Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review.
Nina Schimmers, Joost J. Breeksema, Sanne Y Smith-Apeldoorn, Jolien K E Veraart, Wim van den Brink, Robert A Schoevers
Psychopharmacology 2022 DOI: 10.1007/s00213-021-06027-y (opens in new tab)
The journal has published a correction to this paper. Read the correction (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Terminally ill patients |
| Interventions | LSD psilocybin DPT MDMA ketamine |
| Topics | Anxiety Depression End-of-life distress |
| Keywords | Life-threatening disease Psychedelics |
| Key findings | Both classical and atypical psychedelics are promising treatment options for existential distress, depression, and anxiety in terminally ill patients, with recent controlled trials indicating positive effects and few adverse effects. |
Abstract
Terminally ill patients may experience existential distress, depression, or anxiety, limiting quality of life in the final stage. Existing psychotherapeutic or pharmacological interventions have (time) limited efficacy. Psychedelic treatment may be a safe and effective alternative treatment option. Systematically review studies on psychedelic treatment with and without psychotherapy for existential distress, depression, and anxiety in terminally ill patients. Medline, PsycINFO, and Embase were searched for original-data studies on the treatment of depression, anxiety, and existential distress with classical or a-typical psychedelics in patients with a terminal illness, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1850 records were screened, and 33 articles were included in this review: 14 studies on classical psychedelics (DPT, LSD, and psilocybin) and 19 studies on atypical psychedelics (MDMA and ketamine). Results of early pre-post studies are promising but have serious methodological flaws. Recent (controlled) trials with LSD, psilocybin, ketamine, and MDMA are of higher methodological quality and indicate positive effects on existential and spiritual well-being, quality of life, acceptance, and reduction of anxiety and depression with few adverse and no serious adverse effects. Both classical and a-typical psychedelics are promising treatment options in patients with terminal illness. To draw final conclusions on effectiveness and safety of psychedelics, we need larger high-quality studies for classical psychedelics and MDMA. Ketamine studies should pay more attention to existential dimensions of well-being and the psychotherapeutic context of the treatment.
Comparable studies
Other systematic reviews and meta-analyses on end-of-life distress, most cited first.
Citations in the library
Cited by 113
- Towards an understanding of psychedelic-induced neuroplasticity. Neuropsychopharmacology 2023
- Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Journal of Affective Disorders February 1, 2023
- Therapeutic effect of psilocybin in addiction: A systematic review Frontiers in Psychiatry February 9, 2023
- The therapeutic potential of psilocybin: a systematic review Expert Opinion on Drug Safety February 26, 2022
- Pattern breaking: a complex systems approach to psychedelic medicine Neuroscience of Consciousness 2023
and 108 more in the library
Cites 45
- 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
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases The Journal of Nervous and Mental Disease March 4, 2014
- Ketamine use: a review Addiction July 21, 2011
and 40 more in the library