Nature medicine
June 3, 2025
Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman et al.
26 citations
A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.
Palliative Medicine
January 22, 2024
Louis Plourde, Sue-Ling Chang, Houman Farzin et al.
22 citations
A survey of 2,800 adults in four Canadian provinces found high social acceptability of psilocybin-assisted therapy for existential distress at the end of life. 79.3% considered it a reasonable medical choice, 84.8% agreed public health insurance should cover it, and 63.3% would support legalization for medical purposes. More favorable attitudes were linked to prior psilocybin use, exposure to palliative care, and progressive political orientation. The findings suggest public support is strong enough to help mobilize resources and improve access to this emerging therapy in palliative and end-of-life care.
Palliative & supportive care
October 1, 2024
Marianne Masse-Grenier, Sue-Ling Chang, Ariane Bélanger et al.
4 citations
Palliative care professionals see psilocybin-assisted therapy as a promising treatment for existential distress in patients with serious illnesses, but they have several concerns. In a qualitative study using World Café methodology with 16 palliative care professionals, participants identified needs for educational and certified training, medical legalization of psilocybin, more research, refined therapy protocols, and clarity on who dispenses the therapy, where it is given, and eligibility criteria. The acceptability of the therapy and expanding access appear interrelated, and developing guidelines will be essential for wider deployment.
Journal of Psychedelic Studies
May 15, 2025
Sara G. Gloeckler, Julien Thibault Lévesque, Alexandre Lehmann et al.
3 citations
Music is a standard part of psilocybin-assisted psychotherapy, but the role of silence is not well understood. In a compassionate-access program in Canada, two breast cancer patients undergoing psilocybin therapy experienced a 30-minute silent period that included mindfulness exercises and therapist discussion. One patient initially found the absence of music difficult but later found the mindfulness exercises highly meaningful. The other patient reported that music had evoked challenging memories early in the session, which were then productively explored during the silent period. The findings suggest that integrating silent intervals may enhance mindfulness and therapist-patient interactions, offering distinct therapeutic benefits. The authors call for more detailed reporting on session components in psychedelic research.
Palliative Medicine Reports
April 17, 2025
Michel Dorval, Sue-Ling Chang, Houman Farzin et al.
3 citations
A forum in Quebec, Canada, with 57 participants including patients, healthcare professionals, researchers, and policymakers, produced 16 recommendations for expanding access to psilocybin-assisted psychotherapy in palliative care. The recommendations address patient eligibility and equity, regulatory frameworks and respect for autonomy, logistical and organizational aspects, professional education and training, public awareness and information, and research. The report suggests these recommendations could guide similar efforts in other jurisdictions facing barriers to this therapy.
The Journal of Law Medicine & Ethics
January 1, 2025
Katherine Cheung, M J Brodie, Sue-Ling Chang et al.
2 citations
Physicians may hesitate to prescribe psilocybin for conditions like end-of-life anxiety and depression due to stigma and potential medical malpractice liability. This paper examines the risk of malpractice claims arising from psilocybin treatment in Canada, using exploratory vignettes to illustrate the relevance and limits of such claims. It argues that the absence of established medical standards, standardized training, and credentialing increases liability risks. More clinical trials, meta-studies, and knowledge sharing are needed to develop training programs and medical standards of practice to better realize psilocybin's potential.
Palliative Medicine
May 19, 2026
Louis Plourde, Sue-Ling Chang, Olivia Nguyen et al.
1 citation
Most palliative care stakeholders in Canada view psilocybin-assisted therapy favorably, with 95% of physicians reporting positive attitudes. A cross-sectional online survey of 121 adults involved in palliative care found that the lack of trained healthcare providers is the primary barrier to implementation, while further research and standardized protocols are key facilitators. Sixty-eight percent of stakeholders support introducing this therapy early in the illness trajectory. The findings highlight significant divergence in perspectives between clinical and non-clinical groups, suggesting tailored interprofessional education could build shared understanding. The study's Canadian context may limit transferability to other regulatory frameworks.
Healthcare
September 12, 2025
Ariane Bélanger, Sue-Ling Chang, Jean-François Stephan et al.
