Education / Research

Can Psilocybin Help With Anxiety? What the Studies Say

Last reviewed

Anxiety is one of the things people most want to know about, and the honest answer depends on which kind. The best trials so far were in people facing a life-threatening illness. For everyday anxiety and for anxiety disorders, the published evidence is much thinner.

Every study below links to its source so you can read it yourself.

What the trials found

Randomized trials

Cancer patients: large drops in anxiety, still seen at six months

In a randomized, double-blind crossover trial, 51 people with life-threatening cancer and symptoms of depression or anxiety each had two sessions five weeks apart, one with a very low placebo-like dose and one with a high dose, in random order. After the high-dose session, clinician-rated and self-rated anxiety and depression fell sharply, and quality of life, sense of meaning, and optimism improved. Six months later, about 80 percent still showed clinically significant reductions in depressed mood and anxiety.

Worth knowing

Everyone had cancer-related distress, so this does not show the same result for everyday anxiety. It was one site, with careful preparation and support, and the experience is hard to disguise from the person having it. The six-month results come after both groups had received the high dose, so they are not a controlled comparison.

Randomized trials

A second cancer trial, against niacin

A randomized, double-blind crossover trial gave 29 people with cancer-related anxiety and depression either one psilocybin session or niacin, a vitamin that causes a noticeable flush, with psychotherapy in both groups. Before the groups crossed over at seven weeks, psilocybin had produced immediate and lasting improvements in anxiety and depression. At about six months, after everyone had received psilocybin, 60 to 80 percent of participants showed clinically significant reductions.

Worth knowing

Small, in people with cancer, and therapy was part of both arms, so it tested psilocybin on top of therapy, not on its own. Niacin is an active control with limited blinding, since it makes people feel something but not the same thing. The six-month results come after the crossover, so they are not a controlled comparison.

Reviews

Pooling the small trials

A systematic review and meta-analysis pooled five studies of psilocybin for anxiety in people with life-threatening illness, about 130 people in all. Psilocybin reduced anxiety more than placebo in the first days and weeks after treatment, and trait anxiety, a person's general tendency toward anxiety, was lower at six months. Blood pressure rose temporarily, while serious adverse events and dropouts did not differ significantly from placebo.

Worth knowing

The five include a long-term follow-up of one of the other trials and an open-label study with no placebo group, so they are not five independent randomized comparisons. The trials are small, long-term results varied a lot, and the authors say larger randomized trials are needed. The abstract and the body of the paper give different timepoints for some results, so we have not quoted exact figures.

What about everyday anxiety?

The trials above were in people with cancer who were also dealing with fear about their illness. That is a different situation from generalized anxiety disorder, social anxiety, or panic, and the results may not carry over.

For generalized anxiety disorder, a company has announced results from a phase 2 trial, but we could not find a peer-reviewed paper, so we are not treating it as evidence yet. For social anxiety we found no randomized trials. We will update this page when that changes.

The experience itself can be hard

Psilocybin can cause anxiety, especially during a session. In surveys of microdosers, some people report more anxiety, not less. In one study, people who had taken an antidepressant beforehand felt less anxiety during the session, which hints at how much the experience itself drives how people feel. Our page on microdosing safety goes through those studies.

In the trials above, a clinical team prepared people, stayed with them throughout, and followed up afterward. That support is part of the result.

If you are struggling

This page describes research. It is not medical advice, and it is not a substitute for care. Anxiety is very treatable, and a doctor or therapist can help you find what fits. Please do not stop or change a prescription on your own.

If you are thinking about harming yourself or are in crisis, call or text 988 in the US to reach the Suicide and Crisis Lifeline, any time.

Keep reading

This page is for adults 21 and older. It summarizes published research for education only. It is not medical or legal advice, and it makes no claim that any product sold by Luna treats, cures, prevents, or helps any condition. Laws about these mushrooms vary by place, and you are responsible for knowing yours.

Research moves quickly. We last checked this page against its sources on , and we will correct it if we get something wrong.