Treatment-Resistant Depression (TRD)Depressive DisordersObsessive-Compulsive Disorder (OCD)Substance Use Disorders (SUD)Psilocybin

Psychedelic science in post-COVID-19 psychiatry

This commentary (2020) examines how the COVID-19 pandemic has affected the trajectory of clinical trials investigating psilocybin-treatment for a wide range of conditions, some of which are likely to become even more prevalent in post-COVID-19 clinical psychiatry. Although many of these clinical trials have been temporarily stagnant due to safety measures, ongoing efforts from large scale clinical studies of psilocybin will provide valuable information on its safety, dose optimization, and its efficacy compared to a conventional selective serotonin reuptake inhibitor (SSRI) and additional studies will elucidate whether it is safe to combine them with psilocybin therapy.

Authors

  • John Kelly
  • Veronica O'keane

Published

Irish Journal of Psychological Medicine
meta Study

Abstract

Introduction: The medium- to long-term consequences of COVID-19 are not yet known, though an increase in mental health problems are predicted. Multidisciplinary strategies across socio-economic and psychological levels may be needed to mitigate the mental health burden of COVID-19. Preliminary evidence from the rapidly progressing field of psychedelic science shows that psilocybin therapy offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and maladaptive habitual patterns of cognition and behaviour, notably depression, addiction and obsessive compulsive disorder. The COMPASS Pathways (COMPASS) phase 2b double-blind trial of psilocybin therapy in antidepressant-free, treatment-resistant depression (TRD) is underway to determine the safety, efficacy and optimal dose of psilocybin. Results from the Imperial College London Psilodep-RCT comparing the efficacy and mechanisms of action of psilocybin therapy to the selective serotonin reuptake inhibitor (SSRI) escitalopram will soon be published. However, the efficacy and safety of psilocybin therapy in conjunction with SSRIs in TRD is not yet known. An additional COMPASS study, with a centre in Dublin, will begin to address this question, with potential implications for the future delivery of psilocybin therapy. While at a relatively early stage of clinical development, and notwithstanding the immense challenges of COVID-19, psilocybin therapy has the potential to play an important therapeutic role for various psychiatric disorders in post-COVID-19 clinical psychiatry.

Available with Blossom Pro

Research Summary of 'Psychedelic science in post-COVID-19 psychiatry'

Introduction

Crises such as the COVID-19 pandemic provoke a wide range of psychological reactions, and the authors highlight predictions of an increased burden of mental health problems, especially among vulnerable groups. They position multidisciplinary responses across socioeconomic and psychological levels as necessary to mitigate this burden and note that early clinical data indicate psilocybin therapy could be a promising transdiagnostic option for disorders marked by restricted or maladaptive cognitive and behavioural habitual patterns, notably depression, addiction and obsessive–compulsive disorder. Kelly and colleagues set out to summarise recent advances in psychedelic science relevant to post-COVID-19 psychiatry, emphasising mechanistic findings, emerging clinical trial evidence and practical considerations for delivering psilocybin therapy during and after the pandemic. The paper describes ongoing and planned clinical trials (including COMPASS and the Imperial College Psilodep-RCT), discusses biological and imaging studies that inform mechanisms of action, and raises questions about safety, acceptability and the implications of concomitant antidepressant use.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Full Text PDF

Full Paper PDF

Create a free account to open full-text PDFs.

Study Details

References (37)

Papers cited by this study that are also in Blossom

Emotions and brain function are altered up to one month after a single high dose of psilocybin

Barrett, F. S., Doss, M. K., Sepeda, N. D. et al. · Scientific Reports (2020)

Long-term use of psychedelic drugs is associated with differences in brain structure and personality in humans

Rodríguez-Fornells, A., Ribeiro, S., Sanches, R. F. et al. · European Neuropsychopharmacology (2015)

Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences

Carbonaro, T. M., Bradstreet, M. P., Barrett, F. S. et al. · Journal of Psychopharmacology (2016)

Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study

Carhart-Harris, R. L., Bolstridge, M., Rucker, J. et al. · Lancet Psychiatry (2016)

1174 cited
REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics

Carhart-Harris, R. L., Friston, K. J. · Pharmacological Reviews (2019)

Serotonin and brain function: a tale of two receptors

Carhart-Harris, R. L., Nutt, D. J. · Journal of Psychopharmacology (2017)

Effects of psilocybin therapy on personality structure

Erritzoe, D., Roseman, L., Nour, M. R. et al. · Acta Psychiatrica Scandinavica (2018)

219 cited
Cessation and reduction in alcohol consumption and misuse after psychedelic use

Garcia-Romeu, A., Davis, A. K., Fire Erowid et al. · Journal of Psychopharmacology (2019)

