Only high-dose psilocybin was better than placebo in antidepressant trials of escitalopram
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Aug. 28, 2024 (HealthDay News) — Patients treated with high-dose psilocybin have better responses than those treated with placebo in antidepressant trials, according to a study published online Aug. 21 in The BMJ.
Tien-Wei Hsu, M.D., from E-DA Dachang Hospital in Kaohsiung, Taiwan, and colleagues examined the comparative effectiveness and acceptability of oral monotherapy using psychedelics and escitalopram in patients with depressive symptoms in a systematic review and Bayesian network meta-analysis. The primary outcome was change in depression, which was measured by the 17-item Hamilton Depression Rating Scale.
The researchers found that compared with antidepression trials of escitalopram, placebo response in psychedelic trials was lower (mean difference, −3.90). Most psychedelics were better than placebo in psychedelic trials, but in antidepression trials of escitalopram, only high-dose psilocybin was better than placebo (mean difference, 6.45). When the reference arm changed from placebo response in the psychedelic trials to antidepressant trials, the effect size of high-dose psilocybin decreased from large to small (standardized mean difference, 0.88 to 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). Of the interventions, none were associated with higher all-cause discontinuation or severe adverse events than the placebo.
“Serotonergic psychedelics, especially high-dose psilocybin, appeared to have the potential to treat depressive symptoms,” the authors write.
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