Predictors of therapeutic response to psychedelic-assisted therapy: A systematic review.
Grace Viljoen, Henrik Walter, Antonia Bendau, Michael Koslowski, Felix Betzler
Journal of psychopharmacology (Oxford, England) May 1, 2026 Peer reviewed DOI: 10.1177/02698811251389581 via PubMed
Summary
Psychedelic-assisted therapy (PAT) shows considerable effectiveness for various mental disorders, but individual responses vary. A systematic review of 54 studies identified the intensity of the acute psychedelic experience, especially mystical-type experiences (MTEs), as a common predictor of therapeutic response, though this varied by disorder and time point. Factors such as set, setting, and dose also influenced MTEs. Future research should examine more predictors and enhance methodological consistency.
Study at a glance
| Design | systematic review |
|---|---|
| Sample size | 54 |
| Population | adult populations with various mental disorders including substance-use disorders and major depressive disorder |
| Key finding | The intensity of the acute psychedelic experience, particularly mystical-type experiences, was the most frequently reported predictor of therapeutic response. |
Abstract
Psychedelic-assisted therapy (PAT) has demonstrated substantial efficacy across a range of mental disorders. However, heterogeneity between patients confers differential responsiveness. This systematic review aims to explore factors which may predict therapeutic responses to PAT. A systematic search was performed from inception through to March 2024 and studies that assessed predictors of response related to the use of classic psychedelics for mental disorders were included. A total of 54 studies investigating potential predictors of treatment response to psychedelic-assisted therapy were included in the review. These studies encompassed adult populations diagnosed with substance-use disorders, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder and existential distress related to life-threatening illness as well as naturalistic samples reporting psychopathological symptoms without a formally confirmed diagnosis. The most frequently reported predictor of therapeutic response was the intensity of the acute psychedelic experience, particularly mystical-type experiences (MTEs), though this was not consistent across all disorders or time points. Factors related to set, setting and dose were frequently associated with the likelihood and intensity of MTEs. The acute psychedelic experience, especially MTEs, was the most frequently reported predictor of therapeutic response. Future trials should explore a broader range of predictors, include longer-term follow-up and improve methodological consistency to strengthen the evidence base for reliable predictors of therapeutic response.