A new study from Imperial College London suggests psilocybin could keep emotional responses to music more intact in depressed patients, while the common antidepressant escitalopram tends to blunt those emotions. Both treatments produced similar improvements in core depressive symptoms, but psilocybin appeared to sustain a richer emotional engagement with music. The research, published in Molecular Psychiatry, and summarized by Medical Xpress, highlights how psychedelic-assisted therapy might influence emotional processing alongside symptom relief. The findings offer potential relevance for Thai audiences where music holds deep cultural and spiritual significance.
Depression affects millions worldwide and is characterized by persistent sadness, loss of interest, and impaired daily functioning. SSRIs like escitalopram are widely used as first-line treatments, yet many patients report emotional blunting—reduced emotional range and pleasure. Interest in psychedelic-assisted therapy, particularly psilocybin, is growing as researchers explore whether such treatments can improve not just symptoms but also emotional well-being.
In this study, researchers compared two high-dose psilocybin treatments (25 mg) with placebo over six weeks to a low-dose psilocybin (1 mg) plus daily escitalopram regimen. Participants diagnosed with major depressive disorder listened to a carefully annotated music piece during functional MRI scans to map brain activity, focusing on moments of musical surprise designed to elicit strong emotions.
Participants also rated their own emotional experiences in real time, judging both valence (pleasantness) and arousal, and completed questionnaires on anhedonia and musical responsiveness. This design mirrors real-life experiences more closely than artificial lab tasks and emphasizes everyday emotional engagement.
The study’s lead author, a researcher at Imperial College London, explained to Medical Xpress that music serves as a practical tool for examining affective processing in a real-world context. Using fMRI, the team examined activity in the ventromedial prefrontal cortex, a region linked to self-referential thought and processing surprises. The psilocybin group showed reduced activity in this area and heightened responses in the sensory cortex during surprising musical moments. This pattern suggests a shift away from negative, repetitive thought toward greater openness to external experiences.
Although both groups showed similar improvements in depressive symptoms, those treated with psilocybin retained or even enhanced their emotional sensitivity to music. In contrast, the escitalopram group tended to experience emotional blunting, dampening both positive and negative feelings. The researchers emphasize the significance of these differences for understanding how antidepressants influence patients’ emotional lives.
For Thai readers, the implications are meaningful. Thailand’s rich musical heritage spans sacred piphat ensembles used in Buddhist ceremonies, Isaan lam and mor lam folk music, and a vibrant contemporary scene. Among rural seniors, music often serves as social and cognitive stimulation, while Buddhist monks use chanting as meditative practice. The potential for psilocybin to preserve emotional resonance with music could resonate with individuals whose mental health intersects with cultural and musical identity.
From a scientific perspective, the findings support the idea that psychedelics may help “reset” rigid negative thought patterns and restore reward responsiveness, helping patients reengage with everyday pleasures such as art and music. With Thailand facing a growing mental health burden amid social and economic changes, approaches that connect therapeutic outcomes with cultural touchstones may be particularly valuable.
However, psychedelic therapies remain illegal in Thailand and many places, classified as controlled substances with limited medical acceptance. Some Thai researchers are exploring integrative approaches that combine traditional herbal practices, ritual aspects, and modern therapy. Any move toward clinical psilocybin use would require regulatory review, safety validation, and careful cultural adaptation.
Historically, psychedelic plants and fungi have featured in Southeast Asian ritual practices but are not part of mainstream Thai Buddhist medicine. Any clinical adoption would need to navigate legitimate ethical and cultural considerations, as well as public education to distinguish medical use from recreational use.
Looking ahead, the Imperial and University College London team is expanding research to other psychedelics such as DMT and is incorporating naturalistic stimuli, like full-length films, during brain imaging to better capture real-world emotional processing. The researchers suggest that naturalistic approaches may be the next frontier in psychiatry for understanding moment-to-moment experiences affected by mental illness.
For Thais living with depression or supporting someone who is, these findings offer a glimpse of potential future therapies that could restore emotional vitality and connections to culture and the arts. In the meantime, individuals should seek help from licensed mental health professionals and prioritize safe, evidence-based self-care, including music engagement and social connectedness. Policymakers and health practitioners should monitor global psychedelic research developments and consider carefully how such therapies might be ethically and safely evaluated for Thailand’s healthcare system.
Thailand’s Department of Mental Health emphasizes accessible mental health services and resources. Readers seeking local support can consult national health services for guidance, while communities continue to explore how music, art, and culture support recovery from depression. As science progresses and regulations evolve, the Thai public will benefit from clear, culturally sensitive information guiding future mental health care decisions.