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Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies

Kristoffer Andreas Aamodt Andersen, Robin Carhart-Harris, David Nutt, David Erritzøe

Acta Psychiatrica Scandinavica October 30, 2020 DOI: 10.1111/acps.13249 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Sample size 188
Population Patients with cancer- or illness-related anxiety and depression, major depressive disorder, obsessive-compulsive disorder, or substance use disorder
Interventions Psilocybin Ayahuasca LSD
Topics Anxiety Depression Psilocybin Serotonin
Keywords Hallucinogen Depression economics Adverse effect Clinical psychology Psychotherapist Cognition
Citations 352
Key findings Serotonergic psychedelic-assisted therapy appears safe and shows promising early efficacy for several psychiatric conditions, with long-lasting effects after few sessions.

Abstract

Abstract Objective To conduct a systematic review of modern‐era (post‐millennium) clinical studies assessing the therapeutic effects of serotonergic psychedelics drugs for mental health conditions. Although the main focus was on efficacy and safety, study characteristics, duration of antidepressants effects across studies, and the role of the subjective drug experiences were also reviewed and presented.

Method: A systematic literature search (1 Jan 2000 to 1 May 2020) was conducted in PubMed and PsychINFO for studies of patients undergoing treatment with a serotonergic psychedelic.

Results: Data from 16 papers, representing 10 independent psychedelic‐assisted therapy trials (psilocybin = 7, ayahuasca = 2, LSD = 1), were extracted, presented in figures and tables, and narratively synthesized and discussed. Across these studies, a total of 188 patients suffering either cancer‐ or illness‐related anxiety and depression disorders (C/I‐RADD), major depressive disorder (MDD), obsessive‐compulsive disorder (OCD) or substance use disorder (SUD) were included. The reviewed studies established feasibility and evidence of safety, alongside promising early data of efficacy in the treatment of depression, anxiety, OCD, and tobacco and alcohol use disorders. For a majority of patients, the therapeutic effects appeared to be long‐lasting (weeks‐months) after only 1 to 3 treatment session(s). All studies were conducted in line with guidelines for the safe conduct of psychedelic therapy, and no severe adverse events were reported.

Conclusion: The resurrection of clinical psychedelic research provides early evidence for treatment efficacy and safety for a range of psychiatric conditions, and constitutes an exciting new treatment avenue in a health area with major unmet needs.

In the evidence

This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.

  • Psychedelic-assisted therapy appeared safe and showed promising early efficacy for depression, anxiety, OCD, and substance use disorders, with effects often lasting weeks to months after 1-3 sessions.

    Synthesized

  • Serotonergic psychedelic-assisted therapy appears safe and shows promising early efficacy for several psychiatric conditions, with long-lasting effects after few sessions.

    Synthesized

Comparable studies

Other systematic reviews and meta-analyses on psilocybin for anxiety, most cited first.

Study Year Design Participants
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
Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews Patients with mood, anxiety, or substance-use disorders, including cancer patients and... 2018 Systematic review of systematic reviews
A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy 2020 Systematic review
Serotonergic hallucinogens in the treatment of anxiety and depression in patients suffering from a life-threatening disease: A systematic review. Patients with life-threatening diseases and symptoms of anxiety or depression 2018 Systematic review n = 445

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