Exploring psilocybin's role in mental health and palliative medicine: a path to improved well-being

Introduction: Although long known for their psychoactive effects, psychedelic drugs have only recently been investigated for medicinal use. Psilocybin has attracted the greatest interest with studies suggesting that it may be a useful agent in psychiatry and in palliative care. Areas covered: Clinical trials that included psilocybin were searched in PubMed, Embase, and ClinicalTrials.gov, demonstrating that adult psychiatry and palliative care are the medical fields that show the greatest interest in psilocybin treatment. Expert opinion: Psilocybin is a powerful drug that needs to be used with caution but may benefit some patients, including when other options have failed. It is best evidenced in treatment resistant depression and in palliative care, where patients are usually treated in specialist care centers. It has a novel mechanism of action, targeting the 5HT2A receptor, and can show rapid onset of action. There are many questions regarding its use that remain to be clarified, including its efficacy for other indications and its role as adjunctive treatment in psychotherapy. The psychoactive, or psychedelic effects are well documented, but their clinical importance is disputed.