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Effects of Repeated Psilocybin Dosing in OCD

Primary Purpose

Obsessive-Compulsive Disorder

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Psilocybin
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Obsessive-Compulsive Disorder focused on measuring Psilocybin

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Primary DSM-5 diagnosis of OCD, with Y-BOCS-II score of 26 or greater at screening
  2. Failed at least one medication and/or therapy trial of standard care treatment for OCD
  3. English fluency
  4. Agree to sign a medical release for investigators to communicate directly with participants' providers to confirm medication and psychotherapy histories or arrange contingencies in event of crises.
  5. Agree to provide an adult contact (relative, spouse, close friend or other caregiver) who is willing and able to be reached by the PI and/or study personnel in the event of an emergency, and who can provide transportation for study visits and independently comment on any changes in the participant's mood or behavior after each administration of psilocybin.
  6. Agree to commit to all study procedures.
  7. Ability to orally ingest pills for psilocybin dosing visits.
  8. Agree to adhere to lifestyle and medication modifications.
  9. Must not be on psychotropic medications for OCD or comorbid psychiatric conditions for at least 8 weeks at the time of randomization, and agree to refrain from taking or starting any psychiatric medications until after 4 weeks post-second dose.
  10. Must not be in current psychotherapy (CBT or ERP) at the time of pre-screening and must not start new course of psychotherapy (CBT or ERP) for OCD or comorbid psychiatric conditions until after 4 weeks post-second dose.
  11. If participant is of childbearing potential, must have a negative pregnancy test at study entry and prior to each dosing session.
  12. If participant is of childbearing potential, agree to use adequate birth control and not attempt to become pregnant during study up to 4 weeks post-second dose.

Exclusion Criteria:

  1. Personal or immediate (first-degree relative) family history of formally diagnosed schizophrenia or other psychotic disorders, or bipolar I/II disorder
  2. Lack of knowledge about biological families' medical history, due to adoption or other circumstance
  3. Active suicidal intent or suicidal or non-suicidal self-injurious behaviors
  4. Unremitted Tourette syndrome
  5. Lifetime diagnosis of a Pervasive Developmental Disorder
  6. Current substance use disorder (except for mild alcohol use disorder)
  7. Any neurological condition, including history of seizure(s) or chronic/severe headaches
  8. Any history of head injury with loss of consciousness for more than 30 min
  9. Any use of classic psychedelic substances within the prior 12 months
  10. Unwillingness to abstain from use of classic psychedelics outside of the study up to 4 weeks post-second dose.
  11. Use of tobacco products or a THC-containing product more than 2 times per week on average over the past 30 days at screening.
  12. Unwilingness or inability to abstain from use of tobacco or THC-containing products from 1 week prior to randomization up to 4 weeks post-second dose.
  13. Positive urine drug test for any prohibited substance at screening or days of dosing, or positive breathalyzer test for alcohol on days of dosing
  14. Unwillingness or inability to abstain from alcohol use at least 24 hours prior to the days of dosing, up to 24 hours after each dosing day (or corresponding intervals for waitlist group).
  15. Any medical conditions that may render study procedures unsafe, including hypertension, history of cardiovascular disease, moderate-to-severe hepatic or renal impairment, diabetes, and hypo- or hyperthyroidism.

Sites / Locations

  • Connecticut Mental Health CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Immediate Treatment

Waitlist Control/Delayed Treatment

Arm Description

Participants randomized to this condition will receive treatment immediately, facilitated by two study staff members, and which consists of two preparatory sessions, followed by the first dosing session and two integration sessions, then the second dosing session and two integration sessions. This is followed by follow-up and long-term follow-up visits up to 12 months post-second dose.

Participants randomized to this condition will first enter a waitlist phase that lasts for 7 weeks, after which rater unblinding will occur, and participants will be rescreened. If participants remain eligible at this time, they will begin their treatment phase. During their treatment phase, participants in this condition will receive the same treatment as described for participants in the immediate treatment group. This is followed by follow-up and long-term follow-up visits up to 12 months post-second dose.

