Author: Joshua Smith-Sreen
Institution: Boston University
Cancer patients are known to develop clinically significant, long-term symptoms of depression and anxiety. In fact, one in four cancer patients has clinical depression and almost 40% meet the criteria for a mood disorder.1 However, a recent Johns Hopkins University study shows that hope may lie in psychedelic research. In this long-awaited study, published in the Journal of Psychopharmacology on December 1, 2016, psilocybin - the major hallucinogenic compound in 'magic mushrooms' - was found to produce substantial, sustained decreases in depression and anxiety amongst patients with life-threatening cancer1.
In this 9-month long study, 51 cancer patients with severe diagnoses, ranging from breast to hematological cancers, combined with significant mental health diagnoses that included anxiety and/or mood symptoms, were randomized and separated into two groups1. Over the two sessions of the experimental portion of this study, one group was randomly assigned to receive a very low, placebo-like dose of psilocybin (1 - 3mg per 70kg) on the first session, while the other group was assigned to receive a high dose (22 - 30mg per 70kg) on the first session1. On the second session, 5 weeks later, each group received the dosage they had not initially. This study is considered a double-blind crossover trial, meaning that at one point in the experiment all subjects unknowingly switch from an active substance to a placebo or vice versa.2
Expectations are thought to play an especially large role in the qualitative effects of hallucinogens,1 which is why the study had several measures to combat against any given expectations. For example, each session was conducted in the same living-room like environment and all psilocybin was administered to patients in identical, opaque gelatin capsules.1
Results for the study were collected before, during, and after both experimental sessions, as well as five weeks after each session, and then again at the 6-month follow-up. At the 5-week measure, high-dose psilocybin produced large decreases in clinician and self-rated measures of depressed mood and anxiety, as well as increases in quality of life, life meaning and optimism measures1 These changes were sustained, with approximately 80% of participants showing clinically significant decreases in depression and anxiety he 6-month follow-up.1
These results speak volumes.
The prospect of death, amongst other stresses of life with cancer, takes a great toll on mental health. Also, depression is an independent risk factor for early death in cancer patients, and research on treatments involving antidepressants have yielded limited and conflicted efficacy.1 In this study, psilocybin yielded sustained, clinically significant efficacy in decreasing symptoms of depression and anxiety in a sample of cancer patients. Perhaps psilocybin therefore has a place in the drug regimen of a psychologically distressed cancer patient.
This study was significant in another way, as well. The role of hallucinogenic compounds in medical research is not entirely recent. Psychedelic research was beginning to flourish between 1953 and 1973, when the federal government spent four million dollars funding 116 research studies into a hallucinogenic substance related to psilocybin, lysergic acid diethylamide (LSD).3 However, due to widespread counterculture recreational use of psychedelics during the 1960s, President Richard Nixon signed the Controlled Substances Act and placed psychedelics on Schedule 1, prohibiting their use in any context. 3 As a result, medical research with psychedelic compounds shut down for four decades.
The Johns Hopkins study is one amongst a specified few advocating for “a renaissance of psychedelic research” in the United States.3 Its powerful results, indicating a potential role for psychedelics in treating anxiety and depression in cancer patients, may be just the push this growing movement needs.