Lifetime use of MDMA/ecstasy and psilocybin is associated with reduced odds of major depressive episodes.

Abstract

<h4>Background</h4>Depression is a major mental health issue worldwide, with high rates of chronicity and non-recovery associated with the condition. Existing treatments such as antidepressant medication and psychological treatments have modest effectiveness, suggesting the need for alternative interventions.<h4>Aim</h4>The aim of this study was to examine the relationships between MDMA (3,4-methylenedioxymethamphetamine)/ecstasy and psilocybin use and major depressive episodes (MDEs).<h4>Methods</h4>This observational study used data from a large (<i>N</i> = 213,437) nationally representative sample of US adults to test the association of lifetime use of MDMA/ecstasy, psilocybin and other classic psychedelics (lysergic acid diethylamide (LSD), peyote, mescaline), other illegal substances (e.g. cocaine, phencyclidine (PCP)), and legal/medicinal substances of misuse (e.g. pain relievers, tranquilizers) with lifetime, past year, and past year severe MDEs.<h4>Results</h4>Results revealed that lifetime MDMA/ecstasy use was associated with significantly lowered odds of a lifetime MDE (adjusted odds ratio (aOR) = 0.84; <i>p</i> < 0.001), past year MDE (aOR = 0.84; <i>p</i> < 0.001), and past year severe MDE (aOR = 0.82; <i>p</i> < 0.001). Psilocybin was associated with significantly lowered odds of a past year MDE (aOR = 0.90; <i>p</i> < 0.05) and past year severe MDE (aOR = 0.87; <i>p</i> < 0.05). All other substances either shared no relationship with a MDE or conferred increased odds of an MDE.<h4>Conclusions</h4>These results suggest that MDMA/ecstasy and psilocybin use is associated with lower risk of depression. Experimental studies are needed to test whether there is a causal association between use of these compounds and the alleviation of depressive symptoms.

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