Psilocybin for anxiety, and anxiety from magic mushrooms: what research shows

People search for “magic mushrooms and anxiety” with two very different questions in mind. Some want to know whether mushrooms can cause anxiety or panic. Others have read about clinical trials and want to know whether psilocybin has been studied for anxiety. Both questions have research behind them, and the answers do not cancel each other out.

This page covers both, in order: anxiety as an effect of the drug, what clinical studies measured and found, what is known about people who already live with an anxiety disorder, and where medicines come in. It describes research only. It does not say that psilocybin works for anxiety, and it does not tell anyone what to do.

Can magic mushrooms cause anxiety or panic?

Yes. Health Canada lists anxiety and panic attacks among the effects of magic mushrooms, alongside confusion, disorientation, fear and paranoia. It says a “bad trip” can be frightening, with paranoia, loss of boundaries and a distorted sense of self (Health Canada). Evidence: established.

Research guidelines published by Johns Hopkins researchers in 2008 call overwhelming distress during the drug’s action, the “bad trip”, the most likely risk of hallucinogens, and say it could lead to potentially dangerous behaviour such as leaving the study site (Johnson et al., 2008). The same paper describes hallucinogens as relatively safe physiologically but carrying unique psychological risks.

How often did anxiety happen in supervised studies?

Even in carefully prepared research settings, anxiety during sessions was common enough to be counted. In a pooled analysis of eight placebo-controlled Swiss studies with 110 healthy volunteers, acute adverse reactions marked by strong dysphoria or anxiety and panic occurred only in the two highest dose conditions and in a relatively small share of volunteers. All were managed with interpersonal support, without medication (Studerus et al., 2011).

In cancer trials, the same pattern appears. In the Johns Hopkins trial of 51 adults, some psychological discomfort was recorded in 32% of participants during the high-dose session, including an episode of anxiety in 26%, and one participant had a transient episode of paranoid ideation (Griffiths et al., 2016). In the New York trial, transient anxiety was reported by 17% (Ross et al., 2016). In a 2025 Melbourne trial, one participant withdrew because of anxiety during dosing (Ross et al., 2025).

So the same studies that later reported lower anxiety scores also recorded anxiety during the sessions themselves. Those sessions had screening, preparation, trained staff and monitoring. What happens without those things is a different question.

What about use outside research?

The largest survey we found gives a sense of scale. Of 9,233 people in the 2017 Global Drug Survey who had used magic mushrooms in the past year, 19 (0.2%) had sought emergency medical treatment. The most common symptoms were psychological, namely anxiety or panic and paranoia or suspiciousness. Young age was the only predictor, poor “mindset”, poor “setting” and mixing substances were the most reported reasons, and all but one respondent returned to normal within 24 hours (Kopra et al., 2022). Evidence: preliminary. People chose to answer an online survey, so the sample may not match everyone who uses mushrooms.

CAMH adds a longer-term note: some people who take hallucinogens feel depressed or anxious long after they took the drug, and rare “flashbacks” can replay the experience days, weeks or even years later (CAMH). That page carries a 2004 and 2009 copyright, so treat it as a general overview, not current data.

We cover these effects in more depth elsewhere, so we will not repeat them here. See magic mushroom effects, short and long term, how to help someone having a bad trip, and set and setting for what research says about mindset and surroundings.

What did trials of psilocybin for anxiety find?

Most of the controlled research on psilocybin and anxiety comes from one setting: adults with cancer or another life-threatening illness who also had clinically significant anxiety or depression. Every study paired psilocybin with psychotherapy in a clinic. We leave out dose amounts on purpose, because this page is about what was found, not how to use anything.

Scores come from different scales, so the numbers are not directly comparable across rows. All four studies screened their participants and supported them before, during and after sessions.

The cancer and end-of-life trials

The earliest, a 2011 pilot, gave psilocybin to 12 adults with advanced-stage cancer and anxiety. Its authors reported lower trait anxiety at 1 and 3 months and lower depression scores at 6 months, and described the study as establishing feasibility and safety (Grob et al., 2011).

