PSYCHEDELIC DRUGS IN PALLIATIVE CARE

People receiving palliative care often experience depression and anxiety alongside physical suffering, and standard treatments may be insufficient. A review of four clinical trials found that a single dose of a psychedelic substance (such as psilocybin or LSD) produced noticeable improvements in depression and anxiety scores within days, with benefits lasting six to twelve months. No serious permanent side effects were reported, though some temporary non-severe events occurred. The rapid response is especially valuable for patients with short life expectancy who need urgent relief. Although evidence is limited by small sample sizes, combining psychedelics with psychotherapy appears a promising approach for treating depressive and anxiety symptoms in palliative care.

Study at a glance

Abstract

Background and aimsPhysical suffering of a person under palliative care is frequently associated to psychological (or existential) suffering. In fact, people with potentially untreatable diseases present a higher prevalence of depressive symptoms and anxiety than general population. Nevertheless, conventional therapeutic options seem to be insufficient.Inspired by 1950-1960u2019s studies, some researchers have been recently investigating what therapeutic role serotoninergic psychedelics may have in the approach to palliative care patients.Materials and methodsA research in Medline was done for the following terms: Hallucinogen + palliative care, Hallucinogen + end-of-life, Psychedelic + palliative care, psychedelic + end-of-life, Psilocibine + palliative care, Psilocibine + end-of-life, LSD + palliative care and LSD + end-of-life. Only the relevant articles were selected.ResultsBeyond some enlightening case reports, four clinical trials with palliative care patients were selected. None of the studies reported serious permanent side effects, although transient non severe events were reported. The four trials showed a reasonable improvement in depression, and anxiety scales. According to their results, clinical responses appear immediately after the psychedelic experience. The therapeutic benefit of a single administration may remain after a 6-to-12 month period.ConclusionsThe therapeutic response of psychedelics comes well before the response of conventional antidepressants. This is particularly relevant because of the shorter life expectancy of these patients who seek urgently for comfort. Although there is still very little clinical evidence of it (small samples), psychotherapy combined with psychedelics seem to be a promising treatment for palliative care patients presenting ango-depressive symptoms.