Psilocybin for Anxiety Disorders: What does the evidence say?

Introduction

Anxiety disorders, whether generalized anxiety, social anxiety, panic disorder, or anxiety linked to serious illness like cancer,are among the most common mental health conditions globally. They can cause overwhelming worry, panic attacks, social withdrawal, and emotional exhaustion. While treatments like cognitive-behavioral therapy (CBT) and medications such as SSRIs or benzodiazepines help many, a significant number of people continue to struggle. Some don’t respond fully; others experience side effects like insomnia, emotional blunting, or dependency. In cases of terminal illness, the existential fear of death can prove especially resistant to standard approaches.

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In recent years, psilocybin-assisted therapy has gained increasing scientific attention as a promising approach for treating anxiety. Backed by a growing number of clinical studies, this form of therapy is showing potential for rapid and lasting relief—even in individuals who haven’t responded to conventional treatments. Research from leading institutions like Johns Hopkins, NYU, and Imperial College London has helped validate what many clients and facilitators have already experienced firsthand: when administered in a safe, supportive environment, psilocybin can catalyze deep emotional shifts and reduce anxiety symptoms in meaningful ways.

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Unlike conventional medications, psilocybin appears to work not only through changes in brain chemistry, primarily targeting serotonin receptors, but also by inducing profound psychological experiences (Nutt et al., 2020). These sessions, conducted with trained therapists and careful screening, are designed to support individuals through what can be an emotionally intense process. Patients often report gaining new perspectives, emotional release, or a sense of connectedness that outlasts the drug’s effects.

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The idea isn’t to mask symptoms but to catalyze a shift, what some researchers describe as a “reset” of mental patterns. Psilocybin may help quiet the brain’s default mode network (associated with rumination and self-focus), enhance neural flexibility, and promote emotional insight.

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This article explores the latest research on psilocybin for anxiety, from breakthrough trials in cancer-related distress to emerging data on generalized and social anxiety. We’ll look at how it works, what the science says, and how people have actually felt after these sessions.

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Generalized Anxiety Disorder (GAD) and Psilocybin

Generalized Anxiety Disorder – chronic, uncontrollable worry about a variety of everyday things – had never been targeted with psilocybin in a clinical trial until recently. That changed with a study known as PsiGAD (Incannex Healthcare; 2024).
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• PsiGAD Trial (2023-24): This Phase 2 trial was conducted in Australia at Monash University and sponsored by Incannex Healthcare. It tested a single high dose of psilocybin (25 mg, administered with therapy) versus placebo in adults with GAD. The results, announced in early 2024 and not yet published in peer-review research, were fascinating:
  
  • Patients who received psilocybin therapy had a 12.8-point greater drop in anxiety scores (Hamilton Anxiety Rating Scale) from baseline compared to placebo.
  • By the end of the study, 44% of the psilocybin group had at least a 50% reduction in anxiety symptoms, and 27% met criteria for full remission of GAD.
  • No serious side effects emerged; most adverse effects were mild or moderate (things like transient nausea or headache).
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The company is now moving toward larger, multicenter trials.

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Social Anxiety (and related social distress)

Social Anxiety Disorder is another area of interest. While no large randomized trial of psilocybin for social anxiety specifically has been published yet, related research and early evidence point to potential benefits:
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• Psilocybin & social exclusion study (Preller et al., 2016): In a fascinating experiment, researchers gave 21 healthy volunteers a low dose of psilocybin (about 0.2 mg/kg) or placebo, and then had them play a virtual ball-toss game designed to make them feel socially excluded (an established research method called the Cyberball game). The team led by Dr. Katrin Preller found that psilocybin significantly reduced the distress of being excluded and lowered activity in brain regions that process social pain (like the anterior cingulate cortex). In other words, after psilocybin, people didn’t feel the sting of rejection as sharply, and their brains showed less of a “hurt feelings” response. This suggests a possible role for psilocybin in conditions where social rejection sensitivity is high, such as social anxiety disorder.
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• Meditation + psilocybin for social anxiety (Wade et al., 2022): A systematic review looked at how psilocybin combined with mindfulness practices might help social anxiety. It concluded that psilocybin’s effect of “decreasing self-focused attention” (quieting that inner voice that constantly worries about how one is perceived) could synergize with meditation. Essentially, psilocybin disrupts the brain’s usual patterns (like a stuck network of self-criticism), and mindfulness can help rebuild new, healthier thought patterns during the integration phase. The authors suggested future studies to test psilocybin-assisted mindfulness therapy for social anxiety, especially for those not helped by conventional therapy.
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• Autistic adults and social anxiety (Stroud et al., 2023): Adults on the autism spectrum often experience social anxiety. A recent survey study published in Psychopharmacology found that among autistic adults who had a single psychedelic experience (often with psilocybin), about 78% reported lasting reductions in social anxiety and 70% reported increased social engagement. Participants described feeling “more able to accept and cope with difficult thoughts and feelings” after their psychedelic experiences. However, it’s crucial to note that this was a survey of self-selected psychedelic users (not a controlled trial) and about 20% did report increases in anxiety or other negative effects. This highlights the variability of outcomes: psychedelics aren’t a panacea and can cause distress, especially without proper support. Still, the results are intriguing and echo clinical reports of psilocybin fostering social connectedness and reduced fear in some people.
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So, while formal trials for social anxiety are still needed, existing evidence hints that psilocybin could help “loosen” the grip of social fear, possibly by calming overactive fear circuits and enhancing psychological flexibility. Psychological flexibility, the ability to accept and adapt to thoughts and feelings, was actually found to be the key factor predicting positive changes in the aforementioned autistic adults study. In plain terms, psilocybin might make the mind more malleable, so people can break out of fearful patterns.
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Panic Disorder – any evidence?

