Psychedelics are helping people face death with peace in breakthrough trial
'From a therapeutic point of view, that is really valuable,' she said.
'It's intensely challenging and very different [in a clinical setting] to taking it at a doof [music festival].'
Participants took part in two treatment sessions over several weeks. In the first, they were randomly given either a dose of synthetic psilocybin – the psychoactive ingredient in magic mushrooms – or a placebo. During the second session, all participants received psilocybin.
During the eight-hour dosing process, patients lay on a bed in a softly lit room scented with essential oil at the Caritas Christi Hospice in Kew, in Melbourne's east.
After taking their capsule of psilocybin, participants put on eye masks and headphones and tuned into their choice of music while being monitored by two trained clinicians.
'We had access to a large library of music that we actively used to intensify their experience,' Dwyer said. 'Some of that music was world music, some of it was indigenous music, some of it was modern electronic stuff.'
Participants completed questionnaires about their mental health before and after their treatment.
Those in the psilocybin group went from having moderately severe depression to not qualifying for a diagnosis of depression. Those in the placebo group experienced a small improvement in their symptoms, but remained moderately to severely depressed.
Participants had nine psychotherapy sessions, both before and after dosing, to help them prepare for and process their experience.
Michael Quinn took part in the trial in 2023 after enduring two years of gruelling, and ultimately unsuccessful, treatments for prostate cancer.
The keen sailor, who died last year, had heard about how psilocybin had helped US pro surfer Koa Smith overcome depression and trauma, and wanted to give it a shot.
'It softened the edges for him,' said Quinn's wife, Pat. 'He became more empathetic and more emotional. It really improved his ability to cope with the prognosis he had.
'Michael had never taken any psychedelic or any recreational drugs. He couldn't understand why anybody would ever take magic mushrooms or any psychedelics for pleasure because he didn't find it pleasurable.'
But while he did not enjoy the dosing process, he found it incredibly beneficial when combined with the psychotherapy sessions.
'It helped rework his brain,' Pat said. 'Death became a reality that he was at peace with.'
In February 2023, Australia became the first country in the world to formally recognise psychedelics as medicines. That followed the Therapeutic Goods Administration rescheduling psilocybin and MDMA for the treatment of chronic depression and PTSD – under the care of a psychiatrist.
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But psychedelic-assisted therapy is still in its early stages as a medical treatment, and difficult to access due to cost. Ross said some clinics offering the treatment for drug-resistant depression charge upwards of $27,000.
While 7000 people applied to be part of the St Vincent's trial, the researchers were only able to include 35 patients.
Ross and Dwyer are hopeful that private health insurers will one day fund the treatment, with group sessions making it more affordable.
It's not known exactly why psychedelics improve the mental health of patients. But, as Dwyer points out, no one knows why antidepressants work either.
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'It alters different parts of the brain and the way they communicate with one another,' he said. 'But how people go from despairing, disconnected and fearful to feeling they can embrace their life – no one has an explanation for that.'
The Royal Australian and New Zealand College of Psychiatrists says the evidence base for psilocybin and MDMA therapy is 'limited and emerging'.
