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LSD for anxiety

Studies whose primary subject is both LSD and Anxiety, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 20 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for LSD, lysergic acid diethylamide, lysergide, Anxiety, generalized anxiety disorder, GAD, then ranked by relevance.

The research generally supports LSD-assisted therapy as a promising treatment for anxiety, with several trials reporting large, statistically significant reductions in anxiety symptoms that persist for months. A 2023 randomized controlled trial found significant anxiety reductions up to 16 weeks with a large effect size, and a 2014 pilot trial found reductions sustained for 12 months. However, the evidence base is limited by small sample sizes, few randomized controlled trials, and short follow-up durations, so larger and longer studies are needed before firm conclusions can be drawn.

Evidence by study

Direction is which way each study's own result points, not our rating of the study. All 25 matching studies were reviewed; the 20 that directly address the question are shown here.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases 2014 randomized controlled trial 12 Supports LSD-assisted psychotherapy reduced trait and state anxiety at 2 months with large effect sizes, and reductions were sustained for 12 months with no serious adverse events.
LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects 2014 prospective follow-up with qualitative content analysis 10 Supports At 12 months, anxiety reductions measured by STAI were sustained, and participants reported reduced anxiety and improved quality of life with no lasting adverse reactions.
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 2016 systematic review Supports Reviewed clinical trials suggest beneficial effects of ayahuasca, psilocybin, and LSD for anxiety and depression associated with life-threatening diseases, though all studies had small sample sizes and half were open-label.
Psychedelics not linked to mental health problems or suicidal behavior: A population study 2015 observational cohort 135095 No effect Lifetime psychedelic use was not significantly associated with increased likelihood of past-year anxiety or other mental health problems.
Lysergic Acid Diethylamide-Assisted Therapy in Patients With Anxiety With and Without a Life-Threatening Illness: A Randomized, Double-Blind, Placebo-Controlled Phase II Study. 2023 randomized controlled trial 42 Supports LSD-assisted therapy produced significant reductions in anxiety symptoms up to 16 weeks after treatment with a large effect size, and also reduced comorbid depression symptoms.
LSD Acutely Impairs Fear Recognition and Enhances Emotional Empathy and Sociality 2016 randomized controlled trial 40 Supports LSD enhanced emotional empathy and prosocial behavior while impairing recognition of sad and fearful faces, effects the authors suggest may support LSD-assisted psychotherapy.
Long-lasting subjective effects of LSD in normal subjects 2017 observational cohort 16 Supports A single 200 μg dose of LSD produced long-lasting positive effects on well-being and attitudes at 1 and 12 months, with no negative effects attributed to the experience.
Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews 2018 systematic review of systematic reviews Supports Psilocybin and LSD reduced anxiety and depression in cancer patients, though evidence is limited by small samples, few RCTs, and short duration.
Modern Clinical Research on LSD 2017 review Supports Reviews modern clinical LSD research and notes that two doses reduced anxiety for 2 months in patients with life-threatening disease.
Ayahuasca: Pharmacology, neuroscience and therapeutic potential 2016 review Supports Reviews ayahuasca pharmacology and concludes it shows promise as a therapeutic tool for anxiety and depression by enhancing self-acceptance and allowing safe exposure to emotional events.
Psychedelics, but Not Ketamine, Produce Persistent Antidepressant-like Effects in a Rodent Experimental System for the Study of Depression 2020 preclinical study Supports A single administration of psilocybin or LSD produced persistent antidepressant-like effects in a rat model, more durable than ketamine.
Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials 2020 systematic review 567 Supports LSD showed therapeutic potential for reducing psychiatric symptoms, mainly in alcoholism, though long-term benefits may diminish relative to controls.
Psychedelic Drugs in Biomedicine 2017 review Supports Reviews preclinical and clinical data suggesting psychedelics including LSD are promising treatments for addiction, depression, and anxiety, while noting many questions about mechanisms, safety, and efficacy remain.
LYSERGIC ACID DIETHYLAMIDE (LSD-25) 1952 observational cohort 15 No effect Improvement during LSD therapy was not greater than that obtained without its use in comparable cases, and anxiety was a prominent reaction during treatment.
722. Predictors of therapeutic response to LSD in anxiety: short- and long-term outcomes 2026 randomized controlled trial Supports Positive acute subjective drug effects and mystical-type experiences correlated with short-term anxiety reductions at 16 weeks and long-term reductions at one year.
Policy Considerations for Psychedelics in Research and Medicine – What’s Next on the Schedule? 2026 review Supports Notes that the FDA has granted Breakthrough Therapy designation to LSD for generalized anxiety disorder and that over 150 active clinical trials are assessing psychedelic safety and efficacy.
Classic psychedelic medicines for adolescent refractory mental health disease 2026 commentary Unclear Argues that classic psychedelics have shown strong efficacy in adults with refractory psychiatric conditions but that adolescents remain excluded from trials and safety data cannot be extrapolated to them.
Real-world effectiveness and safety of psychedelic-assisted psychotherapy: Outcomes from a large-scale compassionate use cohort in Switzerland. 2026 retrospective observational cohort 115 Supports A single fully-active dose session of psychedelic-assisted psychotherapy with LSD or psilocybin was associated with significant reductions in depressive and anxiety symptoms in a real-world clinical cohort.
Effects of LSD and Psilocybin on Heart Rate in Patients Receiving Psychedelic Treatment for Depressive and Anxiety Disorders: A Retrospective Observational Study 2025 retrospective observational study 30 No effect LSD and psilocybin showed distinct temporal patterns of heart rate change, but anxiety did not significantly modify the relationship between time and substance.
Single dose of LSD formulation improves anxiety in Phase 2b trial 2025 Phase 2b clinical trial Supports The two highest dose strengths of an LSD formulation produced significant dose-dependent reductions in anxiety relative to placebo.

