In a constant search for new ways to fight depression, the researchers compared psilocybin, the active compound in magic mushrooms, with a well-established antidepressant in a small phase II study.
Promisingly, the results show that psilocybin was at least as effective as the usual antidepressant when used with psychological therapy.
There is still very early research. But previous studies have suggested that psilocybin does not produce nearly as many side effects as antidepressants, and its effects are almost immediate.
Trying the most common type of antidepressants, selective serotonin reuptake inhibitors (SSRIs), on the other hand, can be a nauseating experience for many of us, involving brainstorming, lethargy, and emotional turmoil.
Many patients end up feeling worse before it can finally be determined if the drug really works, which can take up to six weeks.
After that, the continuous side effects of antidepressants can include fatigue or insomnia, dizziness, weight gain and loss of libido, among a long list.
The positive effects of the drug can wear off for some people over time, leaving frustrating side effects facing a new wave of impaired mental health. For others, SSRI never works for starters.
But there may be other options on the horizon.
Under the close guidance of mental health professionals, 59 volunteers with depression were divided into two groups. One group was given escitalopram antidepressant (often sold under the brand name Lexapro, Cipralex, and others) daily, with extremely low doses of psilocybin delivered twice, three weeks apart.
For the second group, the doses of psilocybin were much higher and the placebos were administered instead of escitalopram. Both groups also received psychological support throughout the process.
Neither the volunteers nor the research team, led by Imperial College London neuroscientist Robin Carhart-Harris, knew which group would receive what treatment.
After six weeks, self-reported depression scores by volunteers suggest that the magic mushroom ingredient was as effective as the antidepressant. While the psilocybin group reported a slightly greater improvement than the escitalopram group, the researchers pointed out that it was not at a statistically significant level.
They also suspect that because SSRIs have a delayed effect, if the process had continued longer, they may have seen an even greater improvement in depression scores for escitalopram.
Before anyone rushed to self-medicate, Carhart-Harris warns that the volunteers also had guided psychotherapy to help them in any hallucination experience.
“We strongly believe that … the component of psychotherapy is as important as the action against drugs,” he said. the Guardian.
“A psychedelic is more about a release of thought and feeling that, when guided by psychotherapy, produces positive results.”
While five patients taking SSRIs either reduced or discontinued their doses altogether due to the adverse effects they experienced, none in the psilocybin group did. However, due to the hallucinogenic effects of psilocybin, volunteers with a family history of psychosis were excluded from the study, which probably influenced the study sample to those who would not have significant side effects.
“The percentages of patients who had anxiety, dry mouth, sexual dysfunction or a reduced emotional reaction were higher in the escitalopram group than in the psilocybin group,” the team wrote in their paper.
The most common side effect experienced by those taking psilocybin was a transient headache after receiving active doses. This was also observed in a pilot study in which some of the same researchers worked in 2016.
One New England Journal of Medicine accompanying the paper, Columbia University psychiatrist Jeffrey Lieberman warns that while this is “a milestone in the development of psychedelic drugs,” there are still many things we don’t know yet, such as what psilocybin does with physiology. Our.
Like regular antidepressants, the active substance in magic mushrooms works through the serotonin pathways in our brain. Rodent studies have shown that psilocybin binds to a serotonin receptor called 5-hydroxytryptamine type 2A, which is part of a chain of biochemical reactions involved in depression.
While SSRIs lead to some kind of emotional blunting, psilocybin seems to do the opposite – MRI scans have supported patient reports that the magic mushroom compound appears to increase emotional connections, but exactly how this is happening is still unclear.
However, we still do not fully understand how SSRI changes cause serotonin levels in our brain to alleviate depression or anxiety.
While the results require further investigation, we need to be careful about reading them too much, given the small sample size and the fact that many of the participants belonged to the same demographic data of white men with higher education. The results were also self-reported, which means they are difficult to compare objectively.
And given the controversial history of magic mushrooms, Lieberman is cautious about the resources the drug has attracted and how this distorts the usual procedures for drug development. He also raises valid concerns about the hallucinatory effects of the drug.
“How do we explain to patients mystical, ineffable and potentially transformative experiences, especially if they are in a vulnerable state of mind?” he asks.
However, another recent study suggests that this aspect of the effects of psilocybin is not necessary for its antidepressant benefits, and other researchers have sought to synthesize psychedelics for mental health treatments without causing hallucinations.
With nearly 800 million people with mental health disorders worldwide, those of us who rely on outside help in brain chemistry are looking forward to more research in hopes of easier treatment options.
The new research was published in The New England Journal of Medicine.