Psilocybin may improve mental health of people with cancer
Key takeaways:
- Psilocybin-assisted psychotherapy improved several psychiatric symptoms among people with cancer, including anxiety and depression.
- The therapy did not induce lasting phobia, paranoia or psychosis.
Psilocybin-assisted psychotherapy significantly improved a range of psychiatric symptoms among people with cancer, according to research published in Nature Mental Health.
Prior research demonstrated psilocybin-assisted psychotherapy can relieve depression and anxiety; however, the potential benefits for people experiencing other psychiatric symptoms remained unclear.
In the current study, researchers at NYU Langone Health evaluated previously unpublished data from two randomized phase 2, placebo-controlled crossover trials that included a combined 79 individuals with cancer-related distress.
Results showed psilocybin-assisted psychotherapy significantly improved anxiety, depression, interpersonal sensitivity, hostility, obsession-compulsion and somatization.
The approach did not cause lasting phobia, paranoia or psychosis.
“When administered to the right patient by a qualified therapist, this therapy has the potential to significantly alleviate end-of-life distress,” Petros D. Petridis, MD, clinical assistant professor in the department of psychiatry at NYU Langone Center for Psychedelic Medicine, told Healio. “The major challenge now is determining how to roll this out in a cost-effective manner, assuming ongoing clinical trials further confirm its efficacy.”
Healio spoke with Petridis about the study, the implications of the findings and the potential role psilocybin-assisted psychotherapy may have for this patient population.
Healio: How prevalent are psychiatric symptoms among patients with cancer?
Petridis: The prevalence of psychiatric symptoms among patients with cancer varies based on clinical features. Generally, individuals with stage I or II cancers, which have better prognoses, report lower levels of psychological distress. However, as the prognosis worsens, the incidence of psychiatric symptoms increases. Research suggests that about one-third of people with cancer experience clinically significant psychological distress, a number that rises to approximately two-thirds as patients approach end of life.
Healio: What motivated you to study psilocybin-assisted psychotherapy in this patient population?
Petridis: For many patients, confronting their own mortality brings significant existential challenges. They may reflect on their lives, experience regrets about past choices, or have suppressed thoughts and emotions resurface. This process can lead to significant anxiety and depression. Current FDA-approved medications in psycho-oncology — such as selective serotonin reuptake inhibitors and atypical antidepressants like mirtazapine — often take weeks to become effective, have significant drug-drug interactions, cause considerable side effects and show limited efficacy for people with cancer. There is an urgent need for alternative approaches, and I was motivated to explore whether psilocybin-assisted psychotherapy, in particular, could offer more rapid and meaningful relief for these patients.
Healio: How did you conduct this study?
Petridis: The principal investigators laid much of the groundwork. Stephen Ross, MD, at NYU and the late Roland R. Griffiths, PhD, at Johns Hopkins published two seminal papers in 2016 that examined the effects of psilocybin on anxiety and depression among people with cancer. However, people with cancer experience a broad range of other psychiatric symptoms, as well. Some struggle with interpersonal sensitivity, characterized by heightened vulnerability to criticism and rejection. Others experience somatization, where psychological distress manifests as physical symptoms. Some patients become irritable or preoccupied with treatment outcomes, medication side effects and other concerns.
I wanted to explore whether psilocybin could alleviate these additional mental health challenges alongside anxiety and depression. After reaching out to Dr. Ross and Dr. Griffiths, I discovered they had clinical trial data that had not been included in their original publications. I combined and analyzed this unpublished data to gain further insights from their trials.
Healio: What did you find?
Petridis: In addition to significant reductions in anxiety and depression, we observed decreases in interpersonal sensitivity, obsession-compulsive symptoms, hostility, and somatization. These improvements were seen after just a single session of psilocybin paired with psychotherapy. Importantly, we did not observe any increases in psychosis, paranoia or phobia. All participants were screened beforehand to ensure they did not have bipolar disorder, psychotic spectrum disorders, or a family history of such conditions, as psychedelics can potentially trigger psychosis in these individuals. However, across both trials, no participants experienced significant adverse psychiatric effects.
Healio: What are the potential implications of these findings?
Petridis: My hope is that this treatment becomes more widely accessible for end-of-life patients, as existing antidepressants have shown limited effectiveness. In fact, a 2018 Cochrane meta-analysis found that antidepressants are not effective for treating depression in people with cancer.
Healio: What are the next steps in your research?
Petridis: Patients with brain metastases and those with primary brain tumors, such as glioblastoma, have traditionally been excluded from these trials due to concern that psilocybin may lower their seizure threshold, potentially increasing the risk of seizures during treatment. However, patients with glioblastoma, for example, have an average life expectancy of about 12 to 18 months and often experience profound psychological distress, as do their family members. It’s unfortunate that these patients are unable to participate in trials due to seizure risk. My hope is that, in collaboration with our neurology colleagues, we can determine an appropriate antiepileptic regimen to mitigate this risk and make psilocybin-assisted psychotherapy accessible to these patients, as well. Additionally, I’m interested in exploring the potential benefits of this therapy for caregivers, many of whom experience clinically significant anxiety and depression. A cancer diagnosis doesn’t just impact the patient — it affects their entire support system.
Reference:
For more information:
Petros D. Petridis, MD, can be reached at petros.petridis@nyulangone.org.
Collapse
Healio Interviews
Read more about