Psychedelic science in post-COVID-19 psychiatry

The medium- to long-term mental health consequences of COVID-19 are predicted to increase, requiring multidisciplinary strategies. Psilocybin therapy shows promise as a transdiagnostic treatment for disorders with maladaptive habitual patterns, such as depression, addiction, and obsessive compulsive disorder. The COMPASS Pathways phase 2b double-blind trial is testing psilocybin therapy in antidepressant-free treatment-resistant depression (TRD) to determine safety, efficacy, and optimal dose. Results from the Imperial College London Psilodep-RCT comparing psilocybin therapy to the SSRI escitalopram will soon be published. The efficacy and safety of psilocybin therapy with SSRIs in TRD is not yet known; a COMPASS study in Dublin will address this. Psilocybin therapy may play an important role in post-COVID-19 psychiatry, though it is at an early clinical stage.

Study at a glance

Abstract

The medium- to long-term consequences of COVID-19 are not yet known, though an increase in mental health problems are predicted. Multidisciplinary strategies across socio-economic and psychological levels may be needed to mitigate the mental health burden of COVID-19. Preliminary evidence from the rapidly progressing field of psychedelic science shows that psilocybin therapy offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and maladaptive habitual patterns of cognition and behaviour, notably depression, addiction and obsessive compulsive disorder. The COMPASS Pathways (COMPASS) phase 2b double-blind trial of psilocybin therapy in antidepressant-free, treatment-resistant depression (TRD) is underway to determine the safety, efficacy and optimal dose of psilocybin. Results from the Imperial College London Psilodep-RCT comparing the efficacy and mechanisms of action of psilocybin therapy to the selective serotonin reuptake inhibitor (SSRI) escitalopram will soon be published. However, the efficacy and safety of psilocybin therapy in conjunction with SSRIs in TRD is not yet known. An additional COMPASS study, with a centre in Dublin, will begin to address this question, with potential implications for the future delivery of psilocybin therapy. While at a relatively early stage of clinical development, and notwithstanding the immense challenges of COVID-19, psilocybin therapy has the potential to play an important therapeutic role for various psychiatric disorders in post-COVID-19 clinical psychiatry.