Magic mushrooms have a long and rich history. Now scientists say they could play an important role in the future, with their active ingredient a promising treatment for depression.
The results from a small, phase two clinical trial have revealed that two doses of psilocybin appears to be as effective as the common antidepressant escitalopram in treating moderate to severe major depressive disorder, at least when combined with psychological therapy.
“I think it is fair to say that the results signal hope that we may be looking at a promising alternative treatment for depression,” said Robin Carhart-Harris, head of the center for psychedelic research at Imperial College London and a co-author of the study.
Photo: Reuters via Imperial College London
Carhart-Harris said psilocybin was thought to work in a fundamentally different way to escitalopram. While both act on the brain’s serotonin system, he said escitalopram seemed to work by helping people tolerate stress more easily.
“With a psychedelic it is more about a release of thought and feeling that, when guided with psychotherapy, produces positive outcomes,” he said, adding participants given psilocybin had often reported feeling they had got more fully to the root of why they were depressed.
However, Carhart-Harris cautioned against seeking out magic mushrooms — a class A drug in the UK — for DIY treatment.
“That would be an error of judgment,” he said. “We strongly believe that the … psychotherapy component is as important as the drug action.”
The ￡1 million (US$1.37 million) trial builds on previous work by the team exploring how psilocybin affects the brain, and an earlier clinical trial in which the drug helped alleviate treatment-resistant depression in 12 patients.
Over the six-week trial, 30 out of 59 adults with moderate to severe major depressive disorder were randomly allocated to receive two 25mg doses of psilocybin three weeks apart — a dose that Carhart-Harris said was high enough to produce the kind of experiences often described as existential or even “mystical.” The day after the first dose of psilocybin, this group began a daily placebo.
The other 29 participants were given two very low, or “inactive,” doses of psilocybin three weeks apart. This was to ensure any differences in outcomes between the groups would not simply be down to the expectation of being given psilocybin. The day after the first dose of psilocybin, this group began a daily dose of escitalopram, the strength of which increased over time.
Each psilocybin session — which lasted six hours, including a three to four-hour “trip” for those on the high dose — was supervised by at least two mental health professionals, with the participants lying on their back, propped up by pillows and listening to emotionally evocative neoclassical music.
All participants received psychological therapy the day after a psilocybin session, as well as a phone or video call in the week after the first dose.
The results, published in the New England Journal of Medicine, reveal that after six weeks both groups showed, on average, a decrease in the severity of depressive symptoms, according to scores from a questionnaire completed by the participants. However, this reduction did not differ significantly between the two groups.
“Psilocybin therapy, as we predicted, works more quickly than escitalopram,” said Carhart-Harris.
He added that results from other scales were “tantalisingly suggestive of potential superiority of psilocybin therapy” not only for depression but other aspects of wellbeing. He warned the findings were not conclusive as the team did not take into account the number of comparisons being made.
However, the team noted that 57 percent of patients in the high-dose psilocybin group were judged to be in remission for their depression by the end of the six weeks, compared with 28 percent in the escitalopram group, while neither group had serious side-effects.
While the team said the results were promising, others said the study was not big enough to draw firm conclusions. Among other limitations, the majority of participants were white, middle-aged, highly educated and male, while participants may have been able to guess which treatment they received and there was no group given a placebo and therapy alone.
Anthony Cleare, professor of psychopharmacology at King’s College London, said the study provided “some of the most powerful evidence to date that psychedelics may have a role to play in the treatment of depression.”
However, he said far more data was needed before drugs such as psilocybin could be used outside of research, adding they would not replace existing treatments for depression.
Sifting through the last week or so of writing on Taiwan in the major media, the original title of this piece was going to be “Three Cheesy Pieces.” But in truth, the flow of effluent from the media exceeds my ability to represent it in a single pithy headline. It seems that the output of bad writing on Taiwan is equal to the square of the amount of attention our island nation receives. TRIFECTA OF TURGIDITY Leading off a terrible 10-day of prose on Taiwan was the The Economist’s piece, “The Most Dangerous Place on Earth” with Taiwan on the cover. The
Who would have thought that Taiwan — just over 100km from China and a few hundred kilometers away from Vietnam, which are the world’s first and second biggest consumers of pangolin scales — would become the last beacon of hope for this imperiled species? In fact, pangolins — from sub-species in Africa all the way down to Indonesia — are the world’s most highly trafficked mammal. Thought to cure anything from HIV to hangovers, ground pangolin scales and pangolin soup (the photos online are difficult to stomach) are expensive delicacies in Vietnam and China, and the rarer the species becomes,
May 10 to May 16 Many elderly people wept as the crowds flooded Raohe Street (饒河街) on May 11, 1987. It had been over a decade since the street was this busy, the Minsheng Daily (民生報) reported. Locals set up altars along the way, praying that the grand opening of the Raohe Street Night Market would reverse their fortunes. It was Taipei’s first night market with government-mandated traffic control hours, banning cars from 5pm to midnight. “This is a great way to manage a night market, and other locales should follow suit,” the article stated. There were still some kinks to
People living in Taiwan’s cities hope for many things. Some might put cheaper housing or quieter neighbors at the top of their wish-list. Quite a few surely dream of more orderly, less congested roads. To get an international perspective — and find out what a specialist thinks could be done to make driving and riding less stressful and the streets safer — I reached out to Chiu Bing-yu (邱秉瑜), a PhD student in City and Regional Planning at the University of Pennsylvania. Chiu’s research focuses on how the supply of public transportation and land-use planning affect travel behavior, with particular attention