Psilocybin May Help Alleviate Cancer-Related Depressive Symptoms

A need to provide effective medication to aid patients with psychological challenges related to a serious cancer diagnosis may be addressed by psilocybin, according to Michael P. Bogenschutz, MD.

CancerNetwork® spoke with Bogenschutz, director of the NYU Langone Center for Psychedelic Medicine and professor of Psychiatry at NYU Grossman School of Medicine, about potential unmet needs that treatment with psilocybin-assisted psychotherapy (PAP) may reduce in the context of a pooled analysis of 2 phase 2 trials published in Nature Mental Health.

Bogenschutz began by highlighting a paucity of effective medicinal treatment to help patients manage psychological ailments associated with serious cancer diagnoses. He additionally detailed that although antidepressants can mitigate symptoms of depression, they have not been particularly effective in treating patients with cancer.

Describing the time after a serious cancer diagnosis as an adjustment period, Bogenschutz explained that PAP can treat those who would otherwise be incapacitated by psychological challenges. He further iterated that prior studies have shown how a single dose of psilocybin demonstrated lasting mitigative effects on depressive symptoms for weeks to months in patients with major depression. He concluded by expressing that patients under the influence of psilocybin may better come to terms with the reality of their cancer prognosis.

Efficacy findings from the pooled analysis study found that PAP was associated with improved anxiety (P = .0049), depression (P = .0007), interpersonal sensitivity (P = .0005), obsession-compulsion (P = .0002), hostility (P = .009), and somatization (P <.0001) among patients with cancer.

Transcript:

There are not any effective medications to help [patients with] psychological challenges presented by a serious cancer diagnosis. If [patients] have major depression, they can be treated with antidepressants. They can be treated with medicines for anxiety. The antidepressants do not appear to be particularly helpful in this population, and they do not address what the underlying cause is, which, in many cases, is [having] this existential crisis of one’s own possible or probable death in the near future.

In some ways, I tend to think about this situation as an adjustment reaction. [Patients have] a challenging situation, and they may become symptomatic [or] become incapacitated because of the psychological challenges. The psilocybin-assisted treatment, in some ways, acts like any other medication––to treat the symptoms. There are studies for major depression independent of a cancer diagnosis demonstrating enduring effects on depressive symptoms for weeks to months after a single dose of psilocybin.

In this population, one of the ideas behind how this works is that the experiences that [patients] have under the influence of psilocybin may help them better to come to terms with the reality of death and what that means, and to find some acceptance and meaning in the face of [a] challenging situation.

Reference

Petridis PD, Grinband J, Agin-Liebes G, et al. Psilocybin-assisted psychotherapy improves psychiatric symptoms across multiple dimensions in patients with cancer. Nat Mental Health. 2024;2:1408-1414. doi:10.1038/s44220-024-00331-0