Psilocybin Efficacy and Mechanisms of Action in Major Depressive Disorder: a Review.
Damien Prouzeau, Ismaël Conejero, Peter L Voyvodic, Carine Becamel, Mocrane Abbar, Jorge Lopez-Castroman
Current psychiatry reports October 1, 2022 Peer reviewed DOI: 10.1007/s11920-022-01361-0 via PubMed
Summary
Psilocybin shows a large, rapid, and persistent effect in treating resistant or end-of-life depression, with mild side effects that last a few hours. However, one clinical trial comparing psilocybin to escitalopram did not find significant superiority in the main outcome. The neurobiological mechanisms of psilocybin differ from traditional SSRIs and remain mostly unknown. Further research with larger sample sizes is necessary to explore its potential as a treatment.
Study at a glance
| Design | narrative review |
|---|---|
| Population | individuals with resistant or end-of-life depression |
| Key finding | One clinical trial found no significant superiority of psilocybin over escitalopram in the main outcome. |
Abstract
We aim to provide an overview of the current state of knowledge about the efficacy of psilocybin in the treatment of depression, as well as its mechanisms of action. Psilocybin has a large, rapid, and persistent clinical effect in the treatment of resistant or end-of-life depression. Tolerance is good, with mild side effects limited to a few hours after dosing. The studies conducted to date have had small sample sizes. One clinical trial has been conducted against a reference treatment (escitalopram) without showing a significant superiority of psilocybin in the main outcome. The neurobiological mechanisms, mostly unknown, differ from those of SSRI antidepressants. Psilocybin represents a promising alternative in the treatment of depression. Further research with larger sample sizes, particularly against reference treatments, is needed to better understand the neurobiological factors of its effects and to investigate its potential for use in everyday practice.