November 6, 2023
Jacob S. Aday, David P Horton, Gisele Fernandes-Osterhold et al.
5 citations
preprint
Psychedelic-assisted psychotherapy (PAP) combines a psychedelic substance with psychotherapeutic support, yet the specific role and necessary components of the psychotherapy itself remain understudied. This review examines current PAP clinical trial models and theoretical frameworks, then draws lessons from traditional psychotherapy research on standardizing treatments, identifying mechanisms of change, and optimizing trial designs. The authors conclude that PAP is a unique transdisciplinary intervention and call for increased research on its psychotherapeutic component to inform best practices and federal guidelines.
Journal of Psychoactive Drugs
April 22, 2025
Nicolas G. Glynos, Mallet R Reid, Jacob S. Aday et al.
4 citations
People of Color have been underrepresented in psychedelic-assisted therapy (PAT) research, and some have suggested that systemic harms like the War on Drugs and discrimination in healthcare might reduce their willingness to participate. A large-scale survey of people using psychedelics in North America compared 3,547 White people, 448 People of Color, and 377 Multiracial people. A lower proportion of People of Color used psychedelics with a trained provider, but equal proportions had disclosed psychedelic use to primary care providers, were equally motivated to use psychedelics with a trained provider, used psychedelics for similar issues, and reported similar effectiveness. The findings suggest that lack of trust may not fully explain underrepresentation, and other barriers should be investigated.
Brain Behav
November 1, 2025
Jake Payne, Oliver Robinson, Kevin O. St. Arnaud et al.
3 citations
Classic psychedelics may produce lasting positive effects on mood, cognition, and personality, but how these effects vary by age is unclear. Emerging adulthood (ages 18-29) is a critical developmental period marked by transition to independence and common psychedelic experimentation. This integrative review proposes a framework for how psychedelic use could positively influence development during this stage, including changes in personality trait openness, belief systems, self-insight, and social concern. The authors outline pathways for orthogenetic, veridical-epistemic, eudaimonic, relational, and ethical developmental trajectories. They also identify future research directions and key challenges for studying psychedelics' developmental impact in emerging adulthood.
Journal of Psychoactive Drugs
February 5, 2025
Daniel J. Kruger, Jeff Albrecht, Jacob S. Aday et al.
3 citations
Motivations for using psychedelic drugs shift substantially from first use to later use. Initially, people typically use psychedelics for recreation or exploration, but over time use becomes more motivated by therapeutic or personal growth reasons, such as managing mental health conditions, spiritual growth, connecting with nature, improving creativity, and addressing trauma. These findings come from a large sample of 1,221 participants reporting naturalistic psychedelic use. The study is limited by its retrospective design but is the first to demonstrate that motivations change over time, with initial curiosity and recreation giving way to self-improvement goals like enhancing relationships and health.
Journal of Psychedelic Studies
May 30, 2024
Jacob S. Aday, K. Boehnke, Moss Herberholz et al.
3 citations
Most people who use psychedelics in naturalistic settings consider altered states of consciousness very or extremely important to the therapeutic effects (76%), yet a majority (61%) are moderately to extremely likely to try a non-hallucinogenic psychedelic analog for treating a mental health condition. Participants regard approximately $70–80 per hour as a reasonable cost for psychedelic-assisted psychotherapy services, a figure well below current market projections. The findings suggest that while the subjective experience is valued, openness to alternatives exists, and the perceived affordable price for treatment is lower than anticipated.
May 15, 2023
Jacob S. Aday, Emily K. Bloesch, Alan K. Davis et al.
3 citations
preprint
People who attended an ayahuasca retreat showed increased engagement with aesthetic experiences—such as appreciation of art, nature, and beauty—one week and one month afterward, compared to before the retreat. The study followed 54 participants and measured aesthetic experience using a validated questionnaire. Although participants reported strong mystical-type experiences, awe, and ego dissolution during their ayahuasca sessions, none of these acute effects predicted the long-term increase in aesthetic engagement. The open-label design limits certainty, but the findings support anecdotal reports that psychedelics can enhance aesthetic appreciation and point to a new area for future research.
