Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews

This expert review (2018) of systematic reviews concludes that the research into psychedelics is promising but needs bigger samples and longer duration studies.

Abstract of Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders

Introduction: Mood, anxiety, and substance-use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent studies suggest that serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) have anxiolytic, antidepressive, and antiaddictive effects.

Areas Covered: A systematic review of systematic reviews assessing the efficacy, safety, and tolerability of serotonergic hallucinogens/psychedelic was performed using the PubMed data base until 11 April 2018. Systematic reviews with or without meta-analysis were analyzed, but only reviews that described at least one randomized controlled trial (RCT) were included.

Expert Commentary: Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression. Although the results are promising, several studies were open-label, and only few were RCTs, and most had small sample sizes and short duration. Single or few doses of these drugs seem to be well-tolerated, but long-term studies are lacking. New RCTs with bigger samples and longer duration are needed to replicate these findings.”

Authors: Rafael G. dos Santos, José Carlos Bouso, Miguel Ángel Alcázar-Córcoles & Jaime E. C. Hallak

Notes on Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders

This paper is included in our ‘Top 10 Articles on Psychedelics in the Treatment of Depression

Summary of Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders

Mental and substance-use disorders are the fifth cause of global disability-adjusted life years, and the leading cause of Years Lived with Disability worldwide. However, traditional medications are not effective for a significant proportion of patients. Researchers argue that psychedelics, or serotoninergic hallucinogens, could be new psychopharmacological therapies for psychiatric and mental health disorders, and that they might have a beneficial effect on memory and cognitive deficits, which could open new avenues for the treatment of neurodegenerative diseases.

Psychedelics are serotoninergic hallucinogens that interact with 5-HT2A receptors to increase glutamate release, increasing electrical activity at the cortex and thus increasing information processing. This increases neuroplasticity by disrupting neural hierarchies and increasing bottom-up information transfer.

Psychedelics improve emotion processing, improve positive mood and emotional empathy, and induce mystical type experiences. These effects may be mediated by ‘ego dissolutive’ experiences.

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Find this paper

Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews

https://doi.org/10.1080/17512433.2018.1511424

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Cite this paper (APA)

Dos Santos, R. G., Bouso, J. C., Alcázar-Córcoles, M. Á., & Hallak, J. E. (2018). Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews. Expert review of clinical pharmacology11(9), 889-902.

Study details

Topics studied
Depression Anxiety Addiction

Study characteristics
Literature Review