BMJ
August 21, 2024
Trevor Thompson, Ping-Tao Tseng, Chih-Wei Hsu et al.
24 citations
A systematic review and network meta-analysis of randomized controlled trials compared oral psychedelics (MDMA, LSD, psilocybin, ayahuasca) and escitalopram for depressive symptoms. Placebo responses were lower in psychedelic trials than in antidepressant trials. Only high-dose psilocybin outperformed placebo from antidepressant trials, with a mean difference of 6.45 on the Hamilton depression rating scale. However, when the reference arm shifted from psychedelic-trial placebo to antidepressant-trial placebo, the effect size dropped from large (0.88) to small (0.31). High-dose psilocybin showed a larger relative effect than escitalopram at 10 mg and 20 mg. No intervention caused higher discontinuation or severe adverse events than placebo.
Frontiers in Psychiatry
August 13, 2024
Mu-Hong Chen, Shu-Li Cheng, Yu-Chen Kao et al.
8 citations
A Bayesian meta-analysis of 10 clinical trials involving 515 adults with diagnosed depression found that psilocybin-assisted therapy produced a pooled mean reduction of 10.08 points on the 17-Item Hamilton Depression Rating Scale. The psychological protocols used alongside psilocybin varied: manualized directive psychotherapy, manualized nondirective psychological support, non-manualized nondirective psychological support, and non-manualized supportive psychotherapy. Compared with manualized nondirective psychological support, the other three approaches did not differ significantly in their effect on depressive symptoms. The improvement in depressive symptoms was not associated with the type of psychological protocol employed.
Progress in neuro-psychopharmacology & biological psychiatry
June 20, 2026
Jen-Ping Chen, Chih-Wei Hsu, Yi-Ya Fang et al.
Esketamine initiation, compared with oral antidepressant monotherapy, was associated with a 26% lower risk of all-cause mortality over two years among adults aged 18–74 with cancer-related depression, according to a target trial emulation using electronic health records. After propensity score matching of 1,751 patients per group, esketamine also corresponded to lower risks of emergency room visits, intensive care unit visits, ischemic stroke, and psychotherapy utilization. Safety outcomes were generally comparable between groups. The associations were more pronounced in older patients. These real-world findings support esketamine as a potential therapeutic option for managing cancer-related depression.
Journal of affective disorders
April 15, 2026
Jen-Ping Chen, Chih-Wei Hsu, Yi-Ting Chen et al.
Among adults with treatment-resistant depression, repetitive transcranial magnetic stimulation (rTMS) was associated with fewer medical complications than esketamine over the first year, including lower risks of hospitalization, arrhythmia, and any injury. Suicide-related outcomes were broadly comparable overall, though esketamine showed a protective advantage during the 30-90-day interval and among patients aged 45-65 years. The analysis used target trial emulation with propensity score matching on 50 covariates, drawing on electronic health records of 1,690 matched patients per treatment group. The findings suggest rTMS has a more favorable overall medical safety profile, while suicide risks were similar except for specific subgroups and time periods.