Anxiety and Affective Symptoms Related to the Use of Classic Psychedelics: A Systematic Review.
Grace Viljoen, Felix Betzler
Current Topics in Behavioral Neurosciences October 23, 2024 DOI: 10.1007/7854_2024_534 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 39 |
| Population | Individuals using classic psychedelics in clinical and recreational settings |
| Topics | Anxiety Depression LSD Psilocybin |
| Keywords | Psychological wellbeing Risks Contraindications Affective disorders Psychedelics hallucinogens Entheogens |
| Citations | 5 |
| Key findings | Persisting anxiety and affective disorders related to classic psychedelics are infrequent and mainly occur in individuals with multiple risk factors, while in clinical psychedelic-assisted therapy such enduring symptoms are rare and acute anxiety typically resolves without intervention. |
Abstract
There is a large and rapidly growing body of literature investigating the therapeutic effects of classic psychedelics in affective and anxiety disorders, but very few studies have examined the inverse of this, that is, the potential for psychedelics to inflict anxiety and affective symptoms. A systematic literature search was performed and 39 papers were included in the final review to qualitatively synthesize the current literature on anxiety and affective disorders related to the use of classic psychedelics. Persisting disorders were less frequent but generally occurred in individuals who presented with several risk factors (overdose, polydrug use, unstructured recreational setting, psychosocial stress, personal/familial psychiatric histories). When psychedelics were administered in clinical studies under the framework of psychedelic-assisted therapy, the incidence of enduring anxiety and affective symptoms was low. In most cases, acute transient anxiety emerged and resolved during the dosing session without the need for additional treatment interventions. The nuance of such cases is discussed, shedding light on the role of emotional catharsis in the therapeutic process. Several suggestions are proposed to enhance patient safety including strengthening the therapeutic alliance, ensuring adequate mental preparation, acclimating to high doses and providing on-going therapeutic support.
Comparable studies
Other systematic reviews and meta-analyses on LSD for depression, most cited first.
Citations in the library
Cited by 6
- Psychedelic-Related Psychosis: From Model Psychosis to Psychotherapy. Current Topics in Behavioral Neurosciences 2026
- Classifying Psychedelic-Related Complications Current Topics in Behavioral Neurosciences 2026
- Three Cases of Depersonalization/Derealization Disorder Related to the Use of Classic Psychedelics SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice December 1, 2025
- DT120 (MM120): a single-dose orally disintegrating formulation of lysergide tartrate for generalized anxiety disorder Expert Review of Neurotherapeutics October 8, 2026
- Klassische Halluzinogene in der Behandlung von Suchterkrankungen – Ein narrativer Überblick Suchttherapie August 1, 2026
and 1 more in the library
Cites 44
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
and 39 more in the library