Can Dosing with Psilocybin Mushrooms Treat Depression?

May is mental health month, and we're talking about treatments for depression. Today, we're looking at the evidence for using psilocybin mushrooms to treat depression. There's lots of studies to look at, so here we goooo!

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Credits:
Aaron Carroll -- Writer
Meredith Danko – Social Media
Tiffany Doherty -- Writer and Script Editor
John Green -- Executive Producer
Stan Muller -- Director, Producer
Mark Olsen – Art Director, Producer

[levijulian]

Psilocybin containing mushrooms saved my life. The drastically reduced my benzodiazepine withdrawal allowing me to quite illicit pill addiction after three years of heavy daily use before it would had became medically dangerous to quit. It has also helped me survive depression.

[DonaldAMisc]

Thank you as always for sticking to the data, as well as noting some of these very studies may include publication bias. I'm tired of staunch advocates overhyping the health claims of psychedelics (the same thing happened with marijuana), so I'm all for more research. 💯

[DarkBananaPhone]

An important distinction that should be made is that these studies that were discussed only focus on depression and anxiety; traumatic stress is worthy of inclusion in mental health and not many treatments for depression work well for trauma. Psilocybin and other psychedelic medicines are an interest for treating trauma, so I'd be interested in that topic.

In fact, it'd be great to get a healthcare triage specifically on trauma treatment.

[amanatee]

3:39 hold on, your report of the 2021 trial's "negative results" feels lacking. While the conclusion section of the trial states there was not statistically significant difference BETWEEN the psilocybin and escitalopram group when strictly looking at depression score reduction, BOTH groups still saw a decrease in their QIDS-SR-16 scores compared to baseline:
"The mean scores on the QIDS-SR-16 at baseline were 14.5 in the psilocybin group and 16.4 in the escitalopram group. The mean (±SE) changes in the scores from baseline to week 6 were −8.0±1.0 points in the psilocybin group and −6.0±1.0 in the escitalopram group... A QIDS-SR-16 response occurred in 70% of the patients in the psilocybin group and in 48% of those in the escitalopram group...QIDS-SR-16 remission occurred in 57% and 28%, respectively... Other secondary outcomes generally favored psilocybin over escitalopram, but the analyses were not corrected for multiple comparisons. The incidence of adverse events was similar in the trial groups."
To reiterate, the response rate in the psilocybin group was over *2/3* while escitalopram was just under *half*, plus remission in over *half* of psilocybin group vs just over *a quarter* of escitalopram.
I feel that's saying a lot for an intervention administered once every 3 weeks to be comparable to a pill taken daily.

[locochingadero]

The difference between the final two papers you mentioned had to do primarily with the NEJM exerting unusually conservative and limiting editorial control over the interpretation of the findings, particularly the tools used to classify and interpret traditional SSRI findings. In the authors defence, he chooses to use far more meaningful outcome analyses, meaningful for sufferers of depression that is. All of this data is actually in the first study, but editors refused its admission in the main body of the paper, and it could only appear in an index.
Another thing you might have mentioned that is a game-changer in terms of depression/psilocybin, is that effects are seen often after one single dose and are immediate, unlike SSRIs . Also psilocybin, when compared to literally any other pharmecutical, is as safe as can be measured or assessed. This alone makes it an appealing candidate for treatment, but always in combination with therapy.

[ScholarlyPotato]

I may not always like what he's saying but I never doubt his sincerity

[joonzville]

Pure anecdote but back in my hippie days I preferred Psilocybin and Peyote to LSD. Both left me felling ‘mellower’ during and after. Since I’ve never had depressive symptoms and no one in my immediate family has either, it’s not even a helpful anecdote! 🥴

[Rolyataylor]

I think that psilocybin will help people who suffer from depressed mood or a lack of emotion as it amplifies emotional response. Sadness and despair may be improved through feelings of unity and oneness but I don't think it will improve negative emotions otherwise.

[louismasar]

As a proud mushroom enthusiast, YES. WITHOUT QUESTION YES. When I can find mushrooms I am not just happy when I take them, they can greatly improve my mood for actual months at a time from only a single dose, non-micro of course. 2-3.5 grams can greatly help if not cure depression

[asliuf]

highly recommend michael pollan's book "how to change your mind" to anyone who wants to know more! there is much much more to know about this topic and pollan does an incredible job.