Panic disorder, characterized by recurrent panic attacks and fear of those attacks, has not been directly studied with psilocybin in a published trial as of early 2025. This may be due to the risk of giving a panic-prone person a hallucinogen, there’s a reasonable concern it could provoke anxiety during the acute experience. However, some experts theorize that if carefully controlled, a psilocybin session could potentially help a person confront and move through the fear sensations that fuel panic attacks.

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Researchers are likely to explore panic disorder in the future, but given ethical considerations, they may start once psilocybin’s safety is even more firmly established in other anxiety disorders. For now, much of what we think about panic and psilocybin comes from broader anxiety and depression studies.

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Cancer-related anxiety and psilocybin

Perhaps the most compelling and advanced research on psilocybin for anxiety comes from studies with cancer patients facing end-of-life distress. For someone with a terminal diagnosis, anxiety often centers on death anxiety, a profound fear of the unknown, of suffering, of nonexistence. Traditional treatments offer very limited relief for this type of existential anxiety. Psilocybin-assisted therapy, however, has shown remarkable effects in this realm, effectively giving patients a sense of peace that can last for months or even years.
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Let’s break down key studies and what they found:
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• UCLA Pilot Study (Grob et al., 2011): This was the first modern study (after the 1970s) on psilocybin for cancer-related anxiety. In 12 patients with advanced cancers, Dr. Charles Grob’s team administered a moderate dose of psilocybin (14 mg/70kg) in one session, comparing it to a placebo session in a double-blind crossover design. Results showed significant reductions in anxiety at 1 and 3 months after the psilocybin session (measured by the State-Trait Anxiety Inventory). Mood also improved, with depression scores trending better by 6 months. No serious adverse events occurred. One participant in the study famously said that after psilocybin, “I don’t have a fear of death – I mean, I don’t have any desire to die… but death itself does not scare me”. This pilot established feasibility and safety, paving the way for larger trials. It showed that even a moderate dose could provide relief and that it was safe for these vulnerable patients.
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• NYU and Johns Hopkins Trials (2016): Two larger randomized controlled trials (RCTs) were published side-by-side in 2016:‍
  • Johns Hopkins (Griffiths et al., 2016): 51 cancer patients with anxiety/depression were given either a very low placebo-like dose (1–3 mg) or a high dose (22–30 mg) of psilocybin, in a crossover design. The high dose led to “large decreases” in both clinician-rated and self-rated anxiety and depressed mood. About 80% of participants had clinically significant reductions in anxiety and depression at 6-month follow-up, which is astounding for a single-dose therapy. Many also reported increased quality of life, life meaning, and optimism, and less fear of death. Over two-thirds rated it among the most meaningful experiences of their lives (comparable to birth of a child, etc.), and these profound experiences were correlated with the lasting benefits
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  • ‍NYU (Ross et al., 2016): 29 patients with cancer-related anxiety/depression got either a single psilocybin session (0.3 mg/kg) or an active placebo (niacin) with therapy. Similar outcomes: about 60-70% had significant reductions in anxiety and depression at 1 month, and at 6.5 months about 60-80% were still improved. Many patients talked about a shift in perspective on life and death. One described it as “a journey from darkness to light, from fear to love”. Another patient, featured in a case report, said: “I was terrified of dying until that experience. Now, I’m not exactly ready to die, but I’m no longer afraid. It’s like I’ve been shown that there’s something fundamental inside me that is peaceful.” Notably, even some atheists or non-spiritual people had mystical-type experiences that helped them; they described it in terms of deep personal meaning or connectedness rather than religious imagery.
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• HOPE Trial (Lewis et al., 2023): A more recent innovation, the HOPE study, piloted group psilocybin therapy for cancer patients. At the University of Utah, 12 patients with cancer-related depression/anxiety participated in a group session, all took psilocybin together in the same room, with multiple therapists present. They had group therapy preparation and integration sessions. Remarkably, this was well-tolerated and no one panicked or needed to leave the group setting. At 2 weeks, half the participants were in remission from depression, and at 6 months, most had maintained significant improvement. Qualitatively, patients reported that sharing the experience in a group amplified feelings of support and understanding. One participant said, “we all went through it together, and I felt this unspoken bond – like we all touched the same profound place”. Group models like this could be important for scalability, making treatment more affordable and accessible if psilocybin therapy becomes an approved treatment.
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In summary for cancer-related anxiety: The evidence is strong that psilocybin-assisted therapy can provide relief from fear, anxiety, and depression in patients facing life-threatening illness. Many of these patients describe no longer being afraid of dying, feeling an “interconnectedness” or a sense of peace that stays with them. 

