Home-based psilocybin-assisted therapy for a patient with advanced cancer: A case report

A 51-year-old man with metastatic lung cancer and a prognosis of less than 6 months experienced depression and anxiety linked to demoralization and existential distress, which persisted despite psychotherapy and 100 mg of sertraline. Through Health Canada’s Special Access Program, he received 25 mg of oral psilocybin in a homecare setting, with preparative and integrative therapy before and after the session. The treatment was well tolerated, and the patient reported a sustained reduction in suffering and improved well-being at 2 months post-intervention. Psilocybin-assisted therapy may be safely delivered at home and offer lasting relief for anxiety and depression associated with existential distress in palliative care.

Study at a glance

Abstract

Abstract Objectives Psychospiritual distress affects many patients with cancer, contributing to diminished quality of life, decreased survival and a desire for hastened death. The current standard of care, which primarily consists of antidepressants and psychotherapy, has demonstrated only modest benefits. Psilocybin-assisted therapy (PAT) has shown evidence of rapid, durable, and significant effects on measures of both depression and anxiety in this patient population. Methods A 51-year-old man diagnosed with metastatic lung cancer, referred to palliative care (PC) with a prognosis of less than 6 months, experienced depression and anxiety in the context of demoralization and existential distress. His suffering persisted despite psychotherapy and treatment with 100 mg of sertraline. He was granted access to PAT through Health Canada’s Special Access Program (SAP) and was treated with 25 mg of oral psilocybin in a homecare setting, with preparative and integrative therapy prior to and following the PAT session. Results PAT was well tolerated, with significant decreases in both anxiety and depression. The patient subjectively reported a sustained reduction in suffering and improved well-being at 2 months post-intervention. Significance of results PAT, when utilized within an appropriate therapeutic framework, may be safely delivered at home and may serve as an effective and long-lasting treatment for symptoms of anxiety and depression associated with psychospiritual symptoms of existential distress in PC. Future studies should examine differences in outcomes between clinical and homecare settings for PAT, and could include creating practice guidelines and protocols for home-based PAT.