Outcomes

Primary Outcome Measures

Change in Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II) Severity Scale total score from baseline at 4 days post-second dose
Clinician-administered assessment of severity of OCD symptoms over the past seven days. The most prominent obsessions and compulsions are rated on the Severity Scale from 0 to 4. Total Y-BOCS-II scores range from 0 to 40, with higher scores indicating greater severity of OCD symptoms.

Secondary Outcome Measures

Change in Montgomery-Asberg Depression Scale (MADRS) total score from baseline at 4 days post-second dose
Clinician-administered assessment of severity of depressive symptoms over past month. Total scores range from 0 to 60, with higher scores indicating greater severity of depressive symptoms.
Change in Dimensional Obsessive-Compulsive Scale (DOCS) total score from baseline at 4 days post-second dose
Self-report measure of various OCD symptoms over the modified time frame of the past week. Total scores range from 0 to 140, with higher scores indicating greater severity of OCD symptoms.
Change in Obsessive Beliefs Questionnaire-44 (OBQ-44) total score from baseline at 4 days post-second dose
Self-report measure of various obsessive beliefs implicated in OCD in general. Total scores range from 44 to 308, with higher scores indicating greater severity of obsessive beliefs.
Change in Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) total score from baseline at 4 days post-second dose
Self-report measure of experiential avoidance and psychological flexibility in the context of OCD symptoms in general. Total scores range from 13 to 91, with higher scores indicating greater psychological inflexibility.
Change in Tolerance of Uncontrollability Questionnaire (TOUQ) total score from baseline at 4 days post-second dose
Self-report measure of ability to tolerate uncontrollability (or inversely need for control) in general. Total scores range from 19 to 133, with higher scores indicating greater tolerance of uncontrollability.
Change in White Bear Suppression Inventory (WBSI) total score from baseline at 4 days post-second dose
Self-report measure of thought suppression tendencies in general. Total scores range from 15 to 75, with higher scores indicating stronger thought suppression tendencies.
Change in Difficulties in Emotion Regulation Scale (DERS) total score from baseline at 4 days post-second dose
Self-report measure of emotion regulation difficulties in general. Total scores range from 36 to 180, with higher scores indicating greater difficulties with regulating emotions.
Change in Southampton Mindfulness Questionnaire (SMQ) total score from baseline at 4 days post-second dose
Self-report measure of trait mindfulness in regards to distressing thoughts and images. Total scores range from 0 to 96, with higher scores indicating greater trait mindfulness.
Toronto Mindfulness Scale (TMS)
Self-report measure of state mindfulness during dosing session. Total scores range from 0 to 52, with higher scores indicating greater state mindfulness.
Set, Setting, and Intentions (SSI) Scale
Self-report measure of set, setting, and clarity of intentions just prior to dosing session. Total mean scores range from 0 to 100 (after reverse-scoring two items), with higher scores indicating greater preparedness for the dosing session.
Mystical Experience Questionnaire (MEQ)
Self-report measure of acute mystical experiences during dosing. Total mean scores range from 0 to 5, with higher scores indicating greater mystical experiences.
Psychological Insight Questionnaire (PIQ)
Self-report measure of acute psychological insights during dosing. Total mean scores range from 0 to 5, with higher scores indicating greater insightful experiences.
Challenging Experience Questionnaire (CEQ)
Self-report measure of acute challenging experiences during dosing. Total mean transformed scores range from 0 to 1, with higher scores indicating greater challenging experiences.
Ego Dissolution Inventory (EDI)
