According to a study published in the BMJ, researchers say that psilocybin is an effective treatment procedure for depression and can act as an antidepressant. The findings are quite interesting but further research needs to be conducted to maximize the potential of psilocybin’s treatment. With 300 million people worldwide affected with depression today, there is an acute need for a treatment that is accessible.
Psilocybin has shown promise in reducing symptoms of depression without any side effects. This ingredient also has no evidence of causing long-term addiction. Researchers have examined numerous databases looking for trails that compared this ingredient as a treatment option for depression. They found seven relevant trials for analysis involving 436 participants with depression (52% female; 90% white). The change in depression scores was significantly greater after treatment with psilocybin than with a comparator treatment, with an overall Hedge’s g of 1.64 indicating a large effect size favoring psilocybin.
Further analyses to account for trial differences indicated that having secondary depression (related to an underlying disease) rather than primary depression, being assessed with a self-reported scale rather than a clinician assessed scale, older age, and previous use of psychedelics, were correlated with greater improvements.
The study authors acknowledge that high levels of variation (heterogeneity) between trials resulted in a low certainty of evidence to support a strong antidepressant effect of psilocybin, findings were limited by the lack of participant diversity. Furthermore, in clinical trials, patients receive psilocybin in a calm living room with soothing music, supervised by a psychotherapist, which is unlikely to be achievable in a healthcare system.
Researchers say that this study has its own limitations. For instance, psilocybin’s potential as an antidepressant is yet to recognize its cost of accumulation, regulatory guidelines and legal safeguards. They say that companies need to sort this before the ingredient can be established within clinical practice.
For instance, they argue that it cannot provide evidence for psilocybin’s effectiveness (performance under ‘real-world’ conditions) in depression until more information about potential effect modifiers is gathered and that pragmatic clinical trials and real-world data could help to deliver that. Furthermore, there is still ongoing debate on whether psychedelics can express antidepressant activity on their own rather than by assisting specific forms of psychotherapy.
Finally, and perhaps most importantly, the authors say that as per all analyses using aggregate data, we cannot differentiate between those individuals most likely to benefit from psilocybin and those who might instead experience adverse events. As such, they conclude that these promising findings “support a prudent approach in both scholarly and public settings, because more and better evidence is needed before any clinical recommendation can be made about therapeutic use of psilocybin.”