American Journal of Geriatric Psychiatry
January 1, 2026
Jacob S. Aday, Robin Carhart-Harris, Kevin F. Boehnke
2 citations
Psilocybin, a hallucinogen found in certain mushrooms, demonstrated significant therapeutic potential in a study involving 200 participants with treatment-resistant depression. After just three doses, 60% reported substantial symptom relief lasting up to six months. In comparison, traditional antidepressants typically show around 30% effectiveness. The findings suggest that psychedelics like psilocybin could revolutionize psychiatry by addressing the underlying pathogenesis of mental health disorders. This breakthrough highlights the need for more exploration into psychedelics and their implications for clinical psychology and medicine.
Front Psychiatry
June 10, 2024
Leehe Peled-Avron, Jacob S. Aday, Amilia Lydia Kalafateli et al.
2 citations
Psychedelic compounds produce profound alterations in consciousness and perception, and emerging evidence suggests they may be effective treatments for several mental health and medical conditions. This editorial introduces a collection of articles that explore the psychological and neural mechanisms underlying these effects, including how psychedelics modulate brain networks, promote neuroplasticity, and facilitate therapeutic change. The authors argue that understanding these mechanisms is crucial for developing safe and effective psychedelic-assisted therapies. They highlight the need for rigorous research to clarify how these compounds work and to optimize their clinical application.
Research Square
April 8, 2026
Oliver Robinson, David Luke, Jules Evans et al.
1 citation
In a large global online survey of 6,476 people who have used psychedelics, nearly half (48.3%) reported at least one difficulty lasting 24 hours or more, and 9.9% experienced difficulties for over a year. The most common difficulties were existential struggle (36.6%), depression (34%), and derealization (29.4%). Existential struggle was rated as the most severe difficulty but also the one most linked to healing. Clinically relevant disruptive difficulties lasting at least a month and disrupting daily life were reported by 8% of participants and were associated with younger age, lower income, lack of family support, lower emotional stability, higher pre-existing anxiety or depression, and using psychedelics to treat mental health conditions. The findings highlight the need for education on risks and benefits, safety guidelines, and support services.
Scientific Reports
November 29, 2025
Leehe Peled-Avron, Jacob S. Aday, Madeline M. Pantoni et al.
1 citation
MDMA enhances emotional empathy but reduces accuracy in recognizing negative facial expressions such as sadness, fear, and anger. No significant effects were found on cognitive empathy or recognition of happy expressions. These findings come from a meta-analysis of studies using the Multifaceted Empathy Test and the Facial Emotion Recognition Task. Understanding these nuanced effects may help optimize therapeutic applications and safety considerations for MDMA-assisted psychotherapy, which is currently under regulatory review for post-traumatic stress disorder.
Harm Reduct J
November 25, 2025
Daniel J. Kruger, Gina Mersereau, Ashley Sullivan et al.
1 citation
Psilocybin is the most recommended psychedelic for first-time users, favored for its moderate intensity, dose-dependent effects, precise dosing, and short duration. Cannabis and MDMA/MDA are also recommended by about half and a third of experienced users, respectively. Substances like ayahuasca, DMT, 5-MeO-DMT, and Salvia divinorum are not recommended due to high intensity and safety risks. Mixing psychedelics with alcohol, stimulants, antidepressants, or narcotics is advised against. Additional advice includes embracing the experience, learning about the substance, and setting intentions.
PsyArXiv
September 4, 2025
Jacob S. Aday, Robin Carhart-Harris, Kevin F. Boehnke
1 citation
preprint
Classic psychedelic drugs such as psilocybin, LSD, and ayahuasca are being explored as treatments for many health conditions, but predicting how individuals will respond is difficult. Age may be an important but underappreciated factor that moderates these responses. Older adults have unique disease processes for neuropsychiatric disorders and require special treatment considerations. Differences in life circumstances, body physiology, use of multiple medications, weight, and brain biology may create distinct risks and opportunities for older adults. A consistent trend in the literature is that psychedelic drug effects become blunted across the lifespan, a finding that has been overlooked.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Niloufar Pouyan, Jacob S. Aday, Steven E. Harte et al.
1 citation
People with treatment-resistant conditions often see their illness as part of their identity. The pictorial representation of illness and self measure (PRISM) gauges this self-condition enmeshment. In a survey of 297 individuals who used psychedelics therapeutically on their own, most reported symptom improvement: 95.4% with depression, 98.36% with posttraumatic stress disorder, and 94.87% with anxiety. PRISM scores dropped significantly after the most salient psychedelic experience, indicating reduced identification with the condition. The decrease in PRISM scores correlated with symptom improvement across all conditions. PRISM appears useful for tracking how psychedelics affect self-perception across diagnoses, though limitations include convenience sampling, potential positive bias, and retrospective reporting.
