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What Experts Say About Taking Psilocybin as an Alternative Treatment for Depression

Taking Psilocybin As An Alternative Treatment For Depression
Dr. Casey Wolfington, a licensed psychologist, simulates guiding a research subject through their psilocybin experience at Vail Health Behavioral Health Innovation Center in Colorado. Katie Harmon

For a good number of people antidepressants have been a blessing, at least at the beginning of treatment, but for up to a third of depressed patients, antidepressants fail to work at all, said Dr. Charles Raison, a professor of psychiatry and human ecology at the University of Wisconsin School of Medicine and Public Health in Madison and also the director of the Vail Health Behavioral Health Innovation Center in Colorado, where psilocybin is studied.

Initial reactions to antidepressants, such as nausea or headaches often fade within a few weeks after starting an antidepressant, but sexual side effects can last for months or even years. In rare cases, sexual dysfunction can persist even after stopping the antidepressant. Psilocybin also has the edge when it comes to emotional blunting, which is the tendency of antidepressants to diminish not only depression but also enjoyment in life.

Experts say psilocybin works on a different part of the brain than antidepressants. The psychedelic zeros in on the brain’s ruminative area, where thoughts run in a circular wheel of negativity many find hard to stop. Brain scans taken before, during, and after people are tripping on psilocybin show the brain becomes desynchronized, disrupting those negative thoughts and allowing people to see themselves differently.

Integrating those new insights into daily behavior that lasts, however, is the key to long-term success in fighting depression, experts say. That’s why studies on psilocybin have used trained therapists during the hallucinogenic trip, along with therapy sessions before and after the experience.

Psilocybin’s highest accolades have come from the drug’s apparent success in treating depression. Three versions of synthetic psilocybin have received the US Food and Drug Administration’s “breakthrough therapy” designation — in 2018 for treatment-resistant depression, which is diagnosed when people have tried and failed multiple antidepressants — and in 2019 and 2024 for clinical depression, diagnosed when a person is severely depressed most of the time.

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