Psychedelics are helping people face death with peace in breakthrough trial
An Australian-first trial has found that a compound in magic mushrooms significantly alleviates depression and anxiety in terminally ill patients, when combined with therapy.
The study, which was conducted at St Vincent’s Hospital Melbourne between January 2020 and October 2023, involved 35 patients with life-threatening and advanced illnesses including cancer, motor neurone disease and late-stage heart disease.
Dr Margaret Ross (left) and Dr Justin Dwyer led a trial of psychedelic-assisted therapy.Credit: Simon Schluter
It’s hoped the findings pave the way for the psychedelic drug psilocybin to be used by more palliative care patients facing their terminal diagnosis.
Clinical psychologist Dr Margaret Ross, who led the study alongside psychiatrist Dr Justin Dwyer, said participants had a transformative experience.
The patients, aged between 27 and 75, observed significant improvements to their mental health in as little as 24 hours.
Many reported long-lasting boosts to their mood, outlook and wellbeing for up to six months following the treatment.
‘This enabled people to step back into the feeling of being alive, connected and valued.’
Dr Justin Dwyer, psychiatrist
“When people know they’re going to die, their entire world collapses on them,” Dwyer said.
“Relationships feel distant and eerie. And there really is a sense of walking through the world in the state of existence, rather than a state of life. This enabled people to step back into the feeling of being alive, connected and valued. It also allowed them to confront their death and embrace it as a natural part of their life. That’s extraordinary.”
Ross said that being in an altered state allowed patients to access the depths of their terror and despair.
“From a therapeutic point of view, that is really valuable,” she said.
The dose room at the Melbourne clinic where participants underwent the trial.Credit: Chris Hopkins
“It’s intensely challenging and very different [in a clinical setting] to taking it at a doof [music festival].”
Participants took part in two treatment sessions over several weeks. In the first, they were randomly given either a dose of synthetic psilocybin – the psychoactive ingredient in magic mushrooms – or a placebo. During the second session, all participants received psilocybin.
During the eight-hour dosing process, patients lay on a bed in a softly lit room scented with essential oil at the Caritas Christi Hospice in Kew, in Melbourne’s east.
After taking their capsule of psilocybin, participants put on eye masks and headphones and tuned into their choice of music while being monitored by two trained clinicians.
“We had access to a large library of music that we actively used to intensify their experience,” Dwyer said. “Some of that music was world music, some of it was indigenous music, some of it was modern electronic stuff.”
Participants completed questionnaires about their mental health before and after their treatment.
Pat Quinn holds a photo of her late husband Michael, who took part in the trial.Credit: Simon Schluter
Those in the psilocybin group went from having moderately severe depression to not qualifying for a diagnosis of depression. Those in the placebo group experienced a small improvement in their symptoms, but remained moderately to severely depressed.
Participants had nine psychotherapy sessions, both before and after dosing, to help them prepare for and process their experience.
Michael Quinn took part in the trial in 2023 after enduring two years of gruelling, and ultimately unsuccessful, treatments for prostate cancer.
The keen sailor, who died last year, had heard about how psilocybin had helped US pro surfer Koa Smith overcome depression and trauma, and wanted to give it a shot.
“It softened the edges for him,” said Quinn’s wife, Pat. “He became more empathetic and more emotional. It really improved his ability to cope with the prognosis he had.
“Michael had never taken any psychedelic or any recreational drugs. He couldn’t understand why anybody would ever take magic mushrooms or any psychedelics for pleasure because he didn’t find it pleasurable.”
But while he did not enjoy the dosing process, he found it incredibly beneficial when combined with the psychotherapy sessions.
“It helped rework his brain,” Pat said. “Death became a reality that he was at peace with.”
In February 2023, Australia became the first country in the world to formally recognise psychedelics as medicines. That followed the Therapeutic Goods Administration rescheduling psilocybin and MDMA for the treatment of chronic depression and PTSD – under the care of a psychiatrist.
But psychedelic-assisted therapy is still in its early stages as a medical treatment, and difficult to access due to cost. Ross said some clinics offering the treatment for drug-resistant depression charge upwards of $27,000.
While 7000 people applied to be part of the St Vincent’s trial, the researchers were only able to include 35 patients.
Ross and Dwyer are hopeful that private health insurers will one day fund the treatment, with group sessions making it more affordable.
It’s not known exactly why psychedelics improve the mental health of patients. But, as Dwyer points out, no one knows why antidepressants work either.
“It alters different parts of the brain and the way they communicate with one another,” he said. “But how people go from despairing, disconnected and fearful to feeling they can embrace their life – no one has an explanation for that.”
The Royal Australian and New Zealand College of Psychiatrists says the evidence base for psilocybin and MDMA therapy is “limited and emerging”.
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