Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis

• Published in: Psychiatry research 2024-05, Vol.335, p.115886, Article 115886
• Main Authors: Yao, Yuan, Guo, Dan, Lu, Tang-Sheng, Liu, Fang-Lin, Huang, Shi-Hao, Diao, Meng-Qi, Li, Su-Xia, Zhang, Xiu-Jun, Kosten, Thomas R, Shi, Jie, Bao, Yan-Ping, Lu, Lin, Han, Ying
• Format: Article
• Language: English
• Subjects: Banisteriopsis; Hallucinogens - adverse effects; Hallucinogens - pharmacology; Hallucinogens - therapeutic use; Humans; Lysergic Acid Diethylamide - adverse effects; Lysergic Acid Diethylamide - pharmacology; Mental disorders; Mental Disorders - drug therapy; Meta-analysis; N-Methyl-3,4-methylenedioxyamphetamine - adverse effects; N-Methyl-3,4-methylenedioxyamphetamine - pharmacology; Psilocybin - adverse effects; Psilocybin - pharmacology; Psilocybin - therapeutic use; Psychedelics; Safety
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2024.115886

•Psychedelics may reduce negative mood such as anxiety, depression, and suicidality caused by certain diseases.•Psychedelics demonstrate potential efficacy in primary substance-use disorders and post-traumatic stress disorder.•Psychedelics may improve obsessive-compulsive disorder, sleep disturbances and other rare mental disorders.•Psychedelic show a good safety to a certain extent from the participants reported lasting negative or adverse effects. We aim to systematically review and meta-analyze the effectiveness and safety of psychedelics [psilocybin, ayahuasca (active component DMT), LSD and MDMA] in treating symptoms of various mental disorders. Web of Science, Embase, EBSCO, and PubMed were searched up to February 2024 and 126 articles were finally included. Results showed that psilocybin has the largest number of articles on treating mood disorders (N = 28), followed by ayahuasca (N = 7) and LSD (N = 6). Overall, psychedelics have therapeutic effects on mental disorders such as depression and anxiety. Specifically, psilocybin (Hedges’ g = -1.49, 95% CI [-1.67, -1.30]) showed the strongest therapeutic effect among four psychedelics, followed by ayahuasca (Hedges’ g = -1.34, 95% CI [-1.86, -0.82]), MDMA (Hedges’ g = -0.83, 95% CI [-1.33, -0.32]), and LSD (Hedges’ g = -0.65, 95% CI [-1.03, -0.27]). A small amount of evidence also supports psychedelics improving tobacco addiction, eating disorders, sleep disorders, borderline personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. The most common adverse event with psychedelics was headache. Nearly a third of the articles reported that no participants reported lasting adverse effects. Our analyses suggest that psychedelics reduce negative mood, and have potential efficacy in other mental disorders, such as substance-use disorders and PTSD.