Potential use of psilocybin drugs in the treatment of depression

ABSTRACT

Introduction

Depression is a common disabling psychiatric disorder, which – in extreme cases – may lead to suicide if untreated or inadequately treated. Despite the availability of various treatments for depression, including pharmacotherapy, there is still a need to search for new agents with higher effectiveness and faster onset of action, especially for patients with treatment-resistant depression.

Areas covered

A substance that has attracted considerable attention for nearly a decade is psilocybin, a natural psychedelic found in psilocybin mushrooms. In this study, we evaluated the efficacy and safety of psilocybin in the treatment of depression, based on pivotal randomized clinical trials. Moreover, we used findings from observational studies regarding recreational use. We also looked at ongoing clinical trials and discussed the registration status and clinical potential of the drug.

Expert opinion

Clinical phase I-II trials published to date reported promising results for psilocybin in the treatment of patients with major depressive disorder and treatment-resistant depression, in a relatively short time after administration. However, before psilocybin is approved for use and administered to patients with depression, the results of large ongoing phase III clinical trials are needed to confirm its efficacy and safety and to change the way it is perceived by physicians and patients.

KEYWORDS:

• Anxiety
• depression
• review
• psilocybin
• psychedelics

Article highlights

• Psilocybin, a classic hallucinogen found in certain types of psilocybe mushrooms, is a compound under intensive research for use in a treatment of depression.

• Early-phase clinical trials with psilocybin have provided promising results, indicating a significant reduction in depression with a rapid onset of action.

• Large-scale randomized clinical trials are needed to confirm its efficacy and safety, and further approval.

• Psilocybin recreational use is illegal and controversial in many countries, so its use for the treatment of depression, even after it is approved, should be done in controlled conditions, under the supervision of a depression treatment specialist.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have been previously employed at Lundbeck. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

The study was financed with a grant number N43/DBS/000099 by the Jagiellonian University Medical College. The authors are partially supported by the National Science Centre, Grant number 2020/37/B/NZ7/03499.