Psilocybin-assisted therapy for major depressive disorder: Perspective from meta-analysis.
Abstract
<h4>Objective</h4>This systematic review and meta-analysis of six randomized controlled trials aimed to investigate the temporal changes in the efficacy and safety of psilocybin treatment for major depressive disorder (MDD).<h4>Methods</h4>Separate meta-analyses were conducted for standard-dose psilocybin (25 mg/session, or 20-30 mg/70 kg/session) and low-dose psilocybin (10 mg/session or 15.05 mg/70 kg/session) subgroups. Control conditions included placebo, waiting-list control, niacin, or psilocybin 1 mg.<h4>Results</h4>Standard-dose psilocybin was superior to control in reducing depressive symptoms (standardized mean difference [SMD]: -1.05; 95% confidence intervals [CIs]: -1.60 to -0.50, p = 0.0002, I<sup>2</sup> = 75%, K = 4). Sensitivity analysis excluding studies with waiting-list controls supported the superiority of standard-dose psilocybin compared with control without considerable heterogeneity (SMD: -0.70; 95% CI: -1.03 to -0.36, p < 0.0001, I<sup>2</sup> = 43%, K = 2). This sensitivity analysis included two double-blind trials that incorporated manualized psilocybin-assisted psychotherapy. Compared with controls, standard-dose psilocybin was associated with higher response (risk ratio [RR]: 2.34; 95% CI: 1.52-3.60, p = 0.0001, I<sup>2</sup> = 0%) and remission rates at 2-3 weeks post-treatment (RR: 3.38; 95% CI: 1.88-6.08, p < 0.0001, I<sup>2</sup> = 0%), with response rate at 6-12 weeks post-treatment (RR: 2.61; 95% CI: 1.45-4.71, p = 0.001, I<sup>2</sup> = 0%). Moreover, standard-dose psilocybin was related to lower all-cause discontinuation compared with control (RR: 0.39; 95% CI: 0.18-0.87, p = 0.02, I<sup>2</sup> = 0%). Standard-dose psilocybin was associated with a higher incidence of headache (RR: 2.06; 95% CI: 1.11-3.81, p = 0.02, I<sup>2</sup> = 57%) and nausea within 1-9 days post-treatment (RR: 10.20; 95% CI: 3.80-27.39, p < 0.0001, I<sup>2</sup> = 0%) compared with the control; however, these symptoms resolved after this period. Low-dose psilocybin demonstrated no superior efficacy compared with the control group.<h4>Conclusions</h4>This meta-analysis indicates that standard-dose psilocybin may represent a promising therapeutic option for MDD treatment. Nonetheless, future research should address the considerable methodological heterogeneity across current trials.
Topics & conditions
Detected automatically by Psychedelic Commons from the title and abstract, not labels from the source. They may be incomplete.
Keywords
Psychedelic Commons aggregates metadata from open sources and links back to the original. Rights remain with the authors and publishers. Something wrong with this record? Report a problem.