[Medical Times = Reporter Inbok Lee] Research results have shown that psilocybin, a mushroom extract compound that is attracting attention as a new depression treatment strategy, shows efficacy and safety that are comparable to those of standard antidepressants.

This is the first time that the long-term treatment effect of psilocybin has been demonstrated, and it is expected to have a significant impact on future depression treatment strategies.

On the 15th local time, the Journal of Psychopharmacology published the results of a long-term follow-up study on the effects of psilocybin on severe depression (doi.org/10.1177/02698811211073759).

Psilocybin Therapy is an extract of hallucinogenic mushrooms and is reported to cause perception and mood changes by suppressing the firing of serotonin-dependent neurons.

However, it is also true that it is emerging as a new depression treatment strategy as basic research shows that this perception effect can be effective in treating terminal cancer, depression, or anxiety. However, most of them were retrospective studies, and it was difficult to find any basic research that could provide evidence for them.

This is why a research team led by Professor Natalie Gukasyan of Johns Hopkins University School of Medicine set out to investigate this. The purpose is to determine whether psilocybin can actually be used as a treatment strategy as well as existing antidepressants.

Accordingly, the researchers recruited 27 participants who had suffered from long-term depression, provided them with psilocybin for up to 24 months, and observed the effects.

After administering psilocybin twice at two-week intervals from 2017 to 2019, the degree of improvement in depression was determined every week. This is through the GRID-Hamilton Depression Rating Scale, a standard depression assessment tool.

A grid score of 24 or more is considered severe depression, 17 to 23 points is moderate depression, 8 to 16 points is mild depression, and 7 points or less is not depression.

As a result of psilocybin administration, patients whose depression did not improve even with standard antidepressant therapy in the past and whose grid score reached an average of 22.8 points rapidly improved, dropping to 8.7 points in the first week of treatment.

In addition, after recording 8.9 points in the 4th week, the score was 7 points in the 6th month, showing virtually complete improvement in depression.

These effects lasted for a long time. This is because the grid score was maintained at 7.7 points in the survey 12 months later. In a comprehensive analysis, the response rate after 12 months was 75% and the complete remission rate was 58%.

The researchers explain that these results show that psilocybin is in no way less effective than standard antidepressant therapy in the past, and rather is a sufficient alternative that can continue treatment without side effects for a long time.

Professor Natalie said, "This study showed that psilocybin can be a very effective alternative to depression as it not only has immediate effects but also lasts for a very long time," adding, "Compared to standard antidepressants that have to be taken for a long period of time and have side effects controlled, it can be administered once or twice. “It is superior in that it can continuously relieve symptoms of depression even with treatment,” he explained.

He continued, "If we prove through future research that this effect lasts for more than 12 months, it will be a groundbreaking turning point in the treatment of depression in the future."

American researchers reported the success of the second phase of clinical trials of combined individual and group psilocybin psychotherapy for the treatment of major depression in cancer patients. A report on the work was published in the journal Cancer; a separate publication in the same publication is devoted to the study of the subjective perception of such treatment.

Depression often accompanies cancer; clinically significant manifestations are observed in one out of three to four patients. At the same time, the traditional approach to treatment, including psychotherapy and the prescription of antidepressants, is often not effective enough. Because of this, psychedelic psychotherapy, including the use of psilocybin, is of great interest, which in clinical trials has repeatedly demonstrated high effectiveness in the treatment of major depressive disorder, post-traumatic stress disorder and other mental disorders.

The open-label (non-blinded) phase 2 clinical trial, conducted by Sunstone Therapies CEO Manish Agrawal and colleagues from several US research centers, included 30 cancer patients (average age 56 years). For two thirds of them, one to four years have passed since diagnosis; in 53.3 percent the disease was metastatic and inoperable. Among oncological diseases, breast cancer predominated (33.3 percent), as well as leukemia and lymphoma (26.7 percent). All participants suffered from major depressive disorder without moderate or severe psychotic features (HAM-D score 18 or more). They were not taking antidepressants, antipsychotics or medical cannabis at the time of recruitment.

After interview, assessment, and screening, each participant was assigned to an individual therapist and completed two orientation sessions that included information about psilocybin therapy. They then participated in weekly therapy sessions for eight weeks with 25 milligrams of synthetic psilocybin. In these sessions, the drug was administered to three to four patients at a time, who stayed in adjacent rooms of a community cancer center alone with their therapist for 4.25 hours, and then came together for 3.75 hours for group support and integration of the experience.

The dynamics of depression severity during therapy were assessed using the MADRS scale. At the eighth week, it decreased by an average of 19.1 points (p < 0.0001) compared to baseline. Sustained response to treatment was observed in 80 percent of participants; exactly half achieved complete remission of depressive symptoms in the first week, which persisted throughout the study. No serious side effects were recorded. Some patients complained of moderate and transient nausea and headache. Laboratory tests and ECG were without abnormalities. The participants did not show suicidal tendencies.

To determine the acceptability of combined individual and group psychotherapy using psilocybin for patients, the authors conducted semi-structured interviews with patients in a separate study; 28 people took part in them. In general, patients rated this approach positively in terms of both effectiveness and safety. Group sessions, on the one hand, increased their sense of security and preparedness, on the other hand, generated feelings of connectedness and community that helped to enrich and deepen everyone’s personal experience.

Psilocybin therapy is a therapeutic approach that utilizes the psychedelic compound psilocybin, found in certain species of mushrooms, to facilitate psychological healing and personal growth. It involves the guided administration of psilocybin in a controlled and supportive setting, accompanied by a trained therapist or facilitator.

Psilocybin therapy has gained significant attention in recent years for its potential in treating various mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), and addiction. The psychedelic experience induced by psilocybin is believed to offer unique therapeutic benefits, such as enhanced introspection, emotional release, and the potential for profound insights and spiritual experiences.

During a psilocybin therapy session, individuals are carefully prepared for the experience, including discussions about intentions, expectations, and potential effects. The actual session typically involves ingesting a predetermined dose of psilocybin in a calm and supportive environment, with the therapist or facilitator offering guidance and support throughout the journey.

The effects of psilocybin can vary depending on factors such as dosage, set (mental and emotional state before ingestion), and setting (physical and social environment). Participants may experience a wide range of sensations, emotions, and altered states of consciousness during the session. The therapist or facilitator helps create a safe and comfortable space for individuals to explore their inner experiences, process emotions, and gain insights into their thoughts, behaviors, and life circumstances.

Psilocybin therapy often incorporates integration sessions, which occur after the psychedelic experience. These sessions allow individuals to reflect on and integrate the insights gained during the session into their daily lives. Integration may involve discussing the experience, exploring its meaning, and identifying ways to apply newfound perspectives and insights to personal growth and healing.

Research on psilocybin therapy has shown promising results, with studies suggesting significant reductions in depressive symptoms, anxiety, and improvements in quality of life. The therapeutic benefits of psilocybin are thought to be related to its ability to disrupt rigid patterns of thinking, promote neuroplasticity, and facilitate emotional processing and self-reflection.

It's important to note that psilocybin therapy should only be administered by trained professionals in a controlled and legal setting. The therapy requires careful screening, appropriate dosing, and therapeutic support to ensure safety and maximize the potential benefits while minimizing potential risks.

Psilocybin therapy represents a paradigm shift in mental health treatment, offering a novel approach to addressing various psychological conditions. Ongoing research and clinical trials continue to explore its therapeutic potential, further refining protocols, and providing evidence-based guidelines for its use.

While psilocybin therapy shows promise, it is essential to approach it with caution and respect for its powerful effects. The therapy should always be conducted within a comprehensive treatment framework that includes proper screening, professional guidance, and integration support.