Efficacy of psilocybin on death anxiety in terminal patients: a narrative review

Psilocybin-assisted therapy is a promising and potentially effective intervention for reducing death anxiety in terminally ill patients, with sustained benefits and a generally favourable safety profile

In this new review, the authors highlight the promising efficacy of psilocybin-assisted therapy in reducing death anxiety among terminally ill patients, with evidence from prior clinical trials indicating moderate-to-large and clinically meaningful reductions in anxiety. The review highlights that even a single supervised psilocybin session can produce rapid and sustained improvements lasting several months, likely mediated through serotonergic activity (particularly 5-HT2A receptor activation) and disruption of rigid self-referential brain networks, enabling patients to reframe existential distress and develop greater acceptance of mortality. In addition to reducing anxiety, the therapy appears to enhance emotional and spiritual well-being, with a generally favoupsilocybin-assistedrable safety profile when administered in controlled settings. However, the authors emphasise that the current evidence base remains limited, and further large-scale, well-controlled studies are needed before widespread integration into palliative care practice.

“This narrative review synthesized the use of psilocybin-assisted therapy as a promising treatment for alleviating death anxiety in terminally ill patients.

The insights presented are derived from findings reported in previous studies. Therefore, this review aimed to assess the efficacy, pharmacology, and mechanisms by which psilocybin alters brain function by affecting 5-HT2A receptors and disrupting the default mode network (DMN), helping to reduce existential fear.

Recent randomized controlled trials (RCTs) demonstrated substantial progress in therapy, with results showing standardized mean differences in anxiety reduction ranging from −0.70 to −1.08, with effects lasting up to six months after a single dose. This review examines the implications for clinical practice, highlighting psilocybin’s favorable safety profile and its potential to fill therapeutic gaps left by conventional treatments, and also addresses the ethical issues surrounding the use of psilocybin in terminally ill patients.

The findings support the integration of psychedelic-assisted methods with standard palliative care to enhance end-of-life care and also highlight potential directions for further studies”

Barimbing, M. L., Jeger, D. P., & Sridana, M. E. (2026). Efficacy of psilocybin on death anxiety in terminal patients: a narrative review. Progress in Palliative Care, 1–10. Read Paper

For more psychedelic news and research, visit the psychedelic health professional network homepage.