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Zachary Sager

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA.

9 papers in the library · 138 citations · publishing 2020-2026

Papers

Top Ten Tips Palliative Care Clinicians Should Know About Psychedelic-Assisted Therapy in the Context of Serious Illness.

Journal of palliative medicine August 1, 2022 William E Rosa, Zachary Sager, Megan Miller et al. 49 citations

Psychedelic-assisted therapy (PAT) is a promising treatment for conditions like treatment-resistant depression, substance use disorder, and PTSD. In palliative care, a single PAT session can produce lasting reductions in anxiety, depression, and demoralization—symptoms that harm quality of life for seriously ill and end-of-life patients. Although interest in psychedelics has revived, few resources exist for applying PAT in hospice and palliative care. This article provides 10 evidence-informed tips for palliative care clinicians, developed with international experts, to help familiarize teams with PAT, address legal and logistical barriers, discuss therapeutic competencies, and highlight approaches to maximize safety and benefits for patients and caregivers.

Defining the Roles and Research Priorities for Psychedelic-Assisted Therapies in Patients with Serious Illness: Expert Clinicians' and Investigators' Perspectives

Journal of Palliative Medicine April 1, 2020 Yvan Beaussant, Justin J. Sanders, Zachary Sager et al. 39 citations

Experts in serious illness care and psychedelic research hold polarized views on psychedelic-assisted therapies for patients with serious illness, ranging from strong support for medical utility to reluctance due to risks such as delirium or worsening psychological distress. Research priorities focus on patients with clinically diagnosed psychosocial distress like depression, anxiety, or demoralization, though some roles extend beyond traditional medical diagnosis. Essential safety and efficacy guidelines are needed for integrating these therapies into existing care models. The study proposes a conceptual framework for such integration based on interviews with 17 experts from the United States and Canada.

Older adults in psychedelic-assisted therapy trials: A systematic review

Journal of Psychopharmacology January 1, 2024 Lisa Bouchet, Zachary Sager, Antoine Yrondi et al. 22 citations

Older adults (65+) account for less than 1.4% of participants in psychedelic clinical trials, despite these compounds showing potential for conditions common in this age group, such as depression, anxiety, and existential distress. A systematic review of 36 trials involving 1,400 patients found only 19 were aged 65 or older. Safety data for 10 of these older adults showed no serious adverse events; only transient mild-to-moderate effects like anxiety, gastrointestinal upset, and hypertension occurred during dosing sessions. The authors conclude that psychedelic-assisted psychotherapy appears safe and well tolerated in older adults and warrants more rigorous investigation for psychiatric treatment in this population.

Acceptability of psilocybin‐assisted group therapy in patients with cancer and major depressive disorder: Qualitative analysis

Cancer December 18, 2023 Yvan Beaussant, Kabir Nigam, Zachary Sager et al. 22 citations

Patients with cancer and depression who received psilocybin-assisted therapy in a group setting found the approach generally acceptable. The group sessions increased their sense of safety and preparedness, fostered connection and belonging, and deepened the meaning of their experience, opening dimensions of self-transcendence and compassion. Key factors influencing acceptability included the therapeutic framework, the complementary role of individual sessions, and group size and structure. The findings suggest that combining group and individual sessions may enhance perceived safety and efficacy compared to either format alone, offering a scalable model for integrating psilocybin-assisted therapy into cancer care.

Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression.

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.

Psilocybin-assisted therapy for demoralisation in hospice patients: feasibility, safety and preliminary efficacy

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.

“To Have the Encounter with Our Own Finiteness in that Existential Way”: Descriptions of Existential Experience in Patients with Cancer and Major Depression Participating in Psilocybin-Assisted Group Therapy

Psychedelic Medicine October 8, 2025 Elise C. Tarbi, Skye A. Miner, Kabir Nigam et al. 1 citation

Patients with cancer and depression describe their cancer experience as deepening their awareness of mortality and prompting them to reprioritize relationships and efforts. In a trial of psilocybin-assisted group therapy, participants sought not only relief from depression but also a new perspective on existential worries and spiritual resources. After treatment, they reported lasting effects including an enhanced sense of meaning, agency, aliveness, and connectedness, describing the experience as a healing, unfolding transformation. The findings illuminate how psilocybin-assisted therapy may address existential suffering and foster personal growth in this population.

Older Adults in Psychedelic-Assisted Therapy Trials: A Systematic Review

European Psychiatry April 1, 2024 N. Kabir, B. Anderson, Lisa Bouchet et al. 1 citation

Older adults are severely underrepresented in clinical trials of psychedelic-assisted therapies. A systematic review of 36 studies with 1,400 patients found that only 19 participants were aged 65 or older, less than 1.4% of the total. Detailed safety data for 10 of these older adults showed no serious adverse events; only mild-to-moderate side effects such as anxiety, gastrointestinal upset, and hypertension occurred during dosing sessions. The evidence, though limited, suggests that psychedelic-assisted psychotherapy is safe and well tolerated in older adults and should be more rigorously studied for treating psychiatric conditions in this population.

Views on Psychedelic-Assisted Therapy for Substance Use Disorders from Individuals with Opioid Use Disorder and a History of Injection-Related Infections: A Qualitative Study.

Psychedelic medicine (New Rochelle, N.Y.) March 1, 2026 Veronica Szpak, Samuel Maddams, Amanda Kim et al.

Adults with opioid use disorder who have survived injection-related infections generally support psychedelic-assisted therapy as a treatment for substance use disorders, but they also express concerns. In interviews with 17 participants, common supportive themes included that hospitalization helped them recognize the severity of their disorder, that psychedelic-assisted therapy could foster insight and openness to recovery, and that professional monitoring during sessions was reassuring. Participants also valued addressing underlying mental health issues and the role of spirituality. Concerns centered on the possibility of a "bad trip," adverse effects, relapse risk, and misuse of psychedelics. Further research is needed, especially when standard medications have failed.