Psychiatry Investig.
2021 Oct;18(10):958-967. 10.30773/pi.2021.0209.
Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis
- Affiliations
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- 1Department of Pharmacy, Chang-Gung Memorial Hospital, Linkou, Taiwan
- 2Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- 3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- 4Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- 5Department of Psychiatry, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan
- 6Graduate Institute of Health and Welfare Policy, National Yang Ming University, Taipei, Taiwan
- 7WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan
- 8Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- 9Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, De Crespigny Park, London, UK
- 10Positive Ageing Research Institute (PARI), Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
- 11Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- 12Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- 13Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- 14Department of Nursing, Meiho University, Pingtung, Taiwan
- KMID: 2521657
- DOI: http://doi.org/10.30773/pi.2021.0209
Abstract
Objective
To systematically examine the effectiveness and tolerability of psilocybin for treating end-of-life anxiety symptoms.
Methods
The Medline, Embase, CENTRAL, and PsycINFO databases were searched up to November 25, 2020. We enrolled clinical trials investigating psilocybin for treating end-of-life anxiety symptoms. Meta-analysis was conducted using random-effects model.
Results
Overall, five studies were included, revealing that psilocybin was superior to the placebo in treating state anxiety at 1 day (Hedges’ g, -0.70; 95% confidence interval, -1.01 to -0.39) and 2 weeks (-1.03; -1.47 to -0.60) after treatment. Psilocybin was more effective than placebo in treating trait anxiety at 1 day (-0.71; -1.15 to -0.26), 2 weeks (-1.08; -1.80 to -0.36), and 6 months (-0.84; -1.37 to -0.30) after treatment. Psilocybin was associated with transient elevation in systolic (19.00; 13.58–24.41 mm Hg) and diastolic (8.66; 5.18–12.15 mm Hg) blood pressure compared with placebo. The differences between psilocybin and placebo groups with regard to allcause discontinuation, serious adverse events, and heart rates were nonsignificant.
Conclusion
Psilocybin-assisted therapy could ameliorate end-of-life anxiety symptoms without serious adverse events. Because of the small sample sizes of the included studies and high heterogeneity on long-term outcomes, future randomized controlled trials with large sample sizes are needed.
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