Psilocibina como ferramenta terapêutica em transtornos depressivos em adultos: uma revisão sistemática das evidências e impactos

Abstract

Depressive disorders are among the leading causes of global disability, profoundly affecting emotional, social, and occupational functioning. Although conventional antidepressants are widely available, many patients experience insufficient response or limiting adverse effects, particularly those with treatment-resistant depression (TRD). Psilocybin has emerged as a promising therapeutic alternative due to its rapid, robust, and potentially long-lasting antidepressant effects when administered in a controlled clinical environment and combined with psychological support. This study aimed to synthesize recent evidence on the efficacy, safety, and clinical impact of psilocybin in the treatment of depressive disorders in adults, comparing its effects with placebo and standard therapies. This systematic review followed PRISMA guidelines, with searches performed in PubMed using MeSH descriptors related to psilocybin, depression, and therapeutic outcomes. Eligible studies included randomized clinical trials and observational research published between 2015 and 2025, involving participants aged 18 years or older. Exclusion criteria encompassed studies with pediatric or geriatric populations, preclinical research, narrative reviews, case reports, and studies lacking evaluation of depressive symptoms. Screening was conducted independently by two reviewers using the Rayyan platform, resulting in the inclusion of ten studies. The evidence demonstrates that psilocybin induces rapid and significant reductions in depressive symptoms and improves subjective well-being, quality of life, and social functioning. Reported adverse events were mild and transient, supporting a favorable safety profile when used under controlled conditions. Despite these encouraging findings, the literature still lacks large multicenter trials with standardized dosing protocols and long-term follow-up, which are essential to consolidate the clinical applicability, safety, and effectiveness of psilocybin in treating depressive disorders in adults.