Generic placeholder image

Current Psychiatry Research and Reviews

Editor-in-Chief

ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Meta-Analysis

The Efficacy of Psilocybin in the Treatment of Depression and Anxiety: A Meta-Analysis

Author(s): Andrew Troy Hodge*, Suporn Sukpraprut-Braaten, and Robert C. Strayhan

Volume 19, Issue 1, 2023

Published on: 18 August, 2022

Page: [95 - 106] Pages: 12

DOI: 10.2174/2666082218666220513142002

Price: $65

Abstract

Background: The use of psychedelic compounds to treat psychiatric disorders has become a very significant topic of research over the past several years. Psilocybin has risen to prominence as one of the most studied among these psychedelic compounds. Multiple trials have already shown that it can be a safe and efficacious treatment for various medical conditions. This study intends to perform a meta-analysis of data reported in clinical trials studying psilocybin’s effect on depression and anxiety.

Methods: Articles were searched, screened, and ultimately selected using predetermined inclusion criteria. Data was collected from commonly used psychometric tests that measured mood and anxiety symptoms. Effect sizes were calculated by comparing scores in these tests at baseline and control to experimental groups. Sub-group analysis was performed to assess psilocybin’s effect on depression and anxiety during short, medium, and long-term time frames.

Results: Statistical significance was achieved in reducing depression and anxiety symptoms compared to controls in multiple subgroups. Heterogeneity of the effect sizes was calculated using an I2 value which showed low to moderate values. Multiple tools were used to assess publication bias, and none could be found.

Conclusion: Although research on psilocybin continues to show promise, the evidence is still at a preliminary phase, and more trials need to be conducted with larger patient populations over longer periods for psilocybin to potentially be approved in a community setting.

Keywords: Meta-analysis, psilocybin, depression, anxiety, psychedelics, microdosing, LSD, MDMA.

