Top Ten Tips Palliative Care Clinicians Should Know About Psychedelic-Assisted Therapy in the Context of Serious Illness.
William E Rosa, Zachary Sager, Megan Miller, Ilan Bernstein, Alden Doerner Rinaldi, Katie Addicott, Michael Ljuslin, Chris Adrian, Anthony L. Back, Jamie Beachy, Anthony P. Bossis, William Breitbart, Mary P Cosimano, Stacy M. Fischer, Jeffrey Guss, Emma Knighton, Janis Phelps, Brian D. Richards, William A Richards, James A. Tulsky, Monnica T. Williams, Yvan Beaussant
Journal of Palliative Medicine August 1, 2022 DOI: 10.1089/jpm.2022.0036 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Population | Palliative care clinicians and patients |
| Topics | Anxiety Depression LSD MDMA Psilocybin Psychedelic-assisted therapy End-of-life distress |
| Keywords | Anxiety treatment Demoralization Palliative care Psychedelics Serious illness Psychological support |
| Citations | 49 |
| Key findings | Psychedelic-assisted therapy can safely and effectively reduce anxiety, depression, and demoralization in seriously ill and end-of-life patients, but practical guidance for palliative care clinicians remains limited. |
Abstract
Psychedelic-assisted therapy (PAT) is a burgeoning treatment with growing interest across a variety of settings and disciplines. Empirical evidence supports PAT as a novel therapeutic approach that provides safe and effective treatment for people suffering from a variety of diagnoses, including treatment-resistant depression, substance use disorder, and post-traumatic stress disorder. Within the palliative care (PC) field, one-time PAT dosing may lead to sustained reductions in anxiety, depression, and demoralization-symptoms that diminish the quality of life in both seriously ill patients and those at end of life. Despite a well-noted psychedelic renaissance in scholarship and a renewed public interest in the utilization of these medicines, serious illness-specific content to guide PAT applications in hospice and PC clinical settings has been limited. This article offers 10 evidence-informed tips for PC clinicians synthesized through consultation with interdisciplinary and international leading experts in the field with aims to: (1) familiarize PC clinicians and teams with PAT; (2) identify the unique challenges pertaining to this intervention given the current legalities and logistical barriers; (3) discuss therapeutic competencies and considerations for current and future PAT use in PC; and (4) highlight critical approaches to optimize the safety and potential benefits of PAT among patients with serious illness and their caregivers.
In the evidence
This study is part of the evidence base for 4 syntheses in the library. Here is how each one recorded it.
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Reports that empirical evidence supports psychedelic-assisted therapy as safe and effective for reducing anxiety, depression, and demoralization in seriously ill and end-of-life patients, while noting limited practical guidance.
Synthesized
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Psychedelic-assisted therapy may lead to sustained reductions in anxiety, depression, and demoralization in seriously ill and end-of-life patients.
Synthesized
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Argues that psychedelic-assisted therapy can safely and effectively reduce anxiety, depression, and demoralization in seriously ill and end-of-life patients, though practical guidance is limited.
Synthesized
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Reports that one-time psychedelic-assisted therapy may produce sustained reductions in anxiety, depression, and demoralization in seriously ill and end-of-life patients, while noting limited practical guidance for clinicians.
Synthesized
Comparable studies
Other narrative reviews on psilocybin for end-of-life distress, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The Potential of Psychedelics for End of Life and Palliative Care. Patients with life-threatening diagnoses | 2022 | Review | |
| Psilocybin in Palliative Care: An Update. Palliative care patients | 2023 | Review | |
| Psilocybin-assisted psychotherapy for existential distress: practical considerations for therapeutic application—a review | 2024 | Narrative review | |
| Psychedelics for the treatment of end-of-life distress in patients with a life-threatening disease. Patients with life-threatening disease and end-of-life distress | 2025 | Review | |
| Meaning and Psychedelics in Palliative Care: A Narrative Review. Patients with advanced illnesses in palliative care | 2026 | Narrative review |
Citations in the library
Cited by 17
- Psilocybin in Palliative Care: An Update. Current geriatrics reports 2023
- The perceptions of cancer health-care practitioners in New Zealand and the USA toward psychedelic-assisted therapy with cancer patients: A cross-sectional survey Palliative & Supportive Care November 3, 2022
- Psychedelics, epilepsy, and seizures: a review Frontiers in Pharmacology January 12, 2024
- Ethical issues with psychedelic-assisted treatments in psychiatry: A systematic scoping review Psychological Medicine 2025
- Developing a Direct Observation Measure of Therapeutic Connection in Psilocybin-Assisted Therapy: A Feasibility Study Journal of Palliative Medicine August 17, 2023
and 12 more in the library
Cites 49
- 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
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs Frontiers in Human Neuroscience 2014
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
and 44 more in the library