Cancer
December 18, 2023
Manish Agrawal, Yvan Beaussant, Sarah Shnayder et al.
73 citations
A single 25-mg dose of psilocybin, administered alongside one-to-one and group therapeutic support, was safe and feasible for patients with curable and noncurable cancer who also had major depressive disorder. In a phase 2 open-label trial with 30 participants, no serious adverse events or suicidality occurred, and mild side effects like nausea and headache were as expected. Depression severity scores dropped by an average of 19.1 points from baseline to eight weeks after treatment. Eighty percent of participants showed a sustained response, and half achieved full remission of depressive symptoms by week one that lasted for eight weeks. The group-oriented format and compact delivery in a community cancer center may add to therapeutic gains.
JAMA Oncology
April 13, 2023
Manish Agrawal, Ezekiel Emanuel, Brian D. Richards et al.
48 citations
In a nonrandomized controlled trial, psilocybin was administered to groups of patients with cancer who also had major depressive disorder, using a one-to-one therapist-to-patient ratio. The aim was to develop a scalable, rapidly effective depression treatment. The trial suggests that this approach may offer a feasible model for delivering psilocybin therapy to larger numbers of patients while maintaining therapeutic support.
Frontiers in Psychiatry
December 6, 2023
Elliot Marseille, Manish Agrawal, Paul Thambi et al.
40 citations
Group psychedelic-assisted therapy, compared with individual therapy, reduces clinician costs by 50.9% for MDMA treatment of PTSD and 34.7% for psilocybin treatment of major depressive disorder, saving $3,467 and $981 per patient respectively. Using 2023 data from two trial sites and published prevalence estimates, treating all eligible U.S. adults with PTSD or MDD over ten years with group therapy would require 6,711 fewer full-time clinicians for MDMA-PTSD and 1,159 fewer for psilocybin-MDD, saving up to $10.3 billion and $2.0 billion. Adopting group protocols could lower costs, ease clinician shortages, and expand patient access.
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.
Journal of Palliative Medicine
August 17, 2023
Robert Gramling, Emily Bennett, Keith Curtis et al.
6 citations
Directly observing therapeutic connection during psilocybin-assisted therapy is feasible. In a clinical trial, three coders independently reviewed audio and video from four 8-hour psilocybin administration sessions, identifying 372 moments of therapeutic connection. Eighty-three percent of these moments were detected by at least two coders, and 41% by all three. Coders used both audible cues (speech prosody, words) and visible cues (body movements, eye gaze, touch) in 51% of observed events. The expressions of connection varied as the drug's effects on consciousness changed over time. The findings suggest that evaluating both sound and video is necessary to capture the full range of therapeutic connection.
Journal of Clinical Oncology
June 1, 2022
Manish Agrawal, Paul Thambi, Sarah Shnayder
3 citations
A single 25 mg dose of psilocybin, given in a group setting within a cancer center, produced a large and sustained reduction in depression symptoms in cancer patients with major depressive disorder. Over eight weeks, depression scores on the MADRS scale dropped by an average of 19.1 points, 24 of 30 patients achieved a sustained response (at least 50% reduction), and half showed complete remission one week after treatment, maintained through eight weeks. No serious adverse events occurred, and all 30 patients completed the trial. The results suggest that psilocybin therapy is safe, feasible, and effective for this population, and that group treatment may improve scalability.
Journal of Clinical Oncology
June 1, 2023
Manish Agrawal, Sarah Shnayder, Heather Honstein et al.
2 citations
A single dose of psilocybin combined with group and individual psychological support led to long-term relief from depression in cancer patients with major depressive disorder. At 18 months, 64.2% of patients showed a clinical response (at least 50% reduction in depression scores) and 57.1% achieved full remission. Depression and anxiety severity scores continued to decrease from baseline to 8 weeks and through 18 months. The findings suggest psilocybin-assisted therapy may be an effective treatment for depression in people with cancer.