Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double‐Blind, Placebo‐Controlled, Crossover Study in Healthy Subjects

The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with psilocybin. The present study used a double‐blind, placebo‐controlled, crossover design with two experimental test sessions to investigate the resp...

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Vydáno v:Clinical pharmacology and therapeutics Ročník 111; číslo 4; s. 886 - 895
Hlavní autoři: Becker, Anna M., Holze, Friederike, Grandinetti, Tanja, Klaiber, Aaron, Toedtli, Vanja E., Kolaczynska, Karolina E., Duthaler, Urs, Varghese, Nimmy, Eckert, Anne, Grünblatt, Edna, Liechti, Matthias E.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.04.2022
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ISSN:0009-9236, 1532-6535, 1532-6535
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Abstract The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with psilocybin. The present study used a double‐blind, placebo‐controlled, crossover design with two experimental test sessions to investigate the response to psilocybin (25 mg) in healthy subjects after pretreatment with escitalopram or placebo. The treatment order was random and counterbalanced. Pretreatment consisted of 10 mg escitalopram daily for 7 days, followed by 20 mg daily for 7 days, including the day of psilocybin administration, or 14 days of placebo pretreatment before psilocybin administration. Psilocybin treatments were separated by at least 16 days. The outcome measures included self‐rating scales that evaluated subjective effects, autonomic effects, adverse effects, plasma brain‐derived neurotrophic factor (BDNF) levels, electrocardiogram QTc time, whole‐blood HTR2A and SCL6A4 gene expression, and pharmacokinetics. Escitalopram pretreatment had no relevant effect on positive mood effects of psilocybin but significantly reduced bad drug effects, anxiety, adverse cardiovascular effects, and other adverse effects of psilocybin compared with placebo pretreatment. Escitalopram did not alter the pharmacokinetics of psilocin. The half‐life of psychoactive free (unconjugated) psilocin was 1.8 hours (range 1.1–2.2 hours), consistent with the short duration of action of psilocybin. Escitalopram did not alter HTR2A or SCL6A4 gene expression before psilocybin administration, QTc intervals, or circulating BDNF levels before or after psilocybin administration. Further studies are needed with a longer antidepressant pretreatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin.
AbstractList The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with psilocybin. The present study used a double‐blind, placebo‐controlled, crossover design with two experimental test sessions to investigate the response to psilocybin (25 mg) in healthy subjects after pretreatment with escitalopram or placebo. The treatment order was random and counterbalanced. Pretreatment consisted of 10 mg escitalopram daily for 7 days, followed by 20 mg daily for 7 days, including the day of psilocybin administration, or 14 days of placebo pretreatment before psilocybin administration. Psilocybin treatments were separated by at least 16 days. The outcome measures included self‐rating scales that evaluated subjective effects, autonomic effects, adverse effects, plasma brain‐derived neurotrophic factor (BDNF) levels, electrocardiogram QTc time, whole‐blood HTR2A and SCL6A4 gene expression, and pharmacokinetics. Escitalopram pretreatment had no relevant effect on positive mood effects of psilocybin but significantly reduced bad drug effects, anxiety, adverse cardiovascular effects, and other adverse effects of psilocybin compared with placebo pretreatment. Escitalopram did not alter the pharmacokinetics of psilocin. The half‐life of psychoactive free (unconjugated) psilocin was 1.8 hours (range 1.1–2.2 hours), consistent with the short duration of action of psilocybin. Escitalopram did not alter HTR2A or SCL6A4 gene expression before psilocybin administration, QTc intervals, or circulating BDNF levels before or after psilocybin administration. Further studies are needed with a longer antidepressant pretreatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin.
