Depressive DisordersAnxiety DisordersPalliative & End-of-Life Distress

Therapeutic use of classic psychedelics to treat cancer-related psychiatric distress

This systematic review (2018) investigated studies that used psychedelics for the treatment of psychological distress related to cancer. It found 10 studies (n=445) that qualified of which four (n=104) were randomised controlled trials. Overall studies showed improvements in anxiety, depression, and fear of death.

Authors

  • Stephen Ross

Published

International Review of Psychiatry
meta Study

Abstract

Cancer is highly prevalent and one of the leading causes of global morbidity and mortality. Psychological and existential suffering is common in cancer patients, associated with poor psychiatric and medical outcomes. Promising early-phase clinical research (1960s to early 1970s) suggested a therapeutic signal for serotoninergic psychedelics (e.g. psilocybin, LSD) in treating cancer-related psychiatric distress. After several decades of quiescence, research on psychedelic-assisted therapy to treat psychiatric disorders in cancer patients has resumed within the last 2 decades in the US and Europe. This review article is based on a systematic search of clinical trials from 1960-2018 researching the therapeutic use of psychedelic treatment in patients with serious or terminal illnesses and related psychiatric illness. The search found 10 eligible clinical trials, with a total of 445 participants, with the vast majority of the patients having advanced or terminal cancer diagnoses. Six open label trials, published between 1964 and 1980 (n = 341), suggested that psychedelic therapy (mostly with LSD) may improve cancer-related depression, anxiety, and fear of death. Four RCTs trials were published between 2011 and 2016 (n = 104), mostly with psilocybin treatment (n = 92), and demonstrated that psychedelic-assisted treatment can produce rapid, robust, and sustained improvements in cancer-related psychological and existential distress.

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Research Summary of 'Therapeutic use of classic psychedelics to treat cancer-related psychiatric distress'

Introduction

Ross frames the review around the clinical use of classic serotoninergic psychedelics (notably psilocybin and LSD) to treat psychiatric and existential distress in patients with cancer. Earlier clinical work from the 1960s and early 1970s produced promising early‑phase signals, particularly for cancer‑related psychological and existential distress, but research was interrupted by regulatory changes and only resumed in earnest in the early 1990s and 2000s. The author emphasises that contemporary trials are still relatively small and early‑phase, so while findings are encouraging they are not yet definitive with respect to establishing treatment efficacy. This paper sets out to systematically review clinical trials from the historical period and the recent resurgence of research, focusing on trials that treated seriously ill or terminal patients with classical psychedelics. Ross intends to describe the prevalence and impact of psychiatric and existential distress in cancer patients, review the historical and contemporary clinical trial literature on serotoninergic psychedelics for these indications, and discuss implications for future research and clinical availability of psychedelic‑assisted therapy in this vulnerable population.

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