Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews
Rafael G. Dos Santos, José Carlos Bouso, Miguel Ángel Alcázar‐córcoles, Jaime E. C. Hallak
Expert Review of Clinical Pharmacology August 13, 2018 DOI: 10.1080/17512433.2018.1511424 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review of systematic reviews Randomized Open-label Peer reviewed |
|---|---|
| Population | Patients with mood, anxiety, or substance-use disorders, including cancer patients and those with treatment-resistant depression |
| Interventions | Psilocybin LSD Ayahuasca |
| Topics | Anxiety LSD Psilocybin Serotonin Addiction |
| Keywords | Hallucinogen Tolerability Systematic review Randomized controlled trial Mood disorders Population Anxiolytic Adverse effect Clinical psychology Pharmacology |
| Citations | 231 |
| Key findings | Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression, though evidence is limited by small samples, few RCTs, and short duration. |
Abstract
Mood, anxiety, and substance-use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent studies suggest that serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) have anxiolytic, antidepressive, and antiaddictive effects. Areas Covered: A systematic review of systematic reviews assessing the efficacy, safety, and tolerability of serotonergic hallucinogens/psychedelic was performed using the PubMed data base until 11 April 2018. Systematic reviews with or without meta-analysis were analyzed, but only reviews that described at least one randomized controlled trial (RCT) were included. Expert Commentary: Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression. Although the results are promising, several studies were open label, and only few were RCTs, and most had small sample sizes and a short duration. Single or few doses of these drugs seem to be well tolerated, but long-term studies are lacking. New RCTs with bigger samples and longer duration are needed to replicate these findings.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
-
Psilocybin and LSD reduced anxiety and depression in cancer patients, though most studies were open-label, small, and short in duration.
Synthesized
Comparable studies
Other systematic reviews and meta-analyses on LSD for anxiety, most cited first.
Citations in the library
Cited by 179
- The Therapeutic Potential of Psilocybin Molecules May 15, 2021
- The experimental effects of psilocybin on symptoms of anxiety and depression: A meta-analysis Psychiatry Research January 2, 2020
- Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review Journal of Psychopharmacology August 26, 2022
- Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants Psychopharmacology January 11, 2021
- Meditation Increases the Entropy of Brain Oscillatory Activity Neuroscience February 4, 2020
and 174 more in the library
Cites 66
- 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 with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
and 61 more in the library