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 Pharmacology – August 13, 2018
Source: OpenAlex
Summary
Psilocybin and Lysergic acid diethylamide (LSD) show significant promise in psychiatry, reducing anxiety and improving mood for individuals with prevalent mood disorders. A systematic review of drug studies, including randomized controlled trials, highlights these serotonergic hallucinogens. These psychedelics, often from chemical synthesis and alkaloids, act on neurotransmitter receptors, exhibiting anxiolytic effects. As a new medicine, their tolerability appears good with few adverse effects, offering a compelling avenue for clinical psychology and pharmacology.
Abstract
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 a 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.