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Psychedelics could significantly alleviate the anguish, debilitating depression and death-anxiety often experienced by the terminally ill but its implications could be much more profound, clinicians say. In an Australian-first, a near three-year clinical trial examined the use of psilocybin - a naturally occurring compound found in some species of mushrooms - in combination with psychotherapy for dozens of people living with crippling, life-threatening illness. Psychologist Margaret Ross and psychiatrist Justin Dwyer, who co-led the study, said the drug was able to ease the debilitating death-related anxiety and depression experienced by many palliative care patients. "When you're told you're going to die, your entire world collapses ... it's the final unknowable frontier," Dr Dwyer told AAP. "Many people find themselves stranded in this endless moment of waiting to die, just waiting for the axe to fall ... with that, comes crushing feelings of despair." There are few treatments available for people experiencing distress around dying. Between January 2020 and October 2023, 35 terminally ill participants were given psilocybin over two eight-hour treatment sessions several weeks apart at St Vincent's Hospital in Melbourne. Both sessions were accompanied by nine psychotherapy sessions before and after dosing. The trial's findings have been published in General Hospital Psychiatry. Those in the study reported significant reductions in depression and anxiety as well as sustained gains in mood, outlook, and wellbeing within 24 hours of treatment. But Dr Dwyer said these results only touched the surface. "Many patients reported having a transformational experience," he said. "They felt they had a sense of being back in life in a richer, more vibrant way. "One patient said they felt saturated with a divinity that wasn't there before." While results are promising, the clinicians emphasised psychedelic-assisted therapy is still in its early stages. "It didn't work for everyone," Dr Dwyer cautioned. "And it shouldn't be a treatment open slather for all." Melbourne psychiatrist Eli Kotler is among a handful of Australian doctors able to prescribe psychedelic medication and agreed the treatment needs to used cautiously. Dr Kotler said psychedelics such as psilocybin help with human suffering, a condition he believes is at the heart of the St Vincent's study for those confronting dying. "In many ways mental health has lost it's heart and soul and runs the risk of treating psychiatric diagnoses rather than helping humans heal," he told AAP. Psilocybin appears to work by changing the way parts of the brain connect and interact. But Dr Dwyer says whilst there are theories, nobody really knows how the drug works. In recent years, there has been an explosion of interest in its therapeutic effects with half-a-dozen studies underway in Australia, and many more in the pipeline. Psilocybin and MDMA have been able to be prescribed by approved psychiatrists for certain mental health conditions since July of 2023. Lifeline 13 11 14 beyondblue 1300 22 4636
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Ross said that being in an altered state allowed patients to access the depths of their terror and despair. 'From a therapeutic point of view, that is really valuable,' she said. 'It's intensely challenging and very different [in a clinical setting] to taking it at a doof [music festival].' Participants took part in two treatment sessions over several weeks. In the first, they were randomly given either a dose of synthetic psilocybin – the psychoactive ingredient in magic mushrooms – or a placebo. During the second session, all participants received psilocybin. During the eight-hour dosing process, patients lay on a bed in a softly lit room scented with essential oil at the Caritas Christi Hospice in Kew, in Melbourne's east. After taking their capsule of psilocybin, participants put on eye masks and headphones and tuned into their choice of music while being monitored by two trained clinicians. 'We had access to a large library of music that we actively used to intensify their experience,' Dwyer said. 'Some of that music was world music, some of it was indigenous music, some of it was modern electronic stuff.' Participants completed questionnaires about their mental health before and after their treatment. Those in the psilocybin group went from having moderately severe depression to not qualifying for a diagnosis of depression. Those in the placebo group experienced a small improvement in their symptoms, but remained moderately to severely depressed. Participants had nine psychotherapy sessions, both before and after dosing, to help them prepare for and process their experience. Michael Quinn took part in the trial in 2023 after enduring two years of gruelling, and ultimately unsuccessful, treatments for prostate cancer. The keen sailor, who died last year, had heard about how psilocybin had helped US pro surfer Koa Smith overcome depression and trauma, and wanted to give it a shot. 'It softened the edges for him,' said Quinn's wife, Pat. 'He became more empathetic and more emotional. It really improved his ability to cope with the prognosis he had. 'Michael had never taken any psychedelic or any recreational drugs. He couldn't understand why anybody would ever take magic mushrooms or any psychedelics for pleasure because he didn't find it pleasurable.' But while he did not enjoy the dosing process, he found it incredibly beneficial when combined with the psychotherapy sessions. 'It helped rework his brain,' Pat said. 'Death became a reality that he was at peace with.' In February 2023, Australia became the first country in the world to formally recognise psychedelics as medicines. That followed the Therapeutic Goods Administration rescheduling psilocybin and MDMA for the treatment of chronic depression and PTSD – under the care of a psychiatrist. Loading But psychedelic-assisted therapy is still in its early stages as a medical treatment, and difficult to access due to cost. Ross said some clinics offering the treatment for drug-resistant depression charge upwards of $27,000. While 7000 people applied to be part of the St Vincent's trial, the researchers were only able to include 35 patients. Ross and Dwyer are hopeful that private health insurers will one day fund the treatment, with group sessions making it more affordable. It's not known exactly why psychedelics improve the mental health of patients. But, as Dwyer points out, no one knows why antidepressants work either. Loading 'It alters different parts of the brain and the way they communicate with one another,' he said. 'But how people go from despairing, disconnected and fearful to feeling they can embrace their life – no one has an explanation for that.' The Royal Australian and New Zealand College of Psychiatrists says the evidence base for psilocybin and MDMA therapy is 'limited and emerging'.