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It’s important to acknowledge that not every patient has a miraculous transformation. In the case report series from the NYU trial, one patient named Tom benefited in terms of reduced anxiety and improved outlook, yet said the experience “was not life-changing” for him and he felt a bit disappointed it wasn’t more profound. Still, even he admitted he did reduced his fear of death and discovered “there’s nothing but love” at some deep level. His anxiety and depression improved moderately, though not as dramatically as some others. This reminds us that individual responses vary, a significant number have transformative outcomes, others have moderate benefits, and a few might not get much out of it or could even feel worse. Psychedelic experiences can be unpredictable, which is why the support structure is so crucial.
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Real-World Experiences: A Glimpse into Psilocybin Sessions

To bring the science to life, let’s highlight a few real-world case stories reported in the research:
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• Ellen’s Story (from Swift et al., 2017) Ellen (a pseudonym), a woman living with advanced cancer, entered her psilocybin session carrying a deep fear of dying and of burdening her loved ones. She described a life previously marked by control and resistance, trying to manage her illness with logic and willpower. During her psilocybin session, that control dissolved. She had a powerful vision of death not as an enemy but as a dinner guest at her table—something inevitable, even familiar. This shift stayed with her. After the session, Ellen spoke of feeling emotionally lighter and more accepting. She no longer felt she had to fight or deny what was happening. Instead of viewing cancer as a betrayal, she began to see it as part of life’s larger rhythm. She told researchers: “Now, I sit with it. I don’t need to get away from it. I can talk about death with my kids. I can actually enjoy dinner.” In the weeks that followed, Ellen's family noted she was calmer and more emotionally open. She continued to experience fear at times, but it no longer ran her life. She described the experience as “the most important therapy I’ve ever had.”
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• Tom’s Story (from Belser et al., 2017): We encountered Tom earlier – a middle-aged man in the NYU trial who, despite a somewhat underwhelming trip, his fear of death reduced. Tom’s experience is interesting because it shows not everyone is blown away or mystically transformed. He did feel and articulate shifts: he described an “all-knowing” presence telling him there’s “absolutely nothing to be afraid of” after death, and he felt “overwhelming love.” Yet he expected…more. In follow-up, he rated his life change as modest. Still, therapists noted he stopped talking constantly about his fear of dying, and his family said he was more open and loving after the treatment. So, even when the experience wasn’t “life-changing” subjectively, it still helped him.
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• Chrissy’s Story (from Belser et al., 2017): Chrissy was another patient in that series – a woman with metastatic breast cancer and lifelong GAD (generalized anxiety). During her psilocybin session, she experienced a vision of a Ferris wheel and cycles of life and death. She re-lived her own birth and symbolically confronted her cancer (feeling a pain in her tumor site which she interpreted as her “umbilical cord to the universe”). Afterwards, Chrissy described a profound sense of connectedness: “I felt like I could reach out to anybody and connect with them”. Her previously high anxiety had melted into a feeling of unity and acceptance. She returned to her job and reported that she no longer had paralyzing worry, she even started mentoring others with cancer, something she wouldn’t have had the emotional capacity for before. Chrissy’s case highlights how psilocybin can merge deeply personal insights (revisiting her birth, facing cancer pain directly) with universal ones (unity, the circle of life) to alleviate anxiety.
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How does psilocybin reduce anxiety? (Possible mechanisms)

