Long-Term Improvement in Distress Achieved With Psilocybin in Patients With Life-Threatening Cancer

Cancer survivors often must deal with psychological after-effects.
Cancer survivors often must deal with psychological after-effects.
All patients in this study reported positive behavioral change as much as 4.5 years after treatment with a single dose of psilocybin.

Psilocybin-assisted psychotherapy appeared to be associated with long-term reductions in distress among patients with life-threatening cancer. Results of this recent analysis were published in the Journal of Psychopharmacology.

In this crossover study, patients (N=29) who had psychiatric distress in connection with cancer initially received either a 0.3-mg/kg dose of psilocybin or 250 mg of niacin as a control. At a second session, patients switched treatments, so that each patient ultimately was given a single dose of psilocybin. All patients additionally received psychotherapy. The study included 2 long-term follow-ups that were analyzed for this report.

The first long-term follow-up occurred at a mean of 3.2 years (range, 2.3-4.5) after psilocybin treatment; the second one occurred at a mean of 4.5 years (range, 3.5-5.5) after treatment. Among patients who entered the study, 16 remained alive, and 14 were available for both long-term follow-ups.

At the 4.5-year follow-up, 57% of patients had clinically significant anxiolytic responses. Clinically significant antidepressant responses were reported for 57% to 79% of patients, depending on the screening tool used for analysis. In an analysis that considered anxiety and depression together, clinically significant responses were seen in 71% of patients. Improvements were also prominent in areas of demoralization, hopelessness, and death anxiety.

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All participants at the 4.5-year follow-up indicated they had experienced a positive behavioral change related to the psilocybin treatment. Most patients also considered this treatment to have provided an experience that was spiritually significant, personally meaningful, and/or a contributor to well-being or life satisfaction.

The researchers noted that the study’s crossover design may constrain interpretations, but in their report they wrote that “the treatment continues to be associated with reductions in anxiety, depression, hopelessness, demoralization, and death anxiety up to an average of 4.5 years following a single psilocybin session in conjunction with psychotherapy.”

Reference

Agin-Liebes GI, Malone T, Yalch MM, et al. Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer. J Psychopharmacol. 2020;34(2):155-166.