Psychedelic-assisted psychotherapy to treat psychiatric and existential distress in life-threatening medical illnesses and palliative care

• Published in: Neuropharmacology Vol. 216; p. 109174
• Main Authors: Ross, S., Agrawal, M., Griffiths, R.R., Grob, C., Berger, A., Henningfield, J.E.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 15.09.2022
• Subjects: Anxiety; Demoralization syndrome; Depression; Existential distress; Palliative care; Psychedelics; Palliative care; Depression; Anxiety; Psychedelics; Existential distress; Demoralization syndrome
• ISSN: 0028-3908; 1873-7064
• DOI: 10.1016/j.neuropharm.2022.109174

Psychiatric and existential distress commonly occur in advanced cancer and other serious, life-threatening or end-of-life medical illnesses and are associated with poor medical and psychiatric outcomes. Currently available treatment modalities in this patient population, including medication and psychotherapy, are limited in effectiveness, especially regarding existential distress. The lack of effective psycho-spiritual interventions is a critical shortcoming in palliative care and represents a high unmet need in medicine. In this commentary, we review the rationale of researching and developing psychedelic-assisted psychotherapy as a novel pharmacologic-psychotherapeutic intervention to treat psychiatric and existential distress in life-threatening medical conditions and palliative care. This paper reviews efficacy data from first and second waves of psychedelic research, and future directions for research and implementation science. More rigorous research, especially funded by governments, is needed to assess effectiveness and mechanisms of action of psychedelic therapies to treat psychiatric and existential distress in life-threatening medical illnesses and palliative care. If psychedelic-assisted treatments were made available as approved and prescribable medications in people with serious medical illnesses, it could be a significant development that opens up a pathway for clinical dissemination and public health impact internationally. This article is part of the Special Issue on ‘Psilocybin Research’. •Psychiatric and existential distress are prevalent in serious medical illnesses.•This emotional distress is associated with poor medical and psychiatric outcomes.•Currently available therapies are limited in effectiveness.•Research suggests a role for psychedelic-assisted treatments.•More rigorous research is necessary to explore psychedelic therapies in this area.