Psilocybin for Depression: Is it Worth the Trip?

Authors:
Brittany L. Parmentier, PharmD, MPH, BCPS, BCPP
Andria F. Church, PharmD, BCPS, BCPP

Reviewers:
Richard Silvia, PharmD, BCPP
Stuart T Haines, PharmD, BCPS, BCACP

Citation: 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. DOI: 10.1056/NEJMoa2032994

The Problem

Major depressive disorder (MDD) is a mental health condition that is pervasive.  In 2019, over 19 million adults in the US had a major depressive episode, and nearly 9 million experiences an episode with severe impairment.¹ Although there are numerous medications available to treat MDD, not all patients respond and some experience intolerable side effects. Thus, we need to find and develop new treatment options. There has been considerable interest in psychedelic compounds that may have antidepressant activity. Plant-based psychedelics have been used since ancient times.² Recent research into psychedelics for mental health conditions has made news headlines, but most health professionals have only a vague awareness about psilocybin and its potential role in the treatment of MDD.