Review of drugs for anxiety at the end of life, including psilocybin

The question

Which medicines help with anxiety in people receiving end-of-life care, and how safe are they?

What they did

The authors searched four research databases for studies of drug treatments for anxiety in adults receiving end-of-life care. They followed a standard review method (PRISMA) and registered the plan in advance. Five studies met their criteria: two looked at benzodiazepines (sedative anti-anxiety drugs) combined with opioid painkillers, and three looked at psilocybin, the active compound in so-called magic mushrooms.

What they found

Both approaches were linked to lower anxiety symptoms. The psilocybin studies reported rapid and lasting relief, with roughly 60% to 80% of participants showing clinically meaningful improvement. Both treatment types were described as well tolerated, with no serious adverse events reported. The authors stressed that the overall evidence base was small and limited.

The fine print

Only five studies qualified, all with small numbers of participants and narrow settings, so the findings are preliminary. The abstract does not report the total number of people included, the study designs, doses, or how long people were followed. Results were described rather than pooled statistically, and this summary is based on the abstract alone.

What it means

There is very little high-quality evidence on how to treat anxiety in end-of-life care; early results for psilocybin and for benzodiazepine-opioid combinations are encouraging but far from settled.

Evidence grade: Low. A systematic review that found only five small studies with narrow contexts, and it did not pool the results statistically.

This summary is based on the study’s published abstract.