Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life threatening cancer: a randomized controlled trial
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. Trial Registration: ClinicalTrials.gov Identifier: NCT00957359
Journal of psychopharmacology