AzTrials
AzTrials

Treatment Resistant DepressionPhase 2NCT05029466

Psilocybin for Treatment-Resistant Depression

A Phase 2 study testing Psilocybin in people with Treatment Resistant Depression, run by Brain and Cognition Discovery Foundation at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to see if psilocybin, an investigational drug, is safe and well tolerated. Researchers also want to know if psilocybin can improve symptoms of depression. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Treatment Resistant Depression
What is being tested?
Psilocybin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteCanada
Study dates
19 Nov 2021to 22 Jul 2023
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Over the age of 18 years and under the age of 65;
  • Diagnosed with major depressive disorder or bipolar II disorder by a healthcare provider;
  • Experiencing a major depressive episode (MDE) without psychotic features as defined and operationalized in the DSM-5, where the duration of the current episode is at least 3 months;
  • Have failed to respond to an adequate dose and duration of at least two guideline-concordant pharmacological treatments for the current MDE, as determined by the Massachusetts General Hospital-Antidepressant Treatment History Questionnaire; and
  • Able to complete all protocol required assessment tools without any assistance or alteration to the copyrighted assessments, and to comply with all study visits.
  • Individuals meeting one or more of the following DSM-5-defined criteria will be excluded:
Show all 27Show fewer
  • Current or past history of bipolar I disorder, schizophrenia, psychotic disorder, delusional disorder, paranoid personality disorder, or schizoaffective disorder, as assessed by a structured clinical interview (MINI) and International Personality Disorder Examination (IPDE);
  • First degree history of schizophrenia or any psychotic disorders, including bipolar disorder with psychotic features;
  • Currently experiencing symptoms of hypomania or mania as measured by the Young Mania Rating Scale (YMRS) total score > 12;
  • History of a hypomanic or manic episode in the past 3 months;
  • History of substance use and/or alcohol use disorder, of moderate severity or greater, in the past 3 months;
  • Lifetime history of substance use disorder with a hallucinogen;
  • Lifetime history of substance-induced psychosis;
  • Currently experiencing psychotic symptoms as part of an MDE (mood congruent/mood incongruent).
  • Individuals meeting one or more of the following criteria will also be excluded:
  • Exposure to psilocybin or any other psychedelic in the past 12 months prior to screening and/or during the current MDE;
  • Uncontrolled or insulin-dependent diabetes;
  • Seizure disorder;
  • Other personal circumstances or behaviour judged to be incompatible with establishment of rapport or safe exposure to psilocybin;
  • Women who are pregnant (self-report or via urine test), nursing, or planning a pregnancy;
  • Refusal to use an effective contraceptive method by the participant or participant's partner (i.e., combined estrogen- and progestogen-containing hormonal contraception or progestogen-only hormonal contraception with inhibition of ovulation; intrauterine device; intrauterine hormone-releasing system; bilateral tubal occlusion; vasectomized partner; sexual abstinence) throughout their participation in the study;
  • Recent stroke (< 1 year from signing of ICF), recent myocardial infarction (< 1 year from signing of ICF), uncontrolled hypertension (blood pressure > 140/90 mmHg) or clinically significant arrhythmia within 1 year of signing the ICF;
  • Positive urine drug screen for illicit drugs or drugs of abuse at screening, a week prior to treatment, and during the trial (any positive urine drug test will be reviewed with participants to determine the pattern of use and eligibility will be determined at the investigator's discretion);
  • Current enrolment in any investigational drug or device study or participation in such within 30 days of screening;
  • Current enrolment in an interventional study for depression or participation in such within 30 days of screening;
  • Abnormal and clinically significant results on the physical examination, vital signs, ECG, or laboratory tests at screening;
  • Any other clinically significant cardiovascular, pulmonary, gastrointestinal, hepatic, renal or any other major concurrent illness that, in the opinion of the investigator, may interfere with the interpretation of the study results or constitute a health risk for the participant if he/she takes part in the study.