[mdalie]

This confirms my sentiment on this topic. Considering how difficult it is to study the effects of mainstream pharmacotherapy, attempting to study psychedelics in the same way seems like an unbelievably difficult task.
Can you imagine all the paperwork you'd need from ethics committees, the DEA, grant funders etc...
Hopefully one day it will be better studied but I doubt it will be in the near future, unfortunately.

[lklk]

Before people get carried away dunking on the the anecdotal examples in the comments below, I just want to say this. While suffering from extreme anxiety and depression, I thought Escitalopram was going to kill me. I couldn't tolerate it for the amount of time it would require to start seeing results. I just couldn't do it. My point is this. If the study results for psilocybin and marijuana have results that are mixed, why wouldn't you still provide them as an option (so long as they're deemed to be safe). Drug safety and drug efficacy are two different things. Particularly in the realm of mental health, there is no such thing as a one size fits all solution. Even anti-anxiety and anti-depressants have mixed results. So again, pending safety, why wouldn't we just view psilocybin and marijuana as options, rather than a one size fits all second coming of Jesus? Whatever helps you feel like you don't want to die, should be a positive.

[sebastianocrospomaheraud]

The trial that has no significance mentioned at 4:02 was testing for difference between psicobylin 25 mg alone in two doses vs psicobylin 1 mg in two doses with escitalopram in between. No significance doesn’t mean the drug didn’t work, it may just have meant that the dosage is still no determined. I’m unsure why they added the escotalopram on the other group though as it would’ve been better to have it as a third separate group for control, although that would’ve been a phase 3 trial 🤔

[duruprincewill]

Psilocybin mushrooms and psychedelics generally are very beneficial substances and can really help people with mental health issues.

Psychedelics are just an exceptional mental health breakthrough. It’s quite fascinating how effective they are against depression and anxiety. Saved my life.

[StokedToStripes]

Couldn't it be considered a bit of a "harsh" conclusion to draw on the study mentioned at 4:00 as a negative? They are comparing it to the gold standard for depression and there was not a significant difference found between the two?

[LittleMissTotoro]

A classmate of my in my Psych masters was doing this for her thesis. She sadly didn't find anything in her study, but she really hopes it can help ^€^

[ems]

It's becoming fairly clear, little by little, that psilocybin can be used to treat depression at least in some people. It's just not clear yet how well, how lasting the effects, how safely (for the wide array of patients with depression and co-morbid mental illnesses.)

We should have known this fifty years earlier. Thanks to Nixon's drug laws, we couldn't. How many people suffered from severe depression or are gone because of suicide as a result of his shallow thinking?

[DuchessLizi]

Love this. Would like a companion video about psilocybin's potential for other mental health diagnoses. I've heard (anecdotally but also from clinicians) it has far more potential for treatment for PTSD and addiction than it has for stuff like depression and bipolar. As someone who did psychedelic psychotherapy at a ketamine clinic, this kinda makes sense to me but I'm curious if there's data to support it.

[The_Serpent_of_Eden]

As someone who trips regularly, yes. Yes. Yes. Psilocybin has been a godsend for me. For 20 years, I took a variety of antidepressants (Lexapro, Celexa, Cymbalta, Zoloft, Wellbutrin, and so many others, in different combos and dosages), saw psychiatrists, and went through numerous therapists. Nothing helped me in the slightest. I was cripplingly, hopelessly depressed. I felt like garbage all the time, I had no energy, my life sucked. I was miserable for so, so long.

Finally, I got clean off the antidepressants, and started tripping twice-yearly on magic mushrooms in very carefully planned trips (myself; not guided by anyone else). OMG my life has changed. I find so much more peace and joy in my life. I've become spiritual and regained happiness. I am more level-headed, less quick to anger, far few crying jags (still a few, linked to the hormonal swing of my period), and far, far, FAR happier in general. I never thought I'd get to this point. I didn't think it was possible.

Psychiatry and the US medical establishment taught me that I was broken and I needed tons of (addictive) pills and constant therapy. All of which made certain people a ton of money. Mushrooms showed me reality: money is made up, psychiatry is made up, medicine is made up. You live, you die, you are reborn, you live again, you die again, an endless immortal cycle. So let go of your pain, let go of your fear, let go of your constructs. Let go and be reborn.

[Praisethesunson]

I took mushrooms and they made me anticapitalist. Being anticapitalist cured my depression and gave me purpose in life.

So I give mushrooms an 8/10