Potential benefits of illegal drugs are finally becoming subject to scientific investigation, and one of the first rigorous studies supports claims that one has a lot to offer. Funding limitations kept the study too small to be conclusive, but it certainly suggests “magic mushrooms” could have a big role in treating depression.
Psilocybin-containing mushrooms have been demonized for decades by governments and authority figures, often backed up with heavy legal penalties. Research into any possible benefits has been so regulated that until recently, it was effectively impossible. What investigations been done have often not had a chance to apply the best scientific techniques.
Dr Robin Carhart-Harris of Imperial College London is one of the first to change this. He gave 30 participants with moderate-to-severe depression two rounds of 25 milligrams (0.00088 ounces) of psilocybin three weeks apart, with placebo capsules in between and afterward. Another 29, the control group, received two, 1-milligram doses of psilocybin and six weeks of daily doses of the SSRI escitalopram (marketed as Cipralex and Lexapro).
The average mood of both groups improved substantially, Carhart-Harris reports in the New England Journal of Medicine, but those on the high psilocybin doses appeared to do better – although the difference was not statistically significant.
Before, during, and after the trial, patients were assessed on the QIDS-SR-16 depression assessment scale. Initial average scores were 15.45. After six weeks, these fell by 8.0 points (over a 50 percent reduction in depression symptoms) among those on psilocybin, and by 6.0 for those on the SSRI. Psilocybin's benefits also showed up more quickly.
48 percent of those on escitalopram halved their depression score during the six weeks, the primary measure chosen before the trial: 70 percent of those receiving psilocybin did the same. The improvements were broad-ranging; including a return of capacity to feel pleasure, reduced anxiety, and fewer suicidal thoughts. Twice as many (57 percent) of those on psilocybin had scores that dropped so low they were classed as being in remission from depression – although this was made easier by the random draw putting more people with moderate symptoms in the psilocybin arm.
Aside from headaches, those taking psilocybin suffered fewer side effects than their counterparts.
The small size of the study prevents Carhart-Harris from expressing confidence psilocybin works better than the escitalopram, although he has tweeted it performed even better on some secondary tests. The case that it's an effective medication looks considerably stronger, however. Given the failure rate and side-effects of SSRIs any alternative, even one that performs no better on average, could transform millions of lives.
"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." Carhart-Harris said in a statement. “Psilocybin performed very favourably in this head-to-head.”
Patients in both arms of the trial received psychological support, which presumably contributed to their progress. Nevertheless, it would be very unusual for support to make such a rapid difference alone.
Besides the small sample size and the absence of a placebo-only group, the authors note their sample was mostly made of up well-educated white men, so more diversity is required. Professor Anthony Cleare of the Kings College London, who was not involved in the trial, noted; “This study provides some of the most powerful evidence to date that psychedelics may have a role to play in the treatment of depression." Nevertheless, he added; “We need much more data before these treatments could be considered ready for use outside of carefully controlled research studies.”
The work was only possible through funding from the Alexander Mosley Charitable Trust. Getting government (or industry) funding for research in this field remains immensely different.