Can psilocybin help with anxiety? Some of the earliest modern psychedelic studies focused on this question, especially for people facing a life-threatening illness and the existential distress that often comes with it. This article looks at the research on psilocybin for anxiety, explains what the studies found and where their limits lie, and covers the risks, since psilocybin itself can also cause anxiety.
This article is for general information only. It is not medical advice. If anxiety affects your daily life, please talk to a doctor or a mental health professional.
Psilocybin for Anxiety: Where the Research Began
Modern research on psilocybin for anxiety began with a simple observation. Many people with serious illnesses such as advanced cancer experience deep fear, hopelessness and distress about death. Standard treatments do not always help with this kind of "existential" distress. As a result, researchers wondered whether a guided psilocybin session might help people find meaning and calm.
Key Studies on Psilocybin and Anxiety
2011: A First Pilot Study
Researchers at the University of California, Los Angeles gave a moderate dose of psilocybin to 12 patients with advanced cancer and anxiety [1]. The study mainly tested safety. It found no serious adverse effects, and anxiety scores tended to improve over the following months. Because of its size, however, it could only suggest a possible benefit.
2016: Two Trials on Cancer-Related Anxiety
Five years later, two teams published randomized trials in the same journal. At Johns Hopkins University, 51 patients with cancer received a high dose and a very low dose of psilocybin in separate sessions [2]. After the high dose, most showed large reductions in anxiety and depression, and these improvements were still visible six months later.
At New York University, 29 patients received a single dose of psilocybin or niacin, an active placebo, alongside psychotherapy, and then crossed over to the other treatment [3]. Again, psilocybin produced rapid and lasting reductions in anxiety and depression.
2020: Long-Term Follow-Up
Researchers later contacted participants from the New York trial several years after treatment [4]. Most of those who took part in the follow-up still reported meaningful improvements in anxiety and depression. Many also described the experience as one of the most meaningful of their lives.
A European Perspective
Europe has also played a role in this field. In Switzerland, a small pilot study in 2014 tested LSD, a related psychedelic, with psychotherapy for anxiety in people with life-threatening illnesses [5]. Its results pointed in a similar direction and helped revive psychedelic research in Europe. Our comparison of psilocybin vs LSD explains how the two substances differ.
Why Might Psilocybin Help With Anxiety?
Researchers are still exploring this question. One idea is that psilocybin temporarily loosens fixed patterns of thinking, which may help people step back from repetitive worries. Another is that the experience itself matters. In several studies, patients who had a strong sense of meaning or connection during their session tended to show bigger improvements. Our articles on psilocybin and the brain and psilocybin and spirituality explore both ideas.
Limits of the Research
Although the results are encouraging, the evidence on psilocybin for anxiety is still limited:
- Most studies were small, with a few dozen participants at most.
- Many participants could tell whether they had received psilocybin, which makes placebo comparisons difficult.
- Most research has focused on existential distress in people with cancer, not on general anxiety disorders.
- All participants were carefully screened and supported by trained therapists.
In short, these findings cannot simply be applied to everyday anxiety or to unsupervised use. The same caution applies to trauma, as our article on psilocybin for PTSD explains.
Psilocybin Can Also Cause Anxiety
It is important to remember that psilocybin can trigger anxiety, too. During a session, people may feel fear, panic or paranoia, especially at higher doses or in a stressful setting. For people with anxiety disorders, these experiences can be particularly hard. This is why clinical studies use careful preparation, a calm room and trained guides. For practical safety tips, read our guide to set and setting, and for dose comparisons see our magic mushroom dosage guide.
In addition, psilocybin is not suitable for people with a personal or family history of psychosis or bipolar disorder, and some medications, including lithium, can interact with it dangerously.
Frequently Asked Questions
Does microdosing psilocybin help with anxiety?
The evidence is weak. Some microdosers report feeling calmer, while others report more anxiety. Placebo-controlled studies have not shown clear benefits so far. Learn more in our guide to microdosing magic mushrooms.
Is psilocybin approved for anxiety anywhere?
Not as a standard treatment. In most countries, it is only available for anxiety through clinical trials.
How long do the effects on anxiety last?
In the cancer studies, many patients still reported improvements months or even years later. Still, results vary a lot from person to person.
Conclusion: Psilocybin for Anxiety Needs More Research
Studies of psilocybin for anxiety, especially in people with life-threatening illness, have produced some of the most striking results in psychedelic research. Even so, the studies were small and tightly controlled, and psilocybin can also cause anxiety. If you are curious about this research, discuss it with a qualified professional, and follow new trials as they report their results. For a broader overview, read our guides to psilocybin therapy and psilocybin for depression.
Sources
- Grob CS, et al. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of General Psychiatry. 2011. doi:10.1001/archgenpsychiatry.2010.116
- Griffiths RR, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer. Journal of Psychopharmacology. 2016. doi:10.1177/0269881116675513
- Ross S, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer. Journal of Psychopharmacology. 2016. doi:10.1177/0269881116675512
- Agin-Liebes GI, et al. Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer. Journal of Psychopharmacology. 2020. doi:10.1177/0269881119897615
- Gasser P, et al. Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. Journal of Nervous and Mental Disease. 2014. doi:10.1097/NMD.0000000000000113
