Incremental efficacy systematic review and meta-analysis of psilocybin-for-depression RCTs
Psychopharmacology April 23, 2025 Nicholas C Borgogna, Tyler Owen, Dan Petrovitch et al. 8 citations
Psilocybin moderately reduces depression compared to controls, with a standardized mean difference of 0.62, but effects vary widely across studies and are weaker in larger, better-controlled trials. Most of the nine randomized controlled trials (602 participants, 56% receiving psilocybin) had high risk of bias and poor harm reporting; only two studies had high-quality harm reporting. Therapeutic mechanisms of action were discussed but rarely tested, leaving it unclear how psilocybin alleviates depression. Smaller studies showed stronger effects favoring psilocybin, and nearly all studies reported financial conflicts of interest. Independent, larger trials with active controls and mechanism assessments are needed.