1 citation
A decision aid for psilocybin-assisted therapy (PAT) was developed to help patients and healthcare professionals weigh risks and benefits when considering treatment for existential distress in serious illness. The booklet, created with a multidisciplinary steering committee following international standards, covers PAT education, treatment comparisons, and personal reflection. Feedback from five patients and five healthcare professionals guided refinements to improve clarity, balance, and usability. The final version met acceptability and usability criteria, offering balanced information to support shared decision-making in palliative care.
Journal of Psychedelic Studies
January 21, 2025
Louis Plourde, Sue-Ling Chang, Houman Farzin et al.
1 citation
The debate about whether psychotherapists should personally experience non-ordinary states of consciousness during psilocybin-assisted therapy training is important because it influences treatment safety, effectiveness, and accessibility. Ethical and practical concerns about making such experience a training standard need urgent attention where psilocybin therapy is being integrated into healthcare. The authors argue that the most balanced and ethical approach is to legally allow psilocybin use for professional training but not require it.
Palliative & Supportive Care
January 1, 2025
Houman Farzin, Brigita Koren, Helen Ferrier et al.
1 citation
A 51-year-old man with metastatic lung cancer and a prognosis of less than 6 months experienced depression and anxiety linked to demoralization and existential distress, which persisted despite psychotherapy and 100 mg of sertraline. Through Health Canada’s Special Access Program, he received 25 mg of oral psilocybin in a homecare setting, with preparative and integrative therapy before and after the session. The treatment was well tolerated, and the patient reported a sustained reduction in suffering and improved well-being at 2 months post-intervention. Psilocybin-assisted therapy may be safely delivered at home and offer lasting relief for anxiety and depression associated with existential distress in palliative care.
International Journal of Whole Person Care
January 6, 2023
Houman Farzin
1 citation
Psilocybin, the active ingredient in magic mushrooms, has a long history of ceremonial use by indigenous peoples and is now being studied in Western medicine for treating existential distress in cancer patients. Palliative care has improved management of physical symptoms, but psychospiritual suffering remains difficult to treat with conventional methods. Early research on psychedelic therapies targeted the existential suffering that often accompanies dying, offering a potential new approach to healing in the context of end-of-life care.
Cahiers francophones de soins palliatifs
January 1, 2025
Angie Shen, Andréanne Côté, Pascal Lamanque et al.
Interest in psilocybin, a substance found in so-called 'magic' mushrooms, is experiencing a marked resurgence in psychiatry and palliative care. Well-studied in the 1950s and 1960s, it fell into obscurity with the prohibition of drugs and the decline of counterculture in the 1970s. Today, its return raises questions about its potential in palliative care, possible beneficiaries, and modalities of access for patients, prompting reflection on the implications of its use in the contemporary context of palliative care.
International Journal of Whole Person Care
January 29, 2024
Houman Farzin
Psilocybin-assisted psychotherapy, using psilocybin-containing mushrooms or synthetic psilocybin within a therapeutic mindset and environment, may safely and effectively reduce demoralization, death anxiety, and existential distress in patients with serious illness. A case series of advanced cancer patients in Montreal, Canada, who received physician-supervised home-based treatment suggests safety and efficacy. This work, performed outside clinical trials in Quebec's public healthcare system, aimed to provide equitable access and a more patient-centric, culturally-informed approach. However, societal discrimination and stigma, including from healthcare professionals, remain barriers to equitable care, which the authors discuss along with potential solutions.
Neuroscience and biobehavioral reviews
May 1, 2026
Esmaeel G Gojani, Houman Farzin, Robert J Sutherland et al.
Alzheimer's disease involves amyloid-β accumulation, tau pathology, synaptic dysfunction, and neuroinflammation, driving progressive memory loss and cognitive decline. Epigenetic dysregulation is increasingly recognized as contributing to these processes by altering gene expression. Serotonergic psychedelics, acting as agonists of the serotonin 2A receptor, promote neuroplasticity and induce sustained transcriptional changes in the brain. Preclinical studies suggest these compounds can modulate epigenetic mechanisms, including histone modifications and DNA methylation. This review proposes that targeted engagement of 5-HT2A receptors may help counteract epigenetic abnormalities that contribute to Alzheimer's disease pathogenesis.