期刊
PSYCHOPHARMACOLOGY
卷 235, 期 2, 页码 399-408出版社
SPRINGER
DOI: 10.1007/s00213-017-4771-x
关键词
Serotonin; 5-HT2AR; Depression; Treatment-resistant depression; Psilocybin; Psychedelic; Mood; Hallucinogen; Psychotherapy
资金
- UK Medical Research Council Grant
- Alex Mosley Charitable Trust
- MRC [MR/J00460X/1] Funding Source: UKRI
- Academy of Medical Sciences (AMS) [SGL019\\1063] Funding Source: researchfish
- Medical Research Council [MR/J00460X/1] Funding Source: researchfish
- National Institute for Health Research [CL-2015-18-005, ACF-2013-21-501] Funding Source: researchfish
Recent clinical trials are reporting marked improvements in mental health outcomes with psychedelic drug-assisted psychotherapy. Here, we report on safety and efficacy outcomes for up to 6 months in an open-label trial of psilocybin for treatment-resistant depression. Twenty patients (six females) with (mostly) severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 and 25 mg, 7 days apart) in a supportive setting. Depressive symptoms were assessed from 1 week to 6 months post-treatment, with the self-rated QIDS-SR16 as the primary outcome measure. Treatment was generally well tolerated. Relative to baseline, marked reductions in depressive symptoms were observed for the first 5 weeks post-treatment (Cohen's d = 2.2 at week 1 and 2.3 at week 5, both p < 0.001); nine and four patients met the criteria for response and remission at week 5. Results remained positive at 3 and 6 months (Cohen's d = 1.5 and 1.4, respectively, both p < 0.001). No patients sought conventional antidepressant treatment within 5 weeks of psilocybin. Reductions in depressive symptoms at 5 weeks were predicted by the quality of the acute psychedelic experience. Although limited conclusions can be drawn about treatment efficacy from open-label trials, tolerability was good, effect sizes large and symptom improvements appeared rapidly after just two psilocybin treatment sessions and remained significant 6 months post-treatment in a treatment-resistant cohort. Psilocybin represents a promising paradigm for unresponsive depression that warrants further research in double-blind randomised control trials.
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