September 22, 2024

expert reaction to 6-month follow up of phase 2 trial of psilocybin versus escitalopram for depression

A follow up of a phase 2 trial published in eClinicalMedicine looks at the effect of psilocybin versus escitalopram for depression. 

Dr James Rucker, Consultant Psychiatrist & Senior Clinical Lecturer in Psychopharmacology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London (KCL), said:

“The authors have tended to attribute differences observed in this study to comparative differences between the drugs themselves, however it is also possible that the results reflect biased reporting between groups. This is more likely here because A) studies involving psilocybin tend to attract those with positive preconceptions about psilocybin and negative preconceptions about conventional antidepressants, and B) study participants were unblinded during the long term follow up phase that is reported in the paper, so knew which condition they were allocated to.

“This said, the nature of depression varies hugely between individuals, and this calls for the development of a similarly varied suite of treatment paradigms. Psilocybin therapy is certainly a different paradigm of treatment to escitalopram. The observation of similar levels of effectiveness to antidepressants here is encouraging to see alongside the much larger trials of psilocybin currently underway here in the UK, Europe and the US.”

‘Effect of psilocybin versus escitalopram on depression symptom severity in patients with moderate-to-severe major depressive disorder: observational 6-month follow-up of a phase 2, double-blind, randomised, controlled trial’ by David Erritzoe et al. was published in eClinicalMedicine at 00:30 UK time on Sunday 22 September. This work is being discussed at the European College of Neuropsychopharmacology (ECNP) Congress 2024.

DOI: https://doi.org/10.1016/j.eclinm.2024. 102799    

Declared interests

Dr James Rucker: I’m PI on various commercial trials with psilocybin but have no financial links or shareholdings with the sponsors of those trials.