Depression is a widespread mental disorder in the U.S. The National Institute of Mental Health (NIH) estimated that 21 million adults had at least one major depressive episode in 2021. This is more than eight percent of adults in the country. Women were more apt to experience an episode. It was most common in those aged 18 to 25.
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Selective Serotonin Reuptake Inhibitors (SSRIs) are a common pharmaceutical intervention for patients with depression. However, these pills have multiple side effects that many report drastically impact their quality of life.
Emotional blunting, a reduction in the ability to naturally react to people and situations around a person, is a common side effect of SSRIs. This could look like patients no longer finding things as exciting, or feeling dull. Not having a depressive episode is the goal, and it is often accomplished with these drugs, but some are not sure the benefit is worth the cost.
Two studies tested whether psilocybin, which is being explored to treat depression, also caused emotional blunting.
Psilocybin may solve this problem with SSRIs
Scientists are hypothesizing and testing how shrooms work to help patients with depression and support changing prohibitory laws. Even the prestigious Oxford University is calling for participants in a psilocybin study on treatment-resistant depression. As for completed studies on the topic, some outcomes were promising.
In one research paper, doctors shared results from testing neural responses to emotional faces. Patients with major depression were split into two groups. One group received two 25-milligram (mg) dosing sessions of psilocybin plus six weeks of a placebo. The second group took six weeks of the SSRI escitalopram plus two placebo dosing sessions.
Both groups completed psychological psychedelic journey support, including three hours of preparation, an in-person integration session after each psilocybin or placebo dose, and two more video or phone call integration sessions. The emotional face paradigm test was completed before treatment and after the six-week dosing protocol. It measured how the brain responded to various extremely emotional faces using an MRI machine.
The SSRI was accompanied by the usual reduction in emotional responsiveness, but the same was not true of psilocybin. Patients receiving psilocybin experience “large improvements in depressive symptoms” with only a minor effect on emotional brain responsiveness.
Musical surprises differ from emotional faces
Another study measured the same SSRI, escitalopram, against psilocybin in the ability to process musical surprises. Musical surprises, or expectancy violations, are moments in a song where the brain expects one note, scale, or riff but is instead surprised with something different.
Researchers gauged how patients on escitalopram responded to these surprises compared to those given a dose of psilocybin. The study started with 59 patients but shrunk to 19 patients in the SSRI group and 22 in the psilocybin therapy group due to COVID-19 lockdowns and patient movement in the fMRI rendering data unusable.
Patients listened to a piano arrangement of “The Hours” by Philip Glass. The song followed a minute of silence, and patients stayed silent for a minute following the tune. They were tasked with listening to the song on magnetic-resonance compatible headphones while in the fMRI scanner with their eyes closed.
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The results diverged from those observed in the emotional face response testing. Neither group showed a significant change in how they gauged musical surprises. Researchers posit that this could be due to an already dulled sense of musical intrigue due to having major depressive disorder.
This combination of data adds a relevant perspective to the growing list of research papers supporting psilocybin as viable for some depression patients. Medications, whether pharmaceutical or plant-based, have nuanced results. Documenting each one is essential to providing the best care.
Psilocybin continues showing promise for depression
A lot of Americans are seeking alternatives to traditional healthcare. Plant medicines like psilocybin and cannabis often stand beside this type of patient. Now, as scientists unlock more about the potential and risk, more and more are becoming interested in the possibilities.
