Could Psilocybin Ease Depression in Lung Cancer?

Theodore Wagener, PhD, founding director of the Center for Tobacco Research at The Ohio State University and co-leader of the Cancer Control Program at the Ohio State University Comprehensive Cancer Center – James (OSUCCC – James), discusses a single-arm acceptability and feasibility trial of psilocybin-assisted therapy for depression in patients with non–small cell lung cancer (NSCLC). The study was prompted by the high psychological burden of the disease. About 40% of patients with lung cancer meet criteria for depression, and suicide rates are elevated.

The 10-patient study is the first psychedelic trial at Ohio State to enroll patients with cancer. It uses psilocybin, a schedule I drug. After screening and enrollment, participants complete 3 preparation therapy visits, followed by a 6- to 8-hour dosing session and about 3 integration therapy sessions. Follow-up assessments then track how patients are doing.

Three patients have completed the protocol. The study isn’t designed for efficacy analyses, but Wagener said early observations show a signal similar to what has been seen in other psilocybin studies in depression, including significant improvement.

Wagener, a clinical psychologist, explained that depression in lung cancer often goes beyond low mood and loss of enjoyment. Patients also describe existential distress, hopelessness, questions about the meaning of their lives, and worry about being a burden on their families. Stigma tied to smoking history can add guilt, the sense of having done this to themselves and their loved ones. Existing psychological and psychiatric treatments don’t work for everyone, often don’t reach these deeper concerns, and can take a long time.

Psilocybin has been studied in other populations, including patients with cancer other than lung cancer. Qualitative research from those trials suggests it reaches those deeper issues, with participants often calling the experience among the most meaningful of their lives. Because patients with lung cancer often present with advanced disease and may have limited time, Wagener emphasized the potential value of the rapid, profound changes psychedelics may offer. The team hopes to see the same in this study.