Long term efficacy of psilocybin in patients with cancer and major depressive disorder (MDD).
Manish Agrawal, Sarah Shnayder, Heather Honstein, Ezekiel Emanuel, Paul Thambi
Journal of Clinical Oncology June 1, 2023 DOI: 10.1200/jco.2023.41.16_suppl.12021 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Longitudinal follow-up of a single-arm trial Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Adults with curable or metastatic cancer and major depressive disorder |
| Interventions | Psilocybin group therapy individual psychological therapy |
| Dose | 25 mg |
| Duration | Single-dose intervention, 18-month follow-up |
| Topics | Anxiety Depression Psilocybin |
| Keywords | Depression economics Rating scale Hallucinogen |
| Citations | 2 |
| Key findings | A single dose of psilocybin with psychological support produced sustained clinical response and remission from depression in cancer patients at 18 months. |
Abstract
12021
Background: Up to 25% of people living with cancer have depression. Existing psychological interventions have limited efficacy in treating depression. Psilocybin, a 5-hydroytrptamintergic psychedelic, coupled with group therapy is safe and effective in ameliorating symptoms of depression (Agrawal et al, ASCO 2022). Response to psilocybin treatment was observed in 83.3% of patients at 8 weeks, and 50% of patients showed full remission of depressive symptoms. This study evaluates the efficacy of psilocybin-assisted group therapy in relieving depression in cancer patients over 18 months.
Methods: Adults with curable or metastatic cancer and MDD (according to DSM-5) underwent psychological assessments at baseline. They were treated with single-dose psilocybin 25 mg administered simultaneously in group cohorts of 3-4, supported with group and individual psychological therapy, and evaluated at 8 weeks and 18 months. Primary objectives were long-term effectiveness on depression and anxiety severity (as measured by change in Montgomery Asberg Depression Rating Scale [MADRS] and Hamilton Depression Rating Scale [HAM-A] scores by independent rater assessments) as well as clinical response (≥50% decrease in MADRS total score from baseline to 18 months) and remission (defined as patients with a MADRS total score ≤10 at 18 months).
Results: Of 30 patients enrolled in the parent study, 2 died and 4 were lost to follow-up. Clinical response was demonstrated in 18/28 patients (64.2%) from baseline to 18 months follow-up (see table); 16/28 patients (57.1%) demonstrated remission of depression at 18 months. In 24 evaluable patients, continued reduction in mean depression severity scores was also demonstrated from baseline to week 8 (MADRS by 20.6 points [95% CI 23.2, 18.0, p < 0.001] and HAMA-A by 16.7 points [95% CI 19.7, 13.7, p < 0.001]) and from baseline to 18 months (MADRS by 16.7 points [95% CI 20.4, 12.9, p < 0.001] and HAMA-A by 14.4 points [95% CI 17.3, 11.4, p < 0.001]).
Conclusions: Long-term follow-up suggests continued robust clinical response and remission from depression with a single dose of psilocybin and simultaneous psychological support in patients with cancer and MDD. These findings indicate psilocybin may play a role in treatment of depression in cancer patients, and further investigations are ongoing. [Table: see text]