NEJM: "Changing evil and returning to the right"?

In the 1960s, the mainstream society was unable to avoid psilocybin.
This "primary controlled drug" was considered dangerous and ineffective
.

For decades, evidence that Xeloxibine may have a therapeutic effect has been hidden deep in books

Selective serotonin reuptake inhibitors (SSRIs) are first-line drugs for the treatment of major depression; however, these drugs take several weeks to work, and they do not cause a response in some patients
.

Like other traditional psychedelic substances, the main effect of Xeloxibine is achieved through serotonin type 2A (5-HT2A) receptor activation, which is part of the pathway involved in depression

Like other traditional psychedelic substances, the main effect of Xeloxibine is achieved through serotonin type 2A (5-HT2A) receptor activation, which is part of the pathway involved in depression

In this phase 2 double-blind randomized controlled trial involving patients with long-standing moderate to severe depression, the researchers compared siloxibin with the SSRIs escitalopram for a period of 6 weeks
.

The patients were assigned to receive two different doses of 25mg xilosibin in a 1:1 ratio, 3 weeks apart, plus 6 weeks of daily placebo (Xilosibin group) or two different doses of 1 mg xilo Sibin, 3 weeks apart, plus 6 weeks of daily oral escitalopram (escitalopram group)

All patients receive psychological support
.

The main result is the change from baseline in the scores of the 16 rapid survey of depression symptoms-self-reports (QIDS-SR-16; the score range is 0-27, the higher the score, the more severe the depression) at week 6

A total of 59 patients were selected; 30 were assigned to the siloxibin group and 29 were assigned to the escitalopram group
.

The average QIDS-SR-16 score at baseline was 14.

The mean (±SE) change from baseline to week 6 was: -8.

Differences in QIDS-SR-16 response between celoxibine and escitalopram in the two groups

QIDS-SR-16 reactions occurred in 70% of patients in the cyloxibin group and 48% in the escitalopram group, with a difference of 22% (95% CI, -3 to 48) between the groups; QIDS-SR-16 Remission was 57% and 28%, respectively, and the difference between groups was 28% (95% CI, 2 to 54)
.

Other secondary results usually favor patients with psoriasis rather than escitalopram, but the analysis did not correct for multiple comparisons

QIDS-SR-16 reactions occurred in 70% of patients in the cyloxibin group and 48% in the escitalopram group, with a difference of 22% (95% CI, -3 to 48) between the groups; QIDS-SR-16 Remissions were 57% and 28%, respectively, and the difference between groups was 28% (95% CI, 2 to 54)

It can be seen that there is no significant difference between the antidepressant effects of siloxibin and escitalopram

references:

Trial of Psilocybin versus Escitalopram for Depression.
N Engl J Med 2021; 384:1402-1411.
DOI: 10.
1056/NEJMoa2032994

Trial of Psilocybin versus Escitalopram for Depression.
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