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.
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.
Journal of palliative medicine
October 1, 2023
Noah D Gold, Austin J Mallard, Jacob C Hermann et al.
5 citations
Psychedelic-assisted psychotherapy (PAP) may help alleviate psychiatric and existential distress in people with amyotrophic lateral sclerosis (ALS), a terminal neurodegenerative disease with an average survival of 3-4 years. The authors suggest PAP could also intervene on neuropathological dimensions of ALS, based on neuroprotective properties of psychedelics and robust improvements seen in other populations. They call for future preclinical trials in ALS models and rigorous clinical trials, given the lack of effective treatments for both disease progression and psychological distress.
Journal of palliative medicine
January 1, 2025
Mercy Tomy, William Alexander, Sanjay Gupta et al.
4 citations
Three patients with cancer, treatment-resistant depression, and suicidal ideation received intranasal esketamine (Spravato®) at a palliative care clinic. After treatment, all three had substantial reductions in depression severity and no further suicidal ideation, with improvements lasting up to a year. No serious adverse events occurred. The cases suggest intranasal esketamine may be a useful option for treating depression and suicidal thoughts in palliative care.
Journal of palliative medicine
June 1, 2025
Sam Barta, Joanne Brooker, Clare O'Callaghan
1 citation
Health care workers hold polarized views on psychedelic-assisted therapy for patients with serious illness, with attitudes often shaped by limited research knowledge and heuristics. Most perceive potential benefits for treating refractory psychological distress, desire education about the therapy, and call for a stronger evidence base to support implementation. Barriers to integration into existing care models were identified, and a team-based approach with clinical education was seen as essential. The systematic review of nine studies (seven qualitative, two quantitative) from four countries developed five themes reflecting these findings.
Journal of palliative medicine
March 1, 2026
Robert K Horowitz, William E Rosa, Ali John Zarrabi et al.
Psychospiritual distress causes profound suffering in people with serious illness, yet treatment options are few. A palliative care-embedded ketamine-assisted psychotherapy (KAP) program called Pal-KAP was developed and delivered at an academic medical center. Between May 2023 and September 2025, 59 patients were referred for screening; 43 met eligibility criteria, and 30 elected to participate. Patients (age 19-76, mean 53) completed a median of 1.5 medicine sessions (range 1-5). Most had cancer (80%) or neurological disease (13.3%). Ketamine dose averaged 0.93 mg/kg intramuscularly, with minor adverse effects and no serious adverse events. This experience suggests that KAP can be delivered safely and ethically in palliative care.
Journal of palliative medicine
April 26, 2025
Alyssa A Gonzalez, Gladys Janice Jimenez-Torres, Bryan M Fellman et al.
A five-minute group meditation offered during weekly educational rounds was well-received by palliative care clinicians. Of 70 invited, 23 (59%) participated in the meditation during rounds, and 21 (54%) also meditated at least weekly outside of rounds, averaging 53 minutes per week, mostly after work hours. Participation was linked to perceived stress reduction and control, and satisfaction with meditation (odds ratio: 1.46). No significant differences in participation were found by gender or years worked. Clinicians in psychosocial roles did not show different engagement outside rounds, and those less engaged did not report greater time-related barriers. The findings suggest brief group meditation may be a feasible and helpful tool for clinician well-being.