211 cited
Show all 37 references
Hallucinogens recruit specific cortical 5-HT(2A) receptor-mediated signaling pathways to affect behavior

Gonza ´lez-Maeso, J., Weisstaub, N. V., Zhou, M. et al. · Neuron (2007)

818 cited
Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance

Griffiths, R. R., Richards, W. A., Mccann, U. et al. · Journal of Psychopharmacology (2006)

Psychological and cognitive effects of long-term peyote use among Native Americans

Halpern, J. H., Sherwood, A. R., Hudson, J. I. et al. · Biological Psychiatry (2005)

Psilocybin lacks antidepressant-like effect in the Flinders Sensitive Line rat

Jefsen, O., Højgaard, K., Christiansen, S. L. et al. · Acta Neuropsychiatrica (2019)

60 cited
From Egoism to Ecoism: Psychedelics Increase Nature Relatedness in a State-Mediated and Context-Dependent Manner

Kettner, H., Gandy, S., Haijen, E. C. H. M. et al. · International Journal of Environmental Research and Public Health (2019)

131 cited
Psilocybin-induced decrease in amygdala reactivity correlates with enhanced positive mood in healthy volunteers

Kraehenmann, R., Preller, K. H., Scheidegger, M. et al. · Biological Psychiatry (2015)

Rostral Anterior Cingulate Thickness Predicts the Emotional Psilocybin Experience

Lewis, C. R., Preller, K. H., Braden, B. B. et al. · Biomedicines (2020)

24 cited
Dynamical exploration of the repertoire of brain networks at rest is modulated by psilocybin

Lord, L. D., Expert, P., Atasoy, S. et al. · NeuroImage (2019)

183 cited
Psychedelics promote structural and functional neural plasticity

Ly, C., Greb, A. C., Cameron, L. P. et al. · Cell Reports (2018)

Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives

Martinotti, G., Santacroce, R., Pettorruso, M. et al. · Brain Sciences (2018)

Me, myself, bye: regional alterations in glutamate and the experience of ego dissolution with psilocybin

Mason, N. L., Kuypers, K. P. C., Reckweg, J. et al. · Neuropsychopharmacology (2020)

Psilocybin and LSD Have No Long-Lasting Effects in an Animal Model of Alcohol Relapse

Meinhardt, M. W., Güngör, C., Skorodumov, I. et al. · Neuropsychopharmacology (2020)

The alkaloids of Banisteriopsis caapi, the plant source of the Amazonian hallucinogen Ayahuasca, stimulate adult neurogenesis in vitro

Morales-García, J. A., de la Fuente Revenga, M., Alonso-Gil, S. et al. · Scientific Reports (2017)

Safety, Tolerability, and Efficacy of Psilocybin in 9 Patients With Obsessive-Compulsive Disorder

Moreno, F. A., Wiegand, C. B., Taitano, E. K. et al. · Journal of Clinical Psychiatry (2006)

Psychedelic Psychiatry’s Brave New World

Nutt, D. J., Erritzoe, D., Carhart-Harris, R. L. · Cell (2020)

The fabric of meaning and subjective effects in LSD-induced states depend on serotonin 2A receptor activation

Preller, K. H., Herdener, M., Pokorny, T. et al. · Current Biology (2017)

Effects of serotonin 2A/1A receptor stimulation on social exclusion processing

Preller, K. H., Pokorny, D., Hock, A. et al. · PNAS (2016)

Increased amygdala responses to emotional faces after psilocybin for treatment-resistant depression

Roseman, L., Demetriou, L., Wall, M. B. et al. · Neuropharmacology (2018)

Acute effects of lysergic acid diethylamide on circulating steroid levels in healthy subjects

Strajhar, P., Schmid, Y., Liakoni, E. et al. · Journal of Neuroendocrinology (2016)

Prediction of psilocybin response in healthy volunteers

Studerus, E., Gamma, A., Kometer, M. et al. · PLOS ONE (2012)

Historic psychedelic drug trials and the treatment of anxiety disorders

Weston, N. M., Gibbs, D., Bird, C. I. V. et al. · Depression and Anxiety (2020)

Cited By (5)

Papers in Blossom that reference this study

Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective

Dursun, S. M., Kelly, J. R., Gillan, C. M. et al. · Frontiers in Psychiatry (2021)

Psychedelic perceptions: mental health service user attitudes to psilocybin therapy

Corrigan, K., Haran, M., Mccandliss, C. et al. · Irish Journal of Medical Science (2021)

Can pragmatic research, real-world data and digital technologies aid the development of psychedelic medicine?

Carhart-Harris, R. L., Wagner, A. C., Agrawal, M. et al. · Journal of Psychopharmacology (2021)

40 cited

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.

Psychedelic science in post-COVID-19 psychiatry — Research Summary & Context | Blossom