A single dose of a hallucinogenic chemical found in magic mushrooms can significantly reduce symptoms of resistant depression, according to the largest study of its kind ever conducted.
After three weeks, about a third of the patients were in remission after taking 25 mg of the synthetic form of psilocybin along with psychological support.
All failed to respond to conventional antidepressant treatment.
In the international trial, 233 patients were assigned to one of three different doses of the artificial psilocybin COMP360.
They also received support from a therapist to prepare them for a 6- to 8-hour hallucinogenic “trip”, which was conducted under clinical supervision. Further sessions after medication consolidate the experience.
The results, published in the New England Journal of Medicine, showed that patients who received the highest dose of psilocybin in the study, 25 mg, responded the most, with a significant reduction in the severity of symptoms within one day of treatment.
There was still a clinical effect 12 weeks after travel, although this was not statistically significant.
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The drug’s maker, COMPASS Pathways, will begin a larger trial at the end of the year to confirm the durability of the effect and more accurately assess adverse effects. In the current study, more than seven in 10 patients reported side effects such as nausea, dizziness and fatigue.
Professor Guy Goodwin, the company’s chief medical officer and emeritus professor of psychiatry at the University of Oxford, said: “We have seen positive results in a particularly difficult-to-treat patient population, with the highest doses affecting people the most. frustrated.
“This suggests that COMP360 psilocybin has a real pharmacological effect, a finding that is critical for it to be considered a new therapeutic option in the future.”
‘Rewire the brain’
Scientists believe that psilocybin “rewires” the brains of people with depression, which are locked into negative thought patterns.
This is a completely different mechanism of action from traditional antidepressants, which alter levels of the neurotransmitter serotonin in the brain.
Professor Anthony Cleare, professor of psychopharmacology at King’s College London, who was not involved in the study, said the results were encouraging, but more research was needed before psilocybin could be used in normal clinical practice.
“The effects do start to wear off after three months, and we need to know how best to prevent the depression from recurring,” he said. “This could involve adding other treatments, such as psychotherapy, or repeating psilocybin treatment on a regular basis.
“There is also concern that, given the relatively small number of patients studied so far, we don’t know enough about potential side effects, especially whether some people experience worsening of certain symptoms.”
Patients taking psilocybin enter a dream-like state that allows them to gain insight into their situation, says Nadav Liam Modlin, a psychedelic psychotherapist at King’s College London, a therapist involved in the study.
“Being able to sit with patients who have been feeling hopeless, traumatized, shamed, guilty, powerless for decades at times and reflect on their problems…and then get to a place where they have more flexibility of thinking — It takes a feeling of self-acceptance and self-compassion – it’s always moving.”
COMPASS Pathways said it had to make a synthetic form of psilocybin, rather than using extracts from magic mushrooms, to meet medical regulatory requirements.