Psilocybin therapy appears as effective as escitalopram, small study finds

Research published in the New England Journal of Medicine highlights the potential of psilocybin for treating depression.

Psilocybin therapy appears to be at least as effective as escitalopram in treating depression, findings from a small phase II study published in the New England Journal of Medicine have indicated (15 April 2021)​[1]​.

Researchers compared two sessions of psychedelic psilocybin therapy, delivered in a specialist clinical setting, with a course of the selective serotonin reuptake inhibitor, escitalopram.

Volunteers with long-standing, moderate-to-severe major depressive disorder were randomised to receive either two 25mg doses of psilocybin three weeks apart plus six weeks of daily placebo (n=30), or two 1mg doses of psilocybin three weeks apart plus six weeks of daily escitalopram (n=29).

Participants were assessed using standardised scales of depressive symptom severity. The primary outcome of the trial was the change in score on the Quick Inventory of Depressive Symptomatology – Self Report (QIDS-SR-16), a standardised 16-question survey used to score people on self-reported symptoms of depression, at week six.

Depression scores were reduced in both groups from baseline — -8±1 for psilocybin and -6±1 for escitalopram — but the change in QIDS-SR-16 score did not differ significantly between the two groups (between group difference of 2.0 points [95% confidence interval -5.0 to 0.9], P=0.17). Secondary outcomes, including measures of anxiety and feelings of wellbeing, generally favoured psilocybin over escitalopram.

Remission rates — measured as a score of 0–5 at week six — were twice as high in the psilocybin group than the escitalopram group (57% vs 28%).

“One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment in the same study,” said Robin Carhart-Harris, head of the Centre for Psychedelic Research at Imperial College London.

“Psilocybin performed very favourably in this head-to-head.”

  1. 1
    Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med 2021;384:1402–11. doi:10.1056/nejmoa2032994

Last updated
The Pharmaceutical Journal, PJ, June 2021, Vol 306, No 7950;306(7950)::DOI:10.1211/PJ.2021.1.91592

    Please leave a comment 

    You may also be interested in