Journal of psychopharmacology (Oxford, England)
January 1, 2023
Sandeep M Nayak, Manvir Singh, David B Yaden et al.
87 citations
A survey of 2374 people who reported a belief-changing psychedelic experience found that a single experience increased non-physicalist beliefs, including dualism, paranormal/spirituality, and consciousness in both mammals and non-mammals, with medium to large effects. Beliefs in superstition changed negligibly. The percentage identifying as a believer in a higher power or ultimate reality rose from 29% before to 59% after the experience. Greater mystical experiences during the psychedelic session were linked to larger belief shifts. These changes persisted an average of 8.4 years later.
JAMA network open
June 3, 2024
Amy L McGuire, I Glenn Cohen, Dominic Sisti et al.
41 citations
A consensus statement from a 2023 meeting of 27 experts identifies 20 points of consensus across five ethical issues for integrating psychedelic medicines into mainstream medical practice: reparations and reciprocity, equity, and respect; informed consent; professional boundaries and physical touch; personal experience; and gatekeeping. The meeting included clinicians, researchers, Indigenous groups, industry, philanthropy, veterans, retreat facilitators, training programs, and bioethicists. The statement focuses on government-approved medical use in the US and abroad, emphasizing that policymakers must address challenges ahead while acknowledging the hopeful moment.
Psychopharmacology
April 1, 2023
David S Mathai, Sandeep M Nayak, David B Yaden et al.
36 citations
For esketamine, a form of ketamine used for treatment-resistant depression, there is no clinically meaningful link between how dissociated a person feels during the drug experience and how much their depression improves. Analyzing data from 576 participants across two clinical trials, researchers measured dissociation with the Clinician-Administered Dissociative States Scale (CADSS) and depression with the Montgomery-Åsberg Depression Rating Scale (MADRS). A statistical model found no significant interaction between dissociation and antidepressant effect over four weeks. A separate analysis showed that each additional point on the dissociation scale on day 1 was associated with a very small 0.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
October 1, 2022
David B Yaden, Brian D Earp, Roland R Griffiths
31 citations
Psychedelics partly achieve their therapeutic effects through the subjective experiences they produce and how individuals interpret those experiences. Because these subjective effects can be disturbing for people with certain mental illnesses, researchers are developing 'nonsubjective' psychedelics that cause similar biological changes without the characteristic subjective effects. The authors broadly support creating such substances for scientific and clinical reasons but argue they should be reserved only for cases where subjective effects are specifically contraindicated. Classic psychedelics that produce subjective experiences should remain the default standard of care, as withholding typically positive, meaningful, and therapeutic experiences from most patients raises ethical concerns.
Current topics in behavioral neurosciences
January 1, 2022
David B Yaden, Sandeep M Nayak, Natalie Gukasyan et al.
31 citations
End-of-life and palliative care have improved, but psychopharmacological options for depression, existential distress, and well-being remain limited. This review examines recent clinical research on psychedelics for patients with life-threatening diagnoses and proposes that psychedelics could offer clinicians an additional treatment option in end-of-life and palliative care settings.
The American journal of bioethics : AJOB
January 1, 2025
Katherine Cheung, Brian D Earp, Kyle Patch et al.
30 citations
The authors argue against the idea that psychedelics raise uniquely exceptional ethical issues in clinical medicine, comparing this position to earlier debates about genetic exceptionalism in bioethics. They contend that psychedelics share more commonalities with existing medical interventions than is often assumed, and that adopting a stance of "psychedelic ethical exceptionalism" carries risks. Instead, they propose that consistent ethical rules and evidentiary standards should apply across all relevant areas of clinical medicine. While changes to existing standards may be warranted, such changes should not be justified by appealing to the alleged uniqueness of psychedelics.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
June 27, 2023
Katherine Cheung, Kyle Patch, Brian D Earp et al.
27 citations
Psychedelics like psilocybin produce altered states of consciousness that change perception, cognition, and affect. They show promise as therapeutic agents combined with talk therapy for conditions such as major depression and substance use disorder. It remains unclear whether these acute subjective effects are necessary for therapeutic benefits. This uncertainty has sparked debate about whether psychedelics without subjective effects could still have therapeutic impact, or whether the subjective effects are essential for full therapeutic realization.
Journal of psychoactive drugs
January 1, 2023
Julian Urrutia, Brian T Anderson, Sean J Belouin et al.
21 citations
Combining psychedelic science, contemplative practices, and Indigenous and other traditional knowledge systems in integrative, community-based models of care could transform global health. Both contemplative practices and certain psychedelic substances reliably induce self-transcendent experiences that positively affect health, well-being, and prosocial behavior, and combining them appears synergistic. Traditional knowledge systems offer ethnobotanical expertise and time-tested practices. A decolonized agenda for psychedelic research requires collaborative engagement with traditional knowledge stewards to co-develop evidence-based integrative care accessible to their communities. Health systems could include Indigenous and traditional healers as stakeholders in designing, implementing, and evaluating community-based approaches for safely scaling psychedelic treatments.
Journal of Psychoactive Drugs
May 7, 2024
Sandeep M Nayak, Sydney H White, Samantha N Hilbert et al.
18 citations
A prospective longitudinal study of 657 people planning a psilocybin experience outside a laboratory found that after the experience, participants reported increased perception of minds in various living and non-living entities such as plants and rocks, replicating earlier findings. However, the study found little to no change in participants' metaphysical beliefs, such as dualism, or in their self-reported Atheist-Believer status. These results contrast with cross-sectional studies suggesting psilocybin experiences alter Atheist-Believer status and non-naturalistic beliefs, but they support the relevance of mind perception and mentalization processes.
