Evidence map›Paper›PMID 41502021›Full record

SynthesisHuman psychopharmacology2026

Pharmacological Management of Anxiety in End-of-Life Care: A Systematic Review of Benzodiazepines, Opioids, and Psilocybin.

Brunno Freitas da Costa, Paula Hartmann, Daniel Pagnin

Abstract readSystematic Review
In one paragraph

Synthesis in Human psychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

3 authors.

Brunno Freitas da CostaAntônio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil.ORCID 0000-0002-7483-7319
Paula HartmannAntônio Pedro University Hospital, Fluminense Federal University, Niterói, Brazil.
Daniel PagninDepartment of Psychiatry and Mental Health, Faculty of Medicine, Fluminense Federal University, Niterói, Brazil.ORCID 0000-0002-5213-3935

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAnxiety is common in patients receiving end-of-life care and significantly impacts their quality of life. However, pharmacological management remains challenging due to complex clinical presentations and potential side effects, emphasizing the need for systematically reviewing existing treatments. Here we aim to systematically evaluate the efficacy and safety of pharmacological treatments for anxiety in end-of-life care.

designSystematic review following PRISMA guidelines, prospectively registered in PROSPERO (CRD42024556913). Comprehensive searches were performed in PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. Eligible studies included adults receiving end-of-life care and evaluated pharmacological interventions targeting anxiety.

resultsFive studies met inclusion criteria: two assessing benzodiazepines combined with opioids and three evaluating psilocybin. Both benzodiazepine-opioid combinations and psilocybin reduced anxiety symptoms. Psilocybin studies reported rapid and sustained anxiety relief, with approximately 60%-80% of participants experiencing clinically significant improvements. Both treatment categories showed good tolerability without serious adverse events. However, the evidence base was limited by small sample sizes and narrow study contexts.

conclusionsBenzodiazepine-opioid combinations and psilocybin show promise for anxiety relief in end-of-life patients. Nevertheless, limited high-quality evidence highlights an important research gap. Further robust clinical trials are needed to confirm these findings and guide clinical practice in palliative care.

Indexed as

Analgesics, OpioidAnti-Anxiety AgentsAnxietyBenzodiazepinesPsilocybinTerminal CareHumansAnalgesics, OpioidAnti-Anxiety AgentsBenzodiazepinesPsilocybinanxietybenzodiazepinesend‐of‐life careopioidspsilocybin

Identifiers

PMID41502021
PMCPMC12780303

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.