Depression scores did not differ significantly between patients using psilocybin or escitalopram after 6 weeks. These results from a double-blind, randomized, controlled phase 2 study were published in the New England Journal of Medicine.
Patients (N = 59) with longstanding moderate to severe major depression were recruited through advertising in the UK in 2019. Patients were randomized to receive 2 doses of psilocybin 25 mg daily with placebo (n = 30) or 2 doses of psilocybin 1 mg with escitalopram 10 mg daily for 3 weeks and escitalopram 20 mg daily for 3 weeks (n = 29). The patients were examined using magnetic resonance imaging (MRI) and performed cognitive and affective processing tasks.
The average age of the patients was 41 and 34% were women. Depression symptoms averaged 22 and 15 years in the psilocybin and escitalopram groups, and the 16-point Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR-16) scores were 14.5 and 16, respectively , 4.
After 6 weeks, the mean change in QIDS-SR-16 values was -8.0 ± 1.0 points in the psilocybin and -6.0 ± 1.0 points in the escitalopram cohorts (difference -2.0; 95 % CI -5.0 to 0.9; P =). 17). A total of 70% of psilocybin and 48% of escitalopram recipients showed a QIDS-SR-16 response (difference 22%; 95% CI -3% to 48%) and 57% and 28% were in QIDS-SR-16 -Remission (difference 28.1%; 95% CI 2.3% -53.8%).
Psilocybin recipients reported greater improvements in their ability to cry or feel compassion, intense emotions and pleasure, and fewer reported feeling sleepy compared to escitalopram recipients. No differences were reported for psychotic symptoms or addiction-related behaviors.
Side effects were reported by 87% of the psilocybin and 83% of the escitalopram groups. The most common events were headache, nausea, and fatigue.
This study may have been limited by its short duration as escitalopram has a delayed therapeutic effect on depression.
Overall, no significant difference between the cohorts in the depression scores was found after 6 weeks. Secondary endpoints tended to favor psilocybin over escitalopram in the treatment of long-standing moderate to severe depression.
Disclosure: Some authors have stated links with biotech, pharmaceutical, and / or device companies. For a full list of the authors’ information, see the original reference.
Carhart-Harris R., Giribaldi B., Watts R. et al. Study of psilocybin versus escitalopram for depression. N Engl J Med. Published online April 15, 2021. doi: 10.1056 / NEJMoa2032994
This article originally appeared on Psychiatry Advisor