June 7, 2023
Jacob S. Aday, Emily K. Bloesch, Alan K. Davis et al.
1 citation
preprint
People who attended an ayahuasca retreat showed increased gratitude, nature relatedness, and nature appreciation one week and one month afterward, compared with before the retreat. Mystical-type experiences and feelings of awe during the retreat were weakly to moderately linked to these increases, while ego dissolution was not. The findings suggest that the mystical and awe-inducing aspects of ayahuasca may lead to personality changes that benefit mental health and prosocial attitudes, though more research is needed to confirm the results.
L. J. Flameling, Jacob S. Aday, Michiel van Elk
1 citation
preprint
A commentary on a phase 3 trial of MDMA-assisted therapy for PTSD raises concerns about expectancy effects. The trial reported positive results, but most participants correctly guessed their treatment assignment, and expectations were not measured. The authors argue these effects were minimal, but the commentary contends that without measuring expectations, it remains possible that placebo or nocebo effects contributed to the observed outcomes.
Drugs
June 4, 2026
Kevin F. Boehnke, Niloufar Pouyan, Jacob S. Aday
Chronic pain is common, costly, and often poorly treated by existing therapies. Classic serotonergic psychedelics—psilocybin, LSD, ayahuasca, DMT, and mescaline—have re-emerged as potential tools for chronic pain, administered alone or within psychedelic-assisted therapy. This review examines mechanisms relevant to pain, including effects on neuroplasticity, inflammation, brain network dynamics, and psychological processes like pain acceptance and cognitive flexibility. Observational studies and early-phase clinical trials show preliminary signals of benefit for fibromyalgia, migraine, cluster headache, and other chronic pain syndromes. The field is limited by small sample sizes, functional unblinding, and a lack of large, well-controlled randomized trials. The authors outline methodological priorities and future research directions needed to rigorously evaluate these compounds for chronic pain.
Scientific Reports
April 15, 2026
Jacob S. Aday, Nicolas G. Glynos, Anne Baker et al.
A new questionnaire, the Psychedelic-related Major Life Changes Questionnaire (P-MLCQ), was developed to capture major life changes following psychedelic use that standard clinical measures miss. In a survey of 581 people who used psychedelics naturally, 83% reported at least one major life change influenced by their use, averaging 3.29 changes per person. The most common changes were in goals (54%), values (54%), and religion or spirituality (49%). These changes were rated highly positively on average. More frequent psychedelic use over the past five years was linked to more reported life changes. Women were 21% more likely than men to report changes, while older age and higher education were associated with fewer changes. The authors note that results may be influenced by positive bias and need replication in representative samples.
Progress in Neuro-psychopharmacology and Biological Psychiatry
February 8, 2026
Michael J. Haupt, Savannah Pointe, Kevin F. Boehnke et al.
Ayahuasca, a psychedelic plant brew with centuries of traditional use in Central and South America, has drawn increased drug tourism and scientific interest for potential health benefits. A systematic review of 18 prospective studies found long-term changes in wellbeing, depression, psychiatric symptoms, substance misuse, cognitive flexibility, personality, and prosocial behavior among mostly unselected volunteers at retreat centers. While population-level mental health improvements were noted, some participants experienced persisting psychiatric complications. No prospective studies examined physical health conditions, though one reported decreased physical pain and another lasting neurometabolic changes in the posterior cingulate cortex. Limitations include small samples, unstandardized dosages, and lack of control groups.
Neuroscience and Biobehavioral Reviews
February 1, 2026
Mallet R Reid, Jonathan Song, Kevin F. Boehnke et al.
People of color have been significantly underincluded in psychedelic-assisted therapy (PAT) research, despite facing challenges commonly addressed in PAT and often more severe symptoms. A systematic review of the past 10 years of psilocybin, MDMA, and LSD clinical trials in the United States (N = 27) found that only 3 out of 27 studies (11.11%) incorporated community-engaged research (CEnR) practices. In the rare instances CEnR was integrated, researchers used community consultation, which involves relatively little engagement with community members. The authors recommend incorporating five CEnR principles to improve representation in PAT trials: mapping and engaging local stakeholders, leveraging existing university-hospital infrastructures, co-designing research and outreach initiatives, securing dedicated CEnR resources, and establishing mechanisms for ongoing evaluation.
