Over the past few years, there has been an emerging body of evidence that psylocybin, or the active compound in magic mushrooms, could serve as a potentially effective treatment for major depressive disorder. On Wednesday, the New England Journal of Medicine added to that body of research with a small study from Imperial College London, which indicated that psilocybin could potentially be a more efficient, and equally effective, treatment for depression as a common antidepressant.
Led by Dr. Robin Carhart-Harris, the head of the Centre for Psychedelic Research at Imperial College London, the study had a relatively small sample size of 59 participants, half of whom were given psilocybin as a treatment and half of whom were given escitalopram (known better as the brand-name antidepressant Lexapro). The participants were then given a questionnaire to report their symptoms.
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The study’s authors found that there was not a statistically significant difference between the two treatments in terms of overall reduction of depressive symptoms. But they did find that those who were given psilocybin reported a more rapid reduction of symptoms of depression than those who were given escitalopram, leading researchers to conclude that “larger and longer trials are required to compare psilocybin with established antidepressants.”
It’s important to note that the study had some limitations, including its small sample size and its methodology of solely relying on questionnaires to indicate reduction of symptoms. The study was also only limited to six weeks, and the full effects of escitalopram tend to kick in after several weeks, raising questions as to whether the escitalopram group could’ve improved had the study been longer.
But in light of the historic dearth of studies on psychedelics, which were largely cut off from government funding for decades, the Imperial College London study adds to the growing body of evidence that psilocybin may work for treatment-resistant depression, or TRD. Particularly of note is the fact that no safety concerns were identified in the psilocybin group compared to conventional treatment, says Corine de Boer, MD, PhD, Chief Medical Officer of MAPS, which is important “to educate the public that is generally concerned about the safety of psychedelics.” “The durability of these results need to be confirmed in a larger with a longer follow-up but these results are very promising for the field of psychedelic medicine,” she tells Rolling Stone.
Todd Korthuis, addiction medicine physician and researcher at Oregon Health and Science University and head of their addiction program, agrees that the study results might not seem remarkable at face value, but that it is a step in the right direction in encouraging more funding and research. “The role of psilocybin in the treatment of depression and other conditions holds a lot of promise, but has underdeveloped evidence to support its use at the current time period,” he says. “This group has done a series of really interesting experiments that seek to provide scientific evidence for its use, and that’s what the field is in need of.”
Particularly of note is the fact that the study assessed the effects of psilocybin against an antidepressant rather than a placebo, as previous studies have done. “They went head to head with arguably one of the best most accepted medication treatments for depression and found at a minimum, it improved scores about the same,” Korthuis says. “It’s not as sexy as if there had been a blowout difference between the two treatments, but it’s saying psilocybin, which has been on the margins and grossly understudied, is comparable to something every psychiatrist accepts as normal practice.”
The results of the study will also likely come as a boon to the growing market of psychedelic-based medical treatments focused on mental health, which could soon become a $100 billion market, according to a recent Business Insider report. “It is an important contribution” to the field of research surrounding psychedelics, says Korthuis.
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