Points of agreement

  • Multiple randomized controlled trials and systematic reviews report that LSD-assisted therapy reduces anxiety symptoms, with effects persisting for months after treatment.
  • The most consistent evidence comes from patients with anxiety associated with life-threatening illness, where LSD-assisted psychotherapy has shown large effect sizes.
  • Positive acute subjective effects and mystical-type experiences appear to correlate with therapeutic anxiety reductions.
  • Most reviews note that the evidence base is limited by small sample sizes, few randomized controlled trials, and short follow-up durations.

Conflicts

  • One early observational study found improvement during LSD therapy was not greater than without its use, and anxiety was a prominent reaction during treatment, contrasting with later positive trials.
  • A large population study found no association between lifetime psychedelic use and anxiety, which differs from clinical trial findings of anxiety reduction.
  • One retrospective study found anxiety did not modify heart rate responses to LSD or psilocybin, though this addresses cardiovascular rather than therapeutic outcomes.

Gaps

  • Long-term durability of anxiety reductions beyond 12 months is largely unstudied.
  • Most trials have small sample sizes and few are adequately powered randomized controlled trials.
  • Blinding integrity is difficult to maintain with psychedelics and is rarely assessed.
  • Populations studied are predominantly adults with life-threatening illness or treatment-resistant conditions; adolescents and other groups are excluded.
  • Optimal dose, number of sessions, and the role of psychotherapy versus drug effect remain unclear.
  • Safety data in adolescents and in those with cardiovascular or other comorbidities are lacking.
Browse these studies in the library

