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Safety and risk assessment of psychedelic psychotherapy: A meta-analysis and systematic review.

Bruno Romeo, Ewen Kervadec, Baptiste Fauvel, Lana Strika-Bruneau, Ammar Amirouche, Vincent Verroust, Pascale Piolino, Amine Benyamina

Psychiatry Research May 1, 2024 DOI: 10.1016/j.psychres.2024.115880 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Peer reviewed
Sample size 30
Population Human subjects in studies of psychedelic-assisted psychotherapy
Topics LSD Psilocybin Psychedelic-assisted therapy
Keywords Adverse events Meta-analysis Side effects Drug safety Clinical research Adverse effects Hallucinogens
Citations 48
Key findings Psychedelics are well-tolerated with a low risk of serious adverse events in controlled settings, though they increase risk of elevated heart rate, blood pressure, and nausea during the acute phase.

Abstract

Psychotherapies assisted by psychedelic substances have shown promising results in the treatment of psychiatric disorders. The aim of this systematic review and meta-analysis was to evaluate safety data in human subjects. We carried out a search on MEDLINE, Embase and PsycINFO databases between 2000 and 2022. Standardized mean differences between different dose ranges and between acute and subacute phases were calculated for cardiovascular data after psychedelic administration. Risk differences were calculated for serious adverse events and common side effects. Thirty studies were included in this meta-analysis. There were only nine serious adverse events for over 1000 administrations of psychedelic substances (one during the acute phase and 8 during the post-acute phase). There were no suicide attempts during the acute phase and 3 participants engaged in self-harm during the post-acute phase. There was an increased risk for elevated heart rate, systolic and diastolic blood pressure for all dose range categories, as well as an increased risk of nausea during the acute phase. Other common side effects included headaches, anxiety, and decreased concentration or appetite. This meta-analysis demonstrates that psychedelics are well-tolerated, with a low risk of emerging serious adverse events in a controlled setting with appropriate inclusion criteria.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • Psychedelics are well-tolerated with a low risk of serious adverse events in controlled settings, though they increase risk of elevated heart rate, blood pressure, and nausea during the acute phase.

    Synthesized

Comparable studies

Other systematic reviews and meta-analyses on LSD and psychedelic-assisted therapy, most cited first.

Study Year Design Participants
Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Participants in studies of psychedelic therapy for depressive symptoms (Major... 2023 Systematic review with meta-analysis n = 14
United States National Institutes of Health grant funding for psychedelic-assisted therapy clinical trials from 2006-2020. 2022 Systematic review
The impact of psychedelics on patients with alcohol use disorder: a systematic review with meta-analysis. Patients with alcohol use disorder 2024 Systematic review and meta-analysis
Set and setting of psychedelics for therapeutic use in psychiatry: A systematic review Participants in clinical trials of psychedelics for psychiatric disorders 2025 Systematic review n = 763

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