Self-report measure of acute experiences of ego dissolution during dosing. Total mean scores range from 0 to 100, with higher scores indicating greater ego dissolution.
Emotional Breakthrough Inventory (EBI)
Self-report measure of different experiences of emotional breakthroughs during dosing. Total mean scores range from 0 to 100, with higher scores indicating greater emotional breakthrough.
Change in Self-Compassion Scale (SCS) total mean score from baseline at 4 days post-second dose
Self-report measure of self-compassion in general. Total mean scores range from 1 to 5 (after reverse-scoring 13 items), with higher scores indicating greater self-compassion.
Change in Ten-Item Personality Inventory (TIPI) total score from baseline at 4 days post-second dose
Brief self-report measure of Big Five personality dimensions. Total scores range from 10 to 70 (after reverse-scoring 5 items), with higher scores indicating more positive personality traits.
Change in Persisting Effects Questionnaire (PEQ) subscale scores from 4 weeks post-second dose at 12 months post-second dose
Self-report measure of persisting effects from dosing in general. Subscale scores range from a minimum of 0 to a maximum of 5 to 85, with higher scores indicating greater positive or negative persisting changes since dosing.
Change in Alcohol Use Disorders Identification Test (AUDIT) total score from baseline at 4 weeks post-second dose
Self-report measure of alcohol use severity. Total scores range from 0 to 40, with higher scores indicating greater alcohol use severity.
Change in Drug Use Disorders Identification Test (DUDIT) total score from baseline at 4 weeks post-second dose
Self-report measure of illicit substance use. Total scores range from 0 to 44, with higher scores indicating greater illicit substance use severity.
Change in Fagerstrom Test for Nicotine Dependence (FTND) total score from baseline at 4 weeks post-second dose
Self-report measure of nicotine use. Total scores range from 0 to 10, with higher scores indicating greater nicotine use severity.
Change in World Health Organization Disability Assessment Scale, v2.0 (WHODAS-2.0) 12-item, self-administered version total score from baseline at 4 days post-second dose
Self-report measure of symptom-related functional impairment in general. Total scores range from 12 to 60, with higher scores indicating greater functional impairment.
Change in Quality of Life Enjoyment & Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) percentage maximum score from baseline at 4 days post-second dose
Self-report measure of life satisfaction over the past week. Percentage maximum scores range from 0% to 100%, with higher percentages indicating greater life satisfaction.
Writing task
Online writing task in which participants describe their perceptions of their OCD symptoms with a short written essay
Columbia Suicide Severity and Risk Scale (C-SSRS) Since Last Visit version
Clinician-administered assessment of suicidal ideation and behaviors since the last study visit
Theoretical Orientation Profile Scale-Revised (TOPS-R)
Clinician-reported measure of theoretical orientation over 11 subscales, each corresponding to a different theoretical orientation. Subscale scores range from 1 to 30, with higher scores indicating greater affiliation with a particular theoretical orientation.
Working Alliance Inventory-Short Revised (WAI-SR)
Self-report measure of perceived working alliance with study clinicians. Total scores range from 0 to 60, with higher scores indicating stronger perceived working alliance.
Change in Symptom Provocation Task (SPT) ratings from baseline at 4 days post-second dose
Behavioral measure of OCD symptoms when provoked with idiosyncratic questions. Scores for compulsive urges range from 0-10 in terms of VAS ratings, with higher VAS ratings indicating greater compulsive urges.
Stanford Expectations of Treatment Scale (SETS)
Self-report measure of treatment expectancy over 2 subscales, corresponding to positive and negative expectancy. Subscale scores range from 7 to 21, with higher scores indicating more positive or negative expectancy.