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Canadian Rapid Treatment Centre of Excellence (CRTCE)

    Mississauga, Ontario, L5G 3H4

Other trials in Canada

About this study

Official title: The Efficacy and Tolerability of Psilocybin in Participants With Treatment-Resistant Depression: a Phase 2, Randomized Feasibility Study

The purpose of this study is to see if psilocybin, an investigational drug, is safe and well tolerated. Researchers also want to know if psilocybin can improve symptoms of depression. This study will see if psilocybin is safe and well tolerated by tracking changes in suicidal thoughts and behaviour, monitoring if any participants choose to stop participating in the study, and measuring any serious side effects, as well as how long they take to resolve. This study will also see if depression symptoms improve (or worsen) after psilocybin is administered. Additional information about participants' depressive symptoms and side effects will also be measured during the study.

Read the detailed description

This randomized clinical trial will assess the feasibility, safety, and efficacy of single and repeat doses of psilocybin at point-of-care in persons with treatment-resistant depression as part of major depressive disorder or bipolar II disorder. The primary objective is to evaluate the feasibility of psilocybin in adults with treatment-resistant depression. The secondary objectives are to assess the efficacy and tolerability of psilocybin at point-of-care.

Being tested
Psilocybin
Keywords
Bipolar II Disorder, Major Depressive Disorder, Depressive Disorder, Treatment-Resistant, Mood Disorders, Mental Disorders, Psilocybin, Hallucinogen, Psychedelic, Antidepressant, Phase 2, Depression
Medical subject headings
Depressive Disorder, Treatment-Resistant, Bipolar Disorder, Depressive Disorder, Major, Mood Disorders, Mental Disorders, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PsilocybinDrug

    Participants will receive a single dose of psilocybin and be assessed weekly for six weeks and biweekly for 18 weeks. Participants who relapse may receive up to two repeated doses of psilocybin.

Study groups in NCT05029466
Study groupRoleWhat they receive
Immediate treatmentExperimentalParticipants will commence psilocybin treatment immediately upon study enrollment.
Receives: Drug: Psilocybin
Delayed treatmentExperimentalParticipants will commence psilocybin treatment two weeks after study enrollment.
Receives: Drug: Psilocybin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility of the study based on participant retention

    Participant drop-out rates will be calculated to determine the feasibility of psilocybin in adults with treatment-resistant depression.

    Measured: Up to 24 weeks

  2. Feasibility of the study based on suicidal ideation and behaviour scores

    Feasibility will be judged based on change in Columbia Suicide Severity Rating Scale (CSSRS) scores. The CSSRS evaluates suicidal ideation and behaviour. The suicidal ideation score ranges from 0 (no ideation) to 5 (active suicidal ideation with specific plan and intent). Suicidal ideation intensity score ranges from 0 (no ideation) to 25 (most severe). The presence of suicidal behaviour is rated as a binary response; the lethality of actual attempts are rated on a scale of 0 (no or very minor physical damage) to 5 (death) and the potential lethality of actual attempts are rated on a scale of 0 (behaviour not likely to result in injury) to 2 (behaviour likely to result in death despite available medical care).

    Measured: Up to 24 weeks

  3. Feasibility of the study based on adverse events

    Feasibility will be judged based on the percentage of participants experiencing serious adverse events and the percentage of adverse events resolving within 48 hours of each dose administration.

    Measured: Up to 24 weeks

Secondary outcomes (24)
  1. Montgomery-Åsberg Depression Rating Scale (MADRS) total score

    The MADRS is a clinician-rated scale measuring depression severity, consisting of 10 items, each scored from 0 (normal) to 6 (severe), for a total possible score of 60; higher scores denote greater severity.

    Measured: Up to 24 weeks

  2. Montgomery-Åsberg Depression Rating Scale (MADRS) response rate

    The proportion of participants with at least a 50% reduction in MADRS total score relative to baseline.

    Measured: Up to 24 weeks

  3. Montgomery-Åsberg Depression Rating Scale (MADRS) remission rate

    The proportion of participants with a MADRS total score of 10 or lower.

    Measured: Up to 24 weeks

  4. McIntyre and Rosenblat Rapid Response Scale (MARRRS)

    The MARRS was recently validated in adults with treatment-resistant major depressive or bipolar disorder receiving open-label intravenous ketamine at a community-based treatment center The MARRRS is a self-reported 14-item self-report measure of depressive symptoms present during the past 72 hours. Total score ranges from 0 to 42; a higher score indicates greater symptom severity.

