Do magic mushrooms cure depression? The head-to-head trial

Claim

MUSHROOMS CURE DEPRESSION?

Catch

SMALL TRIAL

Verdict

A LEAD, NOT A CURE

Magic mushrooms are often marketed as a depression cure. A phase 2 randomized controlled trial in the New England Journal of Medicine (2021) put psilocybin head-to-head against the antidepressant escitalopram. Fifty-nine adults with moderate-to-severe major depressive disorder received either two 25 mg psilocybin doses three weeks apart plus six weeks of daily placebo, or two 1 mg psilocybin doses plus six weeks of daily escitalopram — all with psychological support. After six weeks, both groups improved, but the between-group difference on the QIDS-SR-16 depression scale was just 2.0 points (95% CI -5.0 to 0.9, P = 0.17) — not statistically significant. Response (more than 50% symptom reduction) occurred in 70% of the psilocybin group versus 48% of the escitalopram group, and remission (score of 5 or below) in 57% versus 28%, but these secondary outcomes were not corrected for multiple comparisons.

The catch: this was a small trial (59 patients), only six weeks long, with no true placebo, and participants and therapists knew which treatment they received. Results may not generalize. Psilocybin is a promising lead, not a cure — talk to a doctor before changing any treatment.

SOURCES

1. Carhart-Harris R, Giribaldi B, Watts R, et al. "Trial of Psilocybin versus Escitalopram for Depression." N Engl J Med. 2021 Apr 15;384(15):1402-1411. DOI: 10.1056/NEJMoa2032994. PMID: 33852780.

For information only, not medical advice. Talk to a qualified health professional before changing your diet, supplements or treatment.