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Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials

Juan José Fuentes, Francina Fonseca, Matilde Elices, Magı́ Farré, Marta Torrens

Frontiers in Psychiatry January 21, 2020 DOI: 10.3389/fpsyt.2019.00943 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Randomized Double-blind Peer reviewed
Sample size 567
Population Patients with psychiatric disorders, primarily alcoholism
Intervention LSD
Dose 20 to 800 mcg
Topics Addiction Anxiety LSD
Keywords Randomized controlled trial Clinical trial Clinical psychology Personality disorders Systematic review Medline Psychotherapist
Citations 176
Key findings LSD shows therapeutic potential for reducing psychiatric symptoms, especially in alcoholism, though long-term benefits may diminish relative to controls.

Abstract

Lysergic acid diethylamide (LSD) was studied from the 1950s to the 1970s to evaluate behavioral and personality changes, as well as remission of psychiatric symptoms in various disorders. LSD was used in the treatment of anxiety, depression, psychosomatic diseases and addiction. However, most of the studies were not performed under contemporary standards, and it has taken several decades for a resurgence of interest in LSD research and its therapeutic potential for psychiatry. The aim of this review is to identify controlled and randomized clinical trials that assess the potential use of LSD in psychiatry. PRISMA guidelines for systematic review were followed. A literature search of PubMed and Psychedelic bibliography from Multidisciplinary Association for Psychedelic Studies (MAPS) databases was performed as well as a manual search of references from evaluated studies. Only randomized-controlled clinical trials were included. Study quality was systematically calculated by using the Cochrane Collaboration Tool for assessing risk of bias. A final selection of 11 articles was made after considering inclusion and exclusion criteria. LSD was administered to 567 patients in a dose ranging from 20 to 800 mcg. Despite the design heterogeneity of clinical trials, positive results were observed, thus revealing the therapeutic potential of LSD to reduce psychiatric symptomatology, mainly in alcoholism. The vast majority of authors describe significant and positive short-term changes in patients, despite the fact that in some studies an important homogenization was observed between the LSD treatment group and control group at long-term follow-up. Multiple variables regarding LSD treatment therapeutic approach and quality of experience were revealed and related to therapeutic outcomes. LSD is revealed as a potential therapeutic agent in psychiatry; the evidence to date is strongest for the use of LSD in the treatment of alcoholism. Despite the difficulty of designing proper double blind clinical trials with this substance, new studies that conform to modern standards are necessary in order to strengthen our knowledge on its use and open new doors in the future.

In the evidence

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

  • LSD showed therapeutic potential for reducing psychiatric symptoms, especially in alcoholism, though long-term benefits may diminish relative to controls.

    Synthesized

  • LSD showed therapeutic potential for reducing psychiatric symptoms, mainly in alcoholism, though long-term benefits may diminish relative to controls.

    Synthesized

Comparable studies

Other systematic reviews and meta-analyses on LSD for addiction, most cited first.

Study Year Design Participants
The intensity of the psychedelic experience is reliably associated with clinical improvements: A systematic review and meta-analysis. Patients treated with classical psychedelics 2025 Meta-analysis
Psychedelic‐assisted treatment for substance use disorder: A narrative systematic review Participants in studies of psychedelic-assisted treatment for alcohol, tobacco, and... 2025 Systematic review n = 2,035
[Efficacy of psychedelics in psychiatry, a systematic review of the literature]. Patients with psychiatric conditions (anxiety, depression, major depressive disorder,... 2021 Systematic review n = 25
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
Efficacy and Safety of LSD in the treatment of mental and substance use disorders: A systematic review of randomized controlled trials. Adults diagnosed with substance use disorders, anxiety, or depression 2025 Systematic review and meta-analysis n = 682

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