Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.
Cancer patients often develop a chronic, clinically significant syndrome of psychosocial distress having depressed mood, anxiety, and reduced quality of life as core features, with up to 40% of cancer patients meeting criteria for a mood disorder. In cancer patients, depression and anxiety have been associated with decreased treatment adherence, prolonged hospitalization, decreased quality of life, and increased suicidality. Antidepressants and, less frequently, benzodiazepines are used to treat depressed mood and anxiety in cancer patients, although evidence suggesting efficacy is limited and conflicting, and benzodiazepines are generally only recommended for short-term use because of side effects and withdrawal. Although psychological approaches have shown only small to medium effects in treating emotional distress and quality of life, there are several promising interventions utilizing psilocybin and existential orientations to psychotherapy (Breitbart et al., 2015; Spiegel, 2015).
The classic hallucinogens, which include psilocybin (psilocin) and (+)-lysergic acid diethylamide (LSD), are a structurally diverse group of compounds that are 5-HT2A receptor agonists and produce a unique profile of changes in thoughts, perceptions, and emotions (Halberstadt, 2015; Nichols, 2016). Several unblinded studies in the 1960s and 70s suggested that such compounds might be effective in treating psychological distress in cancer patients; however, these studies did not include the comparison conditions that would be expected of modern psychopharmacology trials.
Subsequently, human research with these compounds was halted for almost three decades because of safety and other concerns raised in response to widespread non-medical use in the 1960s. Recent resumption of clinical research with these compounds has established conditions for safe administration and are seeing very promising results using psilocybin as its main subject medicine.
