Psilocybin-assisted psychotherapy as a rapid-acting treatment for cancer-related depression and anxiety: Evidence from a network meta-analysis

Objective To evaluate psilocybin's efficacy in reducing depressive and anxiety symptoms in cancer patients based on randomized controlled trials (RCTs). Methods This systematic review and network meta-analysis (NMA) followed PRISMA and Cochrane Handbook guidelines. PubMed, Embase and Cochrane Library data up to July 2024 were analyzed. Two RCTs met the inclusion criteria. Changes in Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scores were assessed on day 1 and on 2-week follow-up. The risk of bias was evaluated with the Cochrane Risk of Bias Tool 2.0. Results Psilocybin significantly reduced BDI scores at day 1 post-administration (MD = 2.26; P = 0.01), though effects were not sustained at 2 weeks. STAI state scores showed substantial reductions at both day 1 (MD = 11.52; P < 0.001) and 2 weeks (MD = 12.66; P < 0.001). STAI trait scores also improved on both day 1 and day 14. The highest psilocybin dose (0.3 mg/kg) was the most effective, with SUCRA values of 87.81% (BDI), 91.58% (STAI state), and 94.2% (STAI trait). Conclusions Findings suggest psilocybin may rapidly reduce depressive and anxiety symptoms in cancer patients, but methodological limitations, including the small number of trials, necessitate cautious interpretation. Larger, high-quality RCTs are needed to verify its clinical potential.