Many doctors treat depression with SSRIs, but could psychedelic medication be more effective? A study published in BJ Psych Open suggests that psilocybin, a psychedelic substance found in “magic” mushrooms, may be more beneficial than certain antidepressants for helping improve depressive symptoms related to thought suppression and rumination.
Depression is a challenging and debilitating mental illness that affects many people worldwide. Depression is characterized by many difficult symptoms and maladaptive coping mechanisms, including rumination and negative thought suppression. The most common medical treatment for depression is antidepressant medication, but many of these drugs may have unwanted side effects, including weight gain and sexual dysfunction.
An alternative treatment method that has been suggested in recent literature is the use of psychedelic drugs instead of SSRIs. Psilocybin-assisted psychotherapy is a type of treatment that uses psilocybin in combination with talk therapy to treat depression. The idea behind this approach is that the psilocybin can help to break down negative thought patterns and provide a new perspective that can lead to positive change.
In a typical session, a person will consume a measured dose of psilocybin under the guidance of a trained therapist, and then engage in talk therapy to process their experiences and emotions. Psilocybin-assisted psychotherapy is still an experimental approach and more research is needed to determine its efficacy for depression. This study seeks to understand how the two treatment options compare in terms of reducing symptoms of depression.
Tommaso Barba and colleagues recruited 59 participants who were randomly assigned to two groups: one that used psilocybin and one that was treated with escitalopram, an SSRI. Participants had to discontinue other medication or therapy before the trial.
The study consisted of participants attending 6 visits over 6 weeks and completing measures on rumination, thought suppression, depressive symptoms, treatment response, subjective psychedelic experiences, and psychological insights. Participants in the escitalopram group received a negligible amount of psilocybin to ensure participants were not reporting based on expected, rather than actual, differences.
Results showed that the participants who received the psilocybin psychedelic treatment showed significantly greater improvements in both symptoms of rumination and symptoms of thought suppression related to depression. In both the SSRI and the psychedelic groups, rumination improved by the 6-week mark, which could imply that rumination is a particularly treatable symptom of depression.
Decreases in rumination were linked to lower levels of depression for participants. Participants who participated in and responded to the SSRI treatment did not show the same improvements on thought suppression as their psychedelic counterparts. Additionally, while improvements in thought suppression symptoms was associated with lower levels of depression for the psychedelic group, it was not associated to lower levels of depression for the SSRI group.
This could hint at the different underlying mechanisms that make these differing treatments effective. Some of the subjective effects of psychedelics, such as ego dissolution and psychological insights, were linked to decreases in both rumination and thought suppression, showing advantages of psychedelic treatment.
This study took important strides into investigating an alternative medical treatment for depression. Despite this, there are limitations to note. One such limitation is that the sample was small and very homogenous, with most participants being White, employed, and educated. Future research could diversify the sample. Additionally, though the researchers gave a very small dose of psychedelics to the SSRI group to prevent them from identifying which group they were in, the effects of psychedelics are easily identifiable, and participants likely were able to tell which condition they were in.
The study, “Effects of psilocybin versus escitalopram on rumination and thought suppression in depression“, was authored by Tommaso Barba, Sarah Buehler, Hannes Kettner, Caterina Radu, Bruna Giribaldi Cunha, David J. Nutt, David Erritzoe, Leor Roseman, and Robin Carhart-Harris.