Psilocybin May Improve Mental Health Symptoms in Patients With Cancer and Addiction

Psilocybin-assisted therapy (PAT) demonstrated durable shifts in personality, suggesting that normalization of an abnormal personality trait expression is present in alcohol use disorder (AUD), according to study results published in The American Journal of Psychiatry.^1,2 This follows another study published in Nature Mental Health which showed that psilocybin improved the mental health of patients with cancer when accompanied with a psychotherapy.³

The first study, which was published in October 2024³, enrolled 79 patients with cancer and various mental health conditions (eg, anxiety, depression, obsessive compulsive disorder [OCD], paranoia, psychosis) from 2 randomized, placebo-controlled phase 2 trials. During the trials, patients initially received a large dose of psilocybin or either vitamin B3 or a minuscule dose of psilocybin as a placebo.^1,3

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After 6 or 7 weeks, the groups switched treatments and psychotherapy preceded and followed each subsequent dosing session. During these, patients completed questionnaires about their mental health symptoms at the beginning of the study and 6 months following the second dosing.^1,3

The findings demonstrated that psilocybin improved anxiety, depression, interpersonal sensitivity, hostility, OCD, and somatization in patients with cancer. Additionally, the authors observed that there were no lasting phobia, paranoia, or psychosis. These findings were consistent between the 2 clinical trials.³

“Our findings suggest that the mental health benefits of psilocybin therapy for cancer patients may reach far beyond what we have previously understood,” study lead author Petros Petridis, MD, clinical assistant professor in the department of psychiatry at Grossman School of Medicine at New York University (NYU), said in a news release.¹

Because these data show indications that PAT can lead to durable shifts in the brain, the investigators of the second study published in January 2025² evaluated the effect of PAT on personality dimensions in patients who have AUD. The hypothesis was that PAT would attenuate personality abnormalities in AUD, and with treatment, the impulsiveness trait would improve, reducing the urge to drink alcohol, and therefore, lowering the frequency of drinking and the amount of consumption.²

For this second study, 84 adults with AUD were randomly assigned to receive either psilocybin (n = 44) or active placebo (diphenhydramine; n = 40). In addition, they received 12 weekly psychotherapy sessions and completed follow-up for an additional 24 weeks. The end points were changes in personality traits from baseline to week 36 and daily alcohol consumption.²

The results indicated that patients with AUD who received psilocybin showed significant reductions in neuroticism and increases in extraversion and openness. Additionally, secondary analyses showed that reductions in neuroticism were driven by decreases in the facets depression, impulsiveness, and vulnerability, and increases in openness were driven by increases in the facets openness toward feelings and fantasy. Across all participants, decreases in impulsiveness were associated with lower post-treatment alcohol consumption, and an exploratory analysis revealed that these associations were strongest among psilocybin-treated participants who continued moderate- or high-risk drinking prior to the first medication session.^1,2

“Since impulsiveness has long been linked to both excessive drinking and relapse after treatment, the personality changes brought about by psilocybin-assisted psychotherapy may help those recovering from alcohol dependence remain resilient to internal and external stressors known to trigger relapse,” study lead author Broc Pagni, PhD, postdoctoral fellow in the department of psychiatry at Grossman School of Medicine at NYU, said in the news release.¹

REFERENCES

1. Psychedelic drug therapy may address mental health concerns in people with cancer and addiction. News release. NYU Langone Health/NY Grossman School of Medicine. January 2, 2025. Accessed January 14, 2025. https://www.eurekalert.org/news-releases/1068944

2. Pagni BA, Zeifman RJ, Mennenga SE, et al. Multidimensional Personality Changes Following Psilocybin-Assisted Therapy in Patients With Alcohol Use Disorder: Results From a Double-Blind, Placebo-Controlled Clinical Trial. American Journal of Psychiatry. 2024;182(1). doi:10.1176/appi.ajp.20230887

3. Petridis PD, Grinband J, Agin-Liebes G, et al. Psilocybin-assisted psychotherapy improves psychiatric symptoms across multiple dimensions in patients with cancer. Nat. Mental Health 2024;2:1408–1414. doi:10.1038/s44220-024-00331-0