Magic mushrooms could be used to treat mental health conditions

A compound found in magic mushrooms, psilocybin, could be used to treat mental health conditions and help patients suffering with severe depression, as shown by the results of the largest study of its kind to date.

This clinical trial was the largest to date to look at the compound, involving 233 patients diagnosed with ‘treatment-resistant’ depression. Treatment-resistant depression is defined as when the patient has not benefitted from the application of at least two antidepressants. 

The compound in question is psilocybin, a psychoactive ingredient found in over 200 species of fungi. 

The patients involved in the Phase II double-blind trial each received psychological support and then either a 25 mg or 10 mg dose of psilocybin at random, and those in the control group a 1 mg dose. 

Psilocybin is thought to affect the areas of the brain that are involved in processing emotions. 

When the compound was administered to patients, under controlled conditions, it was reported that they entered a dream-like state, lasting between 4 and 6 hours. 

The results, published in The New England Journal of Medicine, show that those who received the higher dose of psilocybin, 25 mg, demonstrated a significant decrease in depressive symptoms after 3 weeks of treatment (the primary end point), compared to those in the lower dose treatment groups. In this 25 mg dose group, the incidence of remission in patients was 29%, compared to 9% and 8% in the 10 mg and 1 mg groups respectively. 

However, between weeks 3 and 12 of treatment (with 12 weeks being the secondary end point), the difference in response between the groups was not statistically significant. Overall in the 25 mg study group 16% of patients showed a sustained response, i.e a response that was held from week 3 through to week 12. 

The trial's findings are positive but not ground-breaking, advised Ravi Das, associate professor at the University College London Institute of Mental Health, UK.

"There were an uneven number of severely depressed patients in each group; with significantly fewer severely depressed people in the apparent 'effective' (25mg) dose group. This does not appear to be acknowledged in the paper."

The trial wasn’t without concerns, several of the patients experienced adverse side effects; in the 25 mg group patients reported headaches (24%), nausea and dizziness and fatigue. In a smaller proportion, severe adverse effects were reported, including suicidal ideation, intentional self-harm behaviour and hospitalisation due to severe depression. 

By studying depression, suicidality is going to be a feature of the illness course, stated Guy Goodwin, chief medical officer at COMPASS Pathways (London, UK).

"Our hypothesis is that the differences are by chance...but we can only settle this by doing further experiments."

Goodwin also mentioned that the compound was being tested in two other late-stage trials looking at its effectiveness as a treatment for PTSD and anorexia nervosa, with hopes the results could be released at the end of 2024. 

The use of these drugs for treatment of mental health conditions remains controversial, but the latest research shows that it worth investigating further.