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Understanding the Psychological Effects of Psilocybin and 3,4-Methylenedioxymethamphetamine in a Non-Clinical Population

Paul B. Fitzgerald, Sara Webb, Nigel Christopher Denning, Tra-Ill Dowie, Monica Schweickle, Anish Modak, Grace J Chan, Jeffrey Knight, Molly Waldron, Kirsten Gainsford, H.a. Hawkes, Stanley Zammit, Novi Christina Sutanto, Bernadette M. Fitzgibbon, Neil W. Bailey

medRxiv May 29, 2025 preprint DOI: 10.1101/2025.05.28.25328532 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Controlled trial
Sample size 48
Population Healthy individuals
Interventions Psilocybin MDMA
Duration Single dose, assessments at baseline, 1-3 days post dose, one week post dose, and 3 month follow up (3 month data not included)
Topics Psilocybin MDMA
Keywords Hallucinogen Population Clinical psychology Psychotherapist
Citations 2
Key findings Psilocybin, but not MDMA, produced significant short-term reductions in neuroticism, increases in extraversion, and improvements in mindfulness and connectedness, with mystical experiences mediating changes in connectedness and mindfulness.

Abstract

Abstract Objective Despite many decades of experimental studies and clinical trials involving a variety of psychedelic agents, we still lack a comprehensive understanding of the effects of these substances on psychological experiences. As such, we designed and conducted a study to comprehensively characterise the effects of both psilocybin and 3,4-Methylenedioxymethamphetamine (MDMA) on a range of psychological outcomes in a substantive non-clinical population.

Methods: This study involved a single dose administration of psilocybin or MDMA in healthy individuals in a group setting (2-4 people per session). All participants underwent a single preparation session, a drug exposure session, and an integration session within 72 hours of dosing. Outcome assessments were conducted at a pre-dosing baseline, 1-3 days post dose (side effects only), one week post dose and at 3 month follow up (the later time point data is not included here).

Results: Of 48 participants, 25 initially received MDMA and 23 psilocybin. Ten cross-over participants received MDMA and then psilocybin and six participants received both in the reverse order: making a total of 31 MDMA and 33 psilocybin dosing sessions. In the week after dosing, we found significant changes in personality (a reduction in neuroticism and increase in extraversion), mindfulness, and connectedness following the administration of psilocybin but not MDMA. Psilocybin also produced significantly stronger mystical experiences compared to MDMA, and there was a significant correlation between the magnitude of these mystical experiences and changes in connectedness and mindfulness (but not changes in personality). Of note, participants seemed more comfortable with, and preferred, larger group sizes when being administered MDMA than psilocybin.

Discussion: Our results identified a range of short-term psychological effects in non-clinical participants following a single dose of psilocybin, that were not reported following a single dose of MDMA. Notably, our results indicate that these effects following psilocybin may be moderated through its induction of mystical experiences, as has been previously hypothesised. Although preliminary, our results also suggest that larger group dosing sessions seem more feasible with MDMA than psilocybin.

Comparable studies

Other non-randomized and open-label trials on MDMA, most cited first.

Study Year Design Participants
Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. Adults with chronic, treatment-resistant PTSD 2013 Long-term follow-up of a completed trial n = 19
First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Patients with alcohol use disorder (AUD) following community alcohol detoxification 2021 Open-label safety and tolerability proof-of-concept study n = 14
MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial. Couples in which one partner was diagnosed with PTSD 2020 Pilot study n = 6
Culturally informed research design issues in a study for MDMA-assisted psychotherapy for posttraumatic stress disorder People of color with posttraumatic stress disorder 2019 Phase 2 open-label multisite study
The Consequences of 3,4-Methylenedioxymethamphetamine Induced CYP2D6 Inhibition in Humans Healthy male subjects 2008 Controlled clinical trial n = 15

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