Psychedelic-Assisted Psychotherapy for Post-Traumatic Stress Disorder, Anxiety Disorders, Mood Disorders, or Substance Use Disorders
Yi‐sheng Chao, Jennifer Horton
Canadian Journal of Health Technologies June 24, 2021 DOI: 10.51731/cjht.2021.90 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | Patients with various mental health conditions |
| Interventions | Psilocybin MDMA LSD ibogaine ketamine nitrous oxide manualized therapy non-directive support integrative psychotherapy cognitive behavioural therapy CBT and motivational enhancement therapy psychosocial interventions group talk therapy guided support |
| Duration | 1 week to 3 years; less than or equal to 1 year in 27 out of 31 relevant publications |
| Topics | Anxiety MDMA Psilocybin Addiction Psychedelic-assisted therapy PTSD |
| Keywords | Randomized controlled trial Psychotherapist Hallucinogen Systematic review Clinical psychology Mood |
| Citations | 5 |
| Key findings | Various combinations of psychedelics and psychotherapy showed clinical effectiveness lasting weeks to months for mental health conditions, with no serious adverse events reported, but findings are limited by small sample sizes and short follow-ups. |
Abstract
Two systematic reviews, 3 randomized controlled trials, and 2 single-arm safety trials were identified that evaluated several combinations of psychedelic-assisted psychotherapy. Psilocybin was the psychedelic most tested. Other psychedelics identified in the systematic reviews and primary studies were 3,4-methylenedioxymethamphetamine (or MDMA), lysergic acid diethylamide (or LSD), ayahuasca (also named N,N-dimethyltryptamine [or DMT]), ibogaine, ketamine, and nitrous oxide. Manualized therapy (not defined) and non-directive support (not defined) were the psychotherapies most studied in the relevant primary studies in the 2 systematic reviews. Other psychotherapies identified included integrative psychotherapy, cognitive behavioural therapy (CBT), CBT and motivational enhancement therapy, psychosocial interventions, non-directive support, group talk therapy, and guided support. Clinical effectiveness lasting weeks to months was observed in 1 systematic review that reviewed primary studies examining various combinations of psychedelics and psychotherapy in patients with various mental health conditions. Significant improvement in symptom scores related to mental illnesses and no serious and long-term adverse events were reported in the other systematic review. Various combinations of psychedelics and psychotherapies were evaluated in 3 randomized controlled trials (RCTs) and 2 safety studies. Ketamine-assisted psychotherapies were associated with improvements in the symptoms related to substance use disorder in 2 RCTs. Psilocybin-assisted psychotherapy was reported to be efficacious in treating MDD in 1 RCT. No serious adverse effects were reported in the RCTs or in 2 safety trials using MDMA-assisted psychotherapy. There were several limitations to the included studies, including small sample sizes (less than 20 in the majority of primary studies), relatively short follow-ups (1 week to 3 years; less than or equal to 1 year in 27 out of 31 relevant publications), differences in psychotherapy classification between systematic reviews, considerable heterogeneity between studies, and unclear generalizability and availability of the interventions in Canadian contexts. Therefore, findings should be interpreted with caution. No relevant guidelines were identified.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 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 Systematic Review of the Neurocognitive Effects of Psychedelics in Healthy Populations: Implications for Depressive Disorders and Post-Traumatic Stress Disorder Healthy individuals and patients with PTSD or MDD | 2024 | Systematic review | n = 43 |
| A Systematic Review of the efficacy, safety, and Tolerability of Psychedelics in the Treatment of post-traumatic Stress Disorder | 2025 | Systematic review |
Citations in the library
Cited by 4
- Therapeutic Potential of Psilocybin for Treating Psychological Distress among Survivors of Adverse Childhood Experiences: Evidence on Acceptability and Potential Efficacy of Psilocybin Use Journal of Psychoactive Drugs October 10, 2023
- The purpose of the psychosocial protocol in the psychedelic-assisted therapy: A scoping review Journal of Psychopharmacology June 26, 2026
- The Effects of Serotonergic systems on Cognitive Flexibility and Perseverative Thinking: a comparison between SSRI, classical psychedelics, and acute tryptophan depletion in a Multilevel Meta-Analysis medRxiv June 22, 2026
- Therapeutics Uses of Psychedelics in patients with psychiatric disorders A Systematic Review Journal For International Medical Graduates April 18, 2024
Cites 13
- Global Street Food: la cocina de la calle Diseño interior 2009
- Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Acta Psychiatrica Scandinavica October 30, 2020
- Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development Frontiers in Pharmacology July 5, 2018
- A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. American Journal of Psychiatry December 2, 2019
- A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. American Journal of Psychiatry June 24, 2019
and 8 more in the library