Psilocybin-assisted therapy for individuals with palliative care needs: A systematic review of safety and efficacy

In a systematic review of six studies involving 74 adults aged 22–75 years in palliative care, psilocybin-assisted therapy produced clinically significant reductions in depression and anxiety. Between 57% and 79% of participants achieved at least a 50% reduction in symptoms on standardized scales such as HAM-D, HAM-A, BDI, and STAI. Improvements lasted up to 6–8 months in most trials, and in one follow-up study, up to 4.5 years. Adverse effects were mild and transient, including nausea, vomiting, and temporary increases in blood pressure and heart rate; no serious adverse events occurred. The evidence indicates that psilocybin-assisted therapy is both effective and safe for reducing depressive and anxiety symptoms in palliative care, though more research on integration into existing healthcare systems is needed.

Study at a glance

Abstract

Background: Palliative Care is concerned with relieving suffering and improving the quality of life of patients and their families. Currently, questions arise about how to provide patients with good end-of-life care. There has been increasing interest in the beneficial effects of using psilocybin-assisted therapy in patients with severe chronic illnesses near the end of their lives and who present symptoms of depression and/or anxiety. Aim: Explore the role of psilocybin-assisted therapy in palliative care, synthesizing evidence from clinical trials and longitudinal studies. Design: Systematic review. Data sources: A bibliographic search was performed in April 2024 in B-on, PubMed, Web of Science, and Scopus. Eligible studies included peer-reviewed quantitative research (RCTs, longitudinal, and observational designs) with adult participants in palliative care settings, examining the efficacy and safety of psilocybin-assisted therapy. Reviews, gray literature, and studies outside the scope of palliative care were excluded. Results: Of the 215 articles found, six studies ( n = 74 participants; age range 22–75 years) met the inclusion criteria. Across randomized and open-label trials, psilocybin-assisted therapy produced clinically significant reductions in depression and anxiety, with 57–79% of participants achieving ⩾ 50% symptom reduction on standardized scales (e.g. HAM-D, HAM-A, BDI, STAI). Improvements were sustained for up to 6–8 months in most trials, and in one follow-up study, for up to 4.5 years. Reported adverse effects were generally mild and transient, including nausea, vomiting, and temporary increases in blood pressure and heart rate; no serious adverse events were observed. Conclusions: Psilocybin-assisted therapy consistently demonstrated efficacy and safety in the reduction of depressive and anxiety symptoms. However, more studies exploring integrating psilocybin-assisted therapy into existing palliative care healthcare systems are needed. This includes investigating the feasibility, acceptability, and cost-effectiveness of integrating psilocybin-assisted therapy into routine clinical practice.