The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with psilocybin. The present study used a double-blind, placebo-controlled, crossover design with two experimental test sessions to investigate the response to psilocybin (25 mg) in healthy subjects after pretreatment with escitalopram or placebo. The treatment order was random and counterbalanced. Pretreatment consisted of 10 mg escitalopram daily for 7 days, followed by 20 mg daily for 7 days, including the day of psilocybin administration, or 14 days of placebo pretreatment before psilocybin administration. Psilocybin treatments were separated by at least 16 days. The outcome measures included self-rating scales that evaluated subjective effects, autonomic effects, adverse effects, plasma brain-derived neurotrophic factor (BDNF) levels, electrocardiogram QTc time, whole-blood HTR2A and SCL6A4 gene expression, and pharmacokinetics. Escitalopram pretreatment had no relevant effect on positive mood effects of psilocybin but significantly reduced bad drug effects, anxiety, adverse cardiovascular effects, and other adverse effects of psilocybin compared with placebo pretreatment. Escitalopram did not alter the pharmacokinetics of psilocin. The half-life of psychoactive free (unconjugated) psilocin was 1.8 hours (range 1.1-2.2 hours), consistent with the short duration of action of psilocybin. Escitalopram did not alter HTR2A or SCL6A4 gene expression before psilocybin administration, QTc intervals, or circulating BDNF levels before or after psilocybin administration. Further studies are needed with a longer antidepressant pretreatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin.The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with psilocybin. The present study used a double-blind, placebo-controlled, crossover design with two experimental test sessions to investigate the response to psilocybin (25 mg) in healthy subjects after pretreatment with escitalopram or placebo. The treatment order was random and counterbalanced. Pretreatment consisted of 10 mg escitalopram daily for 7 days, followed by 20 mg daily for 7 days, including the day of psilocybin administration, or 14 days of placebo pretreatment before psilocybin administration. Psilocybin treatments were separated by at least 16 days. The outcome measures included self-rating scales that evaluated subjective effects, autonomic effects, adverse effects, plasma brain-derived neurotrophic factor (BDNF) levels, electrocardiogram QTc time, whole-blood HTR2A and SCL6A4 gene expression, and pharmacokinetics. Escitalopram pretreatment had no relevant effect on positive mood effects of psilocybin but significantly reduced bad drug effects, anxiety, adverse cardiovascular effects, and other adverse effects of psilocybin compared with placebo pretreatment. Escitalopram did not alter the pharmacokinetics of psilocin. The half-life of psychoactive free (unconjugated) psilocin was 1.8 hours (range 1.1-2.2 hours), consistent with the short duration of action of psilocybin. Escitalopram did not alter HTR2A or SCL6A4 gene expression before psilocybin administration, QTc intervals, or circulating BDNF levels before or after psilocybin administration. Further studies are needed with a longer antidepressant pretreatment time and patients with psychiatric disorders to further define interactions between antidepressants and psilocybin.
Author Eckert, Anne
Klaiber, Aaron
Grünblatt, Edna
Grandinetti, Tanja
Kolaczynska, Karolina E.
Varghese, Nimmy
Liechti, Matthias E.
Becker, Anna M.
Toedtli, Vanja E.
Duthaler, Urs
Holze, Friederike
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  givenname: Anna M.
  surname: Becker
  fullname: Becker, Anna M.
  organization: University of Basel
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  givenname: Friederike
  surname: Holze
  fullname: Holze, Friederike
  organization: University of Basel
– sequence: 3
  givenname: Tanja
  surname: Grandinetti
  fullname: Grandinetti, Tanja
  organization: University of Basel
– sequence: 4
  givenname: Aaron
  surname: Klaiber
  fullname: Klaiber, Aaron
  organization: University of Basel
– sequence: 5
  givenname: Vanja E.
  surname: Toedtli
  fullname: Toedtli, Vanja E.
  organization: University of Basel
– sequence: 6
  givenname: Karolina E.
  surname: Kolaczynska
  fullname: Kolaczynska, Karolina E.
  organization: University of Basel
– sequence: 7
  givenname: Urs
  orcidid: 0000-0002-7811-3932
  surname: Duthaler
  fullname: Duthaler, Urs
  organization: University of Basel
– sequence: 8
  givenname: Nimmy
  orcidid: 0000-0001-8598-0535
  surname: Varghese
  fullname: Varghese, Nimmy
  organization: University of Basel
– sequence: 9
  givenname: Anne
  surname: Eckert
  fullname: Eckert, Anne
  organization: University of Basel
– sequence: 10
  givenname: Edna
  surname: Grünblatt
  fullname: Grünblatt, Edna
  organization: University of Zurich
– sequence: 11
  givenname: Matthias E.
  orcidid: 0000-0002-1765-9659
  surname: Liechti
  fullname: Liechti, Matthias E.
  email: matthias.liechti@usb.ch
  organization: University of Basel
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34743319$$D View this record in MEDLINE/PubMed
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Snippet The psychedelic psilocybin is being investigated for the treatment of depression and anxiety. Unclear is whether antidepressant treatments interact with...
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SubjectTerms Antidepressive Agents - adverse effects
Brain-Derived Neurotrophic Factor - genetics
Citalopram - adverse effects
Cross-Over Studies
Double-Blind Method
Escitalopram
Healthy Volunteers
Humans
Psilocybin - adverse effects
Title Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double‐Blind, Placebo‐Controlled, Crossover Study in Healthy Subjects
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fcpt.2487
https://www.ncbi.nlm.nih.gov/pubmed/34743319
https://www.proquest.com/docview/2595107864
Volume 111
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