Efficacy of psilocybin on death anxiety in terminal patients: a narrative review
M. Barimbing, D. Jeger, Made Edwin Sridana
Progress in Palliative Care December 1, 2025 DOI: 10.1080/09699260.2026.2657096 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Randomized Peer reviewed |
|---|---|
| Population | Terminally ill patients |
| Intervention | Psilocybin-assisted therapy |
| Duration | Up to six months after a single dose |
| Topics | Anxiety Psilocybin |
| Key findings | Psilocybin-assisted therapy reduces death anxiety in terminally ill patients, with effects lasting up to six months after a single dose. |
Abstract
ABSTRACT This narrative review synthesized the use of psilocybin-assisted therapy as a promising treatment for alleviating death anxiety in terminally ill patients. The insights presented are derived from findings reported in previous studies. Therefore, this review aimed to assess the efficacy, pharmacology, and mechanisms by which psilocybin alters brain function by affecting 5-HT2A receptors and disrupting the default mode network (DMN), helping to reduce existential fear. Recent randomized controlled trials (RCTs) demonstrated substantial progress in therapy, with results showing standardized mean differences in anxiety reduction ranging from −0.70 to −1.08, with effects lasting up to six months after a single dose. This review examines the implications for clinical practice, highlighting psilocybin’s favorable safety profile and its potential to fill therapeutic gaps left by conventional treatments, and also addresses the ethical issues surrounding the use of psilocybin in terminally ill patients. The findings support the integration of psychedelic-assisted methods with standard palliative care to enhance end-of-life care and also highlight potential directions for further studies.
Comparable studies
Other narrative reviews on psilocybin for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelics as anti-inflammatory agents Animal models and cellular studies | 2018 | Review | |
| Ayahuasca: Pharmacology, neuroscience and therapeutic potential | 2016 | Review | |
| Psychedelic Drugs in Biomedicine | 2017 | Review | |
| A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses | 2020 | Review | |
| Psychedelics and health behaviour change | 2021 | Review |
Citations in the library
Cites 17
- Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer Journal of Psychopharmacology January 9, 2020
- Psilocybin-induced changes in brain network integrity and segregation correlate with plasma psilocin level and psychedelic experience. European Neuropsychopharmacology September 1, 2021
- Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases—A Systematic Review and Meta-Analysis of Clinical Trials Biomedicines September 5, 2020
- HOPE: A Pilot Study of Psilocybin Enhanced Group Psychotherapy in Patients With Cancer. Journal of Pain and Symptom Management September 1, 2023
- Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis Psychiatry Investigation October 10, 2021
and 12 more in the library