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Review of Psilocybin Use for Depression among Cancer Patients after Approval in Oregon

Summary

Psilocybin, the active compound in certain mushrooms, shows promise as a treatment for depression and anxiety in cancer patients, particularly those nearing end of life. Oregon legalized supervised psilocybin therapy in 2020, making it the first U.S. state to do so. While clinical research shows the treatment can rapidly reduce depression and improve quality of life, the actual rollout has faced challenges including regulatory hurdles, lack of professional standards, and unequal geographic access.

Background

Depression affects 15-25% of cancer patients and is often undertreated despite its significant impact on treatment adherence, quality of life, and mortality. Current antidepressants have limited effectiveness in terminally ill cancer patients. Oregon became the first U.S. state to legalize psilocybin therapy for depression related to terminal illnesses in 2020.

Objective

This review synthesizes empirical data on psilocybin therapy for cancer-related depression following Oregon’s legalization, examining therapeutic benefits, adverse effects, dosing regimens, and barriers to implementation. It analyzes Oregon’s experience as a pioneering state implementing psychedelic-assisted therapy in real-world clinical practice.

Results

Clinical trials demonstrate rapid and sustained reductions in anxiety, depression, demoralization, and existential distress in cancer patients following psilocybin treatment. Neuroimaging studies show increased brain network integration and connectivity. However, implementation in Oregon faces significant barriers including geographic opt-outs, regulatory ambiguities, healthcare system integration challenges, liability concerns, and limited administration methods.

Conclusion

While psilocybin shows promising therapeutic potential for cancer-related depression with sustained benefits observed for months post-treatment, Oregon’s implementation reveals substantial legal, ethical, and logistical challenges. Establishing comprehensive regulatory frameworks, professional standards, equitable access mechanisms, and rigorous data collection protocols is essential as psilocybin transitions from research to clinical practice.
  • Published in:Cancers (Basel),
  • Study Type:Review,
  • Source: PMID: 38730654, DOI: 10.3390/cancers16091702
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