    Measured: Up to 24 weeks

  5. Patient Health Questionnaire 9-item (PHQ-9)

    The PHQ-9 is a self-rated measure of depressive symptom severity in the past two weeks. Each of the nine items is rated on a Likert scale, ranging from 0 (not at all) to 3 (nearly every day), and summed for a total score between 0 (no symptoms) to 27 (most severe).

    Measured: Up to 24 weeks

  6. Clinical Global Impressions Scale (CGI)

    The CGI severity module assesses the severity of a person's depressive illness using a seven-point Likert scale, ranging from "Normal, not at all depressed" to "Among the most extremely depressed patients". The CGI improvement module evaluates the global improvement of a person's condition since their last visit on a seven-point Likert scale, ranging from "Very much improved" to "Very much worse".

    Measured: Up to 24 weeks

  7. Quick Inventory for Depressive Symptomatology, Self-Report, 16-item (QIDS-SR-16)

    The QIDS-SR-16 total score ranges from 0 to 27 with 0 representing no depression and 27 representing severe depression.

    Measured: Up to 24 weeks

  8. Columbia Suicide Severity Rating Scale (CSSRS)

    The CSSRS evaluates suicidal ideation and behaviour. The suicidal ideation score ranges from 0 (no ideation) to 5 (active suicidal ideation with specific plan and intent). Suicidal ideation intensity score ranges from 0 (no ideation) to 25 (most severe). The presence of suicidal behaviour is rated as a binary response; the lethality of actual attempts are rated on a scale of 0 (no or very minor physical damage) to 5 (death) and the potential lethality of actual attempts are rated on a scale of 0 (behaviour not likely to result in injury) to 2 (behaviour likely to result in death despite available medical care).

    Measured: Up to 24 weeks

  9. Clinician-Administered Dissociative States Scale (CADSS), 23-item

    Total scores on the 23-item CADSS range from 0 to 92; a higher score denotes greater dissociative symptom severity.

    Measured: Up to 20 weeks

  10. Clinician-Administered Dissociative States Scale (CADSS), 6-item

    Total scores on the 6-item CADSS range from 0 to 24; a score of 3 or greater denotes the presence of dissociation symptom severity.

    Measured: Up to 20 weeks

  11. Brief Psychiatric Rating Scale (BPRS)

    The BPRS rating scale has 18 items, each item rated on a severity scale of 1 (not present) to 7 (extremely severe). 0 is entered if the item is not assessed.

    Measured: Up to 20 weeks

  12. Young Mania Rating Scale (YMRS)

    Total scores range from 0 to 60, with higher scores indicative of greater symptom severity.

    Measured: Up to 20 weeks

  13. Mystical Experiences Questionnaire (MEQ)

    The MEQ consists of 30 items, each item rated on a Likert scale (0-None/not at all to 5-Extreme, more than any other time in my life). The MEQ total score is computed by taking the average response to all items.

    Measured: Up to 20 weeks

  14. Sheehan Disability Scale (SDS)

    The SDS total score ranges from 0 to 30 with 0 representing no impairment and 30 representing severe impairment. The last two items of the scale (Days Lost and Days Unproductive) range from 0 to 7 (higher number denotes greater impairment).

    Measured: Up to 24 weeks

  15. EuroQol-5D 5-Level (EQ-5D-5L)

    The EQ-5D-5L consists of 5 items; each item ranges from 1 (no problems) to 5 (extreme problems). A participant's self-rated health is recorded on a vertical visual analogue scale (range 100 to 0), where the endpoints are labelled 'The best health you can imagine' (100) and 'The worst health you can imagine' (0).

    Measured: Up to 24 weeks

  16. World Health Organization-5 Well-Being Index (WHO-5)

    The WHO-5 is a measure of overall well-being, rated on a scale of 0 to 25, with higher scores denoting higher quality of life.