Full Information

First Posted
April 19, 2022
Last Updated
July 21, 2023
Sponsor
Yale University
Collaborators
Steven & Alexandra Cohen Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT05370911
Brief Title
Effects of Repeated Psilocybin Dosing in OCD
Official Title
Effects of Repeated Dosing of Psilocybin on Obsessive-Compulsive Disorder: A Randomized, Waitlist-Controlled Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 20, 2023 (Actual)
Primary Completion Date
July 2026 (Anticipated)
Study Completion Date
July 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yale University
Collaborators
Steven & Alexandra Cohen Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study aims to investigate the effects of repeated dosing of oral psilocybin on obsessive-compulsive disorder (OCD) symptomatology in a randomized, waitlist-controlled design with blinded independent ratings, and assess psychological mechanisms that may mediate psilocybin's therapeutic effects on OCD.
Detailed Description
Aim 1: To examine the effects of two doses of psilocybin on OCD symptoms among participants in the immediate treatment condition, compared to participants in the waitlist control/delayed treatment condition. The investigators hypothesize that participants in the immediate treatment group will report statistically significantly greater symptom improvement from baseline 4 days post-second dose, compared to participants in the waitlist control/delayed treatment group at the same interval during their waitlist phase. Aim 2: To examine the effects of two doses of psilocybin on OCD symptoms, compared to one dose. The investigators hypothesize that two doses of oral psilocybin will reduce OCD symptoms to a statistically significantly greater extent than one dose. This study aims to investigate the effects of repeated dosing of oral psilocybin on OCD symptomatology and assess psychological mechanisms that may mediate psilocybin's therapeutic effects on OCD. This study will employ a randomized, waitlist-controlled design with blinded independent ratings, with participants randomized to receive either immediate treatment (two doses oral psilocybin separated by one week) or delayed treatment (7 weeks post-randomization). An adaptive dose selection strategy will be implemented, with the first dose being standardized at 25 mg of psilocybin, and the second dose being either the same or a higher dosage (i.e., 30 mg) on the basis of a clinically significant response from baseline or not, respectively, 4 days post-first dose. This study is conducted entirely on an outpatient basis with the possibility of remote/virtual follow-up visits after each dosing session. The dosing sessions last the entire day, and participants will be medically cleared prior to being permitted to return home with assistance (e.g., driven by a family member or friend, or ride share).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obsessive-Compulsive Disorder
Keywords
Psilocybin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
In the study, participants will be randomized to receive either immediate treatment with two doses of oral psilocybin separated by one week (n = 15) or enter a waitlist control/delayed treatment group and receive the same treatment 7 weeks post-randomization (n = 15).
Masking
Outcomes Assessor
Masking Description
Only the independent rater for each participant will be blinded to their condition; blind will be broken at the end of week 7 (i.e., 4 weeks post-second dosing), after which participants in the waitlist/delayed treatment group will begin their treatment phase.
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Immediate Treatment
Arm Type
Experimental
Arm Description
Participants randomized to this condition will receive treatment immediately, facilitated by two study staff members, and which consists of two preparatory sessions, followed by the first dosing session and two integration sessions, then the second dosing session and two integration sessions. This is followed by follow-up and long-term follow-up visits up to 12 months post-second dose.
Arm Title
Waitlist Control/Delayed Treatment
Arm Type
No Intervention
Arm Description
Participants randomized to this condition will first enter a waitlist phase that lasts for 7 weeks, after which rater unblinding will occur, and participants will be rescreened. If participants remain eligible at this time, they will begin their treatment phase. During their treatment phase, participants in this condition will receive the same treatment as described for participants in the immediate treatment group. This is followed by follow-up and long-term follow-up visits up to 12 months post-second dose.
Intervention Type
Drug
Intervention Name(s)
Psilocybin
Intervention Description
The first oral dose will be 25 mg, and the second dose will be either 25 mg or 30 mg, depending on response to first dose. Psilocybin is a naturally occurring hallucinogenic ingredient found in some varieties of mushrooms that can be produced synthetically. It is considered to be a serotonergic psychedelic. We will use synthetically produced oral psilocybin in this study. Other Names: "Magic Mushrooms"
Primary Outcome Measure Information:
