Adolescent Psychedelic Use and Psychotic or Manic Symptoms
JAMA Psychiatry – March 13, 2024
Source: OpenAlex
Summary
Adolescents using psychedelics naturally showed *reduced* psychotic symptoms after accounting for other drug use, with an effect size around -0.79. A large twin study of 16,255 individuals in Psychiatry and Psychology found that among 541 psychedelic users (99% also used cannabis), this association held. However, a genetic predisposition to Bipolar disorder or schizophrenia increased the risk of mania with psychedelic use. This underscores complex interactions in adolescent medicine regarding drug studies and mental health, crucial for clinical psychology.
Abstract
Importance While psychedelic-assisted therapy has shown promise in the treatment of certain psychiatric disorders, little is known about the potential risk of psychotic or manic symptoms following naturalistic psychedelic use, especially among adolescents. Objective To investigate associations between naturalistic psychedelic use and self-reported psychotic or manic symptoms in adolescents using a genetically informative design. Design, Setting, and Participants This study included a large sample of adolescent twins (assessed at age 15, 18, and 24 years) born between July 1992 and December 2005 from the Swedish Twin Registry and cross-sectionally evaluated the associations between past psychedelic use and psychotic or manic symptoms at age 15 years. Individuals were included if they answered questions related to past use of psychedelics. Data were analyzed from October 2022 to November 2023. Main Outcomes and Measures Primary outcome measures were self-reported psychotic and manic symptoms at age 15 years. Lifetime use of psychedelics and other drugs was also assessed at the same time point. Results Among the 16 255 participants included in the analyses, 8889 were female and 7366 were male. Among them, 541 participants reported past use of psychedelics, most of whom (535 of 541 [99%]) also reported past use of other drugs (ie, cannabis, stimulants, sedatives, opioids, inhalants, or performance enhancers). When adjusting for substance-specific and substance-aggregated drug use, psychedelic use was associated with reduced psychotic symptoms in both linear regression analyses (β , −0.79; 95% CI, −1.18 to −0.41 and β , −0.39; 95% CI, −0.50 to −0.27, respectively) and co-twin control analyses (β , −0.89; 95% CI, −1.61 to −0.16 and β , −0.24; 95% CI, −0.48 to −0.01, respectively). In relation to manic symptoms, likewise adjusting for substance-specific and substance-aggregated drug use, statistically significant interactions were found between psychedelic use and genetic vulnerability to schizophrenia (β , 0.17; 95% CI, 0.01 to 0.32 and β , 0.17; 95% CI, 0.02 to 0.32, respectively) or bipolar I disorder (β , 0.20; 95% CI, 0.04 to 0.36 and β , 0.17; 95% CI, 0.01 to 0.33, respectively). Conclusions and Relevance The findings in this study suggest that, after adjusting for other drug use, naturalistic use of psychedelic may be associated with lower rates of psychotic symptoms among adolescents. At the same time, the association between psychedelic use and manic symptoms seems to be associated with genetic vulnerability to schizophrenia or bipolar I disorder. These findings should be considered in light of the study’s limitations and should therefore be interpreted with caution.