Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis

[摘要] Objective To systematically examine the effectiveness and tolerability of psilocybin for treating end-of-life anxiety symptoms. Methods The Medline, Embase, CENTRAL, and PsycINFO databases were searched up to November 25, 2020. We enrolled clinical trials investigating psilocybin for treating end-of-life anxiety symptoms. Meta-analysis was conducted using random-effects model. Results Overall, five studies were included, revealing that psilocybin was superior to the placebo in treating state anxiety at 1 day (Hedges' g,-0.70; 95% confidence interval,-1.01 to-0.39) and 2 weeks (-1.03;-1.47 to-0.60) after treatment. Psilocybin was more effec-tive than placebo in treating trait anxiety at 1 day (-0.71;-1.15 to-0.26), 2 weeks (-1.08;-1.80 to-0.36), and 6 months (-0.84;-1.37 to-0.30) after treatment. Psilocybin was associated with transient elevation in systolic (19.00; 13.58-24.41 mm Hg) and diastolic (8.66; 5.18-12.15 mm Hg) blood pressure compared with placebo. The differences between psilocybin and placebo groups with regard to all-cause discontinuation, serious adverse events, and heart rates were nonsignificant. Conclusion Psilocybin-assisted therapy could ameliorate end-of-life anxiety symptoms without serious adverse events. Because of the small sample sizes of the included studies and high heterogeneity on long-term outcomes, future randomized controlled trials with large sample sizes are needed. Psychiatry Investig 2021;18(10):958-967

[发布日期] 2021-10-01

[关键词] TEST-RETEST PARADIGM;THREATENING CANCER;DEPRESSION;DIAGNOSIS;OPINION;CARE;HIV;DOI