Title
Change in Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II) Severity Scale total score from baseline at 4 days post-second dose
Description
Clinician-administered assessment of severity of OCD symptoms over the past seven days. The most prominent obsessions and compulsions are rated on the Severity Scale from 0 to 4. Total Y-BOCS-II scores range from 0 to 40, with higher scores indicating greater severity of OCD symptoms.
Time Frame
Baseline & 4 days post-second dose
Secondary Outcome Measure Information:
Title
Change in Montgomery-Asberg Depression Scale (MADRS) total score from baseline at 4 days post-second dose
Description
Clinician-administered assessment of severity of depressive symptoms over past month. Total scores range from 0 to 60, with higher scores indicating greater severity of depressive symptoms.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Dimensional Obsessive-Compulsive Scale (DOCS) total score from baseline at 4 days post-second dose
Description
Self-report measure of various OCD symptoms over the modified time frame of the past week. Total scores range from 0 to 140, with higher scores indicating greater severity of OCD symptoms.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Obsessive Beliefs Questionnaire-44 (OBQ-44) total score from baseline at 4 days post-second dose
Description
Self-report measure of various obsessive beliefs implicated in OCD in general. Total scores range from 44 to 308, with higher scores indicating greater severity of obsessive beliefs.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) total score from baseline at 4 days post-second dose
Description
Self-report measure of experiential avoidance and psychological flexibility in the context of OCD symptoms in general. Total scores range from 13 to 91, with higher scores indicating greater psychological inflexibility.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Tolerance of Uncontrollability Questionnaire (TOUQ) total score from baseline at 4 days post-second dose
Description
Self-report measure of ability to tolerate uncontrollability (or inversely need for control) in general. Total scores range from 19 to 133, with higher scores indicating greater tolerance of uncontrollability.
Time Frame
Baseline & 4 days post-second dose
Title
Change in White Bear Suppression Inventory (WBSI) total score from baseline at 4 days post-second dose
Description
Self-report measure of thought suppression tendencies in general. Total scores range from 15 to 75, with higher scores indicating stronger thought suppression tendencies.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Difficulties in Emotion Regulation Scale (DERS) total score from baseline at 4 days post-second dose
Description
Self-report measure of emotion regulation difficulties in general. Total scores range from 36 to 180, with higher scores indicating greater difficulties with regulating emotions.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Southampton Mindfulness Questionnaire (SMQ) total score from baseline at 4 days post-second dose
Description
Self-report measure of trait mindfulness in regards to distressing thoughts and images. Total scores range from 0 to 96, with higher scores indicating greater trait mindfulness.
Time Frame
Baseline & 4 days post-second dose
Title
Toronto Mindfulness Scale (TMS)
Description
Self-report measure of state mindfulness during dosing session. Total scores range from 0 to 52, with higher scores indicating greater state mindfulness.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Set, Setting, and Intentions (SSI) Scale
Description
Self-report measure of set, setting, and clarity of intentions just prior to dosing session. Total mean scores range from 0 to 100 (after reverse-scoring two items), with higher scores indicating greater preparedness for the dosing session.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Mystical Experience Questionnaire (MEQ)
Description
Self-report measure of acute mystical experiences during dosing. Total mean scores range from 0 to 5, with higher scores indicating greater mystical experiences.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Psychological Insight Questionnaire (PIQ)
Description
Self-report measure of acute psychological insights during dosing. Total mean scores range from 0 to 5, with higher scores indicating greater insightful experiences.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Challenging Experience Questionnaire (CEQ)
Description
Self-report measure of acute challenging experiences during dosing. Total mean transformed scores range from 0 to 1, with higher scores indicating greater challenging experiences.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Ego Dissolution Inventory (EDI)
Description
Self-report measure of acute experiences of ego dissolution during dosing. Total mean scores range from 0 to 100, with higher scores indicating greater ego dissolution.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Emotional Breakthrough Inventory (EBI)
Description
Self-report measure of different experiences of emotional breakthroughs during dosing. Total mean scores range from 0 to 100, with higher scores indicating greater emotional breakthrough.