[1]
Galvão-Coelho NL, Marx W, Gonzalez M, et al. Classic serotonergic psychedelics for mood and depressive symptoms: A meta-analysis of mood disorder patients and healthy participants. Psychopharmacology (Berl) 2021; 238(2): 341-54.
[http://dx.doi.org/10.1007/s00213-020-05719-1] [PMID: 33427944]
[2]
Goldberg SB, Pace BT, Nicholas CR, Raison CL, Hutson PR. The experimental effects of psilocybin on symptoms of anxiety and depression: A meta-analysis. Psychiatry Res 2020; 284: 112749.
[http://dx.doi.org/10.1016/j.psychres.2020.112749] [PMID: 31931272]
[3]
Vargas AS, Luís Â, Barroso M, Gallardo E, Pereira L. Psilocybin as a new approach to treat depression and anxiety in the context of life-threatening diseases-A systematic review and meta-analysis of clinical trials. Biomedicines 2020; 8(9): 331.
[http://dx.doi.org/10.3390/biomedicines8090331] [PMID: 32899469]
[4]
McIntyre RS, Filteau MJ, Martin L, et al. Treatment-resistant depression: Definitions, review of the evidence, and algorithmic approach. J Affect Disord 2014; 156: 1-7.
[http://dx.doi.org/10.1016/j.jad.2013.10.043] [PMID: 24314926]
[5]
Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am J Psychiatry 2006; 163(11): 1905-17.
[http://dx.doi.org/10.1176/ajp.2006.163.11.1905] [PMID: 17074942]
[6]
WHO The global burden of disease: 2004 update. Geneva: World Health Organization 2008.
[7]
Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health 2013; 34(1): 119-38.
[http://dx.doi.org/10.1146/annurev-publhealth-031912-114409] [PMID: 23514317]
[8]
Goldberg D, Fawcett J. The importance of anxiety in both major depression and bipolar disorder. Depress Anxiety 2012; 29(6): 471-8.
[http://dx.doi.org/10.1002/da.21939] [PMID: 22553107]
[9]
Wolfson PE, Andries J, Feduccia AA, et al. MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study. Sci Rep 2020; 10(1): 20442.
[http://dx.doi.org/10.1038/s41598-020-75706-1] [PMID: 33235285]
[10]
Gasser P, Kirchner K, Passie T. LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: a qualitative study of acute and sustained subjective effects. J Psychopharmacol 2015; 29(1): 57-68.
[http://dx.doi.org/10.1177/0269881114555249] [PMID: 25389218]
[11]
National center for biotechnology information. Pub- Chem compound summary for CID 10624, Psilocybine. 2021. Available from: https://pubchem.ncbi. nlm.nih.gov/compound/Psilocybine
[12]
Moreno FA, Wiegand CB, Taitano EK, Delgado PL. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry 2006; 67(11): 1735-40.
[http://dx.doi.org/10.4088/JCP.v67n1110] [PMID: 17196053]
[13]
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med 2009; 151(4): 264-269, W64.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135] [PMID: 19622511]
[14]
Beck AT, Steer RA. BDI beck depression inventory manual. San Antonio, San Diego, Orlando, New York, Chicago, Toronto: The Psychological Corporation Harcourt Brace Jovanovich, Inc. 1987.
[15]
Jackson-Koku G. Questionnaire review: Beck depression inventory. Occup Med (Lond) 2016; 66(2): 175-5.
[http://dx.doi.org/10.1093/occmed/kqv087]
[16]
Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biol Psychiatry 2003; 54(5): 573-83.
[http://dx.doi.org/10.1016/S0006-3223(02)01866-8] [PMID: 12946886]
[17]
Julian LJ. Measures of anxiety: State-Trait anxiety inventory (STAI), Beck anxiety inventory (BAI), and hospital anxiety and depression scale-anxiety (HADS-A). Arthritis Care Res (Hoboken) 2011; 63(S11) (Suppl. 11): S467-72.
[http://dx.doi.org/10.1002/acr.20561] [PMID: 22588767]
[18]
Williams JB, Kobak KA, Bech P, et al. The GRID-HAMD: standardization of the Hamilton Depression Rating Scale. Int Clin Psychopharmacol 2008; 23(3): 120-9.
[http://dx.doi.org/10.1097/YIC.0b013e3282f948f5] [PMID: 18408526]
[19]
Maier W, Buller R, Philipp M, Heuser I. The hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 1988; 14(1): 61-8.
[http://dx.doi.org/10.1016/0165-0327(88)90072-9] [PMID: 2963053]
[20]
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67(6): 361-70.
[http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x] [PMID: 6880820]
[21]
Stangroom J. Effect size calculator for T-Test. Social science statistics. Available from: https://www.socscistatistics.com/effectsize/default3.aspx
[22]
Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates 1988.
[23]
Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to Meta-Analysis. New York: Wiley 2009.
[http://dx.doi.org/10.1002/9780470743386]
[24]
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557-60.
[http://dx.doi.org/10.1136/bmj.327.7414.557] [PMID: 12958120]
[25]
Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions, version 5.1.0. the cochrane collaboration, updated March 2011. 2011. Available from: www.handbook.cochrane.org
[26]
Higgins JP, Altman DG, Gøtzsche PC, et al. Cochrane Bias Methods Group; Cochrane StatisticalMethods Group. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343(oct18 2): d5928.
[http://dx.doi.org/10.1136/bmj.d5928] [PMID: 22008217]
[27]
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17(1): 1-12.
[http://dx.doi.org/10.1016/0197-2456(95)00134-4] [PMID: 8721797]
