In people with advanced cancer, psychedelics such as psilocybin, LSD and MDMA can have a significant effect reduce the severity of depression and anxiety symptoms.
About 10% of patients with cancer experience anxiety, while 20% report depression. However, current research suggests that antidepressants are available by prescription did not significantly reduce depressive symptoms in cancer patients compared to a placebo.
My team and me recently completed one meta-analysis of five clinical studies investigating anxiety and depression symptoms in patients with advanced cancers and other life-threatening diseases. We found that only taking psychedelic drugs – specifically LSD, psilocybin or MDMA – lowered depression scores, as measured by the Beck’s Depression Inventory with six points, with a score below 10 indicating minimal to no depression and above 30 indicating severe depression. Mean scores at baseline were between 15 and 18 for most studies, although one trial had a baseline of about 30. Psychedelics also reduced anxiety scores as measured by the State Characteristic Anxiety Inventory by seven to eight points, where a score of 20 to 37 indicates no or minimal anxiety and a score of 45 to 80 indicates high anxiety. The average scores were between 40 and 55 mA about 60 in one trial.
In one study of 51 cancer patients, 60% of those who received a single high-dose psilocybin session achieved clinical remission for depression and 52% for anxiety. In comparison, 16% of those who received a placebo achieved remission for depression and 12% for anxiety. These effects still persisted six months later.
Psychedelics and Trauma
Why would one to two psychedelic therapy sessions be more effective than taking prescription medications such as fluoxetine (Prozac) and paroxetine (Paxil) daily?
Getting a cancer diagnosis and experiencing side effects from treatments can be traumatic. In severe cases, patients may develop cancer-related post-traumatic stress disorder.
People who develop PTSD from military service or physical or sexual violence often suffer from depression and anxiety. Investigation MDMA-facilitated psychotherapy, in which psychotherapists integrate psychedelic sessions with traditional counseling, has shown that this treatment approach can effectively reduce PTSD symptoms by allowing patients to share traumatic memories to help process them. These reductions were greater than those seen in studies of prescription antidepressants alone.
Based on this research, my team and I hypothesize that psychedelic sessions may have an advantage over traditional prescription antidepressants for patients with cancer-related depression or anxiety, as it may help them cope with their underlying trauma.
Some of the studies in our review noted what patients considered the reasons for the reduced anxiety and depression symptoms they experienced. Patients stated that the psychedelic sessions helped them process the intense feelings they were suppressing without becoming overwhelmed. Although the catharsis was emotional and difficult, it helped them accept those emotions, reducing their feelings of isolation and inner withdrawal.
Strangers in psychedelic therapy
While these results are promising, there are limitations to the available research that may bias the results. a number of advanced cancer tests we examined people with a history of psychedelic use, among others. People with prior positive recreational psychedelic experiences are more likely to participate in these studies than those who have had a “bad trip” or were totally against recreational drugs. Moreover, even though the placebo was made to look identical, it is unlikely that patients or caregivers were fooled if it did not produce a psychedelic effect.
While previous studies have found moderate benefits from traditional antidepressants compared to placebos in PTSD And cancer-induced anxiety and depression, there have been no clinical trials directly comparing the effectiveness of traditional antidepressants with psychedelics for PTSD or cancer patients. One completed early phase study comparing psilocybin to the traditional antidepressant escitalopram (Lexapro) in patients with major depression found that 57% of people who received psilocybin achieved clinical remission, compared to only 28% who received escitalopram.
Finally, psychedelic sessions caused a lot increases in blood pressure. This may not be the best treatment for patients with poorly controlled hypertension or heart disease.
Next steps for psychedelics
More research is needed on the effectiveness of psychedelics to treat anxiety and depression in cancer patients. Research into psychedelic treatments for patients with other life-threatening illnesses that cause trauma, anxiety or depression could clarify their potential therapeutic benefits.
If the Food and Drug Administration were to approve psychedelics for this type of use, the agency would have to figure out how to legally use these psychedelics. If Schedule 1 drugsthey are currently banned from any medical use in the U.S. Researchers must register with the US Drug Enforcement Agency study controlled substances. However, the FDA has already set a precedent with its June 2018 approval cannabidiol (Epidiolex) for the treatment of rare epileptic disorders in children, even though this cannabis derivative remains banned by the Drug Enforcement Administration.