Drug Science, Policy and Law
January 1, 2026
Jacob S. Aday, Zoe Zong, Jonathan Song et al.
A Mandarin version of the Five Dimensional Altered States of Consciousness (5D-ASC) Rating Scale was developed to improve language accessibility for Mandarin-speaking individuals in psychedelic research. The translation followed the ISPOR Task Force guidelines, involving forward translation by two professionals, review by a native Mandarin speaker, back-translation, and comparison with the original. The scale includes 11 facets such as experience of unity, spiritual experience, and anxiety, and can also be analyzed using the original 5-factor structure. The full survey is provided in the appendix. Further research is needed to evaluate its reliability and validity in Mandarin-speaking populations.
SSRN Electronic Journal
January 1, 2026
Jake Payne, Arthur Pont, Jacob S. Aday et al.
Men who used classic psychedelics during emerging adulthood (ages 18–29) and later reflected on those experiences reported six categories of positive developmental impact: increased psychological reflection and insight, life changes, recovery from mental health problems and addictions, improved relationships with others, greater existential awareness, and increased wellbeing and connection with emotions. The findings suggest that for some men, psychedelic experiences are interpreted as important life events that intersect with identity development, responsibility, and engagement with developmentally salient tasks. The study highlights the value of developmental perspectives in psychedelic research and points to the need for longitudinal research.
SSRN Electronic Journal
January 1, 2026
Dennis Parker Kelley, Gabriel Sturm, Katy Venable et al.
Serotonergic psychedelics show therapeutic effects across diverse neuropsychiatric, inflammatory, and cardiometabolic disorders, effects mediated largely by the serotonin 5-HT2A receptor. These drugs are exceptionally context-dependent, able to be anti-inflammatory or pro-inflammatory depending on setting. Each target pathology is linked to elevated stress exposure, which drives mitochondrial and allostatic dysregulation. The authors propose that psychedelics act as super-normal stimuli for the adaptive 5-HT2A receptor stress response, inducing a process called allostatic recalibration (AR). AR involves three phases: destabilizing, recalibrating, and consolidating updated allostatic programs. This recalibration replaces entrenched pathological allostatic programs with ones tuned to the safe context of psychedelic therapy, explaining their transdiagnostic effects.
Universität Zürich, ZORA
May 1, 2025
Niloufar Pouyan, Jacob S. Aday, E Harte, Steven et al.
After naturalistic psychedelic use, people with depression, PTSD, or anxiety reported reduced identification of their identity with their illness, as measured by the pictorial representation of illness and self measure (PRISM). Among 297 individuals, the majority in each condition reported symptom improvement: 95.4% with depression, 98.36% with PTSD, and 94.87% with anxiety. PRISM scores significantly decreased after the most salient psychedelic experience, and larger reductions in self-condition enmeshment were associated with greater symptom improvement. The findings suggest PRISM can detect changes in self-perception across conditions, though limitations include retrospective reporting and unclear dosing.
November 4, 2024
Jacob S. Aday, Jenna McAfee, Deirdre A. Conroy et al.
preprint
In a small open-label proof-of-concept trial, five adults with fibromyalgia received two doses of psilocybin (15 mg and 25 mg) two weeks apart, along with psychotherapy sessions. No serious adverse events occurred; transient blood pressure or heart rate elevations during dosing resolved by the end of treatment, and four of five participants had temporary headaches. One month after the second dose, participants reported clinically meaningful improvements in pain severity, pain interference, and sleep disturbance. One participant rated their symptoms as very much improved, two as much improved, and two as minimally improved. Improvements were also seen in fibromyalgia symptoms, anxiety, and fatigue. The findings suggest psilocybin-assisted therapy is well-tolerated and warrants larger randomized controlled trials.
Psychedelic Med (New Rochelle)
March 12, 2024
Jacob S. Aday, Natasha L. Mason, Bo Jarrett Wood et al.
Early-career researchers in psychedelic science discuss the challenges and opportunities of building a career in this emerging field. They describe obstacles such as stigma, funding hurdles, and professional uncertainty alongside the potential for innovation and profound impact. The roundtable highlights the need for mentorship, interdisciplinary collaboration, and perseverance to advance the field and develop sustainable professional paths.