Psilocybin Delivers 'Remarkable' Relief in Severe Depression
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Psilocybin, the psychedelic compound in "magic mushrooms," rapidly improves symptoms and produces remission in as little as two sessions for patients with major depression, new research suggests.

Major depressive disorder (MDD) is a substantial public health burden, but current treatments have limited effectiveness and adherence. Recent evidence suggests that 1 or 2 administrations of psilocybin with psychological support produces antidepressant effects in patients with cancer and in those with treatment-resistant depression.

This randomized, waiting list–controlled clinical trial was conducted at the Center for Psychedelic and Consciousness Research at Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Adults aged 21 to 75 years with an MDD diagnosis, not currently using antidepressant medications, and without histories of psychotic disorder, serious suicide attempt, or hospitalization were eligible to participate. A total of 27 participants were randomized to an immediate treatment condition group (n = 15) or delayed treatment condition group (waiting list control condition; n = 12).

Two psilocybin sessions (session 1: 20 mg/70 kg; session 2: 30 mg/70 kg) were given (administered in opaque gelatin capsules with approximately 100 mL of water) in the context of supportive psychotherapy (approximately 11 hours). Participants were randomized to begin treatment immediately or after an 8-week delay.

-- Of the randomized participants, 24 of 27 (89%) completed the intervention and the week 1 and week 4 postsession assessments.

-- This population had a mean age of 39.8 years, was composed of 16 women, and had a mean baseline GRID-HAMD score of 22.8.

-- The mean GRID-HAMD scores at weeks 1 and 4 in the immediate treatment group were statistically significantly lower than the scores at the comparable time points of weeks 5 and 8 in the delayed treatment group.

-- The effect sizes were large at week 5 and week 8.

-- The QIDS-SR documented a rapid decrease in mean depression score from baseline to day 1 after session 1, which remained statistically significantly reduced through the week 4 follow-up.

-- In the overall sample, 16 participants at week 1 and 17 at week 4 had a clinically significant response to the intervention, and 14 participants at week 1 and 13 participants at week 4 were in remission.

Conclusively, the findings suggest that psilocybin with therapy is efficacious in treating MDD, thus extending the results of previous studies of this intervention in patients with cancer and depression and of a nonrandomized study in patients with treatment-resistant depression.