The psychedelic found in magic mushrooms outperformed one of the leading treatments for depression in a scientific study.
Research suggested that it may be at least as effective as a leading antidepressant in a therapeutic setting.
It found that psilocybin appeared to treat depression faster, longer, and with fewer side effects than the antidepressant escitalopram.
While depression levels were decreased in both groups, the decreases occurred faster and were greater in the group that had a psilocybin trip during therapy.
The psilocybin group also spent longer in remission from depression – and suffered fewer side effects.
The researchers compared the therapeutic potential of the naturally occurring psychedelic – found in Liberty Cap mushrooms and some other mushrooms – with a six-week course of the antidepressant escitalopram in 59 people with moderate to severe depression.
However, they cautioned that the main comparison between psilocybin and the antidepressant was not statistically significant.
They said larger studies with more patients over time are needed to show whether the compound can work as well or more effectively than an established antidepressant.
Dr. Robin Carhart-Harris, Director of the Center for Psychedelic Research at Imperial College London, who designed and directed the study, said, “One of the most important aspects of this work is that people can clearly see the promise of properly administered psilocybin therapy through Considered versus a better known, established treatment in the same study.
“Psilocybin has done really well in this head-to-head area.”
For the psilocybin dosing sessions, which lasted six hours, the volunteers received an oral dose of the drug.
During the sessions, they listened to a curated music playlist that included emotionally stimulating and atmospheric sounds, as well as ambient and neoclassical sounds.
Participants were guided through their experiences by a psychological support team that included registered psychiatrists.
Professor David Nutt, Edmond J Safra Chair in Neuropsychopharmacology at Imperial College London, said, “The effect builds up over 30 to 40 minutes, and for most people the sustained effect is around three to four hours and then it fades .
“So the total is six hours, but it’s not six hours of stumbling.”
According to the study published in the New England Journal of Medicine, people treated with psilocybin – named Comp360 Comp360 by developer Compass Pathways – showed improvements in a number of subjective measures.
This included their ability to experience pleasure and express feelings, greater reductions in anxiety and suicidal thoughts, and increased wellbeing.
Most of the therapy took place the following day, when the therapists spoke to the participants about their experiences.
Prof. Nutt said, “Very often for the first time people have actually understood why they are depressed and they really want to talk about it because it helps them overcome the kind of persistent negative attitudes they had about themselves and about their life underpinning depression. “
During the study, 30 volunteers received a starting dose of psilocybin (25 mg) at the start of the study and a second dose (25 mg) three weeks later.
They were given placebo capsules daily for six weeks.
In the escitalopram arm of the study, 29 people received 1 mg of psilocybin during the dosing sessions – a dose so low that it is considered inactive and likely to have no effect.
They also received escitalopram daily for six weeks.
The 16-point rapid inventory of depressive symptoms (QIDS-SR-16) rated depressive symptoms on a continuous scale from 0 to 27, with higher values indicating more severe depression.
At the start of the experiment, the mean value for the psilocybin group was 14.5, but after six weeks the values decreased by an average of 8.0 points, the researchers found.
The study also found that 57% of the psilocybin group saw symptom remission – measured as 0-5 at week six – compared to just 28% in the escitalopram group.
The researchers said the lack of a direct placebo group and the small number of participants narrowed conclusions about the effects of either treatment alone.
The study participants were mostly white, mostly male and relatively well educated, which limited the extrapolation to more diverse population groups.
The psilocybin group reported fewer cases of dry mouth, anxiety, drowsiness, and sexual dysfunction than the escitalopram group and a similar rate of adverse events overall.
The most common side effect of the magic mushroom compound was a headache that occurred a day after dosing.
The authors cautioned that patients with depression should not try to self-medicate with psilocybin as the team provided a specific clinical and therapeutic context.
They stressed that taking magic mushrooms or psilocybin without these safeguards may not have a positive result.
Anthony Cleare, Professor of Psychopharmacology and Mood Disorders at the Department of Psychiatry, Psychology and Neuroscience at King’s College London, said, “We need a lot more data before these treatments can be considered operational outside of carefully controlled research studies.
“In particular, we don’t yet know what types of patients and what types of depression are best suited for psychedelic treatments.
“We also don’t know how long the benefits will last and whether or how often treatments need to be repeated.”
In the UK, magic mushrooms are a Class A drug and illegal to own – but they have now been decriminalized in a number of US cities.