Time Frame
Up to 3 weeks for immediate treatment condition, and up to 10 weeks for waitlist condition
Title
Change in Self-Compassion Scale (SCS) total mean score from baseline at 4 days post-second dose
Description
Self-report measure of self-compassion in general. Total mean scores range from 1 to 5 (after reverse-scoring 13 items), with higher scores indicating greater self-compassion.
Time Frame
Baseline & 4 days post-second dose
Title
Change in Ten-Item Personality Inventory (TIPI) total score from baseline at 4 days post-second dose
Description
Brief self-report measure of Big Five personality dimensions. Total scores range from 10 to 70 (after reverse-scoring 5 items), with higher scores indicating more positive personality traits.
Time Frame
Screening, 4 days and 12 months post-second dose
Title
Change in Persisting Effects Questionnaire (PEQ) subscale scores from 4 weeks post-second dose at 12 months post-second dose
Description
Self-report measure of persisting effects from dosing in general. Subscale scores range from a minimum of 0 to a maximum of 5 to 85, with higher scores indicating greater positive or negative persisting changes since dosing.
Time Frame
4 weeks post-second dose & 12 months post-second dose
Title
Change in Alcohol Use Disorders Identification Test (AUDIT) total score from baseline at 4 weeks post-second dose
Description
Self-report measure of alcohol use severity. Total scores range from 0 to 40, with higher scores indicating greater alcohol use severity.
Time Frame
Baseline & 4 weeks post-second dose
Title
Change in Drug Use Disorders Identification Test (DUDIT) total score from baseline at 4 weeks post-second dose
Description
Self-report measure of illicit substance use. Total scores range from 0 to 44, with higher scores indicating greater illicit substance use severity.
Time Frame
Baseline & 4 weeks post-second dose
Title
Change in Fagerstrom Test for Nicotine Dependence (FTND) total score from baseline at 4 weeks post-second dose
Description
Self-report measure of nicotine use. Total scores range from 0 to 10, with higher scores indicating greater nicotine use severity.
Time Frame
Baseline & 4 weeks post-second dose
Title
Change in World Health Organization Disability Assessment Scale, v2.0 (WHODAS-2.0) 12-item, self-administered version total score from baseline at 4 days post-second dose
Description
Self-report measure of symptom-related functional impairment in general. Total scores range from 12 to 60, with higher scores indicating greater functional impairment.
Time Frame
Baseline & 4 weeks post-second dose
Title
Change in Quality of Life Enjoyment & Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) percentage maximum score from baseline at 4 days post-second dose
Description
Self-report measure of life satisfaction over the past week. Percentage maximum scores range from 0% to 100%, with higher percentages indicating greater life satisfaction.
Time Frame
Baseline & 4 weeks post-second dose
Title
Writing task
Description
Online writing task in which participants describe their perceptions of their OCD symptoms with a short written essay
Time Frame
Baseline & 4 days post-second dose
Title
Columbia Suicide Severity and Risk Scale (C-SSRS) Since Last Visit version
Description
Clinician-administered assessment of suicidal ideation and behaviors since the last study visit
Time Frame
Every study visit through study completion, an average of 12 months and 3 weeks for immediate treatment condition, and an average of 12 months and 10 weeks for waitlist condition
Title
Theoretical Orientation Profile Scale-Revised (TOPS-R)
Description
Clinician-reported measure of theoretical orientation over 11 subscales, each corresponding to a different theoretical orientation. Subscale scores range from 1 to 30, with higher scores indicating greater affiliation with a particular theoretical orientation.
Time Frame
Baseline
Title
Working Alliance Inventory-Short Revised (WAI-SR)
Description
Self-report measure of perceived working alliance with study clinicians. Total scores range from 0 to 60, with higher scores indicating stronger perceived working alliance.
Time Frame
Up to 4 days post-second dose
Title
Change in Symptom Provocation Task (SPT) ratings from baseline at 4 days post-second dose
Description
Behavioral measure of OCD symptoms when provoked with idiosyncratic questions. Scores for compulsive urges range from 0-10 in terms of VAS ratings, with higher VAS ratings indicating greater compulsive urges.
Time Frame
Baseline & 4 days post-second dose
Title
Stanford Expectations of Treatment Scale (SETS)
Description
Self-report measure of treatment expectancy over 2 subscales, corresponding to positive and negative expectancy. Subscale scores range from 7 to 21, with higher scores indicating more positive or negative expectancy.
Time Frame
Baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Primary DSM-5 diagnosis of OCD, with Y-BOCS-II score of 26 or greater at screening Failed at least one medication and/or therapy trial of standard care treatment for OCD English fluency Agree to sign a medical release for investigators to communicate directly with participants' providers to confirm medication and psychotherapy histories or arrange contingencies in event of crises. Agree to provide an adult contact (relative, spouse, close friend or other caregiver) who is willing and able to be reached by the PI and/or study personnel in the event of an emergency, and who can provide transportation for study visits and independently comment on any changes in the participant's mood or behavior after each administration of psilocybin. Agree to commit to all study procedures. Ability to orally ingest pills for psilocybin dosing visits. Agree to adhere to lifestyle and medication modifications. Must not be on psychotropic medications for OCD or comorbid psychiatric conditions for at least 8 weeks at the time of randomization, and agree to refrain from taking or starting any psychiatric medications until after 4 weeks post-second dose. Must not be in current psychotherapy (CBT or ERP) and must not start new course of psychotherapy (CBT or ERP) for OCD or comorbid psychiatric conditions until after 4 weeks post-second dose. If participant is of childbearing potential, must have a negative pregnancy test at study entry and prior to each dosing session. If participant is of childbearing potential, agree to use adequate birth control and not attempt to become pregnant during study up to 4 weeks post-second dose. Exclusion Criteria: Personal or immediate (first-degree relative) family history of formally diagnosed schizophrenia or other psychotic disorders, or bipolar I/II disorder Lack of knowledge about biological families' medical history, due to adoption or other circumstance Active suicidal intent or suicidal or non-suicidal self-injurious behaviors Unremitted Tourette syndrome Lifetime diagnosis of autism spectrum disorder Current substance use disorder (except for mild alcohol use disorder) Any neurological condition, including history of seizure(s) or chronic/severe headaches Any history of head injury with loss of consciousness for more than 30 min Any use of classic psychedelic substances within the prior 12 months Unwillingness to abstain from use of classic psychedelics outside of the study up to 4 weeks post-second dose. Use of tobacco products or a THC-containing product more than 2 times per week on average over the past 30 days at screening. Unwilingness or inability to abstain from use of tobacco or THC-containing products from 1 week prior to randomization up to 4 weeks post-second dose. Positive urine drug test for any prohibited substance at screening or days of dosing, or positive breathalyzer test for alcohol on days of dosing Unwillingness or inability to abstain from alcohol use at least 24 hours prior to the days of dosing, up to 24 hours after each dosing day (or corresponding intervals for waitlist group). Any medical conditions that may render study procedures unsafe, including hypertension, history of cardiovascular disease, moderate-to-severe hepatic or renal impairment, diabetes, and hypo- or hyperthyroidism.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yale OCD Clinic Psychedelic Research
Phone
203-623-3023
Email
psychedelicresearch@yale.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benjamin Kelmendi, MD
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Terence Ching, PhD
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christopher Pittenger, MD, PhD
Organizational Affiliation
Yale University
Official's Role
Study Director
Facility Information:
Facility Name
Connecticut Mental Health Center
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06519
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yale OCD Clinic Psychedelic Research
Phone
203-623-3023
Email
psychedelicresearch@yale.edu
First Name & Middle Initial & Last Name & Degree
Benjamin Kelmendi, MD
First Name & Middle Initial & Last Name & Degree
Terence Ching, PhD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
17196053
Citation
Moreno FA, Wiegand CB, Taitano EK, Delgado PL. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006 Nov;67(11):1735-40. doi: 10.4088/jcp.v67n1110.
Results Reference
background
PubMed Identifier
33146667
Citation
Davis AK, Barrett FS, May DG, Cosimano MP, Sepeda ND, Johnson MW, Finan PH, Griffiths RR. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021 May 1;78(5):481-489. doi: 10.1001/jamapsychiatry.2020.3285. Erratum In: JAMA Psychiatry. 2021 Feb 10;:
Results Reference
background
PubMed Identifier
27909164
Citation
Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, Mennenga SE, Belser A, Kalliontzi K, Babb J, Su Z, Corby P, Schmidt BL. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol. 2016 Dec;30(12):1165-1180. doi: 10.1177/0269881116675512.
Results Reference
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PubMed Identifier
27909165
Citation
Griffiths RR, Johnson MW, Carducci MA, Umbricht A, Richards WA, Richards BD, Cosimano MP, Klinedinst MA. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016 Dec;30(12):1181-1197. doi: 10.1177/0269881116675513.
Results Reference
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Effects of Repeated Psilocybin Dosing in OCD

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