The New England journal of medicine
November 3, 2022
Guy M Goodwin, Scott T Aaronson, Oscar Alvarez et al.
1,095 citations
A single 25 mg dose of psilocybin, but not 10 mg, reduced depression scores more than a 1 mg control dose over three weeks in adults with treatment-resistant depression. In this phase 2 trial, 233 participants were randomly assigned to 25 mg, 10 mg, or 1 mg of synthetic psilocybin with psychological support. The 25 mg group showed an average 12-point drop on the MADRS depression scale versus a 5.4-point drop in the 1 mg group, a significant difference. The 10 mg group did not differ significantly from control. Response and remission rates at three weeks supported the primary result, but sustained response at 12 weeks was not significantly different.
Journal of psychoactive drugs
January 1, 2023
Zachary Herrmann, Mitch Earleywine, Joseph De Leo et al.
19 citations
Subjective responses to psychedelic drugs, such as mystical experiences and oceanic boundlessness, often correlate with therapeutic improvements in conditions like treatment-resistant depression, end-of-life anxiety, and substance use disorders. Measuring these responses is challenging; several scales show good reliability and factor structure, but samples are often small and self-selected. This review examines the psychometric properties of widely used scales and their links to treatment outcomes. Challenging experiences, psychological insight, and emotional breakthroughs also show promise, though replication is needed. A collaborative approach to data collection on subjective reactions in therapeutic settings could help predict improvement across conditions.
Brain stimulation
January 1, 2024
Charles R Conway, Scott T Aaronson, Harold A Sackeim et al.
16 citations
Patients with treatment-resistant unipolar major depressive disorder who qualified for the RECOVER trial—the largest randomized sham-controlled study of vagus nerve stimulation for a psychiatric condition—had severe disability, a median of 11.0 prior failed antidepressant treatments, and high rates of suicidality (77% with suicidal ideation, 40% with previous suicide attempts). Seventy-one percent had received at least one prior interventional psychiatric treatment (electroconvulsive therapy, transcranial magnetic stimulation, or esketamine). Compared to those without such history, recipients of interventional treatments were younger, more severely depressed, had greater suicidal ideation, earlier onset of depression, and more failed medication trials.