Evidence map›Paper›PMID 39655749›Full record

SynthesisJournal of psychopharmacology (Oxford, England)2026

Psychedelics as an intervention for psychological, existential distress in terminally ill patients: A systematic review and network meta-analysis.

Mattia Marchi, Riccardo Farina, Karim Rachedi, Francesca Laonigro, Marija Franka Žuljević, Luca Pingani, Silvia Ferrari, Metten Somers, Marco P M Boks, Gian M Galeazzi

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of psychopharmacology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Trauma-informed palliative care.Canadian family physician Medecin de famille canadien · 2025
    Article
  8. "Integrative cancer therapies
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mattia MarchiDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID 0000-0003-2970-1276
Riccardo FarinaDepartment of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy.
Karim RachediDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Francesca LaonigroDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Marija Franka ŽuljevićDepartment of Medical Humanities, University of Split School of Medicine, Split, Splitsko-Dalmatinska, Croatia.ORCID 0000-0001-9805-7491
Luca PinganiDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Silvia FerrariDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Metten SomersDepartment of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.
Marco P M BoksDepartment of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.
Gian M GaleazziDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID 0000-0003-2706-3362

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe interest in psychedelics as a therapeutic intervention for existential distress of people with terminal illness grounds on their mechanism of action and effect on the spiritual/existential aspects accompanying end-of-life experiences.

aimsThis systematic review and network meta-analysis aimed at examining the efficacy and safety of psychedelic compounds for existential distress in terminally ill people.

methodsPubMed, CINAHL, PsycINFO, EMBASE, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) administering psychedelics for existential distress in people with terminal illnesses. Meta-analysis estimated the standardized mean difference (SMD) and odds ratio (OR), with corresponding 95% confidence intervals (95% CI), between treated and control groups in pairwise and network comparisons, using random-effects models. Post-treatment measures of depression and anxiety, as proxies of existential distress, and tolerability were the primary outcomes.

resultsNine studies, involving 606 participants (362 treated with psychedelics: psilocybin, ketamine, 3,4-methylenedioxymethamphetamine, and lysergic acid diethylamide (LSD)) were included. The meta-analysis supported the efficacy of psychedelics on depression (SMD: -0.80 (95% CI: -0.98, -0.63)) and anxiety (SMD: -0.84 (95% CI: -1.20, -0.48)). Network meta-analysis identified psilocybin as the most effective compound for depression, and LSD for anxiety. However, head-to-head comparison between psychedelics did not reach statistical significance. The rates of treatment discontinuation and adverse events between psychedelics and controls were comparable.

conclusionsPsychedelics, especially psilocybins and LSD, showed promising effects on depression and anxiety in people with terminal illnesses. Limitations include the small number of RCTs, methodological issues related to blinding, and the lack of direct comparisons between psychedelic compounds. Larger studies and comparative research are needed to consolidate these findings.

Indexed as

HallucinogensPsychological DistressStress, PsychologicalTerminally IllAnxietyDepressionHumansNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicHallucinogensanxietycancerdepressionend-of-life carePsychedelics

Identifiers

PMID39655749
PMCPMC13199639

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.