Depression, Parkinson Disease
Conditions
Keywords
Parkinson Disease, Depression, Psilocybin, Psilocybin therapy, Movement disorder
Brief summary
The purpose of this study is to understand whether people with Parkinson's Disease and depression have improvement in their symptoms after psilocybin therapy.
Detailed description
This is a randomized controlled trial of oral psilocybin therapy for depression in people with Parkinson's disease (PD). The primary goal is to examine efficacy of psilocybin therapy in this patient population. We will enroll 60 people ages 40 to 80 with clinically diagnosed early to moderate stage Parkinson's disease (Hoehn and Yahr Stage 1-3 during an "on" period), who meet criteria for moderate or greater depression severity and meet all other inclusion and exclusion criteria at screening. Participants will complete two drug administration sessions where they will each receive a dose of oral psilocybin ranging from low ("microdose") to high in a medically monitored setting with psychotherapeutic support. Participants will also complete a series of psychotherapy sessions before and after each drug administration session. Clinical assessments, neuroimaging, non-invasive brain stimulation, and peripheral blood draws will be used to quantify changes in depression, other non-motor and motor symptoms of PD, quality of life, and selected neural and blood-based biomarkers at multiple time points. Follow-up will continue to 3 months after the second session. Primary endpoints will evaluate efficacy, safety, and tolerability of study procedures. After posting of these trial results, this data will be combined with the data from the trial at Yale University (NCT07610369) for publication purposes.
Interventions
DRUGPsilocybin
Single dose of psilocybin ranging from low ("microdose") to high delivered orally in two separate drug administration sessions with psychological support and monitoring.
DRUGPimavanserin
Participants will receive either pimavanserin or placebo during their drug administration sessions.
Sponsors
Joshua Woolley, MD, PhD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) This trial is testing various doses of psilocybin. Participants, study staff and clinical assessors will be blinded to individual treatment conditions until study close-out. The clinician administered instruments will be administered by different clinical study staff than the facilitators who provide the preparation, psilocybin therapy, and integration sessions.
Intervention model description
All participants will receive two doses of psilocybin ranging from low ("microdose") to high. All participants will receive three psilocybin preparation sessions, two administration sessions of a single dose of psilocybin within a therapeutic environment (6-8 hours), five integration sessions, and two follow up visits. All drugs will be orally administered during the dosing sessions. The study procedures will follow best practices for administering psilocybin in clinical trials.
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 40 to 80 * Comfortable speaking and writing in English * Have neurologist-diagnosed idiopathic Parkinson's disease (PD), Hoehn and Yahr stages 1 to 3 during an "on" phase (time when medication/DBS for parkinsonian motor feature, including bradykinesia and rigidity is in effect) * Currently experiencing depressive symptoms * Able to attend all in-person visits at UCSF as well as virtual visits * Have a primary care provider, neurologist, or psychiatrist who is actively managing or coordinating
Exclusion criteria
* Psychotic symptoms involving loss of insight * Significant cognitive impairment * Regular use of medications that may have problematic interactions with psilocybin * A health condition that makes this study unsafe or unfeasible, determined by study physicians
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the efficacy of psilocybin for improving depression in people living with Parkinson's disease | Baseline to 30 days after first drug dose | Changes in depression as measured by the MADRS |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in depression severity | 7 days after first drug dose to 90 days after second drug dose | Measured by Beck Depression Inventory-2 (BDI-2) scores |
| Changes in clinician-assessed depression | Baseline to 90 days after second drug dose | Measured by the Montgomery-Asberg Depression Rating Scale (MADRS) |
| Changes in anxiety | Baseline to 90 days after second drug dose | Measured by the Parkinson Anxiety Scale (PAS) |
| Changes in PD symptom severity | Baseline to 90 days after second drug dose | Measured by the Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) |
| Changes in Quality of Life | Baseline to 90 days after second drug dose | Measured by the 36-item Short Form survey (SF-36) |
| Changes in cognitive performance | Baseline to 90 days after second drug dose | Measured by a multi-task assessment |
| Safety and tolerability of psilocybin therapy for depression in people with PD | Baseline to 90 days after second drug dose | Incidence, severity, and frequency of Adverse Events (AEs) including Treatment-Emergent AEs (TEAEs) and Serious AEs (SAEs) |
| Changes in clinician-rated psychotic symptoms | Baseline to 90 days after second drug dose | Measured by the Enhanced Scale for the Assessment of Positive Symptoms for Parkinson's Disease (eSAPS-PD) |
| Subjective effects of psilocybin | Up to 30 and 60 days after Baseline | Measured by the 5-Dimensional Altered States of Consciousness Rating Scale (5D-ASC) |
| Participant-reported acceptability of study procedures | 30 days after second drug dose | Measured by the study-specific Treatment Satisfaction Questionnaire-Participant (TSQ-P) |
Countries
United States
Contacts
CONTACTBrigette Sosa
CONTACTEllen Bradley, MD
PRINCIPAL_INVESTIGATORJoshua Woolley, MD,PhD
University of California, San Francisco
PRINCIPAL_INVESTIGATOREllen Bradley, MD
University of California, San Francisco
Outcome results
None listed