Two 2016 trials followed. In New York, 29 people were randomized to psilocybin or niacin, both with psychotherapy. Before the crossover at 7 weeks, psilocybin was associated with lower anxiety and depression scores, and at 6.5 months about 60 to 80% of participants still showed clinically significant reductions in depression or anxiety (Ross et al., 2016). In Baltimore, 51 people received a very low dose in one session and a high dose in the other, in random order. At about 6 months, the overall clinician-rated response rate was 78% for depression and 83% for anxiety (Griffiths et al., 2016).

A long-term follow-up of the New York trial reached 15 of the 16 participants still alive, at an average of 3.2 and 4.5 years. Reductions in anxiety, depression and death anxiety were reported as sustained, but the authors add that limited conclusions about efficacy can be drawn because of the crossover design (Agin-Liebes et al., 2020). It had no comparison group and relied on self-reports.

A newer trial from Melbourne, published in 2025, kept a placebo comparison for longer. It randomized 35 adults with a life-threatening illness and clinically significant depression or anxiety to psilocybin or niacin, each with three preparatory and six integration psychotherapy sessions. At 6 to 7 weeks, the psilocybin group had greater reductions on depression scales and on a state anxiety scale than the placebo group, and the authors report the benefits were sustained at 26 weeks. No serious treatment-emergent adverse events occurred, but psilocybin was associated with more mild-to-moderate adverse events (Ross et al., 2025). With 17 and 18 people per group at a single site, it is still a small study. Evidence: preliminary.

Our full article on psilocybin for end-of-life distress covers these studies in more detail, including how Canadian access works.

What do pooled analyses say about anxiety?

A 2020 meta-analysis pooled four studies (117 participants, three of them placebo-controlled) of psilocybin with behavioural interventions in people with elevated symptoms. It reported large effects on anxiety and depression, and no serious adverse events. Its authors named the small number of studies and the risk of bias within them, and said the results tentatively support future research (Goldberg et al., 2020).

A 2021 meta-analysis focused on end-of-life anxiety pooled five studies and reported lower state anxiety with psilocybin than placebo at 1 day and 2 weeks, and lower trait anxiety at 6 months. It also found transient rises in blood pressure, and stressed small samples and high heterogeneity on long-term outcomes (Yu et al., 2021).

The newest review is more cautious. A 2026 meta-analysis of psilocybin in cancer patients found lower depression scores in randomized trials but mixed results on anxiety: one anxiety scale was not significant, and another gave inconsistent results. The authors call their findings preliminary, citing the small number of studies, high heterogeneity, blinding and expectancy problems, and frequent combination with psychotherapy (Moshfeghinia et al., 2026). Evidence: preliminary.

Anxiety measured in depression trials

Some depression trials also measured anxiety as a secondary outcome. In the large COMP360 phase 2 trial of treatment-resistant depression (233 participants), an exploratory analysis reported that at week 3 the higher dose was associated with greater improvement than the control dose on patient-reported measures, including anxiety. The authors note the absence of an active comparator and possible functional unblinding (Goodwin et al., 2023).

A small open-label study in 15 US veterans with treatment-resistant depression reported lower anxiety scores that lasted through 12 months, but the changes were no longer statistically significant after accounting for improvement in depression. The authors name the small sample and open-label design as limits (Kelly et al., 2026). Evidence: preliminary. Results for depression itself are summarized in psilocybin for depression trials.

Has psilocybin been tested for generalized anxiety disorder?

Not in any published randomized trial we could find. On 17 October 2026 we searched Europe PMC for studies with psilocybin and anxiety disorder in the title. What came back for generalized anxiety disorder was a single case report posted as a preprint and a conference abstract, not a peer-reviewed controlled trial. We do not report results from those.

One trial is under way in Canada. ClinicalTrials.gov lists a phase 2a, randomized, double-blind, placebo-controlled trial of a psilocybin oral solution in adults with generalized anxiety disorder, sponsored through Queen’s University and run in Kingston, Ontario. The record shows it as recruiting, with an estimated 50 participants and an estimated primary completion date of 31 December 2027. Its primary outcome is safety and tolerability (NCT06969170). A registry entry is a research record, not an invitation or a treatment service, and it has no results yet.

