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Brian D. Richards

Gladstone Institutes

8 papers in the library · 3,923 citations · publishing 2011-2025

Papers

Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

Journal of Psychopharmacology November 30, 2016 Annie Umbricht, Mary P Cosimano, Roland R. Griffiths et al. 2,174 citations

In cancer patients with life-threatening diagnoses and symptoms of depression or anxiety, a high dose of psilocybin (22 or 30 mg/70 kg) produced large decreases in depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety, compared with a very low placebo-like dose (1 or 3 mg/70 kg). At 6-month follow-up, about 80% of participants continued to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life, mood, relationships, and spirituality to the high-dose experience, with over 80% endorsing moderately or greater increased well-being or life satisfaction. The mystical-type experience during the session mediated the effect of dose on therapeutic outcomes.

Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects.

Psychopharmacology December 1, 2011 Roland R. Griffiths, Matthew W Johnson, William A Richards et al. 938 citations

Psilocybin can produce mystical-type experiences that lead to lasting positive changes in attitudes, mood, and behavior. In a double-blind study, 18 adults (17 with no prior hallucinogen use) received 0, 5, 10, 20, or 30 mg/70 kg psilocybin in five sessions under supportive conditions. At the two highest doses, 72% of volunteers reported a mystical-type experience, and 39% experienced extreme anxiety or fear. One month later, participants rated these sessions as having substantial personal and spiritual significance, with the ascending dose sequence showing greater positive effects. At 14 months, these positive ratings remained undiminished and were consistent with observer reports. The effects generally increased with dose.

Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors

Journal of Psychopharmacology October 11, 2017 Roland R. Griffiths, Matthew W. Johnson, William A. Richards et al. 528 citations

A double-blind trial compared a high dose of psilocybin (20 and 30 mg/70 kg) with a very low dose (1 mg/70 kg) in healthy adults who also undertook a program of meditation and spiritual practices. At six months, the high-dose groups, compared with the low-dose group, showed large, significant positive changes in interpersonal closeness, gratitude, life meaning, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. The enduring trait-level increases in prosocial attitudes and healthy psychological functioning were linked to the mystical-type experience occasioned by psilocybin and the rate of meditation or spiritual practices.

Development and Evaluation of a Therapist Training Program for Psilocybin Therapy for Treatment-Resistant Depression in Clinical Research

Frontiers in Psychiatry February 3, 2021 Sara Tai, Elizabeth M. Nielson, Molly Lennard-Jones et al. 87 citations

A therapist training program for psilocybin therapy, developed for a phase IIb international, multicenter, randomized controlled study of treatment-resistant depression, is described. The manualized approach, based on evidence-based psychotherapeutic methods and approved by the FDA, includes online learning, in-person training, applied clinical training, and ongoing mentoring. After training 65 health care professionals across the US, Canada, and Europe, feedback indicated that didactic and experiential learning helped build conceptual understanding and skills. Clinical training and participant care under experienced therapists were most beneficial and challenging. Rigorous, scalable training requires collaboration among public, academic, and industry partners.

Psilocybin‐assisted group therapy in patients with cancer diagnosed with a major depressive disorder

Cancer December 18, 2023 Manish Agrawal, Yvan Beaussant, Sarah Shnayder et al. 73 citations

A single 25-mg dose of psilocybin, administered alongside one-to-one and group therapeutic support, was safe and feasible for patients with curable and noncurable cancer who also had major depressive disorder. In a phase 2 open-label trial with 30 participants, no serious adverse events or suicidality occurred, and mild side effects like nausea and headache were as expected. Depression severity scores dropped by an average of 19.1 points from baseline to eight weeks after treatment. Eighty percent of participants showed a sustained response, and half achieved full remission of depressive symptoms by week one that lasted for eight weeks. The group-oriented format and compact delivery in a community cancer center may add to therapeutic gains.

Top Ten Tips Palliative Care Clinicians Should Know About Psychedelic-Assisted Therapy in the Context of Serious Illness.

Journal of Palliative Medicine August 1, 2022 William E Rosa, Zachary Sager, Megan Miller et al. 49 citations

Psychedelic-assisted therapy (PAT) is a promising treatment for conditions like treatment-resistant depression, substance use disorder, and PTSD. In palliative care, a single PAT session can produce lasting reductions in anxiety, depression, and demoralization—symptoms that harm quality of life for seriously ill and end-of-life patients. Although interest in psychedelics has revived, few resources exist for applying PAT in hospice and palliative care. This article provides 10 evidence-informed tips for palliative care clinicians, developed with international experts, to help familiarize teams with PAT, address legal and logistical barriers, discuss therapeutic competencies, and highlight approaches to maximize safety and benefits for patients and caregivers.

Assessment of Psilocybin Therapy for Patients With Cancer and Major Depression Disorder

JAMA Oncology April 13, 2023 Manish Agrawal, Ezekiel Emanuel, Brian D. Richards et al. 48 citations

In a nonrandomized controlled trial, psilocybin was administered to groups of patients with cancer who also had major depressive disorder, using a one-to-one therapist-to-patient ratio. The aim was to develop a scalable, rapidly effective depression treatment. The trial suggests that this approach may offer a feasible model for delivering psilocybin therapy to larger numbers of patients while maintaining therapeutic support.

An international Delphi consensus for reporting of setting in psychedelic clinical trials.

Nature Medicine June 3, 2025 Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman et al. 26 citations

A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.