Psilocybin’s anti-anxiety effects are not like simply taking a benzodiazepine to numb fear. Instead, they seem to involve a complex psychological and neurobiological process that scientists are still unraveling. Here’s what is understood so far:
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• Mystical or Transformative Experiences: A consistent finding is that the more a person has a “mystical” experience (a sense of unity, transcendence of time/space, deep awe and peace), the more their anxiety and depression tend to improve (Ferreira et al., 2024). These experiences can provide a fresh perspective, allowing people to process trauma, accept mortality, or see their life with renewed meaning. For example, cancer patients often report “merging with a universal love” or “seeing the beauty of life and death as a natural cycle”. Such revelations can dramatically reduce existential fear. Important: One doesn’t need to be religious; the experience can be framed in secular ways, like a profound shift in consciousness or perspective, as patient accounts illustrate. The key seems to be a sense of something bigger than oneself and a reassurance that “in the largest frame, everything is fine, there is nothing to fear”.
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• Neuroplasticity and “Resetting” the Brain: At the brain level, psilocybin temporarily disrupts the usual connections and activity patterns (especially in the default mode network, which is active during self-reflection and worry). Brain imaging shows a disintegration of these networks during the trip, followed by a reintegration. Studies have found increased connectivity between certain brain regions after psilocybin, which correlates with enhanced emotional processing and flexibility. There is also evidence that psilocybin can stimulate neurogenesis (growth of new neurons or neural connections) in animal studies, and possibly in humans, which might underlie lasting mood improvements (Ly et al., 2018).
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• Facing Fears vs. Avoiding: Unlike a quick fix, psilocybin sessions often involve confronting fears. Up to 30% of participants in these studies experience significant fear or anxiety at some point during the session. With proper support (therapists reassuring them “you’re on psilocybin, this will pass, you are safe”), these moments can be worked through and often give way to positive breakthroughs. Dr. Roland Griffiths noted that short-lived challenging episodes can be “cathartic and serve as doorways into personal meaning and transcendence”. This is analogous to exposure therapy: by facing the worst fear (whether it’s a vision of death, loss of control, traumatic memories, etc.) in a controlled environment, patients often find that the fear loses its hold. They emerge realizing that they came out the other side okay, and thus their baseline anxiety about that issue decreases. For example, someone with social anxiety might, during a trip, vividly experience scenarios of rejection or embarrassment but also feel a sense of self-acceptance or universal love that helps heal those wounds.
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• Psychological Integration: After the trip, integration sessions are critical. This is where patients, with therapists, discuss and make meaning of what they experienced. It helps translate the often symbolic or intense psychedelic content into concrete changes in outlook or behavior. If someone saw a vision of “dissolving into a bright light and feeling perfect peace,” integration therapy helps them use that as a touchstone: for instance, recalling that feeling when anxiety swells, practicing mindfulness or meditation to reconnect with the sense that “I am okay, no matter what.” The therapy component guides the person to embed new insights into daily life (e.g., improved relationships, self-care, perspective shifts about one’s problems). Thus, psilocybin is best seen not as a standalone drug, but as part of a therapy process.
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Discussion: What the future holds

The use of psilocybin for anxiety disorders is moving from fringe to forefront in mental health research. Major medical centers are now conducting trials, and training therapists to work with psychedelics. The evidence so far, though mostly from small to medium trials – consistently shows meaningful benefits: reductions in anxiety scores, often larger in effect size than standard medications, and lasting for months after just one or two doses. The word “cure” is not something scientists throw around, but terms like “remission” or “transformative experience” are being used without hyperbole.
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However, many questions remain:
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• Can these results be replicated in larger, more diverse populations? (Many trials had predominantly white, well-educated participants, for instance).
• How do we ensure access to those who need it if approved, given that the model is resource-intensive (6-8 hours of therapy for one session, plus prep and aftercare)?
• What about those anxiety disorders not yet studied, like panic or specific phobias? 
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Additionally, some researchers, like those in the UK’s government science office, point out that until larger trials are done, psilocybin should be considered an experimental treatment for anxiety. There’s momentum, for instance, a European consortium is beginning a large trial of psilocybin therapy specifically for patients in palliative care with anxiety. Many feel it’s a matter of time (and data) before psilocybin becomes part of psychiatric practice.
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Conclusion

From the early pilot studies to the latest trials, the use of psilocybin for treating anxiety disorders has evolved from a daring question to a evidence-backed possibility. For generalized anxiety, the new results are promising, suggesting psilocybin could offer relief where other treatments haven’t. For social anxiety, preliminary evidence hints at benefits in reducing the fear of judgment and increasing connectedness. For cancer-related anxiety, psilocybin therapy has repeatedly shown it can help people reclaim peace and meaning in the face of mortality. And for overlapping conditions like OCD or depression with anxiety, it might break the cycle of rumination and fear.

