Treatments for depression are notoriously not very effective.
Which is why when a study says that two-thirds of people who received psilocybin-assisted therapy for major depression were still in complete remission five years later, you sit up and pay attention.
The Numbers That Matter
Researchers at Ohio State University followed up with participants from a 2021 clinical trial, and what they found was pretty remarkable. At the one-year mark, 58% of participants were in remission. Five years out, that jumped to 67%.
"We also saw that across the board, anxiety, depression, global functioning, self-reported depression, all of these measures were showing the same signal of continued improvement up to five years later," said lead author Alan Davis, who directs the Center for Psychedelic Drug Research and Education at Ohio State.
Think about that for a second. Rather than just a short term mood boost, people actually continued to improve over time.
What the Treatment Actually Looked Like
The original trial saw participants receive two doses of psilocybin combined with about 13 hours of psychotherapy. That therapeutic support framework turned out to be crucial (more on that in a bit).
Of the 24 original participants, 18 signed up for this five-year follow-up. They completed a battery of questionnaires, underwent clinical depression ratings, and sat for in-depth interviews.
The researchers even took a conservative approach with the six who didn't participate, assuming they'd relapsed completely. Even with that pessimistic assumption built in, the results held strong.
Importance of Integration
Here's where it gets interesting and a bit more nuanced. Only three people in the follow-up reported receiving no other depression treatment since the trial. Others had tried antidepressants, ketamine, more psychotherapy, or even psychedelics on their own.
But something fundamental had shifted. Before the psilocybin-assisted therapy, these folks were dealing with crushing, life-interfering depression. After the trial, many described viewing their depression differently, as more situational and manageable rather than an all-consuming force.
"They believed that overall, they had greater capacity for positive emotions and enthusiasm, regardless of whether their depression came back or not," Davis explained. It's like the treatment gave them better tools to work with, even when things got tough again.
And here's a telling detail. Some of the participants who tried psychedelics on their own in the years after the study said the experiences weren't as helpful because they lacked the clinical support structure.
The medicine matters, sure, but the therapeutic relationship, professional guidance and integrations may matter even more.
The Real-World Picture
Not everything was sunshine and breakthrough moments, though. At the five-year mark, a few participants reflected that they'd felt unprepared for the heightened emotional sensitivity that came with treatment.
A couple found the medication weaning and waitlist period really difficult. Others wished they'd had more integration therapy afterward to help process and incorporate the experience.
These are important learnings. This isn't a magic bullet—it's a powerful tool that needs to be wielded carefully and with proper support.
What This Means Going Forward
Davis is careful to note the study sample is small, and there's still a ton to learn. But this first real look at the long-term durability of psilocybin-assisted therapy is genuinely exciting.
"Some of the most debilitating aspects of depression are people isolating and withdrawing from things that are important to them," Davis said.
"Despite some of those symptoms coming back, they found they weren't experiencing those same levels of impairment—that really speaks to the potential for some people that this treatment might catalyze future positive effects when they're going through depression."
Five years later, most participants still viewed the treatment as safe, meaningful, and something that sparked ongoing improvement in their lives.
The research was published in the Journal of Psychedelic Studies, backed by Ohio State's Center for Psychedelic Drug Research and Education and Johns Hopkins' Center for Psychedelic and Consciousness Research.
We're still in the early days of understanding how psychedelic-assisted therapy works and for whom it works best. But results like these are hard to ignore. They suggest we might be looking at a genuine paradigm shift in how we treat depression.
Psilocybin therapy could offer lasting change in how people relate to their mental health. Something that current treatments could never do.
Source: Five-year outcomes of psilocybin-assisted therapy for Major Depressive Disorder
Disclaimer. This is not medical advice. This study represents ongoing research into psychedelic-assisted therapy. If you're struggling with depression, please consult with qualified healthcare professionals about treatment options appropriate for your situation.
