People with major depressive disorder who had higher expectations for psilocybin treatment showed greater reductions in depression symptoms compared to those taking escitalopram, while expectations for escitalopram did not predict outcomes. The analysis used data from a randomized clinical trial and suggests that treatment expectancies may influence the relative effectiveness of psilocybin versus a standard antidepressant.
A risk stratification tool is proposed to help decide whether individuals with a family history of bipolar disorder should be included in psilocybin therapy trials. The authors argue for caution due to the potential for serious adverse events, but they recommend against outright exclusion. The tool allows for more nuanced inclusion and exclusion criteria, balancing the need for effective treatments against safety concerns.