Psilocybin therapy might help frontline pandemic workers

The stressors that frontline healthcare workers experienced during the COVID-19 pandemic led to widespread burnout, depression, and post-traumatic stress disorder (PTSD). Based on research showing that psychedelic-assisted therapy led to improvement in symptoms of depression in various populations, investigators conducted a randomized clinical trial to evaluate the effects of psilocybin therapy among clinicians who experienced such symptoms as a result of their work during the pandemic. The trial enrolled physicians, advanced practice professionals, and nurses who had at least one month of frontline clinical care during the pandemic and reported being involved in at least two of these activities for more than half of their day: caring for a critically ill patient, working longer hours to care for COVID patients, witnessing or responding to a COVID-related death, and caring for a patient who died without their family present due to COVID precautions. Participants could not have a pre-pandemic mental health diagnosis or a current substance use disorder. The study intervention comprised two preparation sessions, a medication session in which participants received oral psilocybin 25 mg or control niacin 100 mg, and three integration sessions. The primary outcome was change from baseline to day 28 in depressive symptoms as measured by the Montgomery-Asberg Depression Rating Scale. Secondary outcomes were change in measures of burnout and PTSD. Thirty clinicians with a mean age of 38 participated. Psilocybin led to significant improvement over the control condition in depressive symptoms, with decreases in the psilocybin group sustained at 6 months. There were numerically larger decreases in symptoms of burnout and PTSD in the psilocybin group, but the difference was not significant in the measure of burnout and the comparison for PTSD was not statistically tested. No serious adverse events were reported. “The results establish psilocybin therapy as a new paradigm of treatment for this post-pandemic condition and add to the evidence of psilocybin therapy for depression,” the study's authors asserted. [Back, A., et al. (2024). JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2024.49026]