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NCT Number: NCT07607938

Psilocybin as a Novel Therapy for Residual Anhedonia

The primary objective is to evaluate whether a single dose of psilocybin (25 mg), compared to placebo, can restore fronto-striatal reward circuit function and thereby improve anhedonia and emotional blunting in individuals with residual symptoms despite ongoing SSRI or SNRI treatment. This will be assessed using precision functional mapping (PFM), task-based fMRI, and clinical rating scales (DARS).

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

NYU Langone Health

New York, 10016, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 18 and 65 years
  • Able to provide voluntary signed and dated informed consent.
  • Females of childbearing potential (FOCBP) must agree to practice an effective means of birth control throughout the duration of the trial
  • Males who have FOCBPs as partners must agree to practice an effective means of birth control throughout the duration of the trial
  • State willingness to comply and be available for all study requirements, including psychological, cognitive, imaging and procedural evaluations for the duration of the study
  • Meet DSM-5 criteria for major depressive disorder (MDD)
  • Screening Dimensional Anhedonia Rating Scale (DARS) total score of < 28.5 points
  • Have an identified support person
  • Agree to refrain from taking all non-prescription medications and supplements (nutritional and herbal) for at least 1 week prior to the IP administration session unless approved by the Investigator.

Exclusion criteria

  • Inability to speak and understand English sufficiently to complete informed consent and study procedures.
  • Inability to provide informed consent.
  • Women who are pregnant or who intend to become pregnant or nurse during the study duration.
  • Prior exposure to classic psychedelics (i.e., psilocybin, LSD, ayahuasca, and/or mescaline) within the past 1 year.
  • Current or previous psychiatric conditions that meet DSM-5 criteria for psychotic disorders (i.e., schizophrenia, schizoaffective disorder, MDD with psychosis), bipolar 1 or 2 disorder, or current diagnosis of active substance use disorder.
  • Have active suicidal ideation with intent, based on Columbia-Suicide Severity Rating Scale (C-SSRS assessment (severity score > 3) at the Screening visit, confirmed by the Investigator.
  • Have made a medically significant suicide attempt (i.e., one that had a significant possibility of causing death or permanent harm in the absence of intervention) within the past 12 months, based on Screening C-SSRS assessment and confirmation by the Investigator.
  • Immediate family history (i.e., parents, full siblings, or half siblings) with known or suspected psychotic disorder.
  • Presence of medical conditions that may confound results of imaging study or that are contraindications to or psilocybin exposure (i.e., neurological, renal, hypertension, metabolic or cardiovascular disease or pregnancy);
  • Presence of contraindications to MRI scanning (implantable devices, bone hardware, various IUD).
  • Participants who received electroconvulsive therapy (ECT), trans magnetic cranial stimulation (TMS), and/or ketamine in the past 90 days.
  • Has any other physical or psychological symptom, medication, or other relevant finding prior to randomization that, based on the clinical judgment of trial personnel, would make a participant unsuitable for the trial.
  • Are unable or unwilling to discontinue taking any protocol-prohibited medications and supplements.

Treatment and study plan

Psilocybin

Drug

One-time dose of psilocybin 25 mg, oral, in capsule form.

Placebo

Drug

One-time dose of placebo (25 mg of inert filler), oral, in capsule form.

Primary outcomes

  1. Change in Dimensional Anhedonia Rating Scale (DARS) Score

    Time frame: Baseline (Week -3), End of Study (Week 8)

    DARS is a 17-item, patient-reported instrument designed to measure "state" anhedonia (how a person is feeling right now). The total score is the sum of responses and ranges from 0-68; lower scores indicate more severe anhedonia.

  2. Change in Fronto-Striatal Connectivity (pgACC-NAcc FC)

    Time frame: Baseline (Week -3), End of Study (Week 8)

    This outcome measures the change in functional connectivity (FC) between the pregenual anterior cingulate cortex (pgACC) and the nucleus accumbens (NAcc). PgACC-NAcc FC will be measured using fMRI sequencing. The standard deviation of FC is assumed to be 0.1.

Secondary outcomes

  1. Change in Motivation and Pleasure Scale - Self-Report (MAP-SR) Score

    Time frame: Baseline (Week -3), End of Study (Week 8)

    MAP-SR is an 15-item self-report assessment designed to measure the "experiential" negative symptoms of psychiatric disorders. Each item is rated on a scale from 0-4; the total score is the sum of responses and ranges from 0-60; lower scores indicate more severe psychiatric symptoms.

  2. Change in Experiential Avoidance (BEAQ) Score

    Time frame: Baseline (Week -3), End of Study (Week 8)

    The Brief Measure of Experimental Avoidance Questionnaire (BEAQ) is a 15-item assessment of experiential avoidance. Each item is rated on a scale from 1-6; the total score is the sum of responses and ranges from 15 to 90. Higher scores indicate greater levels of experiential avoidance (and lower psychological flexibility).

  3. Change in Montgomery-Asberg Depression Scale (MADRS) Score

    Time frame: Baseline (Week -3), End of Study (Week 8)

    The MADRS is a 10-item assessment of depression severity. Each item is rated on a scale from 0-6; the total score is the sum of responses and ranges from 0-60. Higher scores indicate greater severity of depression.

Study contacts

Contact information is provided by the study sponsor or research team.

Joshua Siegel, MD, PhD

CONTACT

[email protected]

646-754-4814

Sponsors and collaborators

Lead sponsor

NYU Langone Health

Other

Collaborators

  • National Institute of Mental Health (NIMH)

Registry information

Official study title

Targeting Reward Circuits: Psilocybin as a Novel Therapy for Residual Anhedonia

Important dates

Study start
2026
Primary completion
2030
Study completion
2030
First posted
May 27, 2026
Registry last updated
May 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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