CancerNetwork® spoke with Michael P. Bogenschutz, MD, director of the NYU Langone Center for Psychedelic Medicine and professor of Psychiatry at NYU Grossman School of Medicine, about psilocybin-assisted psychotherapy (PAP) in managing psychological challenges associated with serious cancer diagnoses following the publication of a pooled analysis of 2 phase 2 trials assessing the regimen in this patient population.



In these trials, 87 patients were randomly assigned 1:1 to receive either psilocybin first (n = 45) or control therapy with niacin or low-dose psilocybin first (n = 42) followed by crossover. A total of 79 patients completed at least 1 assessment after the first dose.



He began by touching upon the significance of the results, highlighting an improvement in multiple psychiatric symptoms including anxiety (P = .0049), depression (P = .0007), interpersonal sensitivity (P = .0005), obsession-compulsion (P = .0002), hostility (P = .009), and somatization (P < .0001). Then, Bogenschutz discussed the potential for PAP to reduce an unmet need for patients seeking effective medication to mitigate cancer-related psychological challenges, highlighting limitations of both antidepressants and anxiety medication in this population. 



Next, Bogenschutz discussed implementing PAP into clinical practice for patients with cancer-related psychological challenges. In particular, he expressed that integration could occur through in-house operation, which may build the capacity to provide PAP within cancer centers, or through a referral system to a licensed practitioner trained to administer psilocybin. 



Additionally, he described potential adverse effects associated with psilocybin use, highlighting acute mind-altering and sympathomimetic effects. He then expressed the importance of psychotherapy as a means of supplementing the use of psilocybin, which may help patients better attain positive mental health outcomes than with psilocybin alone.  He concluded by highlighting the lasting effects of psilocybin dosing, which may persist for months after a single dose, as well as areas for future research in assessing PAP. Specifically, he emphasized exploring ideal treatment parameters and the full psychopathological scope of the agent.



Reference



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;2:14 08-1414. doi:10.1038/s44220-024-00331-0