A single dose of psilocybin—the psychoactive compound in “magic mushrooms”—administered with psychological support continued to relieve depression and anxiety for two years in a small study of cancer patients with major depressive disorder.

 

A cancer diagnosis often gives rise to feelings of sadness or distress, but about 25% of patients develop clinically significant depression, which can lead to worse outcomes and reduced quality of life. Psilocybin is a serotonergic agonist that alters perception, mood and ego function. Its potential for improving well-being in people with life-threatening illness was recognized decades ago.

 

Manish Agrawal, MD, of Sunstone Therapies and Aquilino Cancer Center, and colleagues enrolled 30 people at a community cancer center who had curable or incurable cancer and major depressive disorder. This open-label Phase II trial was not randomized, and all participants received a single 25 milligram dose of psilocybin in oral capsules. In addition, they participated in one-on-one therapy sessions with trained clinicians and group therapy before and after psilocybin administration.

 

In 2023, the researchers reported initial results showing that 80% of psilocybin recipients saw an improvement in depression severity at eight weeks, and half experienced full remission. In a new analysis at two years, 50% experienced a sustained improvement in depression, and 43% had a sustained reduction in anxiety.

 

Psilocybin combined with psychotherapy could offer “a potentially paradigm-changing alternative to traditional antidepressants requiring further study,” Agrawal says. Building on these findings, a randomized double-blind trial is now underway.