Doctors tend to prioritize cancer patient’s physical health. But often, the sickest patients suffer mental health ailments, too—up to 40% (paywall) of cancer patients experience some sort of mood disorder while in the hospital. And so far, the evidence (paywall) suggests the drugs typically prescribed for depression can’t help in these circumstances.
Hallucinogens, though, might work. On Dec. 1, researchers from Johns Hopkins University and New York University Langone Medical Center published two studies of small clinical trials testing psilocybin in cancer patients with anxiety and depression related to their physical illness. Psilocybin is the chemical responsible for the intense, otherworldly trips caused by eating psychedelic mushrooms. Both research teams found that in the vast majority of cases, patients felt relieved of their anxiety for up to six months after taking the drug.
Scientists have known for some time that psychedelic drugs may have some kind of mental health benefit. In 2013, Norwegian researchers published work analyzing a massive cohort and found that those who reported taking hallucinogens were much less likely to have mental health problems than their peers.
However, studying these drugs has been extremely difficult in the US; the federal government hasn’t sponsored many tests on psychedelics since the passage of the Controlled Substance Act in 1970.In the US, psilocybin, LSD, and many other hallucinogens are still labeled as schedule I drugs, which labels them as illegal, highly addictive, with no medicinal purposes. (Heroin is also in this category, as is marijuana.)
The two recent trials both received most of their funding through private, nonprofit organizations, and were approved and monitored by their respective university’s institutional review boards.
A typical dose is 3.5 grams of dried mushroom, but the researchers were able to isolate the active ingredient, and found that 25 milligrams of psilocybin given to patients in the presence trained guides was effective in relieving anxiety without negative side effects.
In the NYU study, 29 late-stage cancer patients with anxiety and depression were given either psilocybin or a harmless vitamin called niacin as a placebo. Two months later, they were given the opposite pill. Researchers found that tripping calmed patients both immediately afterward and six months later. In addition, the drug appeared to work as well as antidepressants normally do in as many as 80% of these patients, based on patients’ answers to mental health surveys before and after the trial.
The Johns Hopkins study looked at 51 similar patients who were given either a low dose of psilocybin relative to their body weight (roughly three milligrams) or a high dose (roughly 25 milligrams). Five weeks later, patients received the opposite dose. Similarly, researchers found that most patients felt their mental health symptoms had been alleviated six months after tripping on the high dose, and 65% and 57% reported no longer feeling any depression or anxiety, respectively.
Stephen Ross, a psychiatrist at NYU and lead author of one of the studies, told the Atlantic he was surprised by how well tripping on psilocybin seemed to work for patients. “The moment [the patients] get psilocybin, their distress comes down,” he said. “That’s very new in psychiatry, to have a medication that works immediately for depression and anxiety and can last for that long.”
Scientists still aren’t sure how these drugs work to cause these trips, or the lasting feeling of contentedness. But it seems having these intense, emotional hallucinations helps patients experience and process their circumstances in ways they otherwise couldn’t. “Increasing the power of experience may help people acquire a new perspective on themselves and their lives,” David Spiegel, a psychiatrist at Stanford University unaffiliated with either study, wrote in a commentary accompanying the studies. Even if patients recognize that they can’t do anything about their devastating illness, perhaps psychedelics help them feel more at peace with it.