Psychedelic Therapy and the Role of Music: A Scoping Review of Quantitative Evidence on Subjective and Objective Outcomes.

Abstract

Psychedelics have received considerable attention due to their potential in treating psychiatric disorders. The "setting" during psychedelic-assisted therapy (PAT) is recognized as playing a central role in the experience, during which music features prominently. Although music is theorized as directing and shaping psychedelic sessions, its precise contribution to acute experience and therapeutic outcomes is unclear. This scoping review aimed to map quantitative research on the interplay of psychedelics and music by consolidating existing evidence, identifying gaps, and where possible, reporting on effects of psychedelics and music on subjective (e.g., psychological) and objective (e.g., biological) outcomes. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, relevant papers were identified through electronic databases (MEDLINE, Embase, PsychINFO, Scopus) using terms associated with psychedelic compounds, psychedelic-assisted therapy, and music. Papers were restricted to quantitative studies published in peer-reviewed journals investigating human subjects within therapeutic and controlled experimental contexts, focusing on interactions between music and psychedelics. A total of 19 papers (total human sample = 330) met inclusion criteria. Psilocybin and LSD were the most studied psychedelic compounds; no studies were found investigating MDMA and music. Characteristics of music conditions across studies have been limited. The findings suggest that music modulates the psychedelic experience through: (1) amplifying and intensifying emotions, (2) recruiting brain networks involved in meaning-attribution and visual imagery, and (3) increasing overall neural entropy. Considerable gaps remain in understanding mechanisms of action and how music is delivered to optimize therapeutic response, due in part to methodological inconsistencies and small sample sizes. This review underscores the critical role of music in shaping psychedelic experiences and therapeutic outcomes.