Reappraisal of the hype and hope offered by psilocybin treatment of depression
New Zealand Medical Journal – September 15, 2025
Source: OpenAlex
Summary
Early findings suggest psilocybin holds promise for depression, a significant area in Psychology and Mental Health. However, a review of Psychedelics and Drug Studies reveals methodological challenges like expectation bias. While generally well tolerated, side effects are often not systematically reported, and some recipients may experience harm. Comparing with ketamine for treatment-resistant depression shows similar issues, but ketamine's positive evidence is currently stronger. Therefore, the current data on psilocybin's efficacy and safety in Psychotherapy Techniques and Applications is insufficient to warrant wider availability for depression treatment.
Abstract
aim: To provide a balanced account of psilocybin treatment of depression for expectations to be appropriately set. method: Review and discussion of key psilocybin efficacy studies. Reporting of side effects and risk of harm with psychedelic treatments. Comparisons and contrasts with ketamine studies of treatment-resistant depression (TRD). result: Early psilocybin studies offer promise but expectation bias and functional unblinding are factors in the treatment response. Psilocybin is generally well tolerated but side effects are often not systematically reported, and some recipients may experience harm. The ketamine research has similar methodological considerations, but the weight of positive evidence is stronger for a treatmentresistant group. conclusion: The evidence for psilocybin treatment of depression is insufficient to press for wider availability and use.