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Evaluating the effectiveness of psilocybin in alleviating distress among cancer patients: A systematic review.

Maria I Lapid, Sandeep R Pagali, Andrea L Randall, Kristine A Donovan, Carrie A Bronars, Trevor A Gauthier, Jonathan Bock, Samantha D Lim, Elise C Carey, Elizabeth Sokolowski, Angela M Ulrich, Leslie C Hassett, Simon Kung, Kevin J Whitford, Kenneth R Olivier, Stacy D D'Andre

Palliative & Supportive Care April 22, 2025 DOI: 10.1017/s147895152500032x (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Randomized Open-label Qualitative Case report Peer reviewed
Population Patients with life-threatening cancer
Intervention Psilocybin-assisted therapy
Topics Anxiety Depression End-of-life distress Psychedelic-assisted therapy Psilocybin
Keywords Psychotherapy Mental health treatment Clinical research Cancer patient care Anxiety & depression
Citations 9
Key findings Psilocybin-assisted therapy consistently reduced depression, anxiety, and existential distress in cancer patients, with improvements sustained over several months.

Abstract

Psychological and existential distress is prevalent among patients with life-threatening cancer, significantly impacting their quality of life. Psilocybin-assisted therapy has shown promise in alleviating these symptoms. This systematic review aims to synthesize the evidence on the efficacy and safety of psilocybin in reducing cancer-related distress. We searched MEDLINE, APA PsycINFO, Cochrane database, Embase, and Scopus from inception to February 8, 2024, for randomized controlled trials (RCTs), open-label trials, qualitative studies, and single case reports that evaluated psilocybin for cancer-related distress. Data were extracted on study characteristics, participant demographics, psilocybin and psychotherapy intervention, outcome measures, and results. Two authors independently screened, selected, and extracted data from the studies. Cochrane Risk of Bias for RCTs and Methodological Index for Non-Randomized Studies criteria were used to evaluate study quality. This study was registered with PROSPERO (CRD42024511692). Fourteen studies met the inclusion criteria, comprising three RCTs, five open-label trials, five qualitative studies, and one single case report. Psilocybin therapy consistently showed significant reductions in depression, anxiety, and existential distress, with improvements sustained over several months. Adverse effects were generally mild and transient. This systematic review highlights the potential of psilocybin-assisted therapy as an effective treatment for reducing psychological and existential distress in cancer patients. Despite promising findings, further large-scale, well-designed RCTs are needed to confirm these results and address existing research gaps.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • State of the evidence: Psilocybin for end-of-life distress Supports

    Across 14 studies, psilocybin therapy consistently reduced depression, anxiety, and existential distress, with improvements sustained over several months and generally mild, transient adverse effects.

    Synthesized

Comparable studies

Other systematic reviews and meta-analyses on psilocybin, most cited first.

Study Year Design Participants
Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... 2020 Systematic review n = 188
Blinding and expectancy confounds in psychedelic randomized controlled trials 2021 Systematic review
Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years Patients from included clinical trials 2016 Systematic review
The experimental effects of psilocybin on symptoms of anxiety and depression: A meta-analysis People with elevated symptoms of anxiety and depression 2020 Meta-analysis n = 117
Default Mode Network Modulation by Psychedelics: A Systematic Review Participants from included studies 2022 Systematic review

Citations in the library

Cited by 9

and 4 more in the library

Cites 24

and 19 more in the library

Related reading

Explore topics

Anxiety Depression End-of-life distress Psychedelic-assisted therapy Psilocybin

By condition and practice

Psilocybin and psychedelic-assisted therapy Psilocybin for anxiety Psilocybin for depression Psilocybin for end-of-life distress