The psychedelic afterglow phenomenon: a systematic review of subacute effects of classic serotonergic psychedelics
Ricarda Evens, Tomislav Majić, Timo Torsten Schmidt, Marianna E. Schmidt
Therapeutic Advances in Psychopharmacology 2023 DOI: 10.1177/20451253231172254 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 1,774 |
| Population | Human adults |
| Interventions | LSD psilocybin DMT 5-MeO-DMT mescaline ayahuasca |
| Duration | 1 day to 1 month after drug use |
| Topics | Anxiety Psilocybin Serotonin |
| Keywords | Hallucinogen Adverse effect Clinical psychology Mood |
| Citations | 49 |
| Key findings | Classic serotonergic psychedelics are associated with a subacute 'afterglow' phenomenon comprising beneficial changes in perception and reductions in psychopathological symptoms, with mild to moderate adverse effects and no serious adverse events reported. |
Abstract
Background: Classic serotonergic psychedelics have anecdotally been reported to show a characteristic pattern of subacute effects that persist after the acute effects of the substance have subsided. These transient effects, sometimes labeled as the ‘psychedelic afterglow’, have been suggested to be associated with enhanced effectiveness of psychotherapeutic interventions in the subacute period.
Objectives: This systematic review provides an overview of subacute effects of psychedelics.
Methods: Electronic databases (MEDLINE, Web of Science Core Collection) were searched for studies that assessed the effects of psychedelics (LSD, psilocybin, DMT, 5-MeO-DMT, mescaline, or ayahuasca) on psychological outcome measures and subacute adverse effects in human adults between 1950 and August 2021, occurring between 1 day and 1 month after drug use.
Results: Forty-eight studies including a total number of 1,774 participants were eligible for review. Taken together, the following subacute effects were observed: reductions in different psychopathological symptoms; increases in wellbeing, mood, mindfulness, social measures, spirituality, and positive behavioral changes; mixed changes in personality/values/attitudes, and creativity/flexibility. Subacute adverse effects comprised a wide range of complaints, including headaches, sleep disturbances, and individual cases of increased psychological distress.
Discussion: Results support narrative reports of a subacute psychedelic ‘afterglow’ phenomenon comprising potentially beneficial changes in the perception of self, others, and the environment. Subacute adverse events were mild to severe, and no serious adverse events were reported. Many studies, however, lacked a standardized assessment of adverse effects. Future studies are needed to investigate the role of possible moderator variables and to reveal if and how positive effects from the subacute window may consolidate into long-term mental health benefits.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin for anxiety, most cited first.