Impact of psilocybin on cognitive function: A systematic review
Shakila Meshkat, Fatemeh Gholaminezhad, Eric Vermetten, Yanbo Zhang, Lisa Burback, Olga Winkler, Rakesh Jetly, Venkat Bhat, Triana Juliana Tello‐gerez, Benjamin T. Dunkley, Amy C. Reichelt, David Erritzøe, Andrew J. Greenshaw, Leah M. Mayo
Psychiatry and Clinical Neurosciences October 1, 2024 DOI: 10.1111/pcn.13741 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 2,959 |
| Population | Healthy volunteers and patients with treatment-resistant depression |
| Intervention | Psilocybin |
| Dose | 45 μg/kg to 30 mg/70 kg |
| Topics | Psilocybin |
| Keywords | Cognition Empathy Cognitive flexibility Cognitive psychology Clinical psychology Episodic memory Working memory Hallucinogen Developmental psychology |
| Citations | 24 |
| Key findings | Psilocybin's effects on cognitive function are mixed, with improvements in some domains like sustained attention, working memory, executive function, and emotional processing, particularly in patients with treatment-resistant depression, while global cognitive function and processing speed remain mostly unchanged in healthy individuals. |
Abstract
Psilocybin is a classic psychedelic with demonstrated preliminary clinical efficacy in a range of psychiatric disorders. Evaluating the impact of psilocybin on cognitive function is essential to unravel its potential benefits and risks. In this systematic review, we assessed psilocybin's effect on cognitive function through a comprehensive search of electronic databases from inception to January 2024, identifying 20 articles involving 2,959 participants. While 85% of studies were conducted in healthy volunteers, most of these studies (85%) used macrodoses, ranging from 45 μg/kg to 30 mg/70 kg. Various cognitive aspects were evaluated and yielded mixed results. Global cognitive function, and processing speed remained mostly unchanged in healthy individuals; However, a limited number of studies reported improvements in certain areas such as sustained attention, working memory, and executive function especially in patients with treatment‐resistant depression (TRD). Emotional processing was positively modified, particularly in TRD patients. Psilocybin was observed to enhance emotional empathy without significantly altering cognitive empathy and social cognition. Cognitive flexibility and creative cognition were noted to initially decline but could potentially improve over time. Additionally, with respect to learning and memory skills, psilocybin showed promise in improving specific memory types such as semantic associations and associative learning, while its effects on episodic and verbal memory have been less pronounced compared to other cognitive enhancers. The observed mixed findings underscore the complexity of psilocybin's cognitive influence. Further research is essential to provide a clearer understanding of psilocybin's impact on cognitive domains and to guide the development of safe and effective interventions.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... | 2020 | Systematic review | n = 188 |
| Blinding and expectancy confounds in psychedelic randomized controlled trials | 2021 | Systematic review | |
| Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years Patients from included clinical trials | 2016 | Systematic review | |
| The experimental effects of psilocybin on symptoms of anxiety and depression: A meta-analysis People with elevated symptoms of anxiety and depression | 2020 | Meta-analysis | n = 117 |
| Default Mode Network Modulation by Psychedelics: A Systematic Review Participants from included studies | 2022 | Systematic review |
Citations in the library
Cited by 21
- Psilocybin Outside the Clinic JAMA Psychiatry November 5, 2025
- Psilocybin-assisted psychotherapy for Parkinson's disease without depression: A case-report. Journal of Parkinson's disease March 1, 2025
- Psychedelics and the Serotonin Hypothesis of Eating Disorders Brain Sciences August 21, 2025
- A critical review of brain entropy as a biomarker of the psychedelic state. Neuroscience & Biobehavioral Reviews July 1, 2026
- Effects of LSD, DMT and psilocybin on cognitive and psychological functions: A systematic review of the literature Journal of Psychopharmacology February 16, 2026
and 16 more in the library
Cites 49
- 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
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin Proceedings of the National Academy of Sciences January 23, 2012
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
and 44 more in the library