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Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis.

Lukas A Basedow, Tomislav Majić, Nicklas Jakob Hafiz, Engi A E Algharably, Reinhold Kreutz, Thomas Riemer

Scientific Reports June 26, 2024 DOI: 10.1038/s41598-024-65391-9 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Qualitative Peer reviewed
Interventions Psychedelics MDMA
Duration At least 24 h after acute effects
Topics MDMA
Keywords Afterglow Subacute Psychedelics hallucinogens Entheogens Psychoactive substances Cognition mental processes Brain function Cognitive function Thinking Post-experience effects
Citations 13
Key findings Acute cognitive performance is differentially affected: psychedelics impair attention and executive function, whereas MDMA primarily affects memory; sub-acutely, psychedelics may increase executive functioning and creativity.

Abstract

Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.

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