Neuroscience and biobehavioral reviews
June 1, 2025
Joshua Kugel, Ruben E Laukkonen, David B Yaden et al.
15 citations
A sudden shift in understanding or perspective that feels true—called insight—is common during psychedelic experiences and is often considered central to their therapeutic value. A systematic review of 98 studies (40 survey, 58 interventional) found that insight was positively correlated with psychedelic dose and was significantly higher after psychedelics in 93% of studies comparing to placebo. Crucially, 86% of studies found that insight was associated with therapeutic improvement, and this relationship was often stronger than that of mystical-type experience. The findings suggest insight's importance for clinical practice and understanding mechanisms of psychedelic therapy, though heterogeneous study designs and possible publication bias limit meta-analytic conclusions.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Sean P Goldy, Benjamin A Du, Julia S Rohde et al.
15 citations
Classic psychedelics carry both greater acute challenging effects and persisting negative effects compared to cannabis, but also produce greater positive acute and persisting effects. In two studies using quota-based sampling to approximate US Census demographics, participants reported on their first or most memorable experiences with either substance. Predictors of psychedelic outcomes—such as dose level, presence of others, religiosity, and personality—explained only a small degree of the variation. The findings offer a more nuanced characterization of the risks and benefits of psychedelic experiences relative to cannabis.
AJOB Neuroscience
February 5, 2024
Julian D Sandbrink, Kyle Johnson, Maureen Gill et al.
13 citations
A nationally representative sample of 795 US Americans rated the moral status of psilocybin use in a licensed setting as morally positive for both treating a psychiatric condition and enhancing well-being, showing strong bipartisan support. These attitudes can inform policy-making around supervised psilocybin use. The study did not explore attitudes toward unsupervised or non-licensed use.
Pharmacological research
January 1, 2024
David B Yaden, Andrea P Berghella, Peter S Hendricks et al.
12 citations
Classic psychedelic-assisted therapies show initial promise for treating substance use disorders (SUDs) and may become legally available options. This article describes how these therapies could fit within current evidence-based SUD treatments, suggesting broad compatibility with most mainstream clinical approaches.
Drug and alcohol dependence
January 1, 2025
James M Zech, David B Yaden, Grant M Jones
9 citations
Lifetime psilocybin use and past-year LSD use are associated with higher rates of cannabis use disorder (CUD) among U.S. adults. Analyzing nationally representative data from the National Survey on Drug Use and Health (2015–2019, 2021–2022), the study found that people reporting use of these psychedelics had roughly double the risk of meeting DSM-5 criteria for CUD, including moderate-to-severe forms, after accounting for sociodemographic factors. Past-year LSD use also predicted three of eleven specific CUD symptoms among cannabis users. The findings indicate that naturalistic use of certain psychedelics may signal greater risk of maladaptive cannabis use, rather than supporting therapeutic benefits.
International review of psychiatry (Abingdon, England)
December 1, 2024
Sean P Goldy, Peter S Hendricks, Dacher Keltner et al.
8 citations
This review discusses how psychedelics produce acute subjective effects, including positive emotions such as awe and joy, and outlines the science of positive emotions. Despite a rich literature on distinct emotions and their different correlates and consequences, distinct emotions in psychedelic science remain understudied. Understanding the role of specific positive emotions in psychedelic experiences could help clarify the connection between the acute subjective effects of psychedelics and their therapeutic outcomes, such as decreased depression, anxiety, and substance misuse.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2025
Rebecca Ehrenkranz, Manish Agrawal, Sandeep M Nayak et al.
7 citations
Public discourse about psychedelic treatments has shifted from past fearmongering to current effusive optimism, but the field would benefit from more balanced attention to both risks and benefits. While most adverse events related to psychedelics are mild, some have been severe and serious, and public education about those risks is necessary. As more studies are conducted and eligibility criteria are relaxed to improve access, the incidence and severity of adverse events are predicted to increase. No medical intervention is risk-free, so quantifying and effectively communicating the risk/benefit profile of psychedelics will become increasingly important.
Perspectives in biology and medicine
January 1, 2024
Katherine Cheung, Brian D Earp, David B Yaden
5 citations
A psychedelic experience might be valuable in itself, not just for its lasting therapeutic benefits. Using the concept of psychological richness and ideas from aesthetics and enhancement philosophy, this essay argues that the acute subjective experience can be a source of value independent of any persisting positive effects.
AJOB empirical bioethics
July 16, 2025
Katherine Cheung, Caleigh Propes, Marianna Graziosi et al.
4 citations
Informed consent documents from U.S. psilocybin clinical trials often emphasize mental health and physical risks but rarely include psychedelic-specific elements like ineffability or therapeutic touch, despite calls from bioethicists for tailored consent forms. A content analysis of 28 documents from 13 sites found good coder reliability. The results suggest that while general risks are well covered, the unique features of psychedelic experiences are not consistently addressed in consent materials. The authors recommend ongoing debate about which elements are most important for potential participants to consider when deciding whether to join a study.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Katherine Cheung, Rebecca Ehrenkranz, Jared T Hinkle et al.
1 citation
A commentary responds to a proposed framework for assessing adverse events in psychedelic-assisted therapies, which includes spiritual, existential, religious, and theological impacts. The authors argue that adverse event assessment in psychedelic clinical trials should match the rigor and standards of other research areas, and emphasize the need for transparency and accessibility in reporting. The commentary discusses the framework's feasibility and various assessment methods, focusing on ensuring systematic and unbiased evaluation of adverse events.
Psychopharmacology
May 28, 2026
Mazen A Atiq, Eli Weisman, Rodrigo B Guerra et al.
A healthy 35