“There is something about the psychedelic experience that leads to a rapid resolution of depression symptoms,” said James Rucker, a consultant psychiatrist at King’s College London who worked on the trial. “We don’t really know what that is at this point, but it’s very different from standard antidepressants.”
The trial findings could be an encouraging sign for the 16 million Americans estimated each year by the Centers for Disease Control and Prevention have depression, many of whom are struggling to find treatments that work for them. Its authors hope that the study, which was relatively small, with only 79 participants receiving the 25-mg dose, will pave the way for eventual regulatory approval of psilocybin by the Food and Drug Administration for use as an anti-inflammatory drug. the Depression.
The new study randomly assigned 233 adults with depression to three doses of psilocybin (25 mg, 10 mg and 1 mg) at 22 sites in 10 countries. The authors found that the group receiving the largest dose had the most significant improvements in their depression, both immediately and for several weeks afterward.
Two-thirds of adult study participants who received a 25-mg dose of the active hallucinogen saw significant improvement in their depression in just three weeks, the researchers found. In the same period, nearly a third of those given the higher dose found that their symptoms had eased to the point that they no longer qualified for a clinical diagnosis of depression.
After taking a single psilocybin capsule, study patients were supervised in an environment where they experienced the drug’s hallucinogenic effect while lying down, wearing an eye mask and listening to music. They then discussed their six to eight hour ‘journey’ with a psychotherapist, who guided them through the insights the experience offered.’
Despite the headaches, nausea, and dizziness reported by many as adverse side effects, most adults enjoyed the experience.
“Patients describe it as a waking dream,” Rucker said, where “the nature and breadth of the experience is expanded.” But unlike a dream, the patient is fully aware of what is happening to them and is more likely to remember it as a result, a potential explanation for the relief of depression symptoms, Rucker said.
Another notable result of the study was the immediacy of the effect that the researchers identified psilocybin to have on patients, usually the next day. It stands them out in contrast to conventional antidepressants, which are known to initially exacerbate symptoms before taking effect only four to six weeks later. as muchbased on a 2012 review of existing research on therapy options for depression.
The precise mechanism by which psilocybin works against depression is unclear, but it may be related to the unique way the hallucinogen allows people to access and interrogate their own emotions, the study authors suggested.
“People often gain some clarity about why they might be depressed. They can be grieving for someone, but they can’t get in touch with that pain, just as an example,” Rucker said. “With awareness comes a kind of clarity.”
The authors concluded that larger, longer-term clinical trials were needed to effectively determine the medical efficacy and safety of psilocybin, but they were hopeful that the drug might eventually receive regulatory approval.
The trial is the latest in a series of clinical studies examining the potential of psychedelics to treat mental health disorders. Among the drugs attracting renewed interest is ketamine, an anesthetic often used recreationally by partygoers but a recent study also found significantly reduced symptoms of depression.
Long-term data on its effectiveness are not yet available, but early small studies found that ketamine therapy significantly and rapidly reduced symptoms of depression in about 50 to 70 percent of patients. The FDA has already approved esketamine, a nasal spray treatment for depression based on ketamineto take along with conventional oral medications.
Barriers to conducting clinical research on certain restricted substances, including psilocybin, have also been lowered in recent years. In 2018, the Drug Enforcement Administration announced that it was streamlining its application process for researchers who wish to study Schedule I substances, defined in 1971 as “no currently accepted medical use and with a high potential for abuse,” and which includes psilocybin.
“What people forget about psychedelics is that they were used as medicine before 1971, when they essentially got caught up in the war on drugs,” Rucker said. “We’re just picking up the baton of history.”