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Efficacy and Safety of Four Psychedelic-Assisted Therapies for Adults with Symptoms of Depression, Anxiety, and Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis

Anees Bahji, Isis Lunsky, Gilmar Gutierrez, Gustavo Vazquez

Journal of Psychoactive Drugs November 15, 2023 DOI: 10.1080/02791072.2023.2278586 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Peer reviewed
Sample size 18
Population Adults with symptoms of depression, anxiety, or PTSD
Interventions Psilocybin 3 Ayahuasca
Topics Anxiety PTSD Depression Psychedelic-assisted therapy
Keywords Psychedelic-assisted therapies Anxiety disorders Mental health treatment Psychiatric research Hallucinogenic therapy Mood disorders depression
Citations 21
Key findings Psilocybin and MDMA-assisted therapies showed large effect sizes for reducing depression symptoms, but evidence certainty was low.

Abstract

There has been a resurgence in psychedelic research for managing psychiatric conditions in recent years. This study aimed to present a comprehensive review of the current state of the field by applying a systematic search strategy for articles on the effectiveness and tolerability of four psychedelic-assisted therapies (psilocybin, lysergic acid diethylamide [LSD], 3,4-Methylenedioxymethamphetamine [MDMA], and ayahuasca) for adults with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Psychometric scores and adverse events were pooled using random-effects meta-analysis models with Hedges' g bias-corrected standardized mean differences (g) and rate ratios (RR) with 95% confidence intervals (CI). Bias evaluation followed PRISMA and Cochrane guidelines. Eighteen studies were identified, which suggested that psychedelic therapies were well tolerated and presented a large effect size for the management of depression symptoms in a transdiagnostic population with psilocybin (g = -1.92, 95% CI, -2.73 to -1.11) and MDMA (g = -0.71; 95% CI, -1.39 to -0.03). These are promising results that complement the current literature. However, evidence certainty was low to very low due to methodological limitations, small sample size, blinding, study heterogeneity, and publication bias. These results also highlight the need for more adequately powered studies exploring these novel therapies.

Comparable studies

Other systematic reviews and meta-analyses on PTSD, most cited first.

Study Year Design Participants
Sleep Disturbance in Adults With Posttraumatic Stress Disorder Adults with posttraumatic stress disorder 2007 Systematic review
Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy Patients with PTSD 2016 Meta-analysis
Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder: A systematic review and meta-analysis. Individuals with chronic, treatment-refractory PTSD 2020 Systematic review and meta-analysis n = 106
Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin Adults with PTSD 2020 Systematic review n = 9
A comparison of MDMA-assisted psychotherapy to non-assisted psychotherapy in treatment-resistant PTSD: A systematic review and meta-analysis Patients with treatment-resistant PTSD 2020 Systematic review with meta-analysis

Citations in the library

Cited by 21

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Anxiety PTSD Depression Psychedelic-assisted therapy Ayahuasca LSD MDMA Psilocybin