The Research Case For Using Psilocybin To Treat Clinical Depression
Alex Jones, a 34-year-old Washington woman whose “severe depression had descended on her at age 10, and stayed there, relentlessly, for the next two decades” recently described to Stateline Magazine how psilocybin treatment shifted her mental state from feeling like “the walking dead” to feeling “like me again.” Jones described how she “endured hours of talk therapy and rotated through 30 different drug regimens” to no avail until she experienced psilocybin treatment, which “changed the way I look at myself and possibilities for the future.”
Jones’ experience is bolstered by a growing backbone of research suggesting that psilocybin can be extremely effective at treating clinical depression, including treatment-resistant depression—the number one cause of disability in the world.
A Johns Hopkins University Medical School study found that psilocybin-assisted therapy was effective in “producing large, rapid, and sustained antidepressant effects in patients with major depressive disorder.” The study, published in the prestigious Journal of the American Medical Association—revealed that the magnitude of these antidepressant effects compared very favorably to prevailing treatment options—“2.5 times greater than the effect sizes found in psychotherapy [alone] and more than 4 times greater than the effect sizes found in [FDA approved drugs for] depression treatment studies.” Moreover, for most participants, these positive effects persisted for four or more weeks. The researchers also noted that, unlike traditional antidepressant medications which can be associated with “more problematic effects [like] suicidal ideation, decrease in sexual drive, and weight gain” psilocybin has “no serious adverse effects.”
A companion study found that patients still benefited from the initial round of psilocybin-assisted therapy even a year after their first round of treatment. The study, published in The Journal of Psychopharmacology, found that the initial psilocybin treatment “produced large and stable antidepressant effects that persisted throughout a twelve-month follow-up period.” Remarkably, “the effect size at 12 months was very large,” “there were no serious adverse events,” and “depression symptoms were not significantly exacerbated in any participant[.]”
Researchers at the University of California San Francisco School of Medicine and Kings College London shed light on how psilocybin works to treat clinical depression. The results of a study published this year in Nature explained that while “neuroimaging research has consistently found examples of abnormal brain functioning in depression,” treatment with “psilocybin fosters greater connections between different regions of the brain in depressed people, freeing them up from long-held patterns of rumination and excessive self-focus…” Here’s the New York Times’ Andrew Jacobs describing the study in more detail:
“A group of neuroscientists … [used] advanced neuroimaging technology that peered deep into the brain … [of] 43 people with severe depression … and gave them either psilocybin … or a conventional antidepressant … Over the course of three weeks, participants who had been given the antidepressant reported mild improvement in their symptoms, and the scans continued to suggest the stubborn, telltale signs of a mind hobbled by major depressive disorder … By contrast, the participants given psilocybin therapy reported a rapid and sustained improvement in their depression, and the scans showed flourishes of neural activity across large swaths of the brain that persisted for the three weeks. That heightened connectivity, they said, resembled the cognitive agility of a healthy brain that, for example, can toggle between a morning bout of melancholia, a stressful day at work and an evening of unencumbered revelry with friends.”
The Biden Administration forecasts near-term FDA approval. Based on the early promise of the research, the U.S. Food and Drug Administration has already designated two psilocybin drugs—one for major depressive disorder; one for treatment resistant depression—as “breakthrough” therapies, meaning early clinical evidence demonstrates the drug “may have substantial improvement on at least one clinically significant endpoint over available therapy”. And, earlier this summer, a high ranking official in the U.S. Department of Health and Human Services signaled that the Biden Administration “anticipated approval … of psilocybin for the treatment of depression within approximately 24 months.”
