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Psilocybin and psychedelic-assisted therapy

Studies whose primary subject is both Psilocybin and Psychedelic-assisted therapy, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 25 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for Psilocybin, magic mushrooms, psilocin, psychedelic mushrooms, Psychedelic-assisted therapy, psychedelic therapy, then ranked by relevance.

Psilocybin-assisted therapy shows consistent, large short-term reductions in depression, anxiety, and substance use, with several trials reporting benefits lasting months to years. Placebo-controlled trials and a meta-analysis support a real effect, though effect sizes are smaller in blinded and larger trials than in open-label work. The main caveats are small samples, mostly open-label designs, limited blinding integrity, and sparse long-term and diverse-population data.

Evidence by study

Direction is which way each study's own result points, not our rating of the study.

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
Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. 2017 open-label trial 20 Supports Two psilocybin doses produced large reductions in depressive symptoms (Cohen's d 2.2-2.3 early) that remained significant at 6 months (d 1.4-1.5).
Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects. 2011 RCT 18 Supports Doses of 20-30 mg/70 kg occasioned mystical-type experiences in 72% and were rated as producing sustained positive changes in attitudes, mood, and behavior at 14 months.
Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder 2022 RCT 95 Supports Psilocybin plus psychotherapy reduced heavy drinking days to 9.7% versus 23.6% with active placebo plus psychotherapy over 32 weeks.
Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression 2017 qualitative study 20 Supports Patients described psilocybin treatment as fostering connection and emotional acceptance, contrasting with conventional treatments they felt reinforced disconnection and avoidance.
Increased global integration in the brain after psilocybin therapy for depression. 2022 open-label trial and RCT Supports Antidepressant response to psilocybin was rapid and sustained and correlated with decreased brain network modularity, while escitalopram response was milder without this change.
Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer 2020 long-term follow-up 15 Supports Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at 3.2 and 4.5 years, with 60-80% meeting response criteria.
Single-dose psilocybin-assisted therapy in major depressive disorder: A placebo-controlled, double-blind, randomised clinical trial. 2023 RCT 52 Supports A single moderate psilocybin dose reduced depressive symptoms significantly more than placebo at 14 days (MADRS d 0.97), with 54% meeting remission criteria.
Psilocybin therapy increases cognitive and neural flexibility in patients with major depressive disorder. 2021 open-label study 24 Mixed Psilocybin therapy increased cognitive flexibility for at least 4 weeks, but greater neural flexibility increases were associated with less cognitive flexibility improvement.
Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. 2024 theoretical Unclear Argues that borderline personality disorder may be reframed as a trauma-related disorder and that psychedelic-assisted therapy may be a treatment pathway for it and PTSD.
Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis 2017 qualitative study 13 Supports Participants described themes of relational embeddedness, emotional range, meaningful visual phenomena, and revised life priorities after psilocybin-assisted psychotherapy.
Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts 2018 qualitative follow-up 12 Supports Participants attributed smoking cessation to vivid insights, interconnectedness, and awe, and reported persisting positive changes beyond cessation.
Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development 2018 review Supports Argues that psychedelic-assisted psychotherapy shows safety and efficacy, including for treatment-resistant conditions, and challenges the current psychiatric paradigm.
Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin 2012 RCT 10 Supports Intravenous psilocybin enhanced autobiographical recollection with additional sensory cortical activations and higher ratings of memory vividness and visual imagery versus placebo.
Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. 2016 review Supports Reports that psilocybin and MDMA show promise as adjuncts to psychotherapy for several difficult-to-treat conditions, with further research needed.
A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy 2020 meta-analysis Supports Across nine placebo-controlled trials, psychedelic-assisted therapy showed a large between-groups effect (Hedges g = 1.21), generally maintained at follow-up.
Psilocybin-assisted psychotherapy for people with cancer: a scoping review of intervention components, psychotherapeutic frameworks, and models of delivery 2026 scoping review Unclear Maps the extent and types of evidence on psilocybin-assisted psychotherapy in cancer, including psychotherapy types and delivery models, without reporting results.
Mystical Experiences Mediate the Effects of Psilocybin-Assisted Psychotherapy + Mindfulness-Based Stress Reduction on Trait Mindfulness and Depression Symptoms: Mechanistic Results from a Randomized Controlled Trial 2026 RCT 25 Supports Adding psilocybin-assisted therapy to MBSR produced greater mindfulness gains than MBSR alone at 2 weeks, with mystical experience intensity mediating effects; authors call for larger samples.
Exploratory safety, tolerability, and feasibility of psilocybin-assisted psychotherapy for adults with co-occurring treatment-resistant depression and cluster B personality disorders 2026 secondary analysis of a trial 10 Supports Mean MADRS scores fell from 30.4 to 22.3 at 6 months and suicidal ideation declined, with substantial heterogeneity and no serious adverse events.
Oncology Providers' Perspectives on Psychedelic-Assisted Therapy. 2026 cross-sectional survey 385 Opposes 80% of oncology providers were uncomfortable counseling patients on psychedelic-assisted therapy and only 44% knew its legal status, though willingness to recommend it rose with familiarity.
Pilot study comparing the effects of high dose THC to high dose psilocybin and placebo in the set and setting of a classic psychedelic therapy session 2026 pilot crossover RCT 4 Mixed A 25 mg oral THC dose produced subjective effects similar to 25 mg psilocybin and was mistaken for a classic hallucinogen, suggesting set and setting shape subjective effects.
Psilocybin-assisted psychotherapy for substance use disorders as a complex intervention: A systematic review of efficacy, mechanisms and psychotherapeutic frameworks 2026 systematic review Supports Across 17 studies, psilocybin-assisted psychotherapy was associated with reduced substance use, higher abstinence, and improved well-being, though findings were heterogeneous and design-dependent.
Psilocybin-containing mushroom-assisted psychotherapy is associated with sustained psychological and somatic improvements: two case studies from Jamaica 2026 case study 2 Supports Both patients reported psychological and somatic improvements after a structured mushroom protocol, though authors caution spontaneous improvement cannot be excluded.
Music Playlist Use in Clinical Trials of Psychedelic Assisted Psychotherapy: A Systematic Review 2026 systematic review 36 Unclear Music use in psychedelic-assisted psychotherapy varies considerably with no standardized protocol across studies.
Developing Methods for Observing Awe Narration in Psilocybin-Assisted Therapy. 2026 observational coding study 8 Supports Awe narration during psilocybin-assisted therapy could be reliably identified by coders, with higher confidence when vastness was present.
Trials, trips, and tribulations: pathways for implementing psychedelic therapy in Ireland. 2026 review Mixed Notes emerging transdiagnostic efficacy but more modest effects in recent larger phase 3 trials, and outlines regulatory, workforce, and long-term outcome challenges for implementation.

