WEDNESDAY, Aug. 28, 2024 (HealthDay News) — Patients treated with high-dose psilocybin responded better in antidepressant trials than those treated with a placebo, according to a study published online Aug. 21 in. The BMJ.
Tien-Wei Hsu, MD, from E-DA Dachang Hospital in Kaohsiung, Taiwan, and colleagues examined the comparative efficacy and acceptability of oral psychedelic monotherapy and escitalopram in patients with depressive symptoms in a systematic review and Bayesian network meta-analysis. The primary outcome was change in depression, measured using the 17-item Hamilton Depression Rating Scale.
The researchers found that the placebo effect was smaller in psychedelic trials compared to antidepressant trials with escitalopram (mean difference: -3.90). Most psychedelics outperformed placebo in psychedelic trials, but in antidepressant trials with escitalopram, only high-dose psilocybin outperformed placebo (mean difference: 6.45). When the reference arm changed from the placebo effect in the psychedelic trials to antidepressant trials, the effect size of high-dose psilocybin decreased from large to small (standardized mean difference: 0.88 and 0.31, respectively). Compared with escitalopram at 10 mg and 20 mg, the relative effect of high-dose psilocybin was larger (4.66 and 4.69, respectively). None of the interventions were associated with a higher overall discontinuation rate or serious adverse events than placebo.
“Serotonergic psychedelics, particularly high-dose psilocybin, appeared to have the potential to treat depressive symptoms,” the authors write.
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