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A scoping review of the effects of serotonergic psychedelics on attitudes towards death.

Noah N T Barr, Kayla J Giese, Sam G. Moreton

Psychopharmacology April 21, 2025 DOI: 10.1007/s00213-025-06787-x (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Sample size 31
Population Participants in empirical studies measuring attitudes towards death or death anxiety as outcomes of classical psychedelic use
Topics Serotonin
Keywords Psychedelics hallucinogens Entheogens Psychedelic drugs Death anxiety thanatophobia Mortality anxiety Fear of death Serotonergic psychedelics psilocybin
Citations 1
Key findings Psychedelics can often change attitudes towards death and reduce death anxiety, but the reliability, strength, and predictive conditions of these effects remain poorly understood.

Abstract

Emerging evidence suggests that psychedelic experiences have the potential to change attitudes towards death and reduce death anxiety. Improved attitudes towards death, specifically reduced death anxiety, are of psychological significance for clinical and non-clinical populations alike. Despite this emerging evidence, little is known about the phenomenology of this potential outcome. To provide a systematic overview of studies reporting effects of psychedelics on attitudes towards death and death anxiety, thereby identifying any gaps in the current literature and informing suggestions for future research. MEDLINE, Scopus, PsycINFO, and Web of Science were systematically searched for empirical studies that measured attitudes towards death and death anxiety as an outcomes of classical psychedelic use. There were no limits on the date or design of the study. The thirty-one studies included in the review all reported changes in attitudes towards death and/or changes in death anxiety. Despite finding evidence for psychedelics improving death anxiety, we found significant gaps in the existing research relating to the role of set and setting, potential differences across substances, the underlying psychological mechanisms involved, the potential for worsening of death anxiety, and the role of expectancy and placebo effects. There is largely consistent evidence that psychedelics can often change attitudes towards death and reduce death anxiety. However, less is known about the reliability and strength of these effects, the conditions under which they are likely to emerge and aspects of the experience that best predict them.

Comparable studies

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

Study Year Design Participants
Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... 2020 Systematic review n = 188
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
Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review Patients in clinical trials with MDMA or serotonergic psychedelics 2022 Systematic review n = 598
Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants Healthy volunteers and patients with mood disorders 2021 Meta-analysis n = 257
Serotonergic psychedelics and personality: A systematic review of contemporary research 2018 Systematic review

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