Psilocybin for major depressive disorder: An updated systematic review and meta-analysis of randomized clinical trials.

IF 4.5 3区 医学 Q1 CLINICAL NEUROLOGY Journal of Psychopharmacology Pub Date : 2024-10-31 DOI:10.1177/02698811241287542
Sepehr Aghajanian, Arman Shafiee, Samira Parvizi Omran, Aida Rezaei Nejad, Kyana Jafarabady, Omid Kohandel Gargari, Shahryar Rajai, Ida Mohammadi, Touran Bahrami Babaheidari, Mahmood Bakhtiyari
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Abstract

Background: Due to the unsatisfactory therapeutic effects of current antidepressants, research has been launched into alternative treatment approaches, such as the administration of psychedelics. Psilocybin, a classic hallucinogen, has been shown to exert considerable positive influence on depression symptoms through its serotonergic and glutamatergic effects. This systematic review and meta-analysis aimed to evaluate the effectiveness of psilocybin in treating depression.

Methods: A comprehensive search of Medline (via PubMed) and the Cochrane Library databases was conducted to identify relevant studies. Inclusion criteria were applied to select studies that investigated the therapeutic impact of psilocybin on depression. A mixed-effects multi-level model was used to estimate the overall effect size. Effectiveness over time was also investigated as a secondary analysis.

Results: The results of the primary analysis revealed a large and clinically observable reduction (SMC: -1.24, 95%CI: -1.83 to -0.65, I2level2 = 11.39%, I2level3 = 77.67%) of depressive symptomatology in patients receiving psilocybin in addition to supportive therapy compared to baseline measurements. The decrease was also marked when compared to placebo (p-value = 0.032). The results remained significant even when a secondary analysis assessed the effect in various time intervals since the administration of psilocybin.

Conclusion: This systematic review and meta-analysis substantiate the claim that psilocybin is superior in treating depression compared to established psychotherapy alone used for treating depression. This finding warrants further studies with larger sample sizes and across a longer timeframe.

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治疗重度抑郁症的迷幻药:随机临床试验的最新系统综述和荟萃分析。
背景:由于目前的抗抑郁药物治疗效果不尽人意,人们开始研究其他治疗方法,如服用迷幻药。迷幻药是一种典型的致幻剂,其血清素能和谷氨酸能效应已被证明对抑郁症状有相当积极的影响。本系统综述和荟萃分析旨在评估迷幻药治疗抑郁症的效果:方法:对 Medline(通过 PubMed)和 Cochrane Library 数据库进行了全面检索,以确定相关研究。方法:对 Medline(通过 PubMed)和 Cochrane 图书馆数据库进行了全面搜索,以确定相关研究,并采用纳入标准筛选出调查迷幻药对抑郁症治疗效果的研究。采用混合效应多层次模型估算总体效应大小。作为辅助分析,还对随时间变化的疗效进行了调查:主要分析结果显示,与基线测量值相比,在接受支持疗法的同时接受迷幻药治疗的患者的抑郁症状明显减轻(SMC:-1.24,95%CI:-1.83 至 -0.65,I2level2 = 11.39%,I2level3 = 77.67%)。与安慰剂相比,抑郁症状也明显减轻(p 值 = 0.032)。即使进行二次分析,评估施用迷幻药后不同时间间隔内的效果,结果依然显著:本系统综述和荟萃分析证实,与治疗抑郁症的传统心理疗法相比,迷幻药在治疗抑郁症方面更具优势。这一发现值得进一步开展样本量更大、时间跨度更长的研究。
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来源期刊
Journal of Psychopharmacology
Journal of Psychopharmacology 医学-精神病学
CiteScore
8.60
自引率
4.90%
发文量
126
审稿时长
3-8 weeks
期刊介绍: The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides an essential forum for researchers and practicing clinicians on the effects of drugs on animal and human behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is truly international in scope and readership.
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