Psilocybin, the psychoactive ingredient in magic mushrooms, can be effective in treating major depression for up to one year, a new study shows.
As scientists try to find a cure for depression, which affects over 280 million people globally, psilocybin is at the center of a resurgence in medical research on psychedelic drugs, with dozens of studies in the last decade.
Data released by researchers at the Johns Hopkins School of Medicine in the Journal of Psychopharmacology found that 2 doses of psilocybin can relieve symptoms of Major Depressive Disorder (MDD) for up to 12 months.
In the study, 24 participants experiencing major depressive symptoms for two years or longer, completed the doses. They had been randomly assigned to two groups; one received the first dose immediately after screening and the other after a two-month wait. The participants attended 6 follow-up visits; one day, one week, one month, three months, six months and one year after their second dose.
The team of researchers observed that antidepressant effects, response and remission 12 months post-treatment, mirrored those reported at the one week and one-month post-treatment marks.
The results show a 75 percent response rate and a 58 percent remission rate at 12 months.
“The results are certainly encouraging, but we still need larger studies to better understand the risks and benefits of this treatment,” said Dr. Natalie Gukasyan, lead researcher and medical director for John Hopkins University Center for Psychedelic and Consciousness Research.
Licensed clinical psychologist, alcohol and drug counselor Dr. Rick Barnett says the prospective model of this research, or monitoring outcomes during the study, instead of a retrospective analysis, strengthens its results.
“If you look at classical pharmaceutical research studies, a year follow-up is unheard of. Most of the classic research studies on pharmacotherapy like SSRIs, we talk about six, eight, maybe 12-week follow-up. And if they have a positive response, after eight weeks, then yes, that’s good. We’ve got two positive studies that show after eight weeks that they have had a response or remission, great, we are going to approve this drug.”
“Now you’re showing with psilocybin, a drug that you don’t have to take every day with a therapy that you don’t have to go to every week and they are showing that after 12 months, a 75% response rate and a 58% remission rate. That to me is both astounding, in a positive way and if you dig deeper into the methodology even if they had found a lower response and remission rate, it would at least be comparable to classic psychotherapy or pharmacotherapy. They are clearly demonstrating that it is at least as good but likely even better than what we currently have.”
Dr. Barnett, who is not part of the study, is a co-founder of the Psychedelic Society of Vermont, an organization of healthcare professionals preparing themselves for when psychedelic medicines become more widely available, through training and knowledge of the latest research and decisions at the Food and Drug Administration. The members help their community and patients to understand the substances and their role in treatment.
The latest research comes at a time when globally, the burden of depression is skyrocketing and with the COVID-19 pandemic causing figures to spiral.
In the US alone, research from the Centers for Disease Control and Prevention shows a 20 percent spike in the prevalence of major depressive disorders in the first year of the COVID-19 pandemic – a 7 percent to 27 percent increase. MDD with anxiety disorder rose from 11 percent to 38 percent.
Dr. Barnett says the case for rapid expansion of psychedelics research remains strong.
“Even pre-pandemic, is the epidemic of loneliness, the epidemic of depression and anxiety was real and the efficacy of the current strategies that we had were okay, but we were desperately in need of new tools and models to help people with depression and anxiety. Then the pandemic hits. And so having studies like this, showing encouraging results for new tools, which are delivered in a sort of new model of mental health or healthcare which is different than just giving somebody a pill every day for their depression, or giving somebody psychotherapy every week for depression, that is encouraging.”
The recent study follows a 2020 finding by Johns Hopkins Medicine. At the time, the team of researchers found that psilocybin treatment could lessen MDD symptoms for up to one month.
While the 2022 study results are positive, Dr. Gukasyan says that larger studies, ‘including placebo-controlled studies that conduct long-term follow-up,’ are needed to determine whether psilocybin-assisted therapy is safe and effective at scale.
“There is much we don’t know, including whether additional psilocybin doses could have helped participants who either did not show a treatment response or experienced worsening depression at some time in the follow-up period. There was also no control group to compare long-term outcomes,” she told Volteface.
With a history that weaves through spirituality, culture and 60’s and 70’s counter- culture, the words magic mushroom conjure images of neon lights, hallucinations and mystical moments. But for the millions of people across the globe who struggle with depression for which current treatments don’t appear to work, researchers are hoping to solve the mysteries surrounding psilocybin’s impact on the brain.
The Food and Drug administration is helping to fast-track drug development. While psilocybin has been classified as a Schedule I drug by the Drug Enforcement Agency, meaning that it has a high potential for abuse, with no accepted medical treatment use, in 2019 the FDA granted ‘breakthrough therapy’ status to psilocybin in two major clinical trials. The Administration’s move amended the classification to a drug with ‘substantial improvement’ over available therapy for treatment-resistant depression.
Psychedelics are making a comeback and psilocybin, with its profound effects on consciousness, is leading the way and has once again found itself at the intersection of medicine, law and politics.
“This study is encouraging and adds to the literature out there that continues the momentum towards taking these new medicines and new approaches much more seriously to get people the help that they desperately need,” says Dr. Barnett.
When it comes to understanding the mechanisms of psychedelic substances, a lot of work remains. Their efficacy in treating depression challenges established psychiatry and psychopharmacology models that anti-depressants are needed to correct a molecular deficit in the brain. Studies like the one conducted by Dr. Gukasyan and her team show how a few applications of psilocybin can be just as, if not more effective – even after 12 months.
While there are many questions left to answer and additional, larger-scale studies needed, it is part of a growing body of evidence forcing a rethink of the psyche and responding to calls for more effective, long-term treatment for MDD.
Jose Alison Kentish is a Caribbean multimedia journalist and former television news anchor. She covers science, health and environment. She credits growing up on Dominica, the Nature Island of the Caribbean, for her passion for the natural world and climate science. Her first degree is in Criminal Justice and she holds an M.A. in science journalism from Columbia University. Her work has appeared in the New Scientist, Inverse Science, Devex Health and Reuters. Tweets @AliKentish