Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis
Psychiatry Investigation – October 10, 2021
Source: OpenAlex
Summary
Psilocybin, a psychedelic compound, significantly alleviates end-of-life anxiety, offering promising medicine. A meta-analysis of five randomized controlled trials showed psilocybin was superior to placebo, reducing trait anxiety with effect sizes up to -1.08 at two weeks. Tolerability was good for this chemical synthesis and alkaloid-derived treatment in internal medicine and psychiatry. Despite transient blood pressure increases (systolic 19.00 mm Hg, diastolic 8.66 mm Hg), no increased adverse effect or discontinuation occurred versus placebo, supporting its potential in complementary and alternative medicine studies.
Abstract
Objective To systematically examine the effectiveness and tolerability of psilocybin for treating end-of-life anxiety symptoms.Methods The Medline, Embase, CENTRAL, and PsycINFO databases were searched up to November 25, 2020. We enrolled clinical trials investigating psilocybin for treating end-of-life anxiety symptoms. Meta-analysis was conducted using random-effects model.Results Overall, five studies were included, revealing that psilocybin was superior to the placebo in treating state anxiety at 1 day (Hedges’ g, -0.70; 95% confidence interval, -1.01 to -0.39) and 2 weeks (-1.03; -1.47 to -0.60) after treatment. Psilocybin was more effective than placebo in treating trait anxiety at 1 day (-0.71; -1.15 to -0.26), 2 weeks (-1.08; -1.80 to -0.36), and 6 months (-0.84; -1.37 to -0.30) after treatment. Psilocybin was associated with transient elevation in systolic (19.00; 13.58–24.41 mm Hg) and diastolic (8.66; 5.18–12.15 mm Hg) blood pressure compared with placebo. The differences between psilocybin and placebo groups with regard to allcause discontinuation, serious adverse events, and heart rates were nonsignificant.Conclusion Psilocybin-assisted therapy could ameliorate end-of-life anxiety symptoms without serious adverse events. Because of the small sample sizes of the included studies and high heterogeneity on long-term outcomes, future randomized controlled trials with large sample sizes are needed.