Long left to the fringes of the recreational drug culture, psilocybin — the hallucinatory ingredient in “magic mushrooms” — has recently been making inroads as a legitimate (and fast-acting) antidepressant.

Research published Dec. 18 in Cancer shows its benefits may extend to people battling cancer, who often experience the added burden of depression.

“As an oncologist for many years, I experienced the frustration of not being able to provide cancer care that treats the whole person, not just the tumor,” said study lead author Dr. Manish Agrawal

“This was a small, open-label study and more research needs to be done, but the potential is significant and could have implications for helping millions of patients with cancer who are also struggling with the severe psychological impact of the disease,” he added in a journal news release.  

Agrawal is CEO of Sunstone Therapies, based in Rockland, Md, which funded the phase 2 trial.

In the trial, 30 people with cancer who were experiencing moderate-to-severe depression got a single, 25 milligram dose of synthesized psilocybin. They also received one-on-one sessions with a therapist and group therapy sessions before, during and after the treatment.

Key to patient outcomes was the fact that people were prepped for the treatment beforehand and then received the therapy in these small groups of three to four people, researchers said. 

Sharing the overall experience seemed to help, most participants said. 

Eight weeks after treatment, average depression scores on standard tests fell to levels that were low enough to suggest that most participants were no longer depressed, researchers reported. 

Half of participants were in full remission of their depression within one week of their therapy, and the benefit was sustained over eight weeks of follow-up for 80% of patients. 

Side effects were typically mild and included nausea and headache, researchers said. 

A second study conducted by the same team sought to gather patients’ views on the therapy. 

Most were very positive, with people saying any initial fears they might have had about taking psilocybin were alleviated by engaging in the therapy as a group. Many spoke of the “togetherness” of the experience as a positive, researchers said.

“As a hematologist and palliative care physician and researcher, it was profoundly moving and encouraging to witness the magnitude of participants’ improvement and the depth of their healing journey following their participation in the trial,” said the second study’s lead author, Dr. Yvan Beaussant.

“Participants overwhelmingly expressed positive sentiments about their experience of psilocybin-assisted therapy while emphasizing the importance of the supportive, structured setting in which it took place,” said Beaussant, who specializes in psychosocial oncology and palliative care at the Dana-Farber Cancer Institute in Boston.

He added in the journal news release that many patients “described an ongoing transformative impact on their lives and well-being more than two months after having received psilocybin, feeling better equipped to cope with cancer and, for some, end of life.”

However, the study authors stressed that before psilocybin becomes part of standard clinical practice, more study is needed in larger groups of patients. 

Research is also needed that includes a “control” group, to see how psilocybin compares to other forms of depression treatment.

The study dovetails with the opening, in June, of America’s first licensed psilocybin service center in Eugene, Ore. The Associated Press reported in September that it had a waitlist of more than 3,000 names, including people with depression, PTSD or end-of-life dread..

Colorado voters last year approved a measure allowing regulated use of magic mushrooms starting in 2024, and California also has plans for health officials to develop guidelines for therapeutic use, the AP reported.

More information

Find out more about the growing interest in psilocybin to treat depression at the U.S. National Institutes of Health.

SOURCE: Cancer, news release, Dec. 19, 2023; Associated Press, Sept. 15, 2023