In a small study in adults with severe depression, researchers at Johns Hopkins Medicine report that two doses of the psychedelic substance psilocybin given with supportive psychotherapy resulted in rapid and severe reductions in depressive symptoms, with most participants showing improvement and half of the study participants achieved remission through the four-week follow-up.
Psilocybin is a compound found in so-called magic mushrooms that causes visual and auditory hallucinations and profound changes in consciousness within a few hours of ingestion. In 2016, researchers at Johns Hopkins Medicine first reported that treatment with psilocybin in psychologically-assisted settings significantly relieved existential anxiety and depression in people with a life-threatening diagnosis of cancer.
Now the results of the new study, published on November 4th in JAMA Psychiatrysuggest that psilocybin may be effective in the much broader population of patients suffering from major depression than previously thought.
“The magnitude of the effect we saw was about four times greater than what clinical trials of traditional antidepressants have shown in the market,” said Alan Davis, Ph.D., associate professor of psychiatry and behavioral science at Johns Hopkins University School of Medicine. “Since most other depression treatments take weeks or months to complete and can have undesirable effects, this could mean a change if these results hold up in future gold-standard placebo-controlled clinical trials.” The published results only cover four weeks of follow-up at 24 Participants who went through every two five-hour psilocybin sessions led by the researchers.
“Because there are different types of depressive disorder that can cause people to respond differently to treatment, I was surprised that most of our study participants found psilocybin treatment effective,” says Dr. Roland Griffiths Oliver Lee McCabe III Professor of Neuropsychopharmacology of Consciousness in the Faculty of Medicine at Johns Hopkins University and Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. He says the major depression treated in the new study may have been different from the “reactive” form of depression in patients they looked at in the 2016 cancer study. Griffiths said his team was encouraged by public health officials to study the effects of psilocybin in the broader population of people with major depressive disorder, as the potential public health effects are far greater.
For the new study, the researchers recruited 24 people with a long-term documented history of depression, most of whom had symptoms that had persisted for about two years prior to enrollment in the study. The average age of the participants was 39 years; 16 were women; and 22 identified as white, one person as Asian, and one person as African American. Participants, with the help of their personal physician, were required to remove all antidepressants prior to the study to ensure safe exposure to this experimental treatment.
Thirteen participants received the psilocybin treatment immediately after enrollment and after the preparatory sessions, and 11 participants received the same preparation and treatment after an eight week delay.
Treatment consisted of two doses of psilocybin given by two clinical monitors who provided guidance and confirmation. The doses were administered two weeks apart between August 2017 and April 2019 in the Behavioral Biology Research Building at Johns Hopkins Bayview Medical Center. Each treatment session lasted approximately five hours, with the participant lying on a couch in the presence of the monitors, wearing visors and headphones that played music.
All participants received the GRID Hamilton Depression Rating Scale – a standard tool for assessing depression – upon enrollment and one to four weeks after completing their treatment. On the scale, a value of 24 or more indicates major depression, 17-23 indicates moderate depression, 8-16 indicates mild depression, and 7 or less indicates no depression. At enrollment, participants had an average depression score of 23, but one week and four weeks after treatment, they had an average depression scale of 8. After treatment, most participants showed a significant decrease in their symptoms, and almost half were in remission from depression at the follow-up examination. The participants in the delayed group showed no decrease in their symptoms prior to treatment with psilocybin.
For the entire group of 24 participants, 67% showed a greater than 50% reduction in symptoms of depression at the one-week follow-up and 71% at the four-week follow-up. In total, four weeks after treatment, 54% of participants were classified as remitted, meaning they were no longer classified as depressed.
“I believe this study is critically important proof of concept for the medical approval of psilocybin for the treatment of depression that I have personally struggled with for decades,” says entrepreneur and philanthropist Tim Ferriss, who supported the funding campaign for this study . “How do we explain the incredible extent and longevity of effects? Treatment research involving moderate to high doses of psychedelics can uncover entirely new paradigms for understanding and improving mood and mind. This is a taste of what Johns Hopkins has to offer. ”
The researchers say they will follow participants for a year after the study to see how long the antidepressant effects of psilocybin treatment last, and publish their results in a later publication.
Griffiths, whose research on psilocybin begun in the early 2000s was initially viewed with skepticism and concern by some, says he was delighted with Johns Hopkins’ support and encouraged by the dozen of startups and research laboratories who have followed with their own research. Numerous companies are currently actively developing marketable forms of psilocybin and related psychedelic substances.
According to the National Institute of Mental Health, more than 17 million people in the United States and 300 million people worldwide have experienced major depression.
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Provided by the Johns Hopkins University School of Medicine
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