Comparative oral monotherapy of psilocybin, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, ayahuasca, and escitalopram for depressive symptoms: systematic review and Bayesian network meta-analysis
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.