Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review.
Bruno Romeo, Marianne Hermand, Amélie Pétillion, Laurent Karila, Amine Benyamina
Journal of Psychiatric Research May 1, 2021 DOI: 10.1016/j.jpsychires.2021.03.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 20 |
| Population | Patients with psychiatric or addictive disorders (alcohol and tobacco use disorders, treatment-resistant depression, obsessive-compulsive disorder, and depressive and anxiety symptoms in patients with life-threatening cancer) |
| Topics | Ayahuasca Psilocybin |
| Keywords | Addictive disorders Psychedelics Psychiatric disorders |
| Citations | 74 |
| Key findings | The intensity of the acute psychedelic experience is the main predictive factor of response to psychedelic treatments across alcohol and tobacco use disorders, treatment-resistant depression, and anxiety and depressive symptoms in patients with life-threatening cancer, but not for obsessive-compulsive disorder. |
Abstract
The use of psychedelic treatments has shown very promising results in some psychiatric and addictive disorders, but not all patients achieved a response. The aim of this review is to explore the clinical and biological factors which could predict the response to psychedelics in psychiatric and addictive disorders. A systematic research was performed on MEDLINE, PsycInfo, Web of science, and Scopus databases from January 1990 to May 2020. All studies investigating the predictive factors of response to psychedelics regardless of psychiatric or addictive disorders, were included. Twenty studies investigating addictive disorder, treatment-resistant depression, obsessive-compulsive disorder and depressive and anxiety symptoms in patients with life-threatening cancer were included in this review. We found that, in all indications, the main predictive factor of response to psychedelics is the intensity of the acute psychedelic experience. Indeed, we found this factor for alcohol and tobacco use disorders, treatment-resistant depression, and anxiety and depressive symptoms in patients with life-threatening cancer, but not for obsessive-compulsive disorder. The intensity of the acute psychedelic experience was the main predicting factor of response. The action mechanism of this experience was not clear, but some hypotheses could be made, such as a modulation of serotoninergic system by 5-HT2A receptors agonism, a modulation of the default mode network (DMN) with an acute modular disintegration of the DMN followed by a re-integration of this network with a normal functioning, or an anti-inflammatory effect of this treatment.
Comparable studies
Other systematic reviews and meta-analyses on ayahuasca, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years Patients from included clinical trials | 2016 | Systematic review | |
| Risk assessment of ritual use of oral dimethyltryptamine (DMT) and harmala alkaloids Humans (ritual ayahuasca use) | 2006 | Systematic review | |
| Default Mode Network Modulation by Psychedelics: A Systematic Review Participants from included studies | 2022 | Systematic review | |
| Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies | 2017 | 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 |
Citations in the library
Cited by 69
- Psychedelics, Mystical Experience, and Therapeutic Efficacy: A Systematic Review Frontiers in Psychiatry July 12, 2022
- Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression Frontiers in Pharmacology March 31, 2022
- The clinical pharmacology and potential therapeutic applications of 5‐methoxy‐N,N‐dimethyltryptamine (5‐MeO‐DMT) Journal of Neurochemistry February 12, 2022
- Importance of Integrating Spiritual, Existential, Religious, and Theological Components in Psychedelic-Assisted Therapies. JAMA Psychiatry July 1, 2023
- A phase 1/2 trial to assess safety and efficacy of a vaporized 5-methoxy-N,N-dimethyltryptamine formulation (GH001) in patients with treatment-resistant depression Frontiers in Psychiatry June 20, 2023
and 64 more in the library
Cites 52
- 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
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study Journal of Psychopharmacology January 13, 2015
and 47 more in the library