The largest published psychedelic trial in generalized anxiety disorder used a different drug. A 2025 phase 2b trial in JAMA randomized 198 adults with moderate to severe generalized anxiety disorder to one of four doses of MM120, a form of LSD, or placebo, at 22 US sites. The two higher doses produced significantly greater reductions in a clinician-rated anxiety score than placebo at 4 weeks, while the two lower doses did not. Visual perceptual changes, nausea and headache were common (Robison et al., 2025). LSD is not psilocybin, so this trial says nothing directly about magic mushrooms. For how the two differ, see psilocybin, LSD and DMT.

What about people who already have an anxiety disorder?

Health Canada says that for individuals predisposed to or with existing psychiatric conditions, there may be an elevated risk of side effects (Health Canada). It does not give rates, and it does not single out anxiety disorders, but anxiety disorders are psychiatric conditions. Evidence: established (official warning); the size of the risk is unknown.

Research screening shows who the studies left out. The 2008 safety guidelines recommend excluding volunteers with a personal or family history of psychotic disorders or other severe psychiatric disorders (Johnson et al., 2008). Depression trials excluded, among others, people with a history of psychotic disorder, serious suicide attempt or hospitalization (Davis et al., 2021), and people with psychosis, mania, active substance use disorder or active suicidal ideation with intent (Raison et al., 2023). Because these groups were excluded, the trials say little about them.

Two points follow from this. First, the anxiety trials above enrolled people with anxiety, but only after screening, and only in a clinic with psychotherapy and monitoring. Second, no source we opened tells us how a person with an anxiety disorder fares when using mushrooms without those safeguards. That gap is not evidence of safety. Our wider guide, are magic mushrooms safe?, lists other groups at higher risk, and can magic mushrooms cause psychosis? covers that question.

What about anti-anxiety medicines and antidepressants?

Many people with anxiety take an antidepressant or another prescribed medicine. Health Canada notes that using magic mushrooms with other substances such as cannabis, amphetamines and alcohol elevates the risks (Health Canada). What is known about prescription medicines specifically is limited and mixed, and we give it a page of its own: magic mushrooms and antidepressants.

Do not stop, start or change a medicine because of anything you read here. CAMH warns that stopping an antidepressant too soon or too abruptly can bring back symptoms and cause withdrawal, as our antidepressants guide explains. That is a decision to make with the prescriber or a pharmacist.

Is psilocybin an approved treatment for anxiety in Canada?

No. As of 24 October 2026, Health Canada’s page (dated 20 October 2026) says that at this time there are no approved therapeutic products containing psilocybin in Canada or elsewhere, and that the production, sale and possession of magic mushrooms are illegal in Canada (Health Canada). Approval positions can change, so check that page for the current position. For the narrow legal routes that do exist, such as the Special Access Program, see psilocybin-assisted therapy in Canada.

What is still unknown?

• Whether psilocybin reduces anxiety in people with an anxiety disorder such as generalized anxiety disorder. No published randomized psilocybin trial in that group was found; a Canadian trial is recruiting.
• How much of the reported change in the cancer studies came from psilocybin, and how much from psychotherapy, preparation, expectancy and the unblinding of a noticeable drug.
• How long any effect lasts when a controlled comparison is kept. The longest follow-ups had no comparison group.
• Who is most likely to have severe anxiety or panic during a session, and how often that happens outside research. Survey data are self-selected.
• How people with anxiety disorders who were not screened, prepared and monitored fare. The studies did not test this.
• How prescription medicines change the picture. See our antidepressants page for what little is known.

The honest summary is that anxiety and panic are recognized effects of magic mushrooms, and that a small number of supervised studies in people with serious illness reported lower anxiety scores afterwards, with design limits their own authors name. Evidence for anxiety disorders in general is not yet published. For the wider research picture, see psilocybin benefits: what research shows, and for low-dose studies, what controlled microdosing trials show. Background on the mushrooms themselves is in what are magic mushrooms?

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