Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer
A recently published randomized controlled trial compared single-dose psilocybin with single-dose niacin in conjunction with psychotherapy in participants with cancer-related psychiatric distress. Results suggested that psilocybin-assisted psychotherapy facilitated improvements in psychiatric and existential distress, quality of life, and spiritual well-being up to seven weeks prior to the crossover. At the 6.5-month follow-up, after the crossover, 60–80% of participants continued to meet criteria for clinically significant antidepressant or anxiolytic responses. The present study is a long-term within-subjects follow-up analysis of self-reported symptomatology involving a subset of participants that completed the parent trial. All 16 participants who were still alive were contacted, and 15 participants agreed to participate at an average of 3.2 and 4.5 years following psilocybin administration. Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at the first and second follow-ups. Within-group effect sizes were large. At the second (4.5 year) follow-up approximately 60–80% of participants met criteria for clinically significant antidepressant or anxiolytic responses. Participants overwhelmingly (71–100%) attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives. These findings suggest that psilocybin-assisted psychotherapy holds promise in promoting long-term relief from cancer-related psychiatric distress. Limited conclusions, however, can be drawn regarding the efficacy of this therapy due to the crossover design of the parent study. Nonetheless, the present study adds to the emerging literature base suggesting that psilocybin-facilitated therapy may enhance the psychological, emotional, and spiritual well-being of patients with life-threatening cancer.
Gabby Agin-Liebes is currently a National Institute on Drug Abuse (NIDA)-funded postdoctoral fellow at Weill Institute for Neuroscience, Department of Psychiatry, UCSF. She received her PhD in clinical psychology from Palo Alto University. Her doctoral research focused on the clinical applications of psilocybin-assisted therapy and mindful self-compassion-based interventions to treat mood, substance use, and trauma-based disorders. Gabby’s work draws on quantitative and qualitative methodologies to explore underlying psychological and neurobiological mechanisms responsible for catalyzing behavioral changes, including emotion regulation, meta-awareness, and prosociality. Gabby’s current research is focused on the use of opioid replacement therapies to treat opioid use disorder and chronic pain. She is also exploring the use of behavioral paradigms (delay discounting) and other psychedelic interventions to help prevent relapse and restructure dysregulated motivational reward systems involved in addiction. Prior to her graduate studies, Gabby served as the lead project manager of the NYU Psychedelic Research Group. Gabby is a passionate promoter of the ethical and responsible use of psychedelic medicines and their accessibility to underserved populations