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Psychedelic-assisted therapy for treating anxiety, depression, and existential distress in people with life-threatening diseases

Sivan Schipper, Kabir Nigam, Yasmin Schmid, Vanessa Piechotta, Michael Ljuslin, Yvan Beaussant, Guido Schwarzer, Christopher Boehlke

Cochrane Database of Systematic Reviews September 11, 2024 DOI: 10.1002/14651858.cd015383.pub2 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Population People facing a life-threatening disease
Interventions Psilocybin LSD
Topics Anxiety Depression End-of-life distress Psychedelic-assisted therapy
Keywords Distress Depression economics Existentialism Psychotherapist Death anxiety Clinical psychology
Citations 34
Key findings Psychedelic-assisted therapy with psilocybin or LSD may be effective for anxiety, depression, and existential distress in people with life-threatening diseases, but evidence certainty is low to very low.

Abstract

Implications for practice Psychedelic-assisted therapy with classical psychedelics (psilocybin, LSD) may be effective for treating anxiety, depression, and possibly existential distress, in people facing a life-threatening disease. Psychedelic-assisted therapy seemed to be well tolerated, with no treatment-emergent serious adverse events reported in the studies included in this review. However, the certainty of evidence is low to very low, which means that we cannot be sure about these results, and they might be changed by future research. At the time of this review (2024), psychedelic drugs are illegal in many countries. Implications for research The risk of bias due to 'unblinding' (participants being aware of which intervention they are receiving) could be reduced by measuring expectation bias, checking blinding has been maintained before cross-over, and using active placebos. More studies with larger sample sizes are needed to reduce imprecision. As the US Drug Enforcement Administration (DEA) currently classifies psychedelics as Schedule I substances (i.e. having no accepted medical use and a high potential for abuse), research involving these drugs is restricted, but is steadily increasing.

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