If there’s one thing that we all want to be true, it’s that things that we usually think are bad for us are secretly good. We see it every time a terrible study implies that chocolate might have secret health benefits (spoiler: it doesn’t). We catch a glimpse when a new piece of research seems to imply that green tea is magically healthsome, that coffee is curative of ills, or that red wine can stave off death itself.
And nowhere is this more true than in illegal drugs. Wouldn’t it be wonderful, the theory goes, if things like cannabis were brilliant for your health. We could deregulate them immediately!
Well, according to the Daily Mail and a host of other online sources, this is exactly the case for magic mushrooms. Shrooms, you see, are not just a bit of psychedelic fun, they can actually cure depression.
Unfortunately, this is simply not true. At best, we can say that there’s not enough evidence to conclude much at all about magic mushrooms. At worst, they have no health benefits at all.
Let me explain.
The story about psychedelic science actually starts way back. In the 50s and early 60s, when these drugs — LSD, mushrooms, etc — were being popularized, there was a spate of investigations looking at their therapeutic potential. The idea went, way back when, that you could give someone a psychedelic drug and it would enhance the experience, turning a psychotherapy session into an almost instant cure for mental health issues.
Sadly, legislation quickly put a stop to these experiments and the pursuit of psychedelic highs during therapy stopped for a bit over 30 years. However, in the late 90s and early 00s, people started revisiting the idea. Depression, anxiety, PTSD, and mental health issues in general are notoriously hard to treat, so why not try psychedelics and see if they worked?
Initially, this was limited to a few lab studies, because it’s much easier to give mice psychedelics than drugging people, but in recent years this has given way to a handful of clinical trials that have actually tested these drugs to see if they work. In fact, there are enough trials that in 2019 two systematic reviews — studies that look at every paper written on a subject — of the literature were published looking at whether psychedelics help with mental health issues.
So what did they find?
Absence of Evidence
In a word: nothing. Or rather, very little that is useful at all. The first systematic review looked at psychedelics in group therapy, and aside from a few studies in the 60s that were poorly reported and hard to assess, there really wasn’t much out there. The best we can say from this study is that the topic hasn’t really been looked at since 1966, and more research is needed before making any conclusions at all.
The second paper is a bit more interesting. They looked at clinical trials conducted in the last decade or so, and found 7 studies that have assessed whether psychedelics — in this case, LSD, mushrooms (psilosybin), or ayahuasca — could help with depression and/or anxiety.
While the conclusions from the authors are hopeful, unfortunately, the actual findings from this paper are…unimpressive, to say the least. Over these 7 trials, a total of 130 patients were enrolled, at an average of less than 20 people per trial. That is simply not enough to make any reasonable conclusions about anything.
But even if we were to take the findings of the studies at face value, the evidence isn’t good for psychedelics. Take psilocybin, the active ingredient in mushrooms. The biggest trial on psilocybin to date involved randomizing people with cancer-induced depression/anxiety into two groups. One received an active dose of psilocybin, the other got a ‘placebo’ dose that was roughly 30x smaller. Before, during, and after, the groups were compared on scales measuring their anxiety and depression. After 5 weeks of treatment, and 6 months of follow-up, there was not a single meaningful difference between the psilocybin and placebo group. An active dose of shrooms didn’t appear to have any real impact whatsoever on depression or anxiety scores.
And this isn’t exactly an outlier. Much of the research into psychedelics is either null — i.e. finding no benefit to them — or so hopelessly small and biased that it’s impossible to tell anything at all from the results.
In other words, we really don’t know anything about the topic. The only thing we do know is that more research is needed before we can say anything definitive.
Ultimately, the story of magic mushrooms — and psychedelics more broadly — is something of a non-starter. We’ve got some vague idea that they might be beneficial, from animal studies and thoughts about traditional use of these drugs, but no hard evidence that they do anything at all. There’s certainly not a shred of evidence that psilocybin, LSD, or other psychedelics can ‘cure’ depression, despite the outlandish claims you often see thrown around.
If anything, the benefit — based on what research we do have — is likely to be pretty small. This is probably unsurprising, because if psychedelics were a miracle cure for depression and anxiety you’d expect anyone who had used them to be perfectly mentally healthy, which definitely doesn’t seem to be the case.
Should we be studying psychedelics more? Well, that’s a harder question to answer. We should probably investigate any therapeutic option for depression, because it is notoriously hard to shake. As someone who suffers from both depression and anxiety, I’m all for identifying new treatments that may be effective. But the evidence we have on psychedelics really isn’t that promising, and given the enormous time and expense required to run these trials, and change people’s minds, it’s hard to be hugely optimistic about future clinical trials.
Psychedelics may be fun.
But, as yet, we have no idea if they can help with depression.