Abstract

Psilocybin is a naturally occurring tryptamine known for its psychedelic properties. Recent research indicates that psilocybin may constitute a valid approach to treat depression and anxiety associated to life-threatening diseases. The aim of this work was to perform a systematic review with meta-analysis of clinical trials to assess the therapeutic effects and safety of psilocybin on those medical conditions. The Beck Depression Inventory (BDI) was used to measure the effects in depression and the State-Trait Anxiety Inventory (STAI) was used to measure the effects in anxiety. For BDI, 11 effect sizes were considered (92 patients) and the intervention group was significantly favored (WMD = −4.589; 95% CI = −4.207 to −0.971; p-value = 0.002). For STAI-Trait, 11 effect sizes were considered (92 patients), being the intervention group significantly favored when compared to the control group (WMD = −5.906; 95% CI = −7.852 to −3.960; p-value ˂ 0.001). For STAI-State, 9 effect sizes were considered (41 patients) and the intervention group was significantly favored (WMD = −6.032; 95% CI = −8.900 to −3.164; p-value ˂ 0.001). The obtained results are promising and emphasize the importance of psilocybin translational research in the management of symptoms of depression and anxiety, since the compound may be effective in reducing symptoms of depression and anxiety in conditions that are either resistant to conventional pharmacotherapy or for which pharmacologic treatment is not yet approved. Moreover, it may be also relevant for first-line treatment, given its safety.

Highlights

  • Major depressive disorder (MDD) is characterized by the persistence of negative thoughts and emotions that disrupt mood, cognition, motivation, and behavior [1]

  • The approach used in their meta-analysis is different from the one we present in several aspects, for instance—it does not include data on previous pathologies of the patients receiving psilocybin and did not analyze physiological effects induced by the drug

  • The detailed steps of the article selection process are depicted as a flow-diagram (Figure 1)

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Summary

Introduction

Major depressive disorder (MDD) is characterized by the persistence of negative thoughts and emotions that disrupt mood, cognition, motivation, and behavior [1]. Symptomatic remission increases the probability for recovery in MDD, most patients do not achieve nor sustain a state of full remission [2]. The options for treatment when the patient is resistant to the available standard treatments generally involve combining, augmenting, or switching medications, introducing electroconvulsive therapy (ECT) or other neurostimulation strategies. The risk of complications associated with those approaches exists, including increased toxicity with higher medication dosages and combination regimens [1]. Anxiety is a very common psychiatric symptom in terminally ill patients. Factors such as treatment process, disease progression, uncontrolled pain, dying and uncertainty about death have a negative impact on these patients [3]. Anxiety contributes to poor recovery from medical procedures and lower survival time in terminally-ill patients [4]

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