Predictors of therapeutic response to psychedelic-assisted therapy: A systematic review.
Grace Viljoen, Henrik Walter, Antonia Bendau, Michael Koslowski, Felix Betzler
Journal of Psychopharmacology May 1, 2026 DOI: 10.1177/02698811251389581 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 54 |
| Population | Adult populations with substance-use disorders, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, existential distress related to life-threatening illness, and naturalistic samples with psychopathological symptoms |
| Topics | Depression Psilocybin Psychedelic-assisted therapy |
| Keywords | Addictive disorders Psychedelics Psychiatric disorders |
| Citations | 3 |
| Key findings | The intensity of the acute psychedelic experience, particularly mystical-type experiences, was the most frequently reported predictor of therapeutic response across studies, though consistency varied by disorder and time point. |
Abstract
Psychedelic-assisted therapy (PAT) has demonstrated substantial efficacy across a range of mental disorders. However, heterogeneity between patients confers differential responsiveness. This systematic review aims to explore factors which may predict therapeutic responses to PAT. A systematic search was performed from inception through to March 2024 and studies that assessed predictors of response related to the use of classic psychedelics for mental disorders were included. A total of 54 studies investigating potential predictors of treatment response to psychedelic-assisted therapy were included in the review. These studies encompassed adult populations diagnosed with substance-use disorders, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder and existential distress related to life-threatening illness as well as naturalistic samples reporting psychopathological symptoms without a formally confirmed diagnosis. The most frequently reported predictor of therapeutic response was the intensity of the acute psychedelic experience, particularly mystical-type experiences (MTEs), though this was not consistent across all disorders or time points. Factors related to set, setting and dose were frequently associated with the likelihood and intensity of MTEs. The acute psychedelic experience, especially MTEs, was the most frequently reported predictor of therapeutic response. Future trials should explore a broader range of predictors, include longer-term follow-up and improve methodological consistency to strengthen the evidence base for reliable predictors of therapeutic response.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy | 2020 | Systematic review | |
| Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Participants in studies of psychedelic therapy for depressive symptoms (Major... | 2023 | Systematic review with meta-analysis | n = 14 |
| Psilocybin-assisted therapy for depression: A systematic review and meta-analysis. Patients diagnosed with life-threatening illnesses or major depressive disorder | 2023 | Systematic review and meta-analysis | n = 686 |
| United States National Institutes of Health grant funding for psychedelic-assisted therapy clinical trials from 2006-2020. | 2022 | Systematic review | |
| Safety and risk assessment of psychedelic psychotherapy: A meta-analysis and systematic review. Human subjects in studies of psychedelic-assisted psychotherapy | 2024 | Systematic review and meta-analysis | n = 30 |
Citations in the library
Cited by 3
- Systems-based psychiatry: insights from psychedelic research on mechanisms of healing Frontiers in Psychiatry July 13, 2026
- Methodological moderators of psilocybin-assisted therapy in depression: A systematic review and meta-analysis Neuroscience & Biobehavioral Reviews January 24, 2026
- Molecules, meaning, and physiology: disentangling the active ingredients of psychedelic therapeutics Frontiers in Neuroscience August 3, 2026
Cites 60
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
and 55 more in the library