Psilocybin and near-death anxiety

“Abstract background: clinically significant anxiety and depression are common in patients with cancer, and are associated with poor psychiatric and medical outcomes. historical and recent research suggests a role for psilocybin to treat cancer-related anxiety and depression. methods: in this double-blind, placebo-controlled, crossover trial, 29 patients with cancer-related anxiety and depression were randomly assigned and received treatment with single-dose psilocybin (0.3 mg/kg) or niacin, both in conjunction with psychotherapy. the primary outcomes were anxiety and depression assessed between groups prior to the crossover at 7 weeks. results: prior to the crossover, psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life. at the 6.5-month follow- up, psilocybin was associated with enduring anxiolytic and anti-depressant effects (approximately 60–80% of participants continued with clinically significant reductions in depression or anxiety), sustained benefits in existential distress and quality of life, as well as improved attitudes towards death. the psilocybin-induced mystical experience mediated the therapeutic effect of psilocybin on anxiety and depression. conclusions: in conjunction with psychotherapy, single moderate-dose psilocybin produced rapid, robust and enduring anxiolytic and anti-depressant effects in patients with cancer-related psychological distress.”

“© british association for psychopharmacology. cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. the effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. this randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. instructions to participants and staff minimized expectancy effects. participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. high-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. at 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. community observer ratings showed corresponding changes. mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. trial registration clinicaltrials.gov identifier: nct00465595”

“This essay describes the founding of the heffter research institute in 1993 and its development up to the present. the institute is the only scientific research organization dedicated to scientific research into the medical value of psychedelics, and it has particularly focused on the use of psilocybin. the first clinical treatment study was of the value of psilocybin in obsessive-compulsive disorder. next was a ucla study of psilocybin to treat end-of-life distress in end-stage cancer patients. while that study was ongoing, a trial was started at johns hopkins university (jhu) to study the efficacy of psilocybin in treating anxiety and depression resulting from a cancer diagnosis. following the successful completion of the ucla project, a larger study was started at new york university, which is near completion. a pilot study of the value of psilocybin in treating alcoholism at the university of new mexico also is nearing completion, with a larger two-site study being planned. other studies underway involve the use of psilocybin in a smoking cessation program and a study of the effects of psilocybin in long-term meditators, both at jhu. the institute is now planning for a phase 3 clinical trial of psilocybin to treat distress in end-stage cancer patients. © taylor & francis group, llc.”

“Recent randomized controlled trials of psilocybin-assisted psychotherapy for patients with cancer suggest that this treatment results in large-magnitude reductions in anxiety and depression as well as improvements in attitudes toward disease progression and death, quality of life, and spirituality. to better understand these findings, we sought to identify psychological mechanisms of action using qualitative methods to study patient experiences in psilocybin-assisted psychotherapy. semistructured interviews were conducted with 13 adult participants with clinically elevated anxiety associated with a cancer diagnosis who received a single dose of psilocybin under close clinical supervision. transcribed interviews were analyzed using interpretative phenomenological analysis, which resulted in 10 themes, focused specifically on cancer, death and dying, and healing narratives. participants spoke to the anxiety and trauma related to cancer, and perceived lack of available emotional support. participants described the immersive and distressing effects of the psilocybin session, which led to reconciliations with death, an acknowledgment of cancer’s place in life, and emotional uncoupling from cancer. participants made spiritual or religious interpretations of their experience, and the psilocybin therapy helped facilitate a felt reconnection to life, a reclaiming of presence, and greater confidence in the face of cancer recurrence. implications for theory and clinical treatment are discussed. [abstract from author]”

“A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. a double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0.3 mg/kg) or niacin in conjunction with psychotherapy. previously published results of this trial demonstrated that, in conjunction with psychotherapy, moderate-dose psilocybin produced rapid, robust, and enduring anxiolytic, and anti-depressant effects. here, we illustrate unique clinical courses described by four participants using quantitative measures of acute and persisting effects of psilocybin, anxiety, depression, quality of life, and spiritual well-being, as well as qualitative interviews, written narratives, and clinician notes. although the content of each psilocybin-assisted experience was unique to each participant, several thematic similarities and differences across the various sessions stood out. these four participants’ personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. the results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient.”

“‘When michael pollan set out to research how lsd and psilocybin (the active ingredient in magic mushrooms) are being used to provide relief to people suffering from difficult-to-treat conditions such as depression, addiction and anxiety, he did not intend to write what is undoubtedly his most personal book. but upon discovering how these remarkable substances are improving the lives not only of the mentally ill but also of healthy people coming to grips with the challenges of everyday life, he decided to explore the landscape of the mind in the first person as well as the third. thus began a singular adventure into the experience of various altered states of consciousness, along with a dive deep into both the latest brain science and the thriving underground community of psychedelic therapists …’– prologue: a new door — a renaissance — natural history: bemushroomed — history: the first wave. part i: the promise ; part ii: the crack-up — travelogue: journeying underground. trip one: lsd ; trip two: psilocybin ; trip three: 5-meo-dmt (or, the toad) — the neuroscience: your brain on psychedelics — the trip treatment: psychedelics in psychotherapy. one: dying ; two: addiction ; three: depression ; coda: going to meet my default mode network — epilogue: in praise of neural diversity.”