RCT · 2025
Psilocybin and escitalopram both reduced negative bias in reading faces in depression
- Original title
- Negative affective bias in depression following treatment with psilocybin or escitalopram - a secondary analysis from a randomized trial.
- Authors
- Martens MAG, Cunha BG, Erritzoe D, et al.
- Journal
- Translational psychiatry, 2025
- Molecules
- Psilocybin
- Conditions
- Depression
- Participants
- 59
- Evidence grade
- Low
- Source
- Read the original paper
The question
Do psilocybin and a standard antidepressant change the way depressed people read emotion in faces, and does that change track with mood improvement?
What they did
This was a secondary analysis of a double-blind randomized trial in patients with long-standing moderate-to-severe depression. Thirty people received two 25 mg doses of psilocybin three weeks apart plus six weeks of daily placebo capsules; 29 received two 1 mg doses of psilocybin three weeks apart plus six weeks of daily escitalopram, a commonly used antidepressant. Everyone got the same psychological support. Participants completed a computerised facial emotion recognition task and a depression questionnaire (the Quick Inventory of Depressive Symptomatology) at the start and at six weeks, with depression also measured at a one-month follow-up (week 10).
What they found
The tendency to read faces as negative decreased after both treatments, to a similar degree. At the six-week point, the change in this negative bias was not associated with the change in depression scores. Looking further ahead, misclassifying fewer positive faces as negative was linked to lower depression scores at week 10, but only in the escitalopram group. The authors conclude that both treatments shifted emotional processing in a more positive direction compared with baseline.
The fine print
This is a secondary analysis of a small trial (59 people in total), so the findings are exploratory rather than confirmatory. There was no inactive placebo arm, so the comparison is between two active treatments, not against no treatment. The facial recognition task is a laboratory measure of emotional processing, not a direct measure of how someone feels day to day, and follow-up was short. This summary is based on the abstract alone.
What it means
Two quite different treatments appeared to shift emotional processing in the same direction, hinting at some shared psychological mechanism, though these shifts did not clearly explain the improvement in depression scores.
Evidence grade: Low. A secondary analysis of a small double-blind randomized trial, looking at outcomes that were not the trial’s main question.
This summary is based on the study’s published abstract.