Psilocybin shows unusually strong anxiety results, yet drug developers largely pursue depression and PTSD instead

A Neuropsychopharmacology commentary argues that psilocybin may have one of the strongest anxiety signals in psychedelic research, while major developers largely pursue depression, PTSD, or other compounds for anxiety. In two influential trials involving people with life-threatening cancer, about 80 percent of patients retained clinically significant improvement six months after one session, with a reported Cohen's d above 2.0. A meta-analysis of six double-blind randomized trials involving 528 patients found that session-related anxiety was usually transient and resolved within 48 hours, while anxiolytic effects held up against active placebo comparators. The evidence remains narrow: the strongest findings come from cancer-related anxiety, and direct evidence for generalized anxiety, social anxiety, and other disorders is limited. The apparent development gap may reflect difficult trial design and uncertain generalizability, but it also leaves psilocybin anxiety treatment as a potentially differentiated and largely unclaimed clinical opportunity.