Psychedelics for Patients With Cancer: A Comprehensive Literature Review

Abstract

Objective: To assess the role of psychedelics in the treatment of anxiety or depression among patients with cancer. Data Sources: PubMed search from inception to March 11, 2022, using the terms anxiety, depression, psychedelics, psilocybin, lysergic acid, methylenedioxymethamphetamine, or ayahuasca. Study Selection and Data Extraction: Studies assessing patients with cancer receiving psychedelics for the treatment of anxiety or depression. Data Synthesis: Five unique randomized, double-blind, placebo-controlled trials were conducted. Significant reductions were found in 2 trials with 2 anxiety scales (State-Trait Anxiety Inventory–State, State-Trait Anxiety Inventory–Trait) and in 1 trial with 2 additional anxiety scales (Hamilton Rating Scale–Anxiety, Hospital Anxiety and Depression Scale–Anxiety). Significant reductions were found in 2 trials in 2 depression scales (Hospital Anxiety and Depression Scale–Depression, Beck Depression Inventory) and in 1 trial with an additional depression scale (Hamilton Rating Scale–Depression). Two studies assessed for clinically relevant reductions in anxiety and depression scores, and they occurred much more commonly in psychedelic-treated patients than those given placebo. Relevance to Patient Care and Clinical Practice: There is a new potential option for treating patients with anxiety and depression along with cancer, which is important given the generally lackluster benefits with traditional antidepressants. Only a few sessions may also provide benefits extending out for 6 to 12 months and possibly beyond that. However, the studies were small, had many methodological limitations, and there were increases in blood pressure and heart rate. Conclusions: Psychedelics have a unique mechanism of action that might be well suited for treating anxiety and depression associated with cancer. This offers new promise for patients who are not being sufficiently treated with current antianxiety or antidepressant medications.