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Psychiatry Investig > Volume 18(10); 2021 > Article
Psychiatry Investigation 2021;18(10):958-967.
DOI: https://doi.org/10.30773/pi.2021.0209    Published online October 8, 2021.
Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis
Chia-Ling Yu1  , Fu-Chi Yang2,3  , Szu-Nian Yang4,5,6  , Ping-Tao Tseng7  , Brendon Stubbs8,9,10  , Ta-Chuan Yeh11  , Chih-Wei Hsu12  , Dian-Jeng Li13,14  , Chih-Sung Liang3,4 
1Department of Pharmacy, Chang-Gung Memorial Hospital, Linkou, Taiwan
2Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
4Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
5Department of Psychiatry, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan
6Graduate Institute of Health and Welfare Policy, National Yang Ming University, Taipei, Taiwan
7WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan
8Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
9Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, De Crespigny Park, London, UK
10Positive Ageing Research Institute (PARI), Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
11Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
12Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
13Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
14Department of Nursing, Meiho University, Pingtung, Taiwan
Correspondence: Dian-Jeng Li ,Tel: +886-7-751-3171, Fax: +886-7-16-1843, Email: edcrfvm45@hotmail.com
Correspondence: Chih-Sung Liang ,Tel: +886-2-2895-9808, Fax: +886-222895-7633, Email: lcsyfw@gmail.com
Received: June 17, 2021   Revised: July 15, 2021   Accepted: July 23, 2021   Published online: October 8, 2021
Abstract
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 effective 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 allcause 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.
Key words   Psilocybin; End-of-life anxiety; Life-threatening disease; Meta-analysis; Cancer


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