Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis
Chia‐ling Yu, Fu‐chi Yang, Szu‐nian Yang, Ping‐tao Tseng, Brendon Stubbs, Ta‐chuan Yeh, Chih‐wei Hsu, Dian‐jeng Li, Chih‐sung Liang
Psychiatry Investigation October 10, 2021 DOI: 10.30773/pi.2021.0209 via OpenAlex
Summary
AI-generated from the abstractA meta-analysis of five clinical trials found that psilocybin is superior to placebo for reducing end-of-life anxiety symptoms. Psilocybin reduced state anxiety at 1 day and 2 weeks after treatment, and trait anxiety at 1 day, 2 weeks, and 6 months after treatment. Psilocybin caused a temporary increase in systolic and diastolic blood pressure compared with placebo. There were no significant differences between psilocybin and placebo in rates of stopping treatment, serious adverse events, or heart rate. The authors conclude that psilocybin-assisted therapy can improve end-of-life anxiety without serious side effects, but note the small sample sizes and high heterogeneity in long-term outcomes.
Study at a glance
| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Population | Patients with end-of-life anxiety |
| Intervention | Psilocybin-assisted therapy |
| Topics | Anxiety Psilocybin |
| Keywords | Placebo Tolerability Discontinuation |
| Citations | 57 |
| Key finding | Psilocybin was superior to placebo in reducing state and trait anxiety in patients with end-of-life anxiety, with transient blood pressure increases and no serious adverse events. |
Abstract
Objective To systematically examine the effectiveness and tolerability of psilocybin for treating end-of-life anxiety symptoms.Methods The Medline, Embase, CENTRAL, and PsycINFO databases were searched up to November 25, 2020. We enrolled clinical trials investigating psilocybin for treating end-of-life anxiety symptoms. Meta-analysis was conducted using random-effects model.Results Overall, five studies were included, revealing that psilocybin was superior to the placebo in treating state anxiety at 1 day (Hedges’ g, -0.70; 95% confidence interval, -1.01 to -0.39) and 2 weeks (-1.03; -1.47 to -0.60) after treatment. Psilocybin was more effective than placebo in treating trait anxiety at 1 day (-0.71; -1.15 to -0.26), 2 weeks (-1.08; -1.80 to -0.36), and 6 months (-0.84; -1.37 to -0.30) after treatment. Psilocybin was associated with transient elevation in systolic (19.00; 13.58–24.41 mm Hg) and diastolic (8.66; 5.18–12.15 mm Hg) blood pressure compared with placebo. The differences between psilocybin and placebo groups with regard to allcause discontinuation, serious adverse events, and heart rates were nonsignificant.Conclusion Psilocybin-assisted therapy could ameliorate end-of-life anxiety symptoms without serious adverse events. Because of the small sample sizes of the included studies and high heterogeneity on long-term outcomes, future randomized controlled trials with large sample sizes are needed.