may reduce depressive symptoms in cancer patients, but its effects on anxiety were inconsistent.
Evidence
This systematic review and meta-analysis of randomized and non-randomized trials in cancer patients found large short-term and 6-month improvements on depression scales, with gains also reported for spiritual well-being and some quality-of-life measures.
Caveat
The findings are preliminary because the evidence base was small and heterogeneous, blinding and expectancy were problematic, and psilocybin was often paired with psychotherapy.
Simplified
INTRODUCTION: may effectively treat psychological distress in cancer patients. A meta-analysis assessed its safety and effectiveness in this context.
METHODS: A comprehensive search across six databases (Scopus, PsycINFO, PubMed, Cochrane, CINAHL Complete, and Web of Science) was conducted to identify studies on psilocybin's effects on mental health in cancer patients up to November 2024. Both randomized and non-randomized trials were included, assessing anxiety, depression, and other mental outcomes at short-term (2-5 weeks) and long-term (6 months) follow-ups. Study quality was assessed using Cochrane tools, and statistical analyses were performed with Stata version 17.
RESULTS: In randomized controlled trials (RCTs), psilocybin significantly reduced depressive symptoms, with the Beck Depression Inventory (BDI) ( [SMD] = - 2.87, 95% confidence interval [CI]: - 3.99 to - 1.76, p < 0.001) and the -Depression subscale (HADS-D) (SMD = - 2.97, 95% CI: - 3.60 to - 2.33, p < 0.001) showing strong effects. Anxiety outcomes were mixed: the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) was not significant (SMD = - 3.63, p = 0.11), while the State-Trait Anxiety Inventory (STAI) also showed inconsistent results. Short-term analyses (2-5 weeks) revealed significant improvements in the BDI (SMD = - 1.17), HADS-D (SMD = - 1.58), and HADS-A (SMD = - 1.99), all p < 0.001. Long-term analyses (6 months) demonstrated sustained benefits on the BDI (SMD = - 2.60, p = 0.04) and HADS-D (SMD = - 3.56, p = 0.01). Measures of quality of life (QOL) and spiritual well-being using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale also improved significantly after psilocybin treatment.
CONCLUSION: Psilocybin may reduce depressive symptoms in cancer patients, with mixed effects on anxiety and time-dependent improvements in spiritual well-being and (in single-arm data) quality of life. Given the small number of studies, high heterogeneity, challenges with blinding/expectancy, and frequent co-intervention with psychotherapy, these findings are preliminary. Larger, rigorously blinded trials are needed to determine clinical effectiveness and safety.
Key numbers
-2.87
Decrease in Depression (BDI)
from randomized controlled trials
-1.17
Short-term Depression Reduction
over 2-5 weeks
-2.60
Long-term Depression Reduction
from long-term follow-up
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