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.
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Psychedelics were well tolerated with only nine serious adverse events across over 1000 administrations, though acute increases in heart rate, blood pressure, and nausea were observed.
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 |
Citations in the library
Cited by 50
- Adverse Events in Studies of Classic Psychedelics JAMA Psychiatry September 4, 2024
- The intensity of the psychedelic experience is reliably associated with clinical improvements: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews May 1, 2025
- A framework for assessment of adverse events occurring in psychedelic-assisted therapies Journal of Psychopharmacology July 31, 2024
- Epigenetic Echoes: Bridging Nature, Nurture, and Healing Across Generations. International Journal of Molecular Sciences March 27, 2025
- Psychedelics: A review of their effects on recalled aversive memories and fear/anxiety expression in rodents Neuroscience & Biobehavioral Reviews September 20, 2024
and 45 more in the library
Cites 42
- 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
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled 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
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
and 37 more in the library