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Release on psilocybin for treating depression in cancer patients strong on financial disclosures and cautions

Single Dose of Hallucinogenic Drug Psilocybin Relieves Anxiety and Depression in Patients with Advanced Cancer

Our Review Summary

psilocybin, magic mushrooms, Psychedelic mushroomsThis release focuses on a recent study that found a single application of the hallucinogen psilocybin is effective at providing meaningful relief to cancer patients suffering from severe depression or anxiety. The release notes that 80 percent of participants showed improvement based on clinical evaluation scores for anxiety and depression for several months following the treatment.

The study is one of two on the subject that were published recently in the Journal of Psychopharmacology (our review of the release for the other study can be found here and a review of a related news article can be read here.) The release does better than its counterpart in terms of addressing conflicts of interest and placing the work in context with previous work in the field. However, the release uses only vague language when addressing the key issues of health benefits and adverse side effects. More specifics on the degree of reduced anxiety and depression scores would have been useful.

 

Why This Matters

Because this study and its counterpart offer an intriguing finding — that a single dose of something could be so helpful in alleviating depression — we’ve completed three reviews related to these studies: one on a news story from the LA Times, one on a news release from Johns Hopkins, and this review on the release from NYU. And the core issues involved are similar across all three items. Cancer is a widespread health problem that affects many millions of Americans. According to the National Cancer Institute, just under 1.7 million people in the United States will be diagnosed with cancer in 2016 alone. If you consider that each of those people has a family and loved ones who are also affected by the diagnosis, you can begin to appreciate the scope of the problem.

According to a report from the National Institutes of Health’s 2002 State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue, “The clinical ‘rule of thumb’ is that 25 percent of cancer patients are likely depressed enough at some point in the course of disease to warrant evaluation and treatment.” This makes it especially important for research institutions and news outlets to write responsibly about studies like those discussed in this release. You want to give readers enough information to help them make informed decisions. You don’t want to raise false hopes, or sensationalize the work. We think all three summaries on this growing body of research reported responsibly on the findings.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

The release refers to psilocybin as being “inexpensive,” if and when it were to become a clinical treatment option. However, there is no basis provided for why the drug would be inexpensive or what that means relative to other treatments. Given that it is currently a banned substance, it’s difficult to assess how expensive the drug would be — or in what clinical circumstances it may be used (which could affect the cost for patients).

You may be wondering, “How can the release further address cost, given that the relevant drug is a banned substance?” One way would be to specifically note that it is difficult to estimate what the cost of psilocybin treatment would be, given that it is currently a banned substance.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The release does tell readers what percentage of patients benefited from psilocybin treatment, but does not explicitly quantify the extent of those benefits — which is what this category is designed to address. Instead, readers are given qualitative assessments of the treatment — that it “significantly lessens mental anguish” and brought “relief from distress.” But those terms are vague. What does “significantly lessens” mean? For example, did patients return to clinically normal levels of anxiety?

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

The release is vague here, noting that patients “experienced no serious negative effects, such as hospitalization or more serious mental health conditions.” But that doesn’t mean they had no side effects. A look at the paper shows that 28 percent of patients, for example, suffered headaches or migraines and 14 percent had nausea. Did the benefits outweigh these effects? Many people might say yes. However, it’s important for research institutions to describe the research — warts and all — and let people make informed decisions. If we think that’s true for clinically available treatments, it should also apply to treatments in the earlier stages of testing.

Does the news release seem to grasp the quality of the evidence?

Satisfactory

The release does an adequate job of describing the study: the number of patients, their clinical background, the study design. That earns it a satisfactory rating here.

Does the news release commit disease-mongering?

Satisfactory

No disease mongering here.

Does the news release identify funding sources & disclose conflicts of interest?

Satisfactory

This is a strength of the release. It not only tells readers who funded the work, but that one of the funding organizations is focused specifically on research involving psychedelic drugs — and that one of the researchers previously served on that organization’s board.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

The release notes that study participants received counseling in addition to the psilocybin treatment — which is an important point to make. However, the release doesn’t discuss the use of counseling as a stand-alone treatment option for anxiety or depression, nor does the release address other pharmaceutical treatment options that can be used to treat mental health problems. The release would have been much stronger if it had compared the pros and cons of this treatment method with other treatment methods.

Does the news release establish the availability of the treatment/test/product/procedure?

Satisfactory

The release does not specifically address drug availability. However, the release does note that psilocybin is a banned substance, and makes clear that larger clinical trials would have to be successful before psilocybin could be used as a “safe, effective and inexpensive medication — dispensed under strict control.” That’s sufficient to merit a satisfactory rating.

Does the news release establish the true novelty of the approach?

Satisfactory

The release does a good job here, in two ways. First, it notes that this study (presumably in conjunction with the one from Johns Hopkins) provides “the strongest evidence to date of a clinical benefit from psilocybin therapy.” That’s important context. Second, the release states that psilocybin “has been studied for decades and has an established safety profile.” Again, that’s important context. These points earn it a satisfactory rating. That said, we would like to have seen how this work compares to previous research done specifically on the use of psilocybin to treat anxiety in cancer patients — such as this 2007 study, this one from 2011, or this one from 2013. We don’t necessarily expect an exhaustive comparison, but the release would have been stronger if there had been some acknowledgment that other work has been done in this field over the past 10 years. More specifically, it would have been nice to see a sentence or two highlighting how the new findings are similar to, or different from, the existing body of work in the field.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Satisfactory

This one was actually a close call, particularly because of one line in the release. In the third paragraph, the release states that “Study results were also endorsed in 11 accompanying editorials from leading experts in psychiatry, addiction, and palliative care.” Cautious optimism may be a more accurate description of some of those editorials. However, much depends on how one chooses to interpret the word “endorse.” Given that all of the editorials acknowledge the work, and that is a reasonable interpretation of the word “endorse,” we’ll give it a pass. However, given that “endorse” can also be read as actively supporting or promoting something, we wish they had chosen different language.

Total Score: 6 of 10 Satisfactory

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