Study: Psilocybin therapy reduces depression in frontline clinicians

Editor's Note

Psilocybin therapy significantly reduces symptoms of depression in frontline clinicians who experienced psychological distress during the COVID-19 pandemic, according to a randomized clinical trial published December 5 in JAMA Network Open.  

The trial enrolled 30 clinicians, including physicians, advanced practice practitioners (APPs), and nurses, who provided frontline care during the pandemic and developed moderate to severe depression. Participants were randomly assigned to receive either psilocybin (25 mg) or niacin (100 mg, active placebo) in a double-blind design. Each intervention included preparatory, medication, and integration sessions with trained facilitators, and outcomes were assessed over six months.

Key findings include:

• Psilocybin therapy resulted in a mean reduction in depression scores (MADRS) of 21.33 points, compared to 9.33 points in the niacin group, with a statistically significant mean difference of 12.00 points (P < .001). This change exceeded the clinically meaningful threshold for depression improvement.
• Symptoms of burnout and PTSD showed numerically greater improvements in the psilocybin group, though burnout changes did not reach statistical significance, and PTSD was evaluated descriptively due to hierarchical testing rules.
• Improvements in depression were sustained through six months, highlighting the durability of psilocybin’s effects.

The trial builds on prior research into psilocybin’s efficacy for treatment-resistant depression, showing similar benefits for clinicians without a prior mental health history but with pandemic-related distress, researchers write. Participants reported profound shifts in perspective, reduced guilt, and increased self-compassion, with many making significant changes to their work-life balance.

Limitations include the small sample size and the potential for unblinding, researchers write, calling for further trials.