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Classical psychedelics for the treatment of depression and anxiety: A systematic review.

Silvia Muttoni, Maddalena Ardissino, Christopher John

Journal of Affective Disorders November 1, 2019 DOI: 10.1016/j.jad.2019.07.076 (opens in new tab)

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Characteristics Systematic review Peer reviewed
Sample size 130
Population Patients with depression and/or anxiety
Interventions ayahuasca psilocybin lysergic acid diethylamide
Topics Depression Anxiety
Keywords Psychedelics
Citations 265
Key findings In a supportive setting, ayahuasca, psilocybin, and LSD produced immediate and significant antidepressant and anxiolytic effects that lasted for several months and were well tolerated.

Abstract

Depression and anxiety are prevalent psychiatric disorders that carry significant morbidity. Pharmacological and psychosocial interventions are used to manage these conditions, but their efficacy is limited. Recent interest into the use of psychedelic-assisted therapy using ayahuasca, psilocybin or lysergic acid diethylamide (LSD) may be a promising alternative for patients unresponsive to traditional treatments. This review aims to determine the efficacy and tolerability of psychedelics in the management of resistant depression. Clinical trials investigating psychedelics in patients with depression and/or anxiety were searched via MEDLINE, EMBASE and PsychINFO. Efficacy was assessed by measuring symptom improvement from baseline, and tolerability was evaluated by noting the incidence and type of adverse effects reported. Risk of bias was assessed. Seven studies, with 130 patients, were analysed in this review. Three were conducted in patients with depression, two in patients with anxiety and two in patients with both. In a supportive setting, ayahuasca, psilocybin, and LSD consistently produced immediate and significant anti-depressant and anxiolytic effects that were endured for several months. Psychedelics were well-tolerated. The most common adverse effects were transient anxiety, short-lived headaches, nausea and mild increases in heart rate and blood pressure. At present, the number of studies on this subject is very limited; and the number of participating patients within these is also limited as the treatment under investigations is a relatively novel concept. Though further evidence is required, psychedelics appear to be effective in significantly reducing symptoms of depression and anxiety and are well-tolerated.

Comparable studies

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

Study Year Design Participants
Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations 2014 Meta-analysis n = 3,515
Research Review: The effects of mindfulness‐based interventions on cognition and mental health in children and adolescents – a meta‐analysis of randomized controlled trials Children and adolescents 2018 Systematic review and meta-analysis n = 3,666
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
Does Mindfulness Meditation Improve Anxiety and Mood Symptoms? A Review of the Controlled Research Clinical populations with medical and emotional disorders 2007 Systematic review n = 15
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

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Depression Anxiety Ayahuasca LSD Psilocybin Psychedelic-assisted therapy