Evidence versus expectancy: the development of psilocybin therapy
BJPsych Bulletin May 29, 2023 DOI: 10.1192/bjb.2023.28 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Opinion piece Peer reviewed |
|---|---|
| Intervention | Psilocybin therapy |
| Topics | Psilocybin |
| Keywords | Expectancy theory Masking illustration Clinical trial Psychoeducation Psychotherapist |
| Citations | 9 |
| Key points | Argues that disambiguating drug and expectancy effects in psilocybin therapy is necessary but difficult due to likely masking failure, and that routine measurement of masking and expectancy represents a research opportunity. |
Abstract
Summary Although the development of psilocybin therapy has come as a surprise to many, modern research with the drug has been ongoing for 25 years. Psilocybin therapy is composed of psilocybin dosing sessions embedded within a wider process of psychoeducation, psychological support and integration. Early phase clinical trial evidence is promising, particularly for treatment-resistant depression. However, masking probably fails and expectancy effects may be a part of the mechanism of change. Disambiguating between drug and expectancy effects is a necessary part of the development process, yet this is difficult if masking fails. Hitherto, masking and expectancy have not been routinely measured in psilocybin or other medication trials. Doing so represents an opportunity for research and may influence psychiatry more widely. In this opinion piece I summarise the clinical development process of psilocybin therapy thus far, discussing the hope, the hype, the challenges and the opportunities along the way.