Effects of psilocybin versus escitalopram on rumination and thought suppression in depression

BJPsych Open

article

Tommaso Barba¹  Sarah Buehler¹  Hannes Kettner¹  Caterina Radu¹  Bruna Giribaldi Cunha¹  David J. Nutt¹  David Erritzoe¹  Leor Roseman¹  Robin Carhart-Harris¹ 

[1] Centre for Psychedelic Research, Department of Medicine, Imperial College London

关键词: Depressive disorders;    pharmaceutical drug trial;    randomised controlled trial;    novel central nervous system drugs;    antidepressants;   

DOI  :  10.1192/bjo.2022.565

学科分类：计算机科学（综合）

来源: Canadian Society For Pharmaceutical Sciences (Csps).

【 摘 要 】

Background Major depressive disorder is often associated with maladaptivecoping strategies, including rumination and thoughtsuppression.AimsTo assess the comparative effect of the selective serotoninreuptake inhibitor escitalopram, and the serotonergic psychedelic psilocybin (COMP360), on rumination and thought suppression in major depressive disorder.MethodBased on data derived from a randomised clinical trial (N = 59),we performed exploratory analyses on the impact of escitalopram versus psilocybin (i.e. condition) on rumination and thoughtsuppression from 1 week before to 6 weeks after treatmentinception (i.e. time), using mixed analysis of variance. Conditionresponder versus non-responder subgroup analyses were alsodone, using the standard definition of ≥50% symptom reduction.ResultsA time×condition interaction was found for rumination (F(1, 56) =4.58, P = 0.037) and thought suppression (F(1,57) = 5.88, P =0.019), with post hoc tests revealing significant decreasesexclusively in the psilocybin condition. When analysing viaresponse, a significant time×condition×response interaction forthought suppression (F(1,54) = 8.42, P = 0.005) and a significanttime×response interaction for rumination (F(1,54) = 23.50,P < 0.001) were evident. Follow-up tests revealed that decreasedthought suppression was exclusive to psilocybin responders,whereas rumination decreased in both responder groups. In thepsilocybin arm, decreases in rumination and thought suppression correlated with ego dissolution and session-linked psychological insight.ConclusionsThese data provide further evidence on the therapeuticmechanisms of psilocybin and escitalopram in the treatment ofdepression.

【 授权许可】

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