    Measured: Up to 24 weeks

  17. World Productivity and Impairment Questionnaire (WPAI)

    The WPAI is a six-item self-administered rating scale measuring work absenteeism, presenteeism, and productivity loss and daily activity impairment. Individuals are asked to rate to what extent health problems affected their ability to do regular daily activities other than work at a job (0-No effect on daily activities to 10-Completely prevented me from doing my daily activities). Respondents who are currently employed are additionally asked to rate the number of hours missed from work due to health problems, the number of hours missed due to other reasons (e.g., vacation, time off to participate in this study), and the number of hours worked in the past seven days, as well as to what extent health problems affected productivity while working (0-No effect on my work to 10-Completely prevented me from working). Responses to each question are scaled to an overall percentage score (0 to 100), with higher values denoting greater impairment

    Measured: Up to 24 weeks

  18. Perceived Deficits Questionnaire - Depression - 5-Item (PDQ-5-D)

    The total score ranges from 0 to 20, with greater scores indicative of greater subjective cognitive impairment.

    Measured: Up to 24 weeks

  19. Digit Symbol Substitution Test (DSST)

    The DSST assesses relative contributions of speed, memory, executive function and visual scanning. Participants are required to copy symbols that are paired with simple geometric shapes or numbers within 90 seconds for a total possible score of 0 to 90. A higher score reflects greater performance.

    Measured: Up to 24 weeks

  20. Trail Making Test A (TMT-A)

    The TMT is a two-part cognitive test. TMT-A assesses cognitive processing speed and consists of 25 circles distributed over a sheet of paper. Participants are asked to connect circles in numerical sequence. If a participant makes a mistake, the administrator points out the error, and the participant must return to the last correct circle and continue the task. Lower scores represent better performance.

    Measured: Up to 24 weeks

  21. Trail Making Test B (TMT-B)

    The TMT is a two-part cognitive test. TMT-B assesses executive functioning and consists of 25 circles distributed over a sheet of paper. Participants are asked to connect circles in alternating numerical and alphabetical sequence (e.g., 1-A-2-B). If a participant makes a mistake, the administrator points out the error, and the participant must return to the last correct circle and continue the task. Lower scores represent better performance.

    Measured: Up to 24 weeks

  22. Generalized Anxiety Disorder-7 (GAD-7)

    Total score ranges from 0 to 21; a higher score denotes greater symptom severity.

    Measured: Up to 24 weeks

  23. Snaith-Hamilton Pleasure Scale (SHAPS)

    The SHAPS total score ranges from 14 to 56, wherein a higher score indicates greater hedonic capacity (lower anhedonic severity).

    Measured: Up to 24 weeks

  24. Peripheral inflammatory and metabolic biomarkers

    Inflammatory, neuroplasticity, and metabolic targets that are hypothesized to be relevant to the therpeutic mechanism of psilocybin in depression (e.g., interleukin-6, brain-derived neurotrophic factor, insulin, leptin).

    Measured: Up to 2 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2021
  2. Study start19 Nov 2021
  3. Primary completion22 Jul 2023
  4. Study completion22 Jul 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05029466
Sponsor's protocol ID
253490
Status last verified
Jul 2023
First submitted
20 Aug 2021
Last updated
27 Jul 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Rosenblat JD, Meshkat S, Doyle Z, Kaczmarek E, Brudner RM, Kratiuk K, Mansur RB, Schulz-Quach C, Sethi R, Abate A, Ali S, Bawks J, Blainey MG, Brietzke E, Cronin V, Danilewitz J, Dhawan S, Di Fonzo A, Di Fonzo M, Drzadzewski P, Dunlop W, Fiszter H, Gomes FA, Grewal S, Leon-Carlyle M, McCallum M, Mofidi N, Offman H, Riva-Cambrin J, Schmidt J, Smolkin M, Quinn JM, Zumrova A, Marlborough M, McIntyre RS. Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin. Med. 2024 Mar 8;5(3):190-200.e5. doi: 10.1016/j.medj.2024.01.005. Epub 2024 Feb 14.

    PubMed 38359838

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Psilocybin in people with Treatment Resistant Depression, run by Brain and Cognition Discovery Foundation at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 27 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of the study based on participant retention (time frame: Up to 24 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05029466, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2023.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in