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One of the most striking aspects of psilocybin therapy is hearing patients talk about it. It’s not “my pill kicked in and I felt less nervous” as one might say with a tranquilizer. Instead, we hear things like: “I faced my deepest fears and now they don’t control me,” “I felt love and connection that have stayed with me,” or “I see my anxiety differently now, and it doesn’t run my life.” These testimonials, alongside the hard data, paint psilocybin not as a chemical band-aid but as a tool for emotional growth and healing. Of course, no treatment is perfect. Psilocybin will not be for everyone with anxiety, factors like personal history, medical conditions, and preference matter. Some might prefer or do better with traditional treatments, and that’s fine. The goal is to have more options available.

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In conclusion, psilocybin is offering a new paradigm for treating anxiety, one that combines pharmacology with profound psychological experience. It’s a blend of ancient wisdom (indigenous cultures have long used psychedelic plants for healing) and modern science. For the many people locked in cycles of worry, fear, and distress, the message emerging is one of cautious hope: that maybe, under the right conditions, a journey with psilocybin can help them find solid ground again, relieve their suffering, and perhaps even approach life with a renewed sense of meaning and connection.
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Read next: Psilocybin Therapy for Depression

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References

• Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of general psychiatry, 68(1), 71-78.
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• Lewis, B. R., Garland, E. L., Byrne, K., Durns, T., Hendrick, J., Beck, A., & Thielking, P. (2023). HOPE: a pilot study of psilocybin enhanced group psychotherapy in patients with cancer. Journal of Pain and Symptom Management, 66(3), 258-269.
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• Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., ... & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology, 30(12), 1181-1197.
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• Nutt, D., Erritzoe, D., & Carhart-Harris, R. (2020). Psychedelic psychiatry’s brave new world. Cell, 181(1), 24-28.
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• Incannex Healthcare (2024). Press release on Phase 2 PsiGAD trial – Healio summary.
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• Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., ... & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of psychopharmacology, 30(12), 1165-1180.
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• Preller, K. H., Pokorny, T., Hock, A., Kraehenmann, R., Stämpfli, P., Seifritz, E., ... & Vollenweider, F. X. (2016). Effects of serotonin 2A/1A receptor stimulation on social exclusion processing. Proceedings of the National Academy of Sciences, 113(18), 5119-5124.
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• Ferreira, A. E., & Reis-Pina, P. (2024). Exploring the role of psychedelic-assisted therapy in enhancing spirituality and mystical experiences in patients with life-threatening illnesses: A systematic review. Journal of Psychosomatic Research, 112020.
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• Ly, C., Greb, A. C., Cameron, L. P., Wong, J. M., Barragan, E. V., Wilson, P. C., ... & Olson, D. E. (2018). Psychedelics promote structural and functional neural plasticity. Cell reports, 23(11), 3170-3182.
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• Nayak, S. M., Jackson, H., Sepeda, N. D., Mathai, D. S., So, S., Yaffe, A., ... & Garcia-Romeu, A. (2023). Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey. Frontiers in Psychiatry, 14, 1199642.
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• Stroud, J., Rice, C., Orsini, A., Schlosser, M., Lee, J., Mandy, W., & Kamboj, S. K. (2025). Perceived changes in mental health and social engagement attributed to a single psychedelic experience in autistic adults: results from an online survey. Psychopharmacology, 242(2), 373-387.
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• Felsch, C. L., & Kuypers, K. P. (2022). Don’t be afraid, try to meditate-potential effects on neural activity and connectivity of psilocybin-assisted mindfulness-based intervention for social anxiety disorder: A systematic review. Neuroscience & Biobehavioral Reviews, 139, 104724.
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• Swift, T. C., Belser, A. B., Agin-Liebes, G., Devenot, N., Terrana, S., Friedman, H. L., ... & Ross, S. (2017). Cancer at the dinner table: experiences of psilocybin-assisted psychotherapy for the treatment of cancer-related distress. Journal of Humanistic Psychology, 57(5), 488-519.