Anxiety and end-of-life distress

Evidence by molecule

How strong the research is for each treatment, on our four-level evidence scale. Each links to the full molecule guide.

What the research shows

Anxiety and depression with life-threatening illness. Two randomised crossover trials of psilocybin, with 51 and 29 people with cancer, found rapid drops in anxiety and depression. About 60–80% of participants still had clinically meaningful improvements six months later.¹² In a 42-person trial of LSD in people with anxiety, some of whom had a serious illness, two sessions reduced anxiety for up to 16 weeks.³ See our psilocybin and LSD guides.

Generalized anxiety disorder. In a 198-person randomised trial, a single dose of a pharmaceutical form of LSD (MM120) reduced anxiety in a dose-dependent way, without added psychotherapy. Phase 3 trials are under way.⁴

Established treatments

Psychotherapy, medicines, and palliative and supportive care all help with anxiety and distress in serious illness. Talk to a qualified health professional about your own situation.

Studies in the library

• Review: psychedelic treatments in psychiatry still count as experimentalOther · 2026 · Evidence: Low
• Two ketamine doses worked similarly across depression, PTSD, anxiety and OCDRCT · 2026 · Evidence: Low
• Review of microdosing trials finds no clear mood benefit over placebo in healthy adultsMeta-analysis · 2026 · Evidence: Moderate
• Review finds psychedelic therapy research uses scattered, inconsistent ways of measuring resultsSystematic review · 2026 · Evidence: Low
• What people said about music during psilocybin therapy for life-threatening illnessOther · 2026 · Evidence: Low
• A scoping review of how psychedelics affect thalamus-to-cortex brain circuitsSystematic review · 2026 · Evidence: Very low
• Review: can psychedelics and ketamine change how people read social cues?Systematic review · 2026 · Evidence: Low
• Psilocybin and anxiety, quality of life and functioning in 15 veterans with hard-to-treat depressionOpen-label trial · 2026 · Evidence: Very low
• Intranasal ketamine and existential distress in advanced cancer: secondary trial resultsRCT · 2026 · Evidence: Very low
• Review of liver safety in ketamine treatment for mood and anxiety disordersSystematic review · 2026 · Evidence: Low
• A second group psilocybin session for cancer patients who only partly improved the first timeOpen-label trial · 2026 · Evidence: Very low
• Review of where psychedelic-assisted therapies stand in the clinic and in regulationOther · 2026 · Evidence: Very low
• Review of interview studies: how psychedelics change how seriously ill people view deathSystematic review · 2026 · Evidence: Low
• Ayahuasca retreat for LGBTQ+ participants linked to lower depression and anxiety scoresObservational · 2026 · Evidence: Low
• Review pooling 8 studies finds psychedelic experiences linked to lower death anxietyMeta-analysis · 2026 · Evidence: Low
• Placebo groups in psychedelic trials also improved, but less than treatment groupsMeta-analysis · 2026 · Evidence: Moderate
• Small open-label trial of low-dose psilocybin for distress in palliative care patientsOpen-label trial · 2026 · Evidence: Very low
• Depression scores after ritual ayahuasca use tracked for six months in 280 patientsObservational · 2026 · Evidence: Low
• Pooled review: psilocybin and psychological distress in people with cancerMeta-analysis · 2026 · Evidence: Moderate
• Review of drugs for anxiety at the end of life, including psilocybinSystematic review · 2026 · Evidence: Low
• Review of psilocybin therapy for depression and anxiety in palliative care patientsSystematic review · 2025 · Evidence: Low
• Ketamine drip for acute injury pain linked to lower PTSD and anxiety scores at 6 monthsRCT · 2025 · Evidence: Moderate
• Review pools psilocybin trials and reports large drops in depression and anxiety scoresMeta-analysis · 2025 · Evidence: Low
• What predicts who responds to psychedelic-assisted therapy? A review of 54 studiesSystematic review · 2025 · Evidence: Low
• Interviews with terminally ill people before and after psilocybin-assisted therapyOther · 2025 · Evidence: Very low
• Review of 78 studies on ketamine and esketamine for anxiety in anxiety disorders and depressionSystematic review · 2025 · Evidence: Low
• Do two psychedelic dosing sessions beat one? A review of 23 depression and anxiety trialsMeta-analysis · 2025 · Evidence: Moderate
• Pooled review of 30 trials of MDMA and psychedelics for mental disordersMeta-analysis · 2025 · Evidence: Moderate
• Review of ayahuasca research finds little controlled evidence for mental health usesOther · 2025 · Evidence: Very low
• Review of side effects reported in 42 psilocybin trials involving 1,068 peopleSystematic review · 2025 · Evidence: Moderate
• Review: how psychedelics and ketamine may reshape brain connections in depression, PTSD and addictionOther · 2025 · Evidence: Very low
• Large survey looks at difficult mental states after ayahuasca and later mental healthSurvey · 2025 · Evidence: Low

References

1. Griffiths RR, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: a randomized double-blind trial. Journal of Psychopharmacology. 2016;30(12):1181–1197. Source
2. Ross S, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of Psychopharmacology. 2016;30(12):1165–1180. Source
3. Holze F, et al. Lysergic acid diethylamide-assisted therapy in patients with anxiety with and without a life-threatening illness: a randomized, double-blind, placebo-controlled phase II study. Biological Psychiatry. 2023;93(3):215–223. Source
4. Robison R, et al. Single treatment with MM120 (lysergide) in generalized anxiety disorder: a randomized clinical trial. JAMA. 2025;334(15):1358–1372. Source