Topic starter
There is a new scientific article which investigates whether psilocybin-assisted psychotherapy can also help against anhedonia, i.e. reduced ability to feel pleasure, in people with therapy-resistant depression.
In it, we discuss:
Anhedonia is a core symptom of depression and often responds poorly to standard treatments. Therefore, in this secondary analysis, the researchers looked specifically at changes in anhedonia in people with treatment-resistant depression who received psilocybin-assisted psychotherapy within a randomised, wait-list-controlled trial.
The real focus of this article is not on depression in general, but on whether psilocybin therapy can also improve this intractable symptom. Participants had a primary diagnosis of major depressive disorder or bipolar II disorder and received at least one oral dose of 25 mg psilocybin in combination with psychotherapy.
The outcomes were positive. At the primary measurement moment after two weeks, scores on the Snaith-Hamilton Pleasure Scale, a measure of anhedonia, decreased statistically significantly. According to the authors, clinically relevant improvements were additionally seen at subsequent follow-up moments at three and six months.
The researchers also explored whether changes in anhedonia might correlate with changes in the general severity of depression, measured with the MADRS. In doing so, this paper seeks to understand a little better whether psilocybin primarily improves general depression, or possibly also has a more specific effect on the ability to experience pleasure and reward again.
Importantly, however, this is a secondary analysis of a relatively small study. In this analysis, 30 participants were included and 29 were included in the main outcome analysis. In addition, the design was wait-list-controlled and not placebo-controlled, so expectancy effects and other biases may still play a role. The authors therefore stress that larger placebo-controlled studies are needed.
In one sentence, this article shows that psilocybin-assisted psychotherapy in therapy-resistant depression can noticeably reduce not only depressive symptoms, but possibly also anhedonia.
Spoiler
New article description
Abstract
Anhedonia, a core symptom of depression, is often resistant to conventional treatments and significantly impacts quality of life. This secondary analysis aimed to evaluate the effects of psilocybin-assisted psychotherapy (PAP) on anhedonia severity in individuals with treatment-resistant depression (TRD). Participants (n = 30) with TRD and a primary diagnosis of Major Depressive Disorder or Bipolar II Disorder received at least one 25 mg dose of oral psilocybin with psychotherapy as part of a randomised, waitlist-controlled trial (NCT05029466). The primary outcome of the present secondary analysis was changes in anhedonia, measured by the Snaith-Hamilton Pleasure Scale (SHAPS). Exploratory analysis examined whether changes in anhedonia were mediated through changes in overall depression severity, measured by the Montgomery-Asberg Depression Rating Scale (MADRS). A mixed ANOVA, adjusted for sex and age, revealed a statistically significant reduction in SHAPS scores following PAP at the 2-week primary endpoint (F(8, 143.48) = 3.43, p = 0.001, n = 29) with clinically significant improvements observed at 3-month and 6-month secondary endpoints. Our findings from this preliminary analysis suggest that PAP may offer a promising intervention for addressing anhedonia in TRD, but further research with larger, placebo-controlled trials are needed to confirm these effects and elucidate potential mediators. This study adds to a growing body of evidence supporting the therapeutic potential of PAP.
Keywords: Anhedonia; Psilocybin; Treatment-resistant depression.
Posted : 18 March 2026 14:45