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Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer

Gabrielle Agin-Liebes, Tara C. Malone, Matthew M. Yalch, Sarah E. Mennenga, Katherine Ponte, Jeffrey Guss, Anthony P. Bossis, Jim Grigsby, Stacy M. Fischer, Stephen Ross

Journal of Psychopharmacology January 9, 2020 DOI: 10.1177/0269881119897615 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Long-term within-subjects follow-up analysis Randomized Peer reviewed
Sample size 15
Population Participants with cancer-related psychiatric distress who completed a parent randomized controlled trial of psilocybin-assisted psychotherapy
Intervention Psilocybin-assisted psychotherapy
Duration Average of 3.2 and 4.5 years following psilocybin administration
Topics Psilocybin End-of-life distress Psychedelic-assisted therapy
Keywords Cancer Distress Psychotherapist Existentialism Term time Hallucinogen Clinical psychology
Citations 353
Key points Psilocybin-assisted psychotherapy produced sustained reductions in anxiety, depression, hopelessness, demoralization, and death anxiety at 3.2 and 4.5 years after administration, with 60–80% of participants still meeting criteria for clinically significant antidepressant or anxiolytic responses.

Abstract

Background: A recently published randomized controlled trial compared single-dose psilocybin with single-dose niacin in conjunction with psychotherapy in participants with cancer-related psychiatric distress. Results suggested that psilocybin-assisted psychotherapy facilitated improvements in psychiatric and existential distress, quality of life, and spiritual well-being up to seven weeks prior to the crossover. At the 6.5-month follow-up, after the crossover, 60–80% of participants continued to meet criteria for clinically significant antidepressant or anxiolytic responses.

Methods: The present study is a long-term within-subjects follow-up analysis of self-reported symptomatology involving a subset of participants that completed the parent trial. All 16 participants who were still alive were contacted, and 15 participants agreed to participate at an average of 3.2 and 4.5 years following psilocybin administration.

Results: Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at the first and second follow-ups. Within-group effect sizes were large. At the second (4.5 year) follow-up approximately 60–80% of participants met criteria for clinically significant antidepressant or anxiolytic responses. Participants overwhelmingly (71–100%) attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives.

Conclusion: These findings suggest that psilocybin-assisted psychotherapy holds promise in promoting long-term relief from cancer-related psychiatric distress. Limited conclusions, however, can be drawn regarding the efficacy of this therapy due to the crossover design of the parent study. Nonetheless, the present study adds to the emerging literature base suggesting that psilocybin-facilitated therapy may enhance the psychological, emotional, and spiritual well-being of patients with life-threatening cancer.

In the evidence

This study is part of the evidence base for 3 syntheses in the library. Here is how each one recorded it.

  • State of the evidence: Psilocybin and psychedelic-assisted therapy Supports

    Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at 3.2 and 4.5 years, with 60-80% meeting response criteria.

    Synthesized

  • State of the evidence: Psilocybin for end-of-life distress Supports

    Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at 3.2 and 4.5 years, with 60-80% still meeting criteria for clinically significant antidepressant or anxiolytic response.

    Synthesized

  • State of the evidence: End-of-life distress Supports

    Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at roughly 3.2 and 4.5 years after psilocybin-assisted psychotherapy, with large within-group effect sizes and 60-80% still meeting criteria for clinically significant antidepressant or anxiolytic responses.

    Synthesized

Comparable studies

Other experimental studies on end-of-life distress, most cited first.

Study Year Design Participants
The Effect of the Meditation Based Mandala Programme on Distress, Anxiety and Depression in the Caregivers of Cancer Patients in Palliative Care Unit. Caregivers of cancer patients in a palliative care unit 2023 Quasi-experimental study, single-group pre-test/post-test design n = 11
Mindfulness-Based Nursing Intervention for Anxiety and Quality of Life in Palliative Cancer Care: A Quasi-Experimental Study Advanced cancer patients in palliative care, predominantly female (60.0%), with stage... 2026 Quasi-experimental study

Citations in the library

Cited by 302

and 297 more in the library

Cites 32

and 27 more in the library

Related reading

Explore topics

Psilocybin End-of-life distress Psychedelic-assisted therapy Anxiety Depression

By condition and practice

Psilocybin and psychedelic-assisted therapy Psilocybin for end-of-life distress