The intensity of the psychedelic experience is reliably associated with clinical improvements: A systematic review and meta-analysis.
Bruno Romeo, Ewen Kervadec, Baptiste Fauvel, Lana Strika-Bruneau, Ammar Amirouche, Aurore Bezo, Pascale Piolino, Amine Benyamina
Neuroscience & Biobehavioral Reviews May 1, 2025 DOI: 10.1016/j.neubiorev.2025.106086 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Population | Patients treated with classical psychedelics |
| Topics | Addiction LSD Psilocybin |
| Keywords | Psychedelics hallucinogens Entheogens Psychological wellbeing Psychiatric conditions Clinical research meta-analysis Scientific studies Medical research Mood disorders |
| Citations | 36 |
| Key findings | A significant positive correlation exists between the intensity of mystical experiences and clinical improvement across studies, with stronger effects for mood disorders and in clinical settings. |
Abstract
Psychedelic-assisted therapies have demonstrated promising results in treating mental disorders, with results suggesting that the subjective intensity and quality of psychedelic experiences plays a significant role in mediating therapeutic effects. However, the strength of this association across diagnoses and treatment settings remains underexplored. We searched MEDLINE, Embase, and PsycINFO databases for studies examining the correlation between the intensity of the psychedelic experience and clinical outcomes in patients treated with classical psychedelics. Meta-correlations were performed, and standardized mean differences of psychedelic experience intensity scores were compared between clinical responders and non-responders using random-effects models. Subgroup analyses were conducted based on diagnosis, study design, setting (clinical vs. naturalistic), and substance used. A significant positive correlation was found between the intensity of mystical experiences and clinical improvement across all studies (r = .33, p < .0001). Subgroup analyses revealed a stronger association (p = .02) for mood disorders (r = .41) compared to addictions (r = .19). The effect was greater (p < .01) in protocol-based clinical settings (r = .50) than in naturalistic use (r = .14). Prospective designs showed stronger (p < .01) correlations (r = .43) compared to retrospective designs (r = .14). The intensity of psychedelic experiences is significantly and reliably associated with therapeutic outcomes, particularly in mood disorders. Clinical settings and prospective study designs strengthen this relationship, emphasizing the importance of controlled environments and therapeutic support to fully benefit from the therapeutic potential of psychedelics.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Intensity of mystical experience correlated positively with clinical improvement overall (r = .33), with a weaker association in addictions (r = .19) than in mood disorders (r = .41).
Synthesized
Comparable studies
Other systematic reviews and meta-analyses on LSD for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials Patients with psychiatric disorders, primarily alcoholism | 2020 | Systematic review | n = 567 |
| Psychedelic‐assisted treatment for substance use disorder: A narrative systematic review Participants in studies of psychedelic-assisted treatment for alcohol, tobacco, and... | 2025 | Systematic review | n = 2,035 |
| [Efficacy of psychedelics in psychiatry, a systematic review of the literature]. Patients with psychiatric conditions (anxiety, depression, major depressive disorder,... | 2021 | Systematic review | n = 25 |
| The impact of psychedelics on patients with alcohol use disorder: a systematic review with meta-analysis. Patients with alcohol use disorder | 2024 | Systematic review and meta-analysis | |
| Efficacy and Safety of LSD in the treatment of mental and substance use disorders: A systematic review of randomized controlled trials. Adults diagnosed with substance use disorders, anxiety, or depression | 2025 | Systematic review and meta-analysis | n = 682 |
Citations in the library
Cited by 38
- Psychological Therapy Quantity and Depressive Symptom Reduction in Psychedelic-Assisted Therapy: A Systematic Review and Meta-Analysis. JAMA Network Open January 2, 2026
- Psychedelics for Alcohol Use Disorder: A Narrative Review with Candidate Mechanisms of Action. CNS Drugs July 10, 2025
- How to Change Minds Ethically: Doxastic Vulnerability, Epistemic Harm Reduction, and the Role of Therapists in Psychedelic Therapy Journal of Applied Philosophy October 24, 2025
- Why psychedelic-assisted therapy studies in eating disorders risk missing the mark on outcomes: a phenomenological psychopathology perspective. Journal of Eating Disorders September 2, 2025
- Commentary on Methods for Addressing Functional Unblinding and Mechanistic Uncertainty in Clinical Trials of Psychedelic-Assisted Treatments Current Treatment Options in Psychiatry November 11, 2025
and 33 more in the library
Cites 98
- 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
- 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
and 93 more in the library