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Psilocybin assisted-therapy may revive emotional responsiveness in depression

Research findings suggest that psilocybin, a psychedelic substance found in ‘magic mushrooms,’ plus psychological support revived emotional responsiveness in depression, which allowed patients to reconnect with their emotions.

“After much early enthusiasm about the therapeutic potential of psychedelics, a politically-led about-turn in the mid-1960s and early 1970s effectively ended all research with these drugs, and it has only been in the last 10-15 years that clinical researchers have begun to work with them again,” PhD candidate Leor Roseman, MSc, from the Psychedelic Research Group at the Centre for Psychiatry in the department of medicine at Imperial College London, and colleagues wrote. “During this renascent period, impressive results have been found for the treatment of depression, end-of-life anxiety, obsessive compulsive disorder and addiction.”

Prior research has found that patients with depression have heightened amygdala responses to fearful faces and treatment with SSRIs reduces this response. Considering this and other data supporting the use of psychedelics like psilocybin on depression, researchers assessed whether psilocybin altered amygdala responses to emotional faces in depression in an open-label study. The researchers used a functional MRI scanner to examine the amygdala responses in 19 patients with moderate to severe treatment-resistant depression. Participants underwent two separate dosing sessions with psilocybin, with psychological support provided before, during and after sessions. Neutral, fearful and happy faces were presented in the scanner.

The results showed rapid, lasting improvements in depressive symptoms after treatment with psilocybin, with increased posttreatment responses in the right amygdala for fearful (P=.001) and happy faces (P =.022), with a trend effect for neutral faces (P=.066). These responses were observed as early as 1 day after treatment. The increased responses in the right amygdala to fearful vs. neutral faces predicted positive clinical improvements 1 week later. Furthermore, psilocybin plus psychological support was associated with increased amygdala responses to emotional stimuli. According to Roseman and colleagues, this shows an opposite effect to prior results with SSRIs, suggesting SSRIs alleviate negative emotions while psilocybin enables patients to work through them.

“Psilocybin represents a novel intervention for major depression that appears to be safe, rapid and potentially enduring in its antidepressant action,” Roseman and colleagues wrote. “Future work is required to test the replicability of these findings and test whether enhanced amygdala responsiveness is related to the potentially enduring positive mood effects of psychedelics. If confirmed, this would suggest an alternative neurobiological basis to the alleviation of depressive symptoms distinct from that of the SSRI antidepressants.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.