TLDR; 🍄 > 💊

I’ll point out the elephant in the appendix: Psilocybin crushes the SSRI standard of care for depression in the first comparative study across ten efficacy outcomes.

The Nᴇᴡ Eɴɢʟᴀɴᴅ Jᴏᴜʀɴᴀʟ ᴏꜰ Mᴇᴅɪᴄɪɴᴇ conservatively called it a tie.

Depression is the leading cause of disability worldwide, and the sales of ineffective antidepressant drugs are $14 billion per year, and growing. “The World Health Organization predicts that – without significant changes – mental illness will cost the world economy $16 trillion by 2030, making it the largest disease burden globally.” — UBS analyst report

Escitalopram is a leading SSRI antidepressant sold under brand names like Cipralex and Lexapro.

“A closer look at the research reveals that the psilocybin group saw greater results in a shorter period of time, including improvements in ability to feel pleasure, express emotions, and increased feelings of well-being. Feelings of anxiety and suicidal ideation were also reduced significantly. ‘It’s hard to avoid looking at the values themselves and thinking, hold on, psilocybin had twice as many people in remission than escitalopram’ Carhart-Harris says.” — Forbes

“57% of patients in the high-dose psilocybin group were judged to be in remission for their depression by the end of the six weeks, compared with 28% in the escitalopram group, while neither group had serious side-effects. Anthony Cleare, professor of psychopharmacology at King’s College London, said the study provided ‘some of the most powerful evidence to date that psychedelics may have a role to play in the treatment of depression’”
Guardian

3 responses to “Psilocybin crushes SSRI for Depression”

  1. some more detail from the NEJM "The percentages of patients who had anxiety, dry mouth, sexual dysfunction, or reduced emotional responsiveness were higher in the escitalopram group than in the psilocybin group. Four patients in the escitalopram group stopped taking their daily capsules entirely, and 1 patient halved the dose because of perceived adverse events. No patient in the psilocybin group requested to cancel the second psilocybin dose" and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) with higher scores indicating greater mental well-being):

  2. Imagine being the researcher exploring this hypothesis. A personal note from Robin to supporters, as he departs Imperial for UCSF: "Personally, this year has been particularly rewarding but this publication in the NEJM feels like a career pinnacle. Does it come any better than being able to communicate to the public that there is new hope for those afflicted by depression?"
    7 years agoa) Your Brain. b) Your Brain on Shrooms.  Any Questions?

  3. IPO update: atai, the largest shareholder of Compass Pathways (provider of psilocybin for this study), is about to go public itself. Here is a somewhat humorous review of the company (while mostly negative, the bull case made me chuckle):

    "If you’ve ever taken acid, you know the scoop. It’s pointless trying to explain how powerful hallucinogens are to anyone who has never dabbled. Even without personally experiencing the incredulousness of hallucinogenic substances, the bull thesis is still easy to imagine.

    The Fourth Industrial Revolution is ushering in an era where people below a certain intelligence level won’t have gainful employment. That minimum required intelligence threshold will only increase over time. That’s a huge problem because jobs aren’t just about income, they provide self-actualization. While income can be replaced, the mental health effects of joblessness will be a much harder problem to solve. People are going to be bored out of their minds and largely depressed with no real sense of purpose. And we’re not convinced “the passion economy” will solve the problem.

    Psychedelics offer mankind a way to expand the notion of reality beyond what we know today. Mental health problems will become a thing of the past as everyone is able to alter their consciousness to achieve something – if not happiness, at least the absence of pain and suffering. Psychedelic medicines could transform the pharmaceutical industry such that they’re the predominantly prescribed therapeutics for mental health."

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