Psilocybin Compared With Escitalopram for Depression

No difference seen in change in depression scores at six weeks for psilocybin plus placebo versus psilocybin plus escitalopram

HealthDay News — For patients with major depressive disorder, the change in scores for depression at 6 weeks does not differ significantly with psilocybin or psilocybin plus escitalopram, according to a study published in the April 15 issue of the New England Journal of Medicine.

Robin Carhart-Harris, PhD, from Imperial College London, and colleagues randomly assigned patients with long-standing, moderate-to-severe major depressive disorder to receive 2 separate doses of 25mg of psilocybin 3 weeks apart plus daily placebo for 6 weeks or 2 separate doses of 1mg psilocybin 3 weeks apart plus 6 weeks of daily oral escitalopram (30 and 29 patients, respectively) in a phase 2 trial. Psychological support was also provided for all patients.

The researchers found that the mean changes in scores on the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16) from baseline to week 6 were −8.0 ± 1.0 points and −6.0 ± 1.0 points in the psilocybin and escitalopram groups, respectively (between-group difference, 2.0 points; 95% confidence interval, −5.0 to 0.9; P =.17). A QIDS-SR-16 response occurred in 70 and 48% of patients in the psilocybin and escitalopram groups, respectively, for a between-group difference of 22 percentage points (95% confidence interval, −3 to 48); QIDS-SR-16 remission occurred in 57 and 28%, respectively (between-group difference, 28%; 95% confidence interval, 2 to 54). In general, psilocybin was favored over escitalopram in other secondary outcomes, but the analyses were not corrected for multiple comparisons.

“Larger and longer trials are needed to compare psilocybin with established treatments for depression,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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