Common questions

What does the research agree on about LSD for anxiety?
  • Multiple randomized controlled trials and systematic reviews report that LSD-assisted therapy reduces anxiety symptoms, with effects persisting for months after treatment.
  • The most consistent evidence comes from patients with anxiety associated with life-threatening illness, where LSD-assisted psychotherapy has shown large effect sizes.
  • Positive acute subjective effects and mystical-type experiences appear to correlate with therapeutic anxiety reductions.
  • Most reviews note that the evidence base is limited by small sample sizes, few randomized controlled trials, and short follow-up durations.
Where do studies on LSD for anxiety conflict?
  • One early observational study found improvement during LSD therapy was not greater than without its use, and anxiety was a prominent reaction during treatment, contrasting with later positive trials.
  • A large population study found no association between lifetime psychedelic use and anxiety, which differs from clinical trial findings of anxiety reduction.
  • One retrospective study found anxiety did not modify heart rate responses to LSD or psilocybin, though this addresses cardiovascular rather than therapeutic outcomes.
What is still unknown about LSD for anxiety?
  • Long-term durability of anxiety reductions beyond 12 months is largely unstudied.
  • Most trials have small sample sizes and few are adequately powered randomized controlled trials.
  • Blinding integrity is difficult to maintain with psychedelics and is rarely assessed.
  • Populations studied are predominantly adults with life-threatening illness or treatment-resistant conditions; adolescents and other groups are excluded.
  • Optimal dose, number of sessions, and the role of psychotherapy versus drug effect remain unclear.
  • Safety data in adolescents and in those with cardiovascular or other comorbidities are lacking.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is LSD for anxiety, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when LSD for anxiety or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

95 articles · 22 from the last two years · 138,356 participants across 44 studies reporting sample size

Common study designs

review 30 case study 6 systematic review 9 observational cohort 4 randomized controlled trial 10

Research volume by year

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88 studies whose primary subject is LSD for anxiety since 2014

Studies about LSD for anxiety per year, 2014 to 2026, peaking at 16 in 2023 Bar chart: one bar per year, taller where more studies were published that year. 0 10 20 2015 2020 2025
2026 is partial
Show the numbers
Studies about LSD for anxiety per year, 2014 to 2026, peaking at 16 in 2023
Year Studies
2014 2
2015 1
2016 4
2017 5
2018 4
2019 5
2020 8
2021 8
2022 7
2023 16
2024 8
2025 12
2026 8

Research

Synthesize the evidence →

722. Predictors of therapeutic response to LSD in anxiety: short- and long-term outcomes

International Journal of Neuropsychopharmacology September 9, 2026 Friederike Holze, F Müller, Peter Gasser et al.

Abstract Background Anxiety disorders are a major health burden and current treatment options yield unsatisfactory results. Psychedelics, such as lysergic acid diethylamide (LSD) that act via agonism on serotonin 2A receptors, have recently been shown to be effective in the treatment of anxiety symptoms. Aims & Objectives Here, we determine the relationship between the acute experience and...

DOI: 10.1093/ijnp/pyag040.494 (opens in new tab)

A randomized, double-blind, placebo-controlled single-ascending-dose study to identify a non-hallucinogenic dose of psilocybin in healthy adults.

medRxiv July 19, 2026 Naama Levy‐Cooperman, Edward M. Sellers, Paul Glue et al. preprint

Psilocybin shows therapeutic promise for several psychiatric disorders, but the acute perceptual and cognitive alterations produced by conventional doses (10-25 mg) require in-clinic supervision, which limits scalability. Whether the therapeutically relevant pharmacology of psilocybin can be separated from its hallucinogenic activity remains unresolved. To address this gap, we conducted a Phase...

DOI: 10.64898/2026.07.16.26358273 (opens in new tab) Psilocybin Anxiety Mescaline Lysergic acid diethylamide +11

Policy Considerations for Psychedelics in Research and Medicine – What’s Next on the Schedule?

Journal of Science Policy & Governance July 2, 2026 Matthew A. Boehm, Oriana Mayorga

There is growing interest in psychedelic compounds such as psilocybin, 3,4-metheylenedioxymethamphetamine (MDMA), lysergic acid diethylamide (LSD), and dimethyltryptamine (DMT) given emerging research on potential uses as treatments for a variety of health conditions. The United States Food and Drug Administration (FDA) has granted multiple “Breakthrough Therapy” designations to various...

DOI: 10.38126/jspg280103 (opens in new tab) Psilocybin Anxiety Lysergic acid diethylamide Variety cybernetics +6

Classic psychedelic medicines for adolescent refractory mental health disease

Journal of Psychedelic Studies March 26, 2026 Aly Shah Aziz

Abstract Adolescent refractory mental health disorders are rising globally, contributing to long-term morbidity and substantial societal burden. Conventional psychotropic medications and psychotherapeutic approaches sometimes fail to provide adequate relief, necessitating an interest in novel investigational interventions. Classic psychedelic compounds—Psilocybin, Lysergic Acid Diethylamide...