[28]
Carhart-Harris RL, Bolstridge M, Rucker J, et al. Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Lancet Psychiatry 2016; 3(7): 619-27.
[http://dx.doi.org/10.1016/S2215-0366(16)30065-7] [PMID: 27210031]
[29]
Romeo B, Karila L, Martelli C, Benyamina A. Efficacy of psychedelic treatments on depressive symptoms: A meta-analysis. J Psychopharmacol 2020; 34(10): 1079-85.
[http://dx.doi.org/10.1177/0269881120919957] [PMID: 32448048]
[30]
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377-84.
[http://dx.doi.org/10.1136/jech.52.6.377] [PMID: 9764259]
[31]
Shi L, Lin L. The trim-and-fill method for publication bias: practical guidelines and recommendations based on a large database of meta-analyses. Medicine (Baltimore) 2019; 98(23): e15987.
[http://dx.doi.org/10.1097/MD.0000000000015987] [PMID: 31169736]
[32]
Rosenthal R. The file drawer problem and tolerance for null results. Psychol Bull 1979; 86(3): 638-41.
[http://dx.doi.org/10.1037/0033-2909.86.3.638]
[33]
Lyons T, Carhart-Harris RL. More realistic forecasting of future life events after psilocybin for treatment-resistant depression. Front Psychol 2018; 9: 1721.
[http://dx.doi.org/10.3389/fpsyg.2018.01721] [PMID: 30369890]
[34]
Agin-Liebes GI, Malone T, Yalch MM, et al. Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer. J Psychopharmacol 2020; 34(2): 155-66.
[http://dx.doi.org/10.1177/0269881119897615] [PMID: 31916890]
[35]
Malone TC, Mennenga SE, Guss J, et al. Individual experiences in four cancer patients following psilocybin-assisted psychotherapy. Front Pharmacol 2018; 9: 256.
[http://dx.doi.org/10.3389/fphar.2018.00256] [PMID: 29666578]
[36]
Ross S, Agin-Liebes G, Lo S, et al. Acute and sustained reductions in loss of meaning and suicidal ideation following psilocybin-assisted psychotherapy for psychiatric and existential distress in life-threatening cancer. ACS Pharmacol Transl Sci 2021; 4(2): 553-62.
[http://dx.doi.org/10.1021/acsptsci.1c00020] [PMID: 33860185]
[37]
Wittmann M, Carter O, Hasler F, et al. Effects of psilocybin on time perception and temporal control of behaviour in humans. J Psychopharmacol 2007; 21(1): 50-64.
[http://dx.doi.org/10.1177/0269881106065859] [PMID: 16714323]
[38]
Hasler F, Grimberg U, Benz MA, Huber T, Vollenweider FX. Acute psychological and physiological effects of psilocybin in healthy humans: a double-blind, placebo-controlled dose-effect study. Psychopharmacology (Berl) 2004; 172(2): 145-56.
[http://dx.doi.org/10.1007/s00213-003-1640-6] [PMID: 14615876]
[39]
Smigielski L, Scheidegger M, Kometer M, Vollenweider FX. Psilocybin-assisted mindfulness training modulates self-consciousness and brain default mode network connectivity with lasting effects. Neuroimage 2019; 196: 207-15.
[http://dx.doi.org/10.1016/j.neuroimage.2019.04.009] [PMID: 30965131]
[40]
Hodge AT, Sukpraput-Braaten S, Narlesky M, Strayhan R. The use of psilocybin in the treatment of psychiatric disorders with attention to relative safety profile: A Systematic Review. J Psychoactive Drugs 2022; 1-11.
[41]
Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol 2016; 30(12): 1181-97.
[http://dx.doi.org/10.1177/0269881116675513] [PMID: 27909165]
[42]
Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of psilocybin versus escitalopram for depression. N Engl J Med 2021; 384(15): 1402-11.
[http://dx.doi.org/10.1056/NEJMoa2032994] [PMID: 33852780]
[43]
Grob CS, Danforth AL, Chopra GS, et al. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Arch Gen Psychiatry 2011; 68(1): 71-8.
[http://dx.doi.org/10.1001/archgenpsychiatry.2010.116] [PMID: 20819978]
[44]
Ross S, Bossis A, Guss J, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol 2016; 30(12): 1165-80.
[http://dx.doi.org/10.1177/0269881116675512] [PMID: 27909164]
[45]
Davis AK, Barrett FS, May DG, et al. Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry 2021; 78(5): 481-9.
[http://dx.doi.org/10.1001/jamapsychiatry.2020.3285] [PMID: 33146667]
[46]
Kuypers KPC. The therapeutic potential of microdosing psychedelics in depression. Ther Adv Psychopharmacol 2020; 10: 2045125320950567.
[http://dx.doi.org/10.1177/2045125320950567] [PMID: 32922736]
[47]
Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 2018; 391(10128): 1357-66.
[http://dx.doi.org/10.1016/S0140-6736(17)32802-7] [PMID: 29477251]
[48]
Luoma JB, Chwyl C, Bathje GJ, Davis AK, Lancelotta R. A meta-analysis of placebo-controlled trials of psychedelic-assisted therapy. J Psychoactive Drugs 2020; 52(4): 289-99.
[http://dx.doi.org/10.1080/02791072.2020.1769878] [PMID: 32529966]
[49]
Gouzoulis-Mayfrank E, Thelen B, Maier S, et al. Effects of the hallucinogen psilocybin on covert orienting of visual attention in humans. Neuropsychobiology 2002; 45(4): 205-12.
[http://dx.doi.org/10.1159/000063672] [PMID: 12097810]
[50]
Kuypers KPC, Ng L, Erritzoe D, et al. Microdosing psychedelics: More questions than answers? An overview and suggestions for future research. J Psychopharmacol 2019; 33(9): 1039-57.
[http://dx.doi.org/10.1177/0269881119857204] [PMID: 31303095]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy