Only high-dose psilocybin was better than placebo in antidepressant trials of escitalopram
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Aug. 28, 2024 (HealthDay News) — Patients treated with high-dose psilocybin have better responses than those treated with placebo in antidepressant trials, according to a study published online Aug. 21 in The BMJ.
Tien-Wei Hsu, M.D., from E-DA Dachang Hospital in Kaohsiung, Taiwan, and colleagues examined the comparative effectiveness and acceptability of oral monotherapy using psychedelics and escitalopram in patients with depressive symptoms in a systematic review and Bayesian network meta-analysis. The primary outcome was change in depression, which was measured by the 17-item Hamilton Depression Rating Scale.
The researchers found that compared with antidepression trials of escitalopram, placebo response in psychedelic trials was lower (mean difference, â3.90). Most psychedelics were better than placebo in psychedelic trials, but in antidepression trials of escitalopram, only high-dose psilocybin was better than placebo (mean difference, 6.45). When the reference arm changed from placebo response in the psychedelic trials to antidepressant trials, the effect size of high-dose psilocybin decreased from large to small (standardized mean difference, 0.88 to 0.31, respectively). Compared with escitalopram at 10 mg and 20 mg, the relative effect of high-dose psilocybin was larger (4.66 and 4.69, respectively). Of the interventions, none were associated with higher all-cause discontinuation or severe adverse events than the placebo.
“Serotonergic psychedelics, especially high-dose psilocybin, appeared to have the potential to treat depressive symptoms,” the authors write.
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