A pilot study suggests the hallucinogen psilocybin may be feasible and safe to administer to patients with advanced-stage cancer and anxiety, with promising effects on mood, according to a report published online today that will appear in the January 2011 print issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
"In recent years, there has been a growing awareness that the psychological, spiritual and existential crises often encountered by patients with cancer and their families need to be addressed more vigorously," the authors write as background information in the article. "From the late 1950s to the early 1970s, research was carried out exploring the use of hallucinogens to treat the existential anxiety, despair and isolation often associated with advanced-stage cancer. Those studies described critically ill individuals undergoing psychospiritual epiphanies, often with powerful and sustained improvement in mood and anxiety as well as diminished need for narcotic pain medication."
Despite initial promising results, no follow-up research had been conducted; however, the medical value of hallucinogens is now being re-examined in psychiatric settings, the authors note. Charles S. Grob, M.D., of Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, explored the safety and efficacy of psilocybin--a hallucinogen with some psychological effects similar to lysergic acid diethylamide (LSD)--among 12 adults with advanced-stage cancer and anxiety.
Participants served as their own controls; in two six-hour treatment sessions several weeks apart, they were given clear capsules either of active psilocybin (in a dose of 0.2 milligrams per kilogram) or a placebo (niacin, 250 milligrams) in random order. Physiological responses such as blood pressure, heart rate and temperature were measured before and after, and psychological measures including assessments of depression, mood and anxiety were administered before and at the end of the session, one day and two weeks after the session and at monthly intervals for the following six months.
"Safe physiological and psychological responses were documented during treatment sessions," the authors write. "We also observed no adverse psychological effects from the treatment. All subjects tolerated the treatment sessions well, with no indication of severe anxiety or a 'bad trip.'" In addition, anxiety scores improved at one and three months after treatment and a depression inventory revealed an improvement of mood that began two weeks after treatment and reached significance at six months.
"This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety," the authors conclude. "Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field."
(Arch Gen Psychiatry. Published online September 6, 2010. doi:10.1001/archgenpsychiatry.2010.116. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This work was supported by the Heffter Research Institute; the Betsy Gordon Foundation; the Nathan Cummings Foundation, with the support and encouragement of James K. Cummings; and a grant from the National Institutes of Health to the Harbor-UCLA General Clinical Research Center. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.