Insights on Psychedelics: A Systematic Review of Therapeutic Effects

This systematic review (s=98) examining psychedelic-catalysed insight found that 86% of studies showed insight was linked to therapeutic improvement, with insight being dose-dependent and significantly higher than placebo in 93% of comparative studies, suggesting insight may be a key mechanism in psychedelic therapy.

Abstract of Insights on Psychedelics

Background: Insight – a sudden change in understanding or perspective that feels true or reliable – is a common occurrence during psychedelic experiences, and often considered by clinicians and patients to be central to their therapeutic value. However, their occurrence and role has not been systematically assessed.

Objectives: We reviewed all peer-reviewed studies that published data on insight catalysed by a classic psychedelic at psychoactive levels, to elucidate several aspects of psychedelic-catalysed insight, including its prevalence, relationship to dose, time-course, and relationship to therapeutic outcomes. Risk of bias was assessed regarding selection, reliability, causality, and transparency.

Findings: The final database and key bibliography searches were completed on July 13, 2024. We screened 741 abstracts and included 98 studies (40 survey, 58 interventional). Insight was positively correlated with psychedelic dose, and was significantly higher following psychedelics in 43 of 46 (93%) studies that presented a comparison to a placebo condition. Crucially, 25 of 29 studies (86%) found that insight was associated with therapeutic improvement, and this relationship was often stronger than mystical-type experience, which has received more research attention.

Interpretation: This review indicates that psychedelic-catalysed insight is associated with therapeutic improvement, suggesting its importance for clinical practice and for understanding the mechanisms of psychedelic therapy.

Limitations: Heterogeneous study designs and operationalisations of insight precluded a meta-analytic summary. Publication bias and selective reporting is possible, given insight was typically not a primary outcome of the included studies.”

Authors: Joshua Kugel, Ruben E. Laukkonen, David B. Yaden, Murat Yücel & Paul Liknaitzky

Summary of Insights on Psychedelics

High doses of psychedelics like MDMA, DMT, ayahuasca, ibogaine, ketamine, esketamine, and arketamine can lead to subjective effects such as connectedness, awe, emotional breakthroughs, ego dissolution, and mystical experiences. These experiences often lead to new insights, which are described as sudden understandings accompanied by certainty. Research increasingly recognises insight as a therapeutic mechanism, correlating it with improvements in wellbeing, reductions in depressive symptoms, anxiety, and even substance use.

Insight is not just an improved understanding but a specific cognitive process marked by a sudden change in perspective. It is often accompanied by positive emotions, surprise, and a sense of certainty, distinguishing it from analytical problem-solving. In research, insight is typically defined by both cognitive restructuring and an affective experience of clarity, with the emotional aspects remaining consistent across various contexts.

The researchers note that current psychedelic research often focuses on specific types or aspects of insight, rather than examining the phenomenon as a whole. This lack of a comprehensive definition could hinder understanding of its role in therapy. The review aims to fill this gap by exploring the prevalence, dose-related factors, time-course, and therapeutic outcomes of psychedelic-induced insights, while also comparing them to mystical experiences as potential predictors of clinical benefit.

Methods

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Find this paper

Insights on Psychedelics: A Systematic Review of Therapeutic Effects

https://doi.org/10.1016/j.neubiorev.2025.106117

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Cite this paper (APA)

Kugel, J., Laukkonen, R. E., Yaden, D. B., Yücel, M., & Liknaitzky, P. (2025). Insights on Psychedelics: A Systematic Review of Therapeutic Effects. Neuroscience & Biobehavioral Reviews, 106117.

Study details

Compounds studied
LSD Psilocybin DMT Ayahuasca 5-MeO-DMT Mescaline

Topics studied
Healthy Subjects

Study characteristics
Literature Review

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