Scientifically Speaking | Can magic mushrooms treat persistent depression?

  • The beauty of a recent study shows that a very short course of psilocybin, found in magic mushrooms, can provide a long-term benefit to patients not responding to standard treatment
Functional MRI brain scans from both trials showed that there were changes in brain function that persisted beyond the use of psilocybin. (Reuters) PREMIUM
Functional MRI brain scans from both trials showed that there were changes in brain function that persisted beyond the use of psilocybin. (Reuters)
Published on May 25, 2022 02:04 PM IST
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ByAnirban Mahapatra

Results of a new study published in the scientific journal Nature Medicine show that psilocybin, a powerful psychedelic compound found in “magic mushrooms” can treat patients suffering from clinical depression. Remarkably, psilocybin was shown to be more effective than a common antidepressant, escitalopram. Brain scans of patients also hinted that psilocybin works in a completely different way from known antidepressants.

People suffering from depression can face low moods together with repetitive patterns of thought. These behavioural patterns have signatures in the brain that are thought to contribute to depressive symptoms. Unfortunately, psychotherapy and antidepressant drugs don’t always alleviate symptoms for everyone suffering from depression.

New research on the use of the psychedelic compound, psilocybin, has found that just one or two doses of this drug provided in a clinical trial in conjunction with psychological support can reduce symptoms of depression even in patients who aren't responding to other forms of treatment. Functional MRI brain scans from both trials showed that there were changes in brain function that persisted beyond the use of psilocybin. This indicates that the changes are durable.

What psilocybin seems to be doing is help the brain become more connected, so that it works more fluidly outside of the rigid patterns of behaviour that it has formed. These inflexible patterns are often associated with depression. People suffering from depression report facing negative thoughts and behaviours that they can’t escape. The improvements in brain connectivity correlate very well with improvements in mood and mental state.

In the new study, Richard Daws at Imperial College, London, and his colleagues looked at data from two clinical trials involving patients suffering from clinical depression. The first set of patients took part in a one-week trial of psilocybin taken orally. The second was a double-blind Phase 2 randomised controlled trial which compared psilocybin to escitalopram, which is a standard antidepressant drug.

Psilocybin worked well to decrease depressive symptom severity in both trials. After three weeks, a 64% reduction in depression severity was seen after two doses of psilocybin. This was higher than the symptom reduction seen after six weeks of daily use of escitalopram.

Although more work is needed, the beauty of the study is that it shows that a very short course of psilocybin can provide a long-term benefit to patients not responding to standard treatment. What I found most stunning is that even a single dose of psilocybin can have a lasting effect on brain connectivity.

What is also intriguing about this study is that it shows both the effectiveness of the use of psilocybin in treating patients and that the mode of action might be different from approved antidepressant drugs. Psilocybin is a naturally occurring psychedelic compound that's found in around 200 different kinds of mushrooms that grow around the world. Since the late 1960s and early 1970s, psychedelic compounds such as psilocybin have been illegal in most countries.

Clinical trials using these compounds stopped after they became outlawed but have picked up in recent years. Since then, there has been accumulating evidence that certain psychedelics may have benefits in treating anxiety, major depression, and in stopping forms of addiction.

Pharmaceutical companies have developed drugs to help people deal with anxiety, depression, and other psychiatric disorders, but they are not equally effective in treating everyone. Alternative means such as natural psychedelic compounds could help people better deal with these conditions.

Certainly, these compounds which have been used by indigenous communities recreationally and for spiritual experiences for thousands of years might serve to treat psychiatric conditions. Psilocybin is not addictive in the physiological sense and isn’t toxic at the doses administered. But because psychedelics are still illegal and not approved for any condition, they should not be consumed unless under the direct guidance of a physician as part of a clinical trial.

Future studies with psilocybin will include Phase 3 trials for use in depression to find how safe and effective it is in a larger population. Additional studies will also glean out just exactly how it works. Right now, no one really knows.

Many patients who have benefitted from psilocybin say that their brains seem to have been reset like computers that have been restarted. So, when proponents say that magic mushrooms “free the mind”, maybe they are correct. But it may soon be time for broader society to open its mind to them too.

Anirban Mahapatra is a scientist by training and the author of a book on COVID-19. He’s writing a second popular-science book

The views expressed are personal

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Friday, July 01, 2022