Efficacy in Relapse Prevention: psilocybin in Alcohol Use Disorder With Depressive Symptoms

Up to 40% of individuals with alcohol use disorder (AUD) experience depression, whichincreases the risk of early relapse. Depression can cause relapse to occur 3 times fasterin individuals with AUD who experience depressive symptoms at discharge. No treatmentshave been approved for individuals with both AUD and depression. Psilocybin, apsychedelic, shows promising results in treating both depression and addiction. It may beparticularly effective for preventing relapse in people with AUD who also have depressivesymptoms after detoxification, offering quicker action than traditional antidepressants.The Psilocybin Alcohol Depression (PAD) pilot study, launched in February 2024, hasprovided critical insights for avoiding methodological flaws and demonstrated thatpsilocybin‐assisted psychotherapy (PAP) is both feasible and acceptable. Preliminaryefficacy analyses were conducted: at 12 weeks, the 25 mg group showed significantlygreater reductions in drinking days (p = 0.038) and craving frequency (p = 0.045).Relapse rates were 35% in the 25 mg group and 50% in the control group (HR = 0.52[0.16‐1.65]). In the ERPPAD trial, the study authors will compare high‐dose PAP withlow‐dose PAP in preventing relapse in individuals with AUD and depressive symptoms. Thehypothesis is that high‐dose PAP will be more effective than low‐dose in preventingrelapse over 6 months.