DOI: 10.1556/2054.2026.00452 (opens in new tab) Lysergic acid diethylamide Anxiety Mental health Observational study +6

Effects of Psilocybin and Select Pharmaceutical Interactions

MacEwan University Student eJournal February 18, 2026 Jordan Mcdowell, Jada Middleton, Alanna Bluett et al.

In Canada, the use of both prescription medications and psychedelics has become increasingly prevalent. As of 2022, approximately 16.5% of Canadians—about 6.3 million individuals—were prescribed at least one antidepressant, with fluoxetine remaining one of the most commonly used options (IQVIA, 2023). Benzodiazepine use, including drugs like alprazolam, ranges between 5% to 10% nationwide, with...

DOI: 10.31542/bcek6t76 (opens in new tab) Psilocybin Anxiety Lysergic acid diethylamide Fluoxetine +9

Real-world effectiveness and safety of psychedelic-assisted psychotherapy: Outcomes from a large-scale compassionate use cohort in Switzerland.

Psychiatry Research February 2, 2026 Tatiana Aboulafia Brakha, Albert Buchard, Cédric Mabilais et al. 1 citation

Classic serotonergic psychedelics such as LSD and psilocybin show promising antidepressant effects in controlled trials, but real-world data from routine clinical care remain limited. This study retrospectively analysed routine data from adults with treatment-resistant depressive and/or anxiety disorders who received a first standardized Psychedelic-assisted Psychotherapy (PAP) cycle with 100...

DOI: 10.1016/j.psychres.2026.116992 (opens in new tab) Full text (opens in new tab) Anxiety Depression LSD Mystical experience +2

Hallucinogen persisting perception disorder in adolescence: a complex case of lysergic acid diethylamide-induced visual disturbances with trauma-associated exacerbation

Neuroscience Applied 2026 A. Fernandez Ribas, V. Pérez Rodríguez, M. Paduraru

Hallucinogen Persisting Perception Disorder (HPPD) is a condition affecting 1-5% of psychedelic users, with higher prevalence observed among recurrentLSD consumers and synthetic cannabinoid users [1]. The disorder is characterised by persistent visual disturbances including palinopsia and visual snow, along with dissociative symptoms, which have been neurobiologically linked to 5-HT2A receptor...

DOI: 10.1016/j.nsa.2025.106728 (opens in new tab) Lysergic acid diethylamide Psilocybin Anxiety disorder Dissociative +14

Effects of LSD and Psilocybin on Heart Rate in Patients Receiving Psychedelic Treatment for Depressive and Anxiety Disorders: A Retrospective Observational Study

Psychology International December 19, 2025 Morgan C H Cheng, Tatiana Aboulafia Brakha, Albert Buchard et al.

Classic psychedelics such as lysergic acid diethylamide (LSD) and psilocybin induce mild cardiovascular activation in addition to their psychological effects. While these effects are well described in healthy adults, little is known about their dynamics in clinical populations undergoing psychedelic-assisted psychotherapy. This retrospective, observational, single-center study analyzed...

DOI: 10.3390/psycholint8010001 (opens in new tab) Psilocybin Lysergic acid diethylamide Anxiety disorder Hallucinogen +5

Single dose of LSD formulation improves anxiety in Phase 2b trial

The Brown University Psychopharmacology Update November 28, 2025

Treatment with a single dose of a pharmaceutical formulation of lysergic acid diethylamide (LSD) resulted in a dose‐dependent reduction in anxiety in individuals with generalized anxiety disorder (GAD), a Phase 2b study has found. The two highest of four tested dose strengths of the MM120 formulation demonstrated significant improvement relative to placebo.

DOI: 10.1002/pu.31394 (opens in new tab) Lysergic acid diethylamide Generalized anxiety disorder Phase matter Drug +3

Clinical trials

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