This is a Phase II, single-center, fixed dose, open label trial to explore the safety, tolerability and efficacy of a 25mg dose of psilocybin in cancer patients with MDD. The study population will include adult men and women, 18 years of age or above, with MDD, diagnosed with a malignant neoplasm. MDD is defined as those who meet DSM 5 diagnostic criteria for a single or recurrent episode of MDD without psychotic features. A diagnosis of a malignant neoplasm is defined as having a diagnostic code from C00 to C97 according to the ICD-10.
Recent randomized, placebo-controlled clinical trials of psilocybin therapy for anxiety and depression associated with cancer diagnosis showed significant improvement in study endpoints reflecting psychological distress, as compared to placebo. The effects of a single psilocybin therapy session endured for up to six months with no specific follow-up care. In this study, we aim to explore the safety and efficacy of psilocybin therapy in cancer patients, diagnosed with Major Depressive Disorder (MDD).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Single 5 capsule oral psilocybin dose: 25mg: 5 x 5 mg capsules.
Maryland Oncology Hematology PA
Rockville, Maryland, United States
The Montgomery-Åsberg Depression Rating Scale (MADRS)
Ten-item diagnostic questionnaire which psychiatrists use to measure the severity of depressive episodes in patients with mood disorders. Minimum Score: 0 Maximum Score: 60 Higher Score is indicative of greater depression
Time frame: 8 weeks
Quick Inventory of Depressive Symptomatology Self reported (QIDS-SR)
16-Item quick inventory of depressive symptomatology. Minimum score: 0 Maximum Score: 16 Higher Score is indicative of worsening depression.
Time frame: 8 weeks
Maudsley Visual Analogue Scale (VAS) current
Minimum score: -50 Maximum Score: 50 Higher score is indicative of a better outcome.
Time frame: 8 weeks
Maudley Visual Analogue Scale (VAS) Change.
Change in Maudsley VAS change scores from Baseline Minimum score: -50 Maximum Score: 50 Higher score is indicative of a better outcome.
Time frame: 8 weeks
Pain Visual Analogue Score (VAS)
Change in use of pain medications from Baseline (Day -1 \[V2\]) to Week 8 (V7) Minimum score: 0 Maximum Score: 10 Higher score is not indicative of a better outcome.
Time frame: 8 weeks
Hamilton Anxiety Rating Scale-A (HAM-A)
The Hamilton Anxiety Rating Scale (HAM-A) is a widely used and well-validated tool for measuring the severity of a patient's anxiety. It should be administered by an experi- enced clinician. The HAM-A probes 14 parameters and takes 15-20 minutes to complete the interview and score the results. Each item is scored on a 5-point scale, ranging from 0=not present to 4=severe. Minimum Score: 0 Maximum Score: 56 Higher Score is indicative of worsening Depression
Time frame: 8 weeks
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State-Trait Anxiety Inventory (STAI)
Psychological inventory based on a 4-point Likert scale and consists of 40 questions on a self-report basis Minimum: 20 Maximum: 80 Higher Score is indicative of worsening outcome.
Time frame: 8 weeks
National Institute of Health Healing Experience of All Life Stressors (NIH-HEALS)
Psycho-social-spiritual healing in NIH-HEALS total score change from Baseline (Day -1 \[V2\]) to Weeks 1 (V5), 3 (V6), and 8 (V7). Additionally changes in the three factor scores on this measure will be assessed for change at the same timepoints: Connection; Reflection and Introspection; Trust and Acceptance.Healing Experience of All Life Stressors (NIH-HEALS) was developed by the NIH Clinical Center Pain and Palliative Care Service as a psycho-social-spiritual measure of healing that assesses positive transformation in response to challenging life events. It is a self-report, 35-item questionnaire.
Time frame: 8 weeks
Patient EQ-5D-5L
EQ-5D is an instrument which evaluates the generic quality of life developed in Europe and widely used. The EQ-5D descriptive system is a preference-based HRQL measure with one question for each of the five dimensions that include mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Participant EQ 5D 5L score change from Baseline (Day -1 \[V2\]) to subsequent follow up visits. Minimum: 0 Maximum: 20 Higher Score is indicative of worsening outcome.
Time frame: 8 weeks
Caregiver Oncology Quality of Life Questionnaire (CarGOQol)
CarGOQol score change from Baseline (Day -1 \[V2\]) to subsequent follow up visits (this assessment is not mandatory) Minimum: 0 Maximum: 116 Higher Score is indicative of worsening outcome.
Time frame: 8 weeks
DS-II
Change in DS-II factor scores from Baseline. Minimum: 0 Maximum: 32 Higher Score is indicative of worsening outcome.
Time frame: 8 weeks
5 Dimension Altered State of Consciousness (5D-ASC)
Summary of the 5D-ASC on the day of psilocybin dosing. o Links between psychedelic intensity and experience (via the 5D-ASC) and depression and anxiety outcomes will also be explored and patient experience and acceptability of the treatment summarised at V3 and V4. This has 11 subscales, and higher scores are indicative of good outcomes.
Time frame: 8 weeks
Sheehan Disability Score (SDS)
SDS score change from Baseline Minimum: 0 Maximum: 30 Higher Score is indicative of worsening outcome.
Time frame: 8 weeks
Scale To Assess Therapeutic Relationship: Patient (STAR-P)
Therapeutic alliance of the clinician and patient, as rated using the STAR-C and STAR-P respectively will be assessed at Baseline, along with assessing correlations with this measure and primary and secondary outcomes as a possible predictor of response Minimum: 0 Maximum: 48 Higher Score is indicative of good outcome.
Time frame: 8 weeks
Scale To Assess Therapeutic Relationship: Clinician. (STAR-C)
Therapeutic alliance of the clinician and patient, as rated using the STAR-C and STAR-P respectively will be assessed at Baseline, along with assessing correlations with this measure and primary and secondary outcomes as a possible predictor of response Minimum: 0 Maximum: 48 Higher Score is indicative of good outcome.
Time frame: 8 weeks
Changes in electrocardiographs.
Abnormal and clinically significant results on the ECG, that in the investigator's opinion may constitute a risk for an individual who is exposed to psilocybin.
Time frame: 8 weeks