New England Journal of Medicine
April 14, 2021
Robin Carhart‐Harris, Bruna Giribaldi, Rosalind Watts et al.
1,372 citations
In a selected group of patients, psilocybin did not show a significantly greater antidepressant effect than escitalopram based on depression scores at week 6. Secondary outcomes generally favored psilocybin, but these analyses were not corrected for multiple comparisons. The authors call for larger and longer trials to compare psilocybin with established antidepressants.
Frontiers in Pharmacology
March 31, 2022
Roberta Murphy, Roberta Murphy, Hannes Kettner et al.
229 citations
In a trial comparing psilocybin-assisted therapy to escitalopram for moderate-to-severe depression, a stronger therapeutic alliance with the therapist predicted greater emotional breakthrough and mystical-type experiences during psilocybin sessions, and these experiences in turn predicted larger reductions in depression symptoms six weeks after treatment. Emotional breakthrough during the first session strengthened the alliance before the second session, while a weaker alliance before the second session directly predicted higher depression scores at the endpoint, independent of the acute psychedelic experience. The findings suggest the therapeutic relationship plays a key role in shaping both the quality of the psychedelic experience and clinical outcomes.
Frontiers in Pharmacology
March 31, 2022
Roberta Murphy, Roberta Murphy, Hannes Kettner et al.
229 citations
In a trial comparing psilocybin-assisted therapy to escitalopram for moderate-to-severe depression, a stronger therapeutic alliance with the therapist predicted greater emotional breakthrough and mystical-type experiences during psilocybin sessions, and these experiences in turn predicted larger reductions in depression symptoms six weeks after treatment. Emotional breakthrough during the first session strengthened the alliance before the second session, while a weaker alliance before the second session directly predicted higher depression scores at the endpoint, independent of the acute psychedelic experience. The findings suggest the therapeutic relationship plays a key role in shaping both the quality of the psychedelic experience and clinical outcomes.
PLoS ONE
October 24, 2023
Jules Evans, Oliver Robinson, Eirini K. Argyri et al.
166 citations
Long-term adverse experiences after psychedelic use can last weeks, months, or even years and are understudied. A mixed-method study of 608 participants who reported extended difficulties found the most common challenges were anxiety and fear, existential struggle, social disconnection, depersonalization, and derealization. For about one-third of participants, problems persisted over a year; for one-sixth, they lasted more than three years. Shorter difficulties were predicted by knowing the dose and drug type and by lower difficulty during the experience; a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for harm reduction are discussed.
Psychopharmacology
January 11, 2020
Ashleigh Murphy-Beiner, Kirstie Soar
142 citations
Ayahuasca enhances mindfulness and alters cognitive flexibility during the 'afterglow' period, suggesting these changes may be psychological mechanisms behind its psychotherapeutic effects. These psychological gains occurred regardless of whether participants had prior ayahuasca experience, indicating potential therapeutic benefits for both naïve and experienced drinkers.
EClinicalMedicine
September 23, 2024
David Erritzoe, Tommaso Barba, Kyle T Greenway et al.
46 citations
In a clinical trial, psilocybin therapy showed comparable effectiveness to a common SSRI antidepressant for treating depression, with both treatments leading to significant reductions in depressive symptoms over a follow-up period. The findings suggest psilocybin may offer a viable alternative to standard antidepressant medication, though the study's design and sample size limit the strength of conclusions.
Psychological medicine
January 1, 2024
Brandon Weiss, Induni Ginige, Lu Shannon et al.
38 citations
In a trial comparing psilocybin therapy with the antidepressant escitalopram for moderate-to-severe major depressive disorder, both treatments led to personality changes in a direction consistent with improved mental health. Psilocybin was linked to decreases in neuroticism, introversion, disagreeableness, and impulsivity, and increases in absorption, conscientiousness, and openness at six weeks, with some changes lasting six months. Escitalopram was linked to decreases in neuroticism, disagreeableness, and impulsivity, and increases in openness at six weeks, with neuroticism remaining decreased at six months. No significant differences between the two treatments were observed, except that patients' pre-trial positive expectations for escitalopram moderated personality changes after that treatment, but not after psilocybin.
PloS one
January 1, 2025
Eirini K Argyri, Jules Evans, David Luke et al.
27 citations
Psychedelic experiences can sometimes trigger long-lasting existential distress, marked by confusion about existence and purpose, alongside cognitive, emotional, social, and bodily difficulties. Interviews with 26 people who experienced such distress revealed that ontological challenges—struggles with understanding reality—were common. Participants alleviated distress primarily through 'grounding' practices: embodiment, social connection, and cognitive normalization of their experience. The findings suggest psychedelic experiences act as pivotal mental states that can facilitate transformative learning, challenging and expanding meaning-making. This work contributes to understanding how people reestablish coherence and grow after ontologically challenging psychedelic experiences.
Frontiers in Psychology
May 28, 2024
Oliver Robinson, Jules Evans, David Luke et al.
24 citations
After a psychedelic experience, some people face difficulties that last at least a day. An international survey of 608 such individuals found they used a variety of coping strategies. The most common individual strategies were meditation and prayer, followed by self-educational activities like reading and journaling. Social coping most often involved seeking support from friends or family, then from a therapist or coach. Helpful features of social support included feeling heard and accepted, a non-judgmental attitude, and sharing similar experiences. These findings can inform therapeutic interventions and educational resources for those experiencing extended post-psychedelic difficulties.
Neuroethics
November 6, 2023
Edward Jacobs, Ashleigh Murphy-Beiner, Ian Rouiller et al.
23 citations
In psychedelic clinical trials, the case for providing patients with continued access to the investigational drug after the trial ends is especially strong due to the drugs' broader legal status, the unique therapist-participant relationship, and the extended therapeutic process. Because the therapy's effectiveness relies heavily on non-drug factors and the cultural setting, the authors argue for expanding post-trial care beyond just drug access. They outline potential provisions and contend that viewing post-trial care as an integral part of research—and a proper use of funding—will help build the infrastructure needed for a future psychedelic medicine system after legalization.
Frontiers in Psychology
May 11, 2023
Hannah Thurgur, Meg J. Spriggs, Ashleigh Murphy-Beiner et al.
13 citations
A framework called Access, Reciprocity and Conduct (ARC) is proposed to build an ethical and equitable infrastructure for psychedelic-assisted therapy (PAT). ARC rests on three pillars: ensuring equal access to PAT for those needing mental health treatment, promoting safety for those delivering and receiving therapy, and respecting traditional and spiritual uses of psychedelic medicines. The framework is being developed through a dual-phase co-design approach, first co-creating ethics statements with stakeholders from research, industry, therapy, community, and Indigenous settings, then inviting broader collaborative review. The authors aim to spark dialogue and help organizations and practitioners address complex ethical questions in PAT.
Psychological Medicine
July 19, 2023
Brandon Weiss, Induni Ginige, Lu Shannon et al.
1 citation
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