A groundbreaking new study from researchers at Imperial College London suggests that the psychedelic compound psilocybin may enhance or preserve depressed patients’ emotional reactions to music, while the commonly prescribed antidepressant escitalopram—an SSRI—can dull these emotions, even though both drugs produce similar clinical improvements in depressive symptoms. The findings, published in Molecular Psychiatry and highlighted by Medical Xpress, provide fresh evidence that psilocybin’s effects on emotional processing could have significant implications for the future of mental health treatment, especially in cultures—such as Thailand’s—where music is integral to social and spiritual life (medicalxpress.com).
Depression is a widespread mental health condition affecting millions globally, marked by persistent sadness, loss of interest, and difficulty in daily functioning. Although selective serotonin reuptake inhibitors (SSRIs) like escitalopram are widely used as first-line treatments, patients often report emotional blunting—a sense of reduced emotional range or pleasure. With the growing interest in psychedelic therapy, particularly psilocybin derived from certain mushrooms, researchers are trying to understand whether these treatments could improve not just symptom count, but also emotional well-being.
The new study, conducted at the Center for Psychedelic Research, recruited patients diagnosed with major depressive disorder and compared the effects of two high doses of psilocybin (25 mg) combined with placebo over six weeks against a regimen of low-dose psilocybin (1 mg) taken with daily escitalopram. Before and after the treatment period, all participants listened to a professionally annotated piece of music while undergoing functional MRI scans to map their brain activity, focusing particularly on “surprising” musical moments intended to evoke emotional reactions.
Crucially, participants were asked to rate their own emotional experiences in real time—assessing both “valence” (pleasantness) and “arousal”—and completed questionnaires about symptoms such as anhedonia (the inability to feel pleasure) and their broader emotional responses to music. This approach moves beyond more artificial lab tests (like facial recognition tasks) and mirrors how people engage with the world in everyday life.
The study’s lead author, a researcher at Imperial College London, explained for Medical Xpress, “We wanted to explore how these treatments work—specifically, the mechanisms by which they affect emotional and reward processing. Music is an ideal tool for examining affective processing in a more ecologically valid way.” By using fMRI brain scans, the research team targeted the ventromedial prefrontal cortex, an area associated with self-referential thinking and processing the unexpected. Their results revealed that psilocybin both reduced activity in this brain region and increased responses in the sensory cortex during musically surprising events—a pattern the researchers interpret as shifting the brain away from negative, repetitive thought processes and toward greater openness to external experiences.
Importantly, although both the psilocybin and SSRI groups showed similar improvement in core depressive symptoms, those treated with psilocybin maintained or even improved their emotional sensitivity to musical stimuli. In contrast, the escitalopram group experienced the familiar “emotional blunting,” where both positive and negative emotions felt muted. “This has important implications for understanding how different antidepressant treatments affect the emotional lives of patients,” the principal investigator noted.
For Thai readers, the implications are notable. Thailand’s musical heritage—from sacred piphat orchestras at Buddhist ceremonies to booming mor lam folk in Isaan and the country’s thriving pop scene—means music often plays a vital role in community and therapeutic contexts. Seniors in rural regions, for instance, frequently engage in local music as a form of social and mental stimulation; Buddhist monks use chanting as meditative practice. The greater ability of psilocybin to preserve emotional response to music may be particularly desirable for individuals whose mental health or cultural identity is closely interwoven with musical expression.
From a scientific perspective, the study advances the theory that psychedelics may help “reset” rigid, negative thought pathways common in depression and restore “reward responsiveness,” making it possible for patients to once again find joy in everyday experiences, including art and music. In Thailand, which faces a growing mental health burden amidst social and economic changes, new strategies to combat depression—especially those that help people reconnect with cultural touchstones—are urgently needed (World Health Organization).
However, despite these promising results, psychedelic therapy—including psilocybin—remains illegal in Thailand and much of the world, classified as a controlled substance with no accepted medical use. Some Thai researchers, however, are beginning to explore the intersections of traditional herbal medicine, spiritual ritual, and modern therapy. Medical authorities in Thailand have previously approved certain alternative treatments, such as medicinal cannabis, following rigorous scientific evaluation and pilot programs (Bangkok Post). The introduction of psilocybin therapy into the Thai healthcare system would require careful regulatory review, extensive safety trials, and significant cultural adaptation.
Historically, psychedelic plants and fungi have been used in religious ceremonies by ethnic minorities in Southeast Asia, including certain highland groups, but not within mainstream Thai Buddhist practice, which traditionally emphasizes meditation and natural therapies over psychoactive substances. The legal and ethical framework for clinical use would need to take this complex background into account. Public understanding about the difference between recreational and clinical use of psychedelics remains limited; comprehensive education campaigns would be essential to avoid misuse and stigma.
Looking ahead, the research team at Imperial and University College London is already investigating other psychedelic compounds, such as DMT, for possible roles in treating disorders like alcohol dependence. They are expanding the use of “naturalistic” stimuli—including full-length films during fMRI scans—to better capture changes in real-world emotional and cognitive processing during treatment. “I believe that naturalistic approaches in neuroimaging research, such as with film or music, are the next frontier in psychiatry,” the study’s first author said. “They allow us to better understand the moment-to-moment shifts in conscious experience that are often disrupted in mental illness.” (Medical Xpress)
For Thai readers living with depression or supporting someone who is, these findings offer hope that future treatments may restore not just functioning, but also emotional vibrancy and connection to the arts—central features of Thai culture and spiritual life. In the meantime, patients are advised to seek help from licensed mental health professionals and to practice safe, evidence-based self-care, such as engaging with music and healthy social connections. Policymakers and medical practitioners should monitor the growing evidence from global psychedelic research and consider preliminary discussions on how such therapies might one day be ethically and safely integrated into Thailand’s healthcare landscape.
For more information and local mental health resources, the Department of Mental Health under the Ministry of Public Health offers free consultation services (dmh.go.th), while numerous academic and community groups are expanding their understanding of how music, art, and culture can support recovery from depression. As research advances and regulations evolve, the Thai public will need reliable information and culturally sensitive policies to navigate the coming transformations in mental health care.