A recent study conducted by Goodwin et al. explored the safety and efficacy of using psilocybin, a synthetic form of the psychedelic compound found in magic mushrooms, as an adjunct to selective serotonin reuptake inhibitors (SSRIs) in patients with treatment-resistant depression (TRD). The study included adults with TRD who had failed to respond to multiple pharmacological treatments, including their current SSRI.
Participants in the study underwent a screening period before receiving a single administration of psilocybin under the guidance of a trained therapist. The session lasted 6 to 8 hours and participants were closely monitored throughout. Follow-up sessions were conducted to assess safety and efficacy. The primary outcome measure was the change in the Montgomery-Asberg Rating Scale (MADRS) from baseline to week 3.
The results of the study showed promising outcomes. Participants experienced a significant reduction in depressive symptoms, as indicated by a decrease in MADRS scores. Approximately 42% of participants were considered responders, with 42% also meeting criteria for remission. There were no severe adverse events reported, and no instances of suicidal ideation or self-harm.
The study provides evidence that psilocybin, in combination with SSRIs, can have a favorable safety and therapeutic efficacy profile in patients with TRD. It challenges the hypothesis that adjunctive SSRIs diminish the antidepressant effects of psilocybin. However, it is important to note that the study had limitations, including a small sample size and lack of a comparator group.
Further research is needed to validate these findings and to determine the long-term effects of psilocybin as an adjunct to antidepressant treatment. Larger, comparator-controlled trials would provide valuable insights, especially for patients who may have difficulty withdrawing from antidepressant drugs. This study offers hope for individuals with treatment-resistant depression and suggests that psychedelic-assisted therapy could be a viable option for those who have not responded to traditional treatments.
– Goodwin GM, Aaronson ST, Alvarez O, et al. Single-dose psilocybin for a treatment-resistant episode of major depression. N Engl J Med. 2022;387(18):1637-1648.