Major Depressive Disorder (MDD)Depressive DisordersAnxiety DisordersSuicidalityPalliative & End-of-Life DistressSafety & Risk ManagementPsilocybin

Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases-A Systematic Review and Meta-Analysis of Clinical Trials

This meta-analysis (n=92) highlights the large, and positive effects of psilocybin-assisted psychotherapy for depression and anxiety related to life-threatening diseases (end-of-life anxiety), it also recommends using it in the first-line (considering the safety profile).

Authors

  • Vargas, A. S.
  • Luís, Â.
  • Barroso, M.

Published

Biomedicines
meta Study

Abstract

“Psilocybin is a naturally occurring tryptamine known for its psychedelic properties. Recent research indicates that psilocybin may constitute a valid approach to treat depression and anxiety associated with life-threatening diseases. The aim of this work was to perform a systematic review with meta-analysis of clinical trials to assess the therapeutic effects and safety of psilocybin on those medical conditions. The Beck Depression Inventory (BDI) was used to measure the effects in depression and the State-Trait Anxiety Inventory (STAI) was used to measure the effects in anxiety. For BDI, 11 effect sizes were considered (92 patients) and the intervention group was significantly favored (WMD = -4.589; 95% CI = -4.207 to -0.971; p-value = 0.002). For STAI-Trait, 11 effect sizes were considered (92 patients), being the intervention group significantly favored when compared to the control group (WMD = -5.906; 95% CI = -7.852 to -3.960; p-value ˂ 0.001). For STAI-State, 9 effect sizes were considered (41 patients) and the intervention group was significantly favored (WMD = -6.032; 95% CI = -8.900 to -3.164; p-value ˂ 0.001). The obtained results are promising and emphasize the importance of psilocybin translational research in the management of symptoms of depression and anxiety, since the compound may be effective in reducing symptoms of depression and anxiety in conditions that are either resistant to conventional pharmacotherapy or for which pharmacologic treatment is not yet approved. Moreover, it may be also relevant for first-line treatment, given its safety.”

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Research Summary of 'Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases-A Systematic Review and Meta-Analysis of Clinical Trials'

Introduction

Major depressive disorder and clinically significant anxiety are common in patients with life-threatening illnesses and contribute to poorer medical outcomes, reduced quality of life and increased suicidality. Conventional pharmacotherapies and neurostimulation approaches have limited efficacy for many patients, have delayed onset or problematic side-effect profiles, and there are no FDA-approved medicines specifically for psychological distress related to life-threatening disease. Interest has grown in alternative approaches including esketamine, MDMA and LSD; classic serotonergic hallucinogens such as psilocybin have also been investigated but require further systematic evaluation. Vargas and colleagues set out to perform a PRISMA-compliant systematic review and meta-analysis of clinical trials that assessed the therapeutic effects and safety of psilocybin for depression and anxiety associated with life-threatening illnesses. The investigators pre-specified the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) as primary psychometric outcomes and sought to examine moderators such as dose and follow-up time as well as physiological effects and safety signals.

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Study Details

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