Even one psychedelic dose might ease depressive symptoms

A single dose of psilocybin may reduce severe depression symptoms, even for the nearly 100 million people globally who haven’t responded to conventional treatments, according to a new study in the UK.

The authors, who did not respond to multiple requests for comment, wrote that they believe their work is the first to test psilocybin against a placebo using the National Health Service.

Using a state-funded health system is a key step in legalizing the drugs as medicine, said Scott Aaronson, a psychedelic researcher at Sheppard Pratt, a psychiatric hospital in Baltimore.

“The most important piece of this study is [looking at] how we’re going to roll out psychedelics and move it outside of the ivory towers that it has existed in,” said Aaronson, who was not involved in the study.

Thirty participants took one 25 mg dose of psilocybin, the active ingredient in magic mushrooms. Twenty-nine others took a placebo. Over weeks of subsequent talk therapy, researchers at Kings College London found improvements in depressive symptoms in those who took the drug. In the week six follow-up, patients who took psilocybin tended to score better than those who took the placebo. 

The study used a depression rating scale from zero to 60 to gauge the drug’s effectiveness. It asked participants about their sleep, mood, concentration ability, cognitive symptoms, appetite and energy levels, all aspects of which can be worsened with depression. 

Nearly 300 million people worldwide grapple with the mood disorder, a condition that can disrupt nearly every aspect of daily life and carries enormous economic costs. A separate study estimated it will cost the global economy around $12 trillion, or about 0.46% of annual global gross domestic product, between 2025 and 2050. 

At the start of the study, scores averaged 29.6, indicating “moderate depression.” By the end of six weeks, the placebo group still averaged 29.3, but the psilocybin group reduced to “mild depression” at 16.3 — a 13-point difference.

Only people with treatment-resistant depression, meaning they already tried at least two other methods of managing their diagnosis, could participate.

“They’re typically people that have been unwell for decades,” said Sally Meikle, a psychedelic researcher at the University of Melbourne who was not involved in the study and called the findings “quite encouraging.”

Meikle said larger studies must be done before advancing the drug to public health care systems. This study only had 60 participants — one of whom dropped out after day one — and exclusively focused on depression. 

“Realistically, the people who have treatment-resistant depression often have a huge amount of comorbidity,” or multiple overlapping conditions, Meikle said.

Cost is another barrier to the drug moving forward. In Australia, Meikle said, a round of psilocybin doses can cost $20,000 to $30,000 Australian dollars because of the lengthy process of actually taking the drug. Meikle said none of this research is covered by the country’s national healthcare system yet, so the price comes directly out of the patient’s pocket.

Aaronson also worries bureaucracy will muddle progress. “In the U.S., it’s going to be all over the map depending on whether it’s Medicare or Medicaid… then the private insurers will each do whatever they decide to do,” he said.

Before a dose, patients have multiple prep sessions with a team of two therapists. Then comes a six-to-eight-hour dosing session, also usually accompanied by two therapists. Lastly, there are integration sessions, or therapy-like check-ins, which require more hours with licensed professionals. 

Some participants experience distress, anxiety and paranoia during their psilocybin dose session. These effects can continue after treatment, Meikle said.

“It’s not that everyone improves,” she said. “Some people improve and maintain that, some people don’t improve at all and some people even get worse.”

Aaronson said despite the risks, he believes in this research.

“We do not have terrific treatments for people who have failed multiple things in depression,” he said. “We’re now developing ways to make these people better.”