Psilocybin in the Management of Psychological Distress and Somatic Symptoms in Palliative Care Patients

I Gusti Agung Dwi Putri Anjani; Dian Pritasari Jeger

doi:10.55606/termometer.v4i4.6864

Authors

I Gusti Agung Dwi Putri Anjani Universitas Udayana
Dian Pritasari Jeger Universitas Udayana

DOI:

https://doi.org/10.55606/termometer.v4i4.6864

Keywords:

Existential distress, Palliative care, Psilocybin, Psychological distress, Quality of life

Abstract

Psychological and existential distress are common in palliative care and often inadequately managed by conventional therapies. This literature review aimed to evaluate current evidence on psilocybin-assisted therapy as an adjunctive intervention for patients with life-limiting illness. We hypothesized that psilocybin may reduce psychological distress and indirectly alleviate somatic symptom burden. A structured review of recent randomized controlled trials and observational studies was conducted, focusing on depression, anxiety, existential distress, and quality of life outcomes. Findings indicate that, when administered in controlled clinical settings with structured psychological support, psilocybin produces rapid and sustained reductions in depression and anxiety, particularly in advanced cancer. It also facilitates meaningful psychological experiences associated with improved spiritual well-being, reduced fear of death, and greater illness acceptance. Although not a conventional analgesic, improvements in psychological domains may lessen subjective pain and fatigue. Psilocybin represents a promising multidimensional adjunct in palliative care, warranting further large-scale investigation.

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References

Breitbart, W., Rosenfeld, B., Pessin, H., Applebaum, A., Kulikowski, J., & Lichtenthal, W. G. (2015). Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology, 33(7), 749–754. https://doi.org/10.1200/JCO.2014.57.2198

Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., Finan, P. H., & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder. JAMA Psychiatry, 78(5), 481–489. https://doi.org/10.1001/jamapsychiatry.2020.3285

Daws, R. E., Timmermann, C., Giribaldi, B., Sexton, J. D., Wall, M. B., Erritzøe, D., et al. (2022). Increased global integration in the brain after psilocybin therapy for depression. Nature Medicine, 28(4), 844–851. https://doi.org/10.1038/s41591-022-01744-z

Dodd, S., Norman, T. R., Eyre, H. A., Stahl, S. M., Phillips, A., Carvalho, A. F., et al. (2023). Psilocybin in neuropsychiatry: A review of its pharmacology, safety, and efficacy. CNS Spectrums, 28(4), 416–426. https://doi.org/10.1017/S1092852922000888

Doss, M. K., Považan, M., Rosenberg, M. D., et al. (2021). Psilocybin therapy increases cognitive and neural flexibility in patients with major depressive disorder. Translational Psychiatry, 11, 574. https://doi.org/10.1038/s41398-021-01706-y

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., et al. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181–1197. https://doi.org/10.1177/0269881116675513

Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of General Psychiatry, 68(1), 71–78. https://doi.org/10.1001/archgenpsychiatry.2010.116

Gukasyan, N., Davis, A. K., Barrett, F. S., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., & Griffiths, R. R. (2022). Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up. Journal of Psychopharmacology, 36(2), 151–158. https://doi.org/10.1177/02698811211073759

Knaul, F. M., Farmer, P. E., Krakauer, E. L., et al. (2018). Alleviating the access abyss in palliative care and pain relief: An imperative of universal health coverage: The Lancet Commission report. The Lancet, 391(10128), 1391–1454. https://doi.org/10.1016/S0140-6736(17)32513-8

Lehto, R. H., Miller, M., & Sender, J. (2022). The role of psilocybin-assisted psychotherapy to support patients with cancer: A critical scoping review of the research. Journal of Holistic Nursing, 40(3), 265–280. https://doi.org/10.1177/08980101211039086

Ling, S., Ceban, F., Lui, L. M. W., et al. (2022). Molecular mechanisms of psilocybin and implications for the treatment of depression. CNS Drugs, 36(1), 17–30. https://doi.org/10.1007/s40263-021-00877-y

Natoli, S., Cuomo, A., Marchesini, M., Luongo, L., Lo Bianco, G., Guardamagna, V. A., et al. (2025). Psilocybin and chronic pain: A new perspective for future pain therapists? Medical Sciences, 13(4), 277. https://doi.org/10.3390/medsci13040277

National Comprehensive Cancer Network. (2022). Palliative care: NCCN clinical practice guidelines for palliative care (Version 2). National Comprehensive Cancer Network.

Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. https://doi.org/10.1124/pr.115.011478

Ross, S., Agin-Liebes, G., Lo, S., et al. (2021). Acute and sustained reductions in loss of meaning and suicidal ideation following psilocybin-assisted psychotherapy for psychiatric and existential distress in life-threatening cancer. ACS Pharmacology & Translational Science, 4(2), 553–562. https://doi.org/10.1021/acsptsci.1c00020

Ross, S., Agrawal, M., Griffiths, R. R., Grob, C., Berger, A., & Henningfield, J. E. (2022). Psychedelic-assisted psychotherapy to treat psychiatric and existential distress in life-threatening medical illnesses and palliative care. Neuropharmacology, 216, 109174. https://doi.org/10.1016/j.neuropharm.2022.109174

Ross, S., Bossis, A., Guss, J., et al. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–1180. https://doi.org/10.1177/0269881116675512

Saunders, C. (2006). The management of terminal illness. In Cicely Saunders (pp. 91–114). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780198570530.003.0016

Schimmers, N., Breeksema, J. J., Smith-Apeldoorn, S. Y., Veraart, J., van den Brink, W., & Schoevers, R. A. (2022). Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: A systematic review. Psychopharmacology, 239(1), 15–33. https://doi.org/10.1007/s00213-021-06027-y

Schuldt, A., Clark, I. C., Schmid, Y., et al. (2025). Psychedelic-assisted therapy in palliative care—Insights from an international workshop. Healthcare, 13(18), 2275. https://doi.org/10.3390/healthcare13182275

Shnayder, S., Ameli, R., Sinaii, N., Berger, A., & Agrawal, M. (2023). Psilocybin-assisted therapy improves psycho-social-spiritual well-being in cancer patients. Journal of Affective Disorders, 323, 592–597. https://doi.org/10.1016/j.jad.2022.11.044

Turizo Smith, A. D., Jaramillo, N. B., & Berrio Cuartas, D. M. (2025). Psilocybin as a tool in the management of palliative care: An historical, pharmacological and clinical approach. Medical & Clinical Case Reports Journal, 3(2), 895–907. https://doi.org/10.51219/MCCRJ/Andres-David-Turizo-Smith/233

Whinkin, E., Opalka, M., Watters, C., Jaffe, A., & Aggarwal, S. (2023). Psilocybin in palliative care: An update. Current Geriatrics Reports, 12(2), 50–59. https://doi.org/10.1007/s13670-023-00383-7

World Health Organization. (2020). Palliative care. World Health Organization.