Trial of Psilocybin versus Escitalopram for Depression

Carhart‐Harris, Robin; Giribaldi, Bruna; Watts, Rosalind; Baker-Jones, Michelle; Murphy-Beiner, Ashleigh; Murphy, Roberta; Martell, Jonny; Blemings, Allan; Erritzoe, David; Nutt, David

doi:10.1056/nejmoa2032994

Cited by 732 publications

(788 citation statements)

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“…Given the possibility that psychiatry may encounter the prospect of psychedelic therapy in the near future [ 4 , 14 ], it would be interesting to survey Irish psychiatrists’ and psychotherapists attitudes to the evolving field of translational psychedelic science, especially considering the previous contentious relationship between psychiatry and psychedelic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Translational psychedelic science is evolving rapidly [ 1 , 2 ]. Preliminary clinical evidence suggests that the synergistic combination of psychedelic compounds with psychological support may improve outcomes in major depressive disorder (MDD) [ 3 , 4 ], treatment-resistant depression (TRD) [ 5 , 6 ], and addiction disorders [ 7 – 10 ]. Exploratory studies suggest potential benefits of psilocybin therapy in OCD [ 11 ], eating disorders [ 12 ], and migraine suppression [ 13 ], with ongoing clinical trials of psychedelic therapy in MDD, TRD, bipolar disorder type II depression, anxiety, alcohol use disorder, smoking cessation, cocaine addiction, anorexia nervosa, depression with mild cognitive impairment, OCD, and various types of headaches [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Society’s relationship and attitude towards psychedelics are complex, but if we are to consider using these compounds in clinical practice, it is essential to look beyond past mistakes of over-exuberance and non-scientific ideology, towards a shared transparent scientific understanding of the risks and benefits of psychedelic therapy [ 59 ]. This is all the more important in the context of increasing rates of recreational psychedelic use, the potential of psychedelics to exacerbate underlying pre-dispositions to psychosis and mania, together with psilocybin therapy being on the verge of translating into the psychiatric clinic for a range of non-psychotic psychiatric disorders [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

et al. 2021

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Introduction Despite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes. Objectives To explore mental health service user attitudes to psychedelics and psilocybin therapy. Methods A questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users. Results Ninety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued. Conclusions The majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

et al. 2021

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“…Classic psychedelic (mind-manifesting) substances such as psilocybin (found in so-called “magic mushrooms”), dimethyltryptamine (DMT) (e.g., a key psychedelic ingredient in ayahuasca, a traditional psychedelic brew used in areas of South America), and lysergic acid diethylamide (LSD) have recently shown promise in the treatment of a variety of mental health disorders, including addiction ( 38 , 39 ), obsessive compulsive disorder ( 40 ), depression ( 41 – 44 ), and existential distress in patients with life-threatening disease ( 45 – 48 ). Several ongoing clinical trials are exploring these and additional indications ( 49 ).…”

Section: Mental Health-promoting and Health-maintaining Effect Of Psychedelic Therapymentioning

confidence: 99%

Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential?

2021

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Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticity via psychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health.

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“…Since then, modern pilot and feasibility trials have demonstrated encouraging preliminary safety and efficacy data for psilocybin as a treatment for anxiety and depression in end-of-life care (Griffiths et al, 2016;Grob et al, 2011;Ross et al, 2016), OCD (Moreno et al, 2006), alcohol dependence (Bogenschutz et al, 2015), tobacco addiction (Johnson et al, 2014), major depression (Carhart-Harris et al, 2021;Davis et al, 2020) and treatment-resistant depression (Carhart-Harris et al, 2016, 2018.…”

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confidence: 99%

Psilocybin and MDMA for the treatment of trauma-related psychopathology

Bird

Modlin

Rucker

2021

International Review of Psychiatry

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This review examines the role of trauma in psychiatric morbidity and analogous psychoneurobiological changes. Trauma is a necessary criterion for Post-Traumatic Stress Disorder (PTSD), however, trauma history is highly correlated with a variety of psychiatric conditions. Some evidence suggests that Major Depressive Disorder (MDD) is the most common psychiatric condition that arises following trauma. Approximately 50% of PTSD cases present with co-morbid MDD. Overlapping symptomatology and neurobiology between these conditions underlie the debate over whether these phenomena result from problematic nosology or whether comorbid MDD þ PTSD is a distinct phenotype of trauma-related psychopathology. Regardless, similar treatment approaches have been employed historically, with varying success. The drug-assisted psychotherapy treatment model, which combines pharmacological and psychotherapeutic approaches, is currently being trialled as a novel treatment approach in psychiatry. Both psilocybin-and 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy have received Food and Drug Administration 'breakthrough therapy' designation for the treatment of resistant MDD and PTSD, respectively. This paper reviews the therapeutic rationale of both psilocybin and MDMA for treating both trauma-related MDD and PTSD.

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Trial of Psilocybin versus Escitalopram for Depression

Cited by 732 publications

References 24 publications

Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential?

Psilocybin and MDMA for the treatment of trauma-related psychopathology

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