Introducing the Evidence: Psilocybin for Depression and Anxiety in Cancer Patients


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By Laetitia Vanderijst


Research into psychedelic-assisted therapy has boomed in the last decade, yielding promising results and giving rise to claims of a paradigm shift in the treatment of psychiatric disorders. In this series of blog articles, we walk you through the evidence regarding the therapeutic applications of psychedelics. Today, we zoom in on the potential of psilocybin to address depression and anxiety symptoms in patients with terminal cancer.


Cancer diagnoses are often associated with mood and adjustment disorders that can be highly debilitating [1]. The usual pharmacotherapies used to treat these mental health difficulties are not as effective as they should be, with a high rate of relapse and non-negligible side effects [2]. Very promising evidence suggests that psilocybin-assisted therapy can provide considerable relief to terminal cancer patients suffering from depression and anxiety.


At first, a pilot study [3] set out to investigate the safety and efficacy of psilocybin-assisted therapy in a sample of 12 advanced-stage patients with reactive anxiety. The observed psychological and physiological responses confirmed the safety of the approach and participants showed considerable, long-lasting decreases in anxiety and depression scores after a single psilocybin intake.


Following these promising results, two larger scale studies took place, both following a randomized double-blind placebo controlled design, aka the Rolls Royce of experimental designs. The first study [4] counted 29 participants split into two groups. One group was first administrated psilocybin then niacin (an active placebo) and the other group inversely.The ‘psilocybin first group’ showed immediate anxiety and depression reduction, with the effects sustaining up to the final evaluation, 26 weeks later. The ‘niacin first group’ showed no significant symptom reduction until the administration of psilocybin at the second session. Compared to niacin, psilocybin significantly improved the spiritual well-being and quality of life of cancer patients, as well as their attitude and adaptation towards death. These therapeutic outcomes were mediated by the quality and intensity of the participants’ mystical experience during psilocybin intake. The second study [5] consisted of 51 patients and confirmed the previously observed results: a single high-dose of psilocybin with therapy produced large reductions in anxiety and depression symptoms. These results were still significant in over three-fourth of the patients at 6-month followup.


With such data, the obvious conclusion of the authors was that psilocybin in combination with

psychotherapy might become a new and effective treatment for cancer-related psychosocial distress. In fact, informed by these results Health Canada has since then approved over 25 applications from cancer patients, allowing them to undergo psilocybin-assisted therapy for end-of-life distress [6]. The Psychedelic Society Belgium is aiming to make that a reality in Belgium, too.



 


[1] Li, M., Fitzgerald, P., & Rodin, G. (2012). Evidence-Based Treatment of Depression in Patients With Cancer. Journal of Clinical Oncology, 30(11), 1187-1196.


[2] 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 lifethreatening cancer: a randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–80. doi: 10.1177/0269881116675512


[3] Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., &

Greer, G. R. (2011). Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-

Stage Cancer. Archives of General Psychiatry, 68(1), 71–78. https://doi.org/10.1001/archgenpsychiatry.2010.116



[4] 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 lifethreatening cancer: a randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–80. doi: 10.1177/0269881116675512


[5] Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B.

D., Cosimano, M. P., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained

decreases in depression and anxiety in patients with life-threatening cancer: A randomized doubleblind trial. Journal of Psychopharmacology, 30(12), 1181–1197. https://doi.org/10.1177/0269881116675513


[6] Bains, C. (2021, January 18). Patient hopes Canada will introduce regulations for treatment with 'magic mushrooms’. The Canadian Press. https://www.ctvnews.ca/health/patient-hopes-canadawill-introduce-regulations-for-treatment-with-magic-mushrooms-1.5270875







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