Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial
In a double-blind, placebo-controlled crossover trial of 29 patients with cancer-related anxiety and depression, a single moderate dose of psilocybin (0.3 mg/kg) given with psychotherapy produced rapid, substantial and sustained reductions in anxiety and depression versus niacin, with around 60–80% of participants maintaining clinically significant improvements at 6.5 months. Psilocybin also reduced demoralisation and hopelessness, improved spiritual wellbeing, quality of life and attitudes to death, and the intensity of the psilocybin-induced mystical experience mediated its therapeutic effects.
Authors
- Gabrielle Agin-Liebes
- Stephen Ross
- James Guss
Published
Abstract
Background
Clinically significant anxiety and depression are common in patients with cancer, and are associated with poor psychiatric and medical outcomes. Historical and recent research suggests a role for psilocybin to treat cancer-related anxiety and depression.
Methods
In this double-blind, placebo-controlled, crossover trial, 29 patients with cancer-related anxiety and depression were randomly assigned and received treatment with single-dose psilocybin (0.3 mg/kg) or niacin, both in conjunction with psychotherapy. The primary outcomes were anxiety and depression assessed between groups prior to the crossover at 7 weeks.
Results
Prior to the crossover, psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life. At the 6.5-month follow-up, psilocybin was associated with enduring anxiolytic and anti-depressant effects (approximately 60–80% of participants continued with clinically significant reductions in depression or anxiety), sustained benefits in existential distress and quality of life, as well as improved attitudes towards death. The psilocybin-induced mystical experience mediated the therapeutic effect of psilocybin on anxiety and depression.
Conclusions
In conjunction with psychotherapy, single moderate-dose psilocybin produced rapid, robust and enduring anxiolytic and anti-depressant effects in patients with cancer-related psychological distress.
Research Summary of 'Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial'
Introduction
Persistent, clinically significant anxiety and/or depressive symptoms affect a substantial proportion of patients with cancer and are associated with poorer medical and psychosocial outcomes, including increased healthcare use, reduced quality of life, greater hopelessness and higher suicide risk. Existing pharmacological and psychosocial treatments for cancer-related psychological distress have mixed efficacy, delayed onset for antidepressants, notable side effects, and no approved medications specifically for this indication. Previous open-label and early controlled trials with serotonergic psychedelics suggested potential benefits for cancer-related existential distress, and growing evidence links higher existential/spiritual wellbeing with better psychological outcomes in cancer care. Ross and colleagues set out to test whether a single moderate oral dose of psilocybin (0.3 mg/kg), administered alongside a manualised psychotherapy platform, would reduce anxiety and depression in patients with life‑threatening cancer compared with an active control (niacin 250 mg) plus the same psychotherapy. The trial aimed to assess both immediate effects and durability up to several months, and to examine whether the intensity of mystical-type subjective experiences mediated clinical outcomes.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
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- APA Citation
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., Su, Z., Corby, P., & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165-1180. https://doi.org/10.1177/0269881116675512
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