The active chemical in magic mushrooms could prove to be a powerful antidepressant, a new review finds.

Psilocybin outperformed a variety of “control” treatments in easing symptoms of depression, researchers reported May 1 in the BMJ.

Those control groups received either placebo medications, the dietary supplement niacin (vitamin B), or microdoses of psychedelics.

“This review’s findings on psilocybin’s efficacy in reducing symptoms of depression are encouraging for its use in clinical practice as a drug intervention for patients with primary or secondary depression, particularly when combined with psychological support and administered in a supervised clinical environment,” concluded the research team led by Athina-Marina Metaxa, a master’s student with the University of Oxford’s Department of Medicine in the U.K.

Depression affects an estimated 300 million people worldwide, an increase of nearly 20% over the past decade, researchers said in background notes.

Psilocybin has shown promise in reducing depression symptoms after one or two doses, with few side effects and no apparent risk of addiction, researchers said.

To provide an overview of where research now stands, a U.K. team examined data from seven clinical trials involving 436 people with depression.

Psilocybin provided a significantly greater change in depression scores than any of the control treatments, results show.

The treatment effects of psilocybin were significantly more powerful among patients who had depression alongside another mental illness, and when participants had previously used psychedelics, researchers found.

“Interestingly, a clear pattern emerged for past use of psychedelics — the higher the proportion of study participants who had used psychedelics in the past, the higher the post-psilocybin treatment effect observed,” the team wrote.

However, more evidence is needed to support psilocybin as an antidepressant, researchers said.

“Real-world” data is also needed, to assess both potential effectiveness as well as potential costs, researchers added.

Trial patients typically receive psilocybin in a calm living room with soothing music, under the supervision of a psychotherapist — a situation unlikely to occur in typical health care settings.

“The combination of these elements makes this a relatively complex and expensive intervention, which could make it challenging to gain approval from regulatory agencies and to gain reimbursement from insurance companies and others,” the researchers wrote.

“The high cost associated with the intervention also increases the risk that unregulated clinics may attempt to cut costs by making alterations to the protocol and the therapeutic process, which could have detrimental effects for patients,” they added.

More information

Johns Hopkins Medicine has more about psilocybin.

SOURCE: BMJ, news release, May 1, 2024

Source: HealthDay