Pilot study of single-dose psilocybin for serotonin reuptake inhibitor-resistant body dysmorphic disorder.
Franklin R Schneier, Jamie Feusner, Michael G Wheaton, Gloria J Gomez, Giselle Cornejo, Akansha Mahesh Naraindas, David J Hellerstein
Journal of psychiatric research May 1, 2023 DOI: 10.1016/j.jpsychires.2023.03.031 via PubMed
Summary
AI-generated from the abstractA single 25 mg oral dose of psilocybin, given with psychological support, significantly reduced body dysmorphic disorder (BDD) symptoms in 12 adults whose condition had not responded to at least one prior serotonin reuptake inhibitor. Over 12 weeks of follow-up, scores on a standard BDD severity scale decreased substantially, with a large effect size and improvements evident from week 1 and sustained through week 12. Seven of 12 participants (58%) showed a 30% or greater reduction in symptoms at week 12. No serious adverse events occurred. These preliminary findings suggest psilocybin may be a promising treatment for BDD, warranting further controlled trials.
Study at a glance
| Characteristics | Open-label trial Randomized Pilot study Peer reviewed |
|---|---|
| Sample size | 12 |
| Population | Adults with moderate-to-severe non-delusional body dysmorphic disorder unresponsive to at least one serotonin reuptake inhibitor trial |
| Intervention | Psilocybin |
| Dose | 25 mg |
| Duration | 12 weeks of follow-up after a single dosing session |
| Topics | Psilocybin |
| Keywords | Body dysmorphic disorder Clinical trial Psychedelic treatment Hallucinogenic medicine |
| Citations | 79 |
| Key finding | A single 25 mg dose of psilocybin with psychological support led to significant and sustained reductions in BDD symptoms over 12 weeks, with 58% of participants classified as responders. |
Abstract
Body dysmorphic disorder (BDD) is an often-severe condition in which individuals are preoccupied by misperceptions of their appearance as defective or ugly. Only serotonin reuptake inhibitors and cognitive-behavioral therapy have been demonstrated efficacious in randomized controlled trials. Psilocybin is a psychedelic drug with growing evidence for safety and efficacy in treatment of depression. This study aimed to pilot test the feasibility, tolerability, safety, and efficacy of psilocybin treatment of adults with BDD. In this open-label trial, 12 adults (8 women, 4 men) with moderate-to-severe non-delusional BDD that had been unresponsive to at least one serotonin reuptake inhibitor trial received a single oral dose of psilocybin 25 mg. There was no control group. Psychological support was provided before, during, and after the dosing session. The primary outcome measure for efficacy was the Yale-Brown Obsessive Compulsive Disorder Scale Modified for BDD (BDD-YBOCS) score during 12 weeks of assessments after dosing. All participants completed dosing and all follow-up assessments. BDD-YBOCS scores decreased significantly over 12 weeks of follow-up (p < .001) with a large effect size (partial eta squared = 0.54), and significant changes from baseline were present at week 1 and persisted through week 12. Secondary efficacy measures of BDD symptoms, conviction of belief, negative affect, and disability also improved significantly, and no serious adverse events occurred. At week 12, seven participants (58%) were rated responders, based on ≥30% decrease in BDD-YBOCS. This study provides promising preliminary support for psilocybin as a treatment of BDD, warranting future controlled studies.