Depression affects millions of people worldwide. For years selective serotonin reuptake inhibitors (SSRIs) have been the treatment of choice for moderate to severe depression. While SSRIs like escitalopram have helped many people manage their symptoms a new study suggests psilocybin the active ingredient in magic mushrooms may be more beneficial in the long term.
A team from Imperial College London have published a study comparing psilocybin therapy and escitalopram for depression. The results presented at the European College of Neuropsychopharmacology (ECNP) Congress and in The Lancet eClinicalMedicine show psilocybin goes beyond symptom relief and improves social functioning and overall sense of meaning and connection.
The Study
The study was a head to head comparison of psilocybin and escitalopram, one of the most commonly prescribed SSRI antidepressants. 59 participants with moderate to severe depression were included in the study. They were divided into two groups, one group received psilocybin therapy and the other group received escitalopram.
The psilocybin group received doses of 1mg to 25mg of the psychedelic and psychological support before and after. The escitalopram group followed the typical SSRI dosage regime, 10mg for three weeks and 20mg for the next three weeks. Both groups saw therapists regularly, 6-8 hours of therapy sessions every few weeks.
After six months the researchers used online questionnaires to follow up with the participants. The study looked at the severity of depression but also secondary outcomes such as social functioning and psychological well-being.
Psilocybin vs SSRIs
Both the psilocybin and escitalopram groups improved on depression symptoms over the six months. Both treatments reduced depression according to the researchers. The main measure of depression symptoms was the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR-16) a well established self report scale for mood disorders.
Both psilocybin and escitalopram relieved symptoms but the difference in depression symptom reduction was small. But that’s where the similarities end. The real breakthrough in this study was in the secondary outcomes where psilocybin outperformed traditional antidepressant treatment.
What’s Different About Psilocybin?
While both treatments managed symptoms, participants who received psilocybin therapy experienced more than just a decrease in sadness or despair. They experienced improvement in several areas of life beyond what you would expect from an antidepressant.
One of the main findings of the study was that the psilocybin group experienced a big increase in psychological connectedness, meaning in life and overall social functioning. This was measured by various scales such as the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and the Meaning in Life Questionnaire (MLQ).
Psilocybin’s ability to connect you with yourself and the world around you is a big advantage over SSRIs. Many participants felt more in touch with their emotions, relationships and purpose in life which led to a better overall quality of life. According to the study’s co-author David Erritzoe this increased sense of connectedness can lead to long term improvements in mental health which SSRIs often don’t provide.
Why Does This Matter?
For many people with depression SSRIs are a lifeline. But they come with many side effects and limitations. People taking SSRIs may gain weight, have sleep problems or sexual dysfunction which can reduce the effectiveness of the treatment. While SSRIs relieve symptoms they don’t always lead to a big improvement in daily functioning or overall wellbeing.
The study shows that psilocybin could be a more holistic way of treating depression. Beyond just reducing symptoms psilocybin therapy seems to improve emotional and social wellbeing in a way that SSRIs can’t. These extra benefits are key for people who want to not just manage their depression but thrive and live a better life.
The lead author of the study Tommaso Barba highlighted the importance of this long term improvement in psychosocial functioning. While reducing symptoms is important, the fact that psilocybin allows people to feel more connected and meaning in life opens up a whole new approach to mental health treatment.
Next Steps
Another thing to consider is that psilocybin therapy is still experimental and not yet available or approved for use in clinical settings. More research is needed to understand the long term effects of psilocybin on depression and other mental health conditions. Future studies with bigger sample sizes and more controls will be needed to replicate these findings.
Depression Treatment Future
If you have depression this study offers some hope. Psilocybin might one day be an option that can help you feel better and live better. It might not just relieve symptoms. It might help you find more meaning and connection in life.
The study shows we might have a new way to treat depression. Psilocybin is a more holistic approach to mental health. It helps with symptoms but it helps people feel more connected and fulfilled.
This doesn’t mean SSRIs don’t have a place in treatment. For many people SSRIs are a lifeline. But psilocybin as a treatment option opens up more people to find relief and healing in ways we’ve never seen before.
More to come. For now this is a taste.
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