The potential role of psychedelics in palliative care

Psychedelic substances such as psilocybin, LSD, MDMA, and ketamine are being considered as an alternative treatment for depression, existential distress, and chronic pain in palliative medicine. The review describes how these compounds enhance neuroplasticity and reorganize neural networks in the brain. Recent clinical studies suggest psychedelics can produce rapid and long-lasting antidepressant and anxiolytic effects with a low risk of serious adverse events. However, legal restrictions in most countries hinder scientific progress. Further large-scale clinical trials and precise clinical guidelines are needed before routine integration into palliative care, with particular attention to patients with suicidal ideation.

Study at a glance

Abstract

In recent years, there has been a growing interest in the therapeutic use of psychedelics. In palliative medicine, they are being considered as an alternative approach to treating depression, existential distress, and chronic pain conditions. This review presents current literature on the use of psychedelic substances such as psilocybin, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, and ketamine in patients at the end of life. The mechanisms of action of these compounds are discussed in detail, with a particular focus on their ability to enhance neuroplasticity and reorganize neural networks in the brain. The paper also examines findings from recent clinical studies, which suggest that psychedelics can produce rapid and long-lasting antidepressant and anxiolytic effects with a low risk of serious adverse events. However, legal restrictions on these substances in most countries continue to hinder scientific progress. While current evidence is promising, further large-scale clinical trials and the development of precise clinical guidelines are needed before psychedelics can be routinely integrated into palliative care. One area that warrants particular attention in future research is the use of psychedelics in patients with suicidal ideation, for whom rapid antidepressant effects are especially critical.