon Weiss, Induni Ginige, Lu Shannon, Bruna Giribaldi, Ashleigh Murphy-Beiner, Roberta Murphy, Michelle Baker-Jones, Jonny Martell, David Nutt, Robin Carhart-Harris, David Erritzøe
Psychological Medicine 2024 DOI: 10.1017/s0033291723001514 (opens in new tab)
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Study at a glance
AI-extracted from the abstract| Characteristics | Phase 2, double-blind, randomized, active comparator controlled trial Peer reviewed |
|---|---|
| Population | Patients with moderate-to-severe major depressive disorder |
| Interventions | Psilocybin therapy Escitalopram |
| Duration | 6-week core trial period with follow-up at month 6 |
| Topics | Psilocybin Depression |
| Keywords | Absorption Escitalopram Five-factor model Impulsivity Personality change Psilocybin therapy Psychedelics psilocybin Hallucinogens Antidepressants ssris Lexapro Big five |
| Citations | 38 |
| Key findings | Both psilocybin therapy and escitalopram were associated with personality changes in a direction consistent with improved mental health, with no significant between-condition differences, except that pre-trial positive expectancy moderated post-escitalopram but not post-psilocybin personality changes. |
Abstract
Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's therapeutic action. In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up. PT was associated with decreases in neuroticism (B = -0.63), introversion (B = -0.38), disagreeableness (B = -0.47), impulsivity (B = -0.40), and increases in absorption (B = 0.32), conscientiousness (B = 0.30), and openness (B = 0.23) at week 6, with neuroticism (B = -0.47) and disagreeableness (B = -0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism (B = -0.38), disagreeableness (B = -0.26), impulsivity (B = -0.35), and increases in openness (B = 0.28) at week 6, with neuroticism (B = -0.46) remaining decreased at month 6. No significant between-condition differences were observed. Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT (v. ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.
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 |