Psilocibina en cuidados paliativos: revisión sistemática de los efectos a nivel emocional y espiritual-existenciales

A single psilocybin session with psychotherapeutic support produces rapid, significant, and sustained reductions in anxiety and depression lasting up to six months in palliative care patients. Increases were observed in meaning in life, acceptance, spiritual well-being, and quality of life, along with impactful mystical experiences. One cohort maintained benefits for up to four years, suggesting durable effects on coping and existential perception. Safety outcomes were favorable, with mild and transient adverse events including nausea, in-session anxiety, headache, and temporary physiological increases without serious complications. The evidence indicates that psilocybin administered in a structured clinical setting constitutes a viable option for addressing spiritual needs in palliative care.

Study at a glance

Abstract

Anxiety, depression, and existential distress are common symptoms in palliative care and significantly impair patients’ quality of life. Psilocybin-assisted therapy, based on preparation, therapeutic support, and psychotherapeutic integration, has emerged as a promising intervention to alleviate this complex cluster of suffering. The aim of this systematic review was to synthesize the evidence on the efficacy, safety, and effects of psilocybin on emotional and spiritual–existential dimensions in palliative populations. PRISMA 2020 guidelines were followed, and searches were conducted between 2015 and 2025 in PubMed, Web of Science, PsycINFO, and MEDLINE to identify eligible studies. After title and abstract screening, twelve studies met the inclusion criteria and were analyzed through systematic extraction of relevant clinical and methodological data. The results showed that a single psilocybin session with psychotherapeutic support produced rapid, significant, and sustained reductions in anxiety and depression, lasting up to six months. In the spiritual–existential domain, increases were observed in meaning in life, acceptance, spiritual well-being, and quality of life, along with impactful mystical experiences of prolonged duration. One cohort demonstrated maintenance of benefits during follow-up periods of up to four years, suggesting durable effects on coping and existential perception. Safety outcomes were favorable, with mild and transient adverse events, including nausea, in-session anxiety, headache, and temporary physiological increases without serious complications. Overall, the evidence clearly indicates that psilocybin, administered within a structured clinical setting, constitutes a viable option for addressing spiritual needs in palliative care.