A new study led by King's College London has found that psilocybin, the natural psychedelic in magic mushrooms, can significantly ease depression that has not responded to other treatments.
The medical trial, published in Nature Medicine, involved 60 people diagnosed with treatment-resistant depression. More than four in ten patients saw their symptoms go into remission after three weeks of taking 25mg of psilocybin. The publicly-funded community trial was carried out on people whose depression had not responded to two prior treatments at South London and Maudsley NHS Foundation Trust.
Trial Results Show Sustained Improvement
The study found that the proportion of people who saw improvement rose to 56% after six weeks, compared to 3% of patients in the placebo group. The trial also found that remission continued at six weeks.
The results were described as "very emotional" at times, as a significant number of patients entered remission, with their symptoms abating enough that they no longer met clinical criteria.
Expert and Patient Perspectives
Professor James Rucker, of King's College London's Institute of Psychiatry, Psychology & Neuroscience (IoPPN) and consultant psychiatrist at South London and Maudsley NHS Foundation Trust, hailed the results. He said: "Here, we show that a randomised trial design of psilocybin compared to a true placebo was feasible in participants who had often failed many different types of treatment. People who were randomised to receive a dose of 25mg of psilocybin were much more likely to improve than those who were randomised to placebo up to six weeks of follow up."
He added: "As is often the case in clinical depression, individual responses were very variable and some of the difference seen between groups will be due to non-drug factors. Publicly funded clinical trials are an important part of the jigsaw of evidence needed for a new intervention to find its place in the real world. Meanwhile, the wider evidence base for psilocybin therapy is growing rapidly, and looks increasingly promising."
One patient said: "It got very intense two or three times... one part that got very emotional for me I felt like I was in a ribcage of some sort and in that I saw my dad holding my sister and that image stays with me because those are two people I have lost. I felt like it was a way of them saying we are here and that was definitely a point of emotional release. I think afterwards I felt pretty tired and broken."
The patient continued: "It has taken me a while to reflect and I think it just helped me understand my depression more and just 'feel' my feelings - I think I am glad I did it. It was very difficult - very painful - but I think that was what I needed and it came at the right time."
Community-Based Administration
Recruitment for the trial started at a research facility before moving to a community mental health building. Catherine Bird, senior clinical trials manager at the IoPPN, said the move shows "psilocybin, unlike many psychiatric drugs, can be administered safely outside a hospital ward" and requires a "calm, supported environment and trained staff rather than medical monitoring".
Prof Rucker added: "This trial makes a strong case for larger publicly funded trials of psilocybin therapy in community settings, which are often more convenient and less anxiety-provoking for patients than hospital settings."
