Psilocybin is better for treating rumination in patients suffering from major depression than the common antidepressant escitalopram, according to a new study by researchers at Cambridge University.
The recent study was published in the BJ Psych journal and assessed the differences between psilocybin and escitalopram on rumination and thought suppression.
Rumination is considered to be a form of rigid introspection characterized by negative thoughts about one’s self and situation. Along with thought suppression, both signs of major depression have been associated with maintenance and relapse of major depressive disorder (MDD) and early improvements in both –rumination and thought suppression– could be predictive of enduring improvements in the disorder.
Researchers found that escitalopram, which is a selective serotonin reuptake inhibitor and the most commonly prescribed antidepressant, had a positive effect on rumination but it wasn’t as efficient as psilocybin. They also found that escitalopram didn’t have a “discernible” impact on thought suppression.
“What we found is that despite psilocybin was superior in reducing rumination, the effect was there also for escitalopram (but only for the patients who got better with it). With suppression, it remained high even in patients who reported to feel significantly less depressed,” wrote the main author Tommaso Barba on a Twitter thread.
My first 1st author paper is out in @TheBJPsych ! We found out that psilocybin is superior in reducing rumination and chronic suppression of negative emotions compared to escitalopram. Big thanks to @RCarhartHarris and @LeorRoseman for the guidance. #Psilocybin #psychiatry #LSD pic.twitter.com/0L1LaeLwpp
— Tommaso Barba (@tommaso_barba) September 6, 2022
Currently, the most common clinical treatment for MDD is antidepressant drugs, with selective serotonin reuptake inhibitors (SSRIs) like escitalopram being the most used.
“However, SSRI response rates are only around 50–60 paper cent and side-effects such as sexual dysfunction and emotional ‘blunting’ are not infrequent,” reads the study.
For the study, researchers used the sample of participants from previous research by Robin Carhart-Harris. 59 patients suffering from MDD were tested where 30 were allocated to the psilocybin group and 29 to the antidepressant group.
Previous studies on psilocybin have shown that it is as effective as escitalopram in reducing depressive symptoms but performed significantly better on measures of well-being, emotional acceptance and work and social functioning.
“We speculate that the direct [serotonin receptor] agonist action of psilocybin engages neuroplastic mechanisms that can be harnessed for therapeutic ends, potentially remediating reinforced habits of mind or behaviour that underly core pathology,” wrote the researchers of the study.