Efficacy and acceptability of psilocybin for primary or secondary depression: A systematic review and meta-analysis of randomized controlled trials
Frontiers in Psychiatry – February 15, 2024
Source: OpenAlex
Summary
Psilocybin, a potent hallucinogen, shows significant promise as an antidepressant medicine. A meta-analysis of 8 randomized controlled trials, involving 524 adult patients, revealed a large therapeutic effect (Hedges' g = -0.89) for major depressive disorder. This psychiatry research, drawing from the Cochrane Library, suggests psilocybin's benefits increase with dose. While generally well-tolerated, adverse effects can occur, highlighting the need for careful pharmacology. This area of Psychedelics and Drug Studies, exploring chemical synthesis and alkaloids, offers a compelling complementary or alternative medicine approach in internal medicine and psychology.
Abstract
Introduction Psilocybin is a classic psychedelics, which has been shown to have antidepressant effects by many studies in recent years. In this study, we aim to evaluate the efficacy, acceptability and tolerability of psilocybin in the treatment of primary (major depressive disorder) or secondary (experiencing distress related to life-threatening diagnoses and terminal illness) depression. Methods We searched PubMed, EMBASE, Web of Science, Cochrane Library and ClinicalTrials.gov for clinical trials of psilocybin for depression (updated to 4 October, 2023). Effect size Hedges’ g was used as an indicator of efficacy, and other outcomes included response rate, drop-out rate, and adverse events. Results A total of 10 studies were finally included in systematic review. 8 studies were included in the meta-analysis, involving a total of 524 adult patients, and produced a large effect size in favor of psilocybin (Hedge’s g =-0.89, 95% CI -1.25~-0.53, I² = 70.19%, P<0.01). The therapeutic effects of psilocybin increase with increasing doses. Adverse events caused by psilocybin are generally transient and reversible, but serious adverse events also may occur. Discussion Our study shows that psilocybin has both short-term and long-term antidepressant effects and holds promise as a potential complementary or alternative therapy for depression, probably. Further research may reveal more about its therapeutic potential.