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Psilocybin therapy significantly decreased moderate to severe symptoms of depression in clinicians after frontline work during the COVID-19 pandemic.

Psilocybin therapy significantly decreased symptoms of depression in clinicians after frontline work during the COVID-19 pandemic, according to a study published in JAMA Network Open.

“What psilocybin-assisted therapy did, was enable participants to take some time amid the urgency of their professional and personal lives to feel, find some perspective on their recent past, and come to terms with what they were unable to do—and what they were able to accomplish—for patients, families, colleagues, and society,” wrote author Anthony L. Back, MD, and colleagues.

The double-blind, randomized clinical trial, which took place in 2022, included 30 physicians, advanced practice practitioners, and nurses who developed symptoms of depression while providing frontline care for 1 month or more during the pandemic. Half were randomly assigned to a psilocybin arm and half to a niacin arm.

The interventions consisted of two preparation visits, one medication session where participants orally received 25 mg of psilocybin or 100 mg of niacin, and three integration visits.

Specially trained facilitators “emphasized the possibility of change,” researchers wrote, “allowing emotions typically avoided, in-the-moment unfolding of the medication session, insights emerging from that experience, and cultivation of practices to bring those insights into daily life.”

Between the first preparation session and 28 days after administration of the medications, depression symptoms on the clinician-administered Montgomery-Asberg Depression Rating Scale (MADRS) decreased by 21.33 points in the psilocybin group and 9.33 points in the niacin group for a 12-point difference favoring psilocybin.

“This 21-point decrease in MADRS scores [with psilocybin] is striking when a 6- to 9-point change in the MADRS is considered clinically meaningful,” wrote the researchers, who added the improvement was sustained over 6 months for most participants in the psilocybin arm.

Improvements were found in burnout and PTSD with psilocybin compared with niacin, although differences between the groups were not statistically significant.

“The efficacy of psilocybin in this study is notable given that 100% of the participants had previously tried counseling and more than 50% had tried an antidepressant,” the researchers wrote. “Their rapid response indicates that psilocybin therapy is a new paradigm of treatment.”