Psilocybin Efficacy and Mechanisms of Action in Major Depressive Disorder: a Review.
Damien Prouzeau, Ismaël Conejero, Peter L Voyvodic, Carine Bécamel, Mocrane Abbar, Jorge Lopez-Castroman
Current psychiatry reports October 1, 2022 DOI: 10.1007/s11920-022-01361-0 via PubMed
Summary
AI-generated from the abstractPsilocybin shows large, rapid, and persistent clinical effects in treating resistant or end-of-life depression, with good tolerance and mild side effects limited to a few hours after dosing. However, studies to date have had small sample sizes, and one clinical trial against escitalopram did not show significant superiority of psilocybin on the main outcome. The neurobiological mechanisms, which differ from those of SSRI antidepressants, remain mostly unknown. Psilocybin is a promising alternative, but further research with larger samples and comparisons to standard treatments is needed.
Study at a glance
| Characteristics | Narrative review Peer reviewed |
|---|---|
| Intervention | Psilocybin |
| Keywords | 5-ht2a agonists Hallucinogen Mood disorder Narrative review Neuroimaging |
| Citations | 32 |
| Key finding | Psilocybin has large, rapid, and persistent clinical effects in treating resistant or end-of-life depression, but one trial against escitalopram did not show significant superiority on the main outcome. |
Abstract
We aim to provide an overview of the current state of knowledge about the efficacy of psilocybin in the treatment of depression, as well as its mechanisms of action. Psilocybin has a large, rapid, and persistent clinical effect in the treatment of resistant or end-of-life depression. Tolerance is good, with mild side effects limited to a few hours after dosing. The studies conducted to date have had small sample sizes. One clinical trial has been conducted against a reference treatment (escitalopram) without showing a significant superiority of psilocybin in the main outcome. The neurobiological mechanisms, mostly unknown, differ from those of SSRI antidepressants. Psilocybin represents a promising alternative in the treatment of depression. Further research with larger sample sizes, particularly against reference treatments, is needed to better understand the neurobiological factors of its effects and to investigate its potential for use in everyday practice.