Psilocybin-Assisted Psychotherapy for Treatment-Resistant Depression in Bipolar II Disorder
Shakila Meshkat, Erica Kaczmarek, Zoe Doyle, Ryan M Brudner, Fabiano A. Gomes, Marc G Blainey, Geneva Weiglein, Roger S McIntyre, Rodrigo B. Mansur, Joshua D. Rosenblat
Psychedelic Medicine November 18, 2024 DOI: 10.1089/psymed.2024.0032 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Subgroup analysis of an open-label trial Peer reviewed |
|---|---|
| Sample size | 4 |
| Population | Adults with treatment-resistant depression associated with bipolar II disorder, excluding those with psychosis |
| Intervention | Psilocybin |
| Dose | 25 mg |
| Duration | 6-month study |
| Topics | Depression Psilocybin Psychedelic-assisted therapy |
| Keywords | Bipolar ii disorder Efficacy Psychedelics Psilocybin therapy Mental health research Psychedelic medicine |
| Citations | 8 |
| Key findings | Psilocybin administration was associated with reduced depressive symptoms and no treatment-emergent mania, hypomania, or psychosis in four participants with bipolar II disorder. |
Abstract
Background: Bipolar II disorder (BD-II) is often associated with chronic and treatment resistant major depressive episodes. Psilocybin has shown promise for its rapid-acting antidepressant effects, though its impact on bipolar depression remains unexplored. In the present subgroup analysis of an already published trial on treatment-resistant depression (TRD), we aimed to preliminarily evaluate the safety and efficacy of psilocybin in patients with BD-II.
Methods: Adults with TRD associated with BD-II, excluding those with psychosis were included. Participants underwent one or two psilocybin sessions, each with a dose of 25 mg, along with preparatory and integrative psychotherapy sessions.
Results: A total of four participants with a mean age of 37.5 ± 4.15 years were included. At baseline, the mean Montgomery–Åsberg Depression Rating Scale (MADRS) score was 32.5 (95% CI: 26.3–38.7, SD = 3.87). By week 2 post-dose, mean MADRS decreased to 20.3, and 2 weeks after dose 2, it further dropped to 19. At the end of the 6-month study, the mean MADRS score was 21.3. Young Mania Rating Scale scores remained stable at a mean of one throughout the study with no evidence of treatment emergent mania, hypomania or psychosis observed in any participants.
Conclusions: These findings suggest potential improvement in depressive symptoms with psilocybin administration in BD-II. Future studies with larger sample size are required to replicate our results and further evaluate antidepressant effects of psilocybin in bipolar depression.