Journal of palliative medicine
January 22, 2025
Roxanne Sholevar, William Kromka, Yvan Beaussant
10 citations
In patients with serious medical illness, ketamine may produce rapid but temporary improvements in psychiatric symptoms such as depression and anxiety, according to a review of nine studies and twelve case reports. The evidence is limited by wide variation in patient groups, treatment settings, dosing, and whether psychotherapy was included. Most reports examined ketamine as a drug alone, not ketamine-assisted psychotherapy (KAP). There is little research on KAP for existential distress, though the findings hint that ketamine used within a psychedelic therapy model could offer advantages over traditional psychedelics. Current treatments for psychiatric and existential distress in palliative care are often ineffective or poorly tolerated.
Palliative & supportive care
December 1, 2023
Roxanne Sholevar, John Peteet, Justin Sanders et al.
9 citations
Experts in serious illness care and psychedelic-assisted therapy (PAT) hold divergent views on PAT's therapeutic potential and safety for patients with serious illness. Five factors shape their attitudes: perception of unmet need, knowledge of empirical studies, personal psychedelic experience, professional background, and age or generation. An overarching theme is PAT's disruptive potential at four levels: the patient's experience of self, illness, and death; relationships with loved ones and healthcare providers; existing clinical models; and societal attitudes toward death. Whether this disruption is seen as a therapeutic opportunity or an undue risk determines the level of support. These points of disruption raise practical and philosophical considerations for integrating PAT into serious illness care.
General hospital psychiatry
January 1, 2025
Yvan Beaussant, Elise Tarbi, Kabir Nigam et al.
3 citations
Psilocybin-assisted therapy (PAT) is promising for cancer-related depression, but little is known about how the therapeutic context affects patient experiences. In interviews with 28 patients with cancer and depression who participated in a clinical trial, participants described the psilocybin experience as intense and demanding. Therapeutic benefits were closely tied to their ability to "surrender"—accepting and remaining open to the experience's intensity and unpredictability. A safe, supportive, and ethical environment was critical for trust and engagement. Preparation and integration were key to maximizing benefit. Music played a variable role, sometimes enhancing and other times distracting. The clinical setting provided safety, while ceremonial elements added meaning.
BMJ Supportive & Palliative Care
November 3, 2025
Yvan Beaussant, Zachary Sager, Caitlin W. Brennan et al.
1 citation
A single 25 mg dose of psilocybin, combined with preparation and integration sessions, was safely administered to ten terminally ill home hospice patients. No serious adverse events occurred. Demoralization scores dropped by an average of 8.8 points three weeks after the session, despite patients' ongoing physical decline. Grief and peace themes were common during the drug sessions. Although most participants rated the treatment favorably, some found the emotional intensity challenging. The results suggest that psilocybin-assisted therapy can be feasibly and safely integrated into hospice care, but larger studies are needed to confirm its benefits.