Points of agreement

  • Multiple trials and reviews report large reductions in depression, anxiety, and substance use after psilocybin-assisted therapy.
  • Benefits often appear rapidly and persist for months to years in follow-up data.
  • Qualitative accounts consistently describe connection, acceptance, mystical-type experience, and revised priorities as central to outcomes.
  • Mystical experience intensity is repeatedly linked to therapeutic response.
  • Placebo-controlled evidence supports a real effect, though smaller than open-label estimates.

Conflicts

  • Open-label trials report very large effect sizes, while a policy review notes more modest effects in recent larger phase 3 trials.
  • One study found greater neural flexibility associated with less cognitive flexibility improvement, contrary to a simple flexibility-benefit model.
  • Blinding integrity is questionable: high-dose THC was mistaken for psilocybin, and active placebos may not preserve blinding.

Gaps

  • Most trials are small and open-label, limiting causal inference.
  • Long-term durability beyond a few years and relapse data are sparse.
  • Blinding integrity and expectancy effects are rarely quantified.
  • Dose, dosing schedule, and psychotherapy protocol are not standardized.
  • Populations studied are narrow; little data on diverse, comorbid, or personality-disordered groups.
  • Implementation, workforce readiness, and provider education remain largely unstudied.
Browse these studies in the library

Common questions

What does the research agree on about psilocybin and psychedelic-assisted therapy?
  • Multiple trials and reviews report large reductions in depression, anxiety, and substance use after psilocybin-assisted therapy.
  • Benefits often appear rapidly and persist for months to years in follow-up data.
  • Qualitative accounts consistently describe connection, acceptance, mystical-type experience, and revised priorities as central to outcomes.
  • Mystical experience intensity is repeatedly linked to therapeutic response.
  • Placebo-controlled evidence supports a real effect, though smaller than open-label estimates.
Where do studies on psilocybin and psychedelic-assisted therapy conflict?
  • Open-label trials report very large effect sizes, while a policy review notes more modest effects in recent larger phase 3 trials.
  • One study found greater neural flexibility associated with less cognitive flexibility improvement, contrary to a simple flexibility-benefit model.
  • Blinding integrity is questionable: high-dose THC was mistaken for psilocybin, and active placebos may not preserve blinding.
What is still unknown about psilocybin and psychedelic-assisted therapy?
  • Most trials are small and open-label, limiting causal inference.
  • Long-term durability beyond a few years and relapse data are sparse.
  • Blinding integrity and expectancy effects are rarely quantified.
  • Dose, dosing schedule, and psychotherapy protocol are not standardized.
  • Populations studied are narrow; little data on diverse, comorbid, or personality-disordered groups.
  • Implementation, workforce readiness, and provider education remain largely unstudied.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is Psilocybin and psychedelic-assisted therapy, 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 Psilocybin and psychedelic-assisted therapy 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

250 articles · 92 from the last two years · 12,388 participants across 107 studies reporting sample size

Common study designs

review 48 qualitative study 18 systematic review 23 randomized controlled trial 16 theoretical or philosophical paper 26

Research volume by year

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248 studies whose primary subject is psilocybin and psychedelic-assisted therapy since 2011

Studies about psilocybin and psychedelic-assisted therapy per year, 2011 to 2026, peaking at 55 in 2025 Bar chart: one bar per year, taller where more studies were published that year. 0 30 60 2015 2020 2025
2026 is partial
Show the numbers
Studies about psilocybin and psychedelic-assisted therapy per year, 2011 to 2026, peaking at 55 in 2025
Year Studies
2011 1
2012 1
2013 0
2014 0
2015 0
2016 1
2017 4
2018 6
2019 1
2020 9
2021 15
2022 28
2023 51
2024 46
2025 55
2026 30

Research

Synthesize the evidence →

Pharmacist Guide to Psilocybin and Psychedelic-Assisted Psychotherapy

American Journal of Health-System Pharmacy November 6, 2026 Jeremy W Vandiver, Brandee K Anderson, Takashi L Suyama et al.

Abstract: Purpose: This primer is designed to provide a broad overview of psilocybin and its use in medically supervised settings as part of psychedelic-assisted psychotherapy. This article will act as a framework to give practicing pharmacists the knowledge they need regarding pharmacology, pharmacokinetics, contraindications, adverse effects, and drug interactions that would impact safe use...

DOI: 10.1093/ajhp/zxag388 (opens in new tab)

Which Psychedelic Therapy Should Rural Health Systems Pursue First: Psilocybin or Ibogaine?

The Permanente Journal November 5, 2026 Todd Davies, Alberto Coustasse

Rural health systems encounter disproportionate behavioral health burdens, including higher suicide rates, overdose mortality, poverty, and reduced access to specialty mental health and addiction care. As psychedelic-assisted therapies move toward possible clinical implementation, rural leaders may need to decide which therapies merit investment planning. This point–counterpoint compares...

DOI: 10.7812/tpp/26.139 (opens in new tab)

Psilocybin-assisted psychotherapy for people with cancer: a scoping review of intervention components, psychotherapeutic frameworks, and models of delivery

OSF Preprints October 7, 2026 Suzanne Grant, Maria González, Hannah Adler preprint

The objective of this scoping review is to map the extent, range, and types of evidence related to psilocybin-assisted psychotherapy in people with cancer, including the types of psychotherapy used, models of delivering therapy, and associated outcomes, as reported in qualitative and quantitative studies.

DOI: 10.17605/osf.io/hvwtm (opens in new tab)

Mystical Experiences Mediate the Effects of Psilocybin-Assisted Psychotherapy + Mindfulness-Based Stress Reduction on Trait Mindfulness and Depression Symptoms: Mechanistic Results from a Randomized Controlled Trial

Journal of Affective Disorders Reports October 1, 2026 Kevin Byrne, Madeleine Odette, Eric L Garland et al.

ABSTRACT Background Healthcare workers experienced amplified depression and burnout during COVID-19. Both Mindfulness Based Stress Reduction (MBSR) and psilocybin have been shown to reduce depressive symptoms in this population, however the psychological mechanisms by which adding psilocybin to mindfulness training improves depression and trait mindfulness remain incompletely characterized....

DOI: 10.1016/j.jadr.2026.101187 (opens in new tab)

Exploratory safety, tolerability, and feasibility of psilocybin-assisted psychotherapy for adults with co-occurring treatment-resistant depression and cluster B personality disorders

npj Mental Health Research September 16, 2026 Orly Lipsitz, Ryan M Brudner, Zoe Doyle et al.

Cluster B personality disorders (PDs) are highly comorbid with depression and are associated with attenuated antidepressant response. No clinical trials to date have reported on psilocybin-assisted psychotherapy (PAP) in comorbid treatment-resistant depression (TRD) and PDs. This is the first clinical trial to describe a subgroup of ten participants with a comorbid PD ( n = 9 cluster B; n = 1...

DOI: 10.1038/s44184-026-00248-9 (opens in new tab) Full text (opens in new tab)

Oncology Providers' Perspectives on Psychedelic-Assisted Therapy.

The American journal of hospice & palliative care August 28, 2026 Krishna Hanubal, Akul Munjal, Jino Park et al.

PurposeDespite most psychedelic substances remaining Schedule I, clinical research exploring psychedelic-assisted therapy (PAT) in oncology is expanding. We sought to assess oncology providers' attitudes toward and understanding of PAT.MethodsWe conducted a cross-sectional survey of healthcare professionals involved in oncology across five academic institutions in California, South Carolina,...

DOI: 10.1177/10499091261483604 (opens in new tab) Full text (opens in new tab) MDMA Ketamine Psilocybin Antidepressants +4

Pilot study comparing the effects of high dose THC to high dose psilocybin and placebo in the set and setting of a classic psychedelic therapy session

Psychopharmacology August 27, 2026 Frederick S. Barrett, David Wolinsky, Zach Daily et al.

RATIONALE: Delta-9-tetrahydrocannabinol (Δ9-THC) has been reported to evoke psychedelic-like experiences at high doses in some individuals. However, the doses of Δ9-THC that occasion such effects and the phenomenology of these experiences are poorly understood. OBJECTIVES: This brief report presents preliminary findings from a pilot human laboratory study that directly compared the acute...

DOI: 10.1007/s00213-026-07138-0 (opens in new tab) Full text (opens in new tab)

Psilocybin-assisted psychotherapy for substance use disorders as a complex intervention: A systematic review of efficacy, mechanisms and psychotherapeutic frameworks

Journal of Psychopharmacology August 17, 2026 Lana Strika-Bruneau, Chérine Elhssaini, Baptiste Fauvel et al.

Background: Psychedelic-assisted psychotherapy (PAP) shows promise for substance use disorders (SUDs), yet the respective contributions of pharmacological, experiential, psychotherapeutic, and contextual factors remain insufficiently understood. Objective: To synthesize contemporary clinical evidence on PAP for SUDs, with particular attention to therapeutic frameworks, dosing strategies,...

DOI: 10.1177/02698811261473436 (opens in new tab)

Psilocybin-containing mushroom-assisted psychotherapy is associated with sustained psychological and somatic improvements: two case studies from Jamaica

Frontiers in Psychiatry July 29, 2026 Caitlyn Hanna Sams, Jasmine Davis, Anuradha Ramdas et al.

We report two case studies that examine the therapeutic potential of structured psilocybin-containing mushroom biomass regimens administered within a clinical framework, evaluating their impact on mental health outcomes as well as associated somatic symptoms. Two patients underwent the De La Haye Psilocybin Treatment Protocol (DPTP), which integrates micro- and high-doses (combined psilocybin...

DOI: 10.3389/fpsyt.2026.1876189 (opens in new tab)

Music Playlist Use in Clinical Trials of Psychedelic Assisted Psychotherapy: A Systematic Review

Journal of Clinical Psychology June 15, 2026 Lucas Cruz, Fernando R. Beserra, Julia M.k. Freind et al.

Recent studies have shown promising results for psychedelics in the treatment of psychiatric disorders. Both in clinical and recreational settings, contextual elements, such as music, can influence the experience of users and may be linked to positive outcomes. This systematic review identifies how music is being selected and used in psychedelisc-assisted psychotherapy (PAP). The search adopted...

DOI: 10.1002/jclp.70167 (opens in new tab) Psilocybin Music therapy Clinical trial Scopus +8

Clinical trials

All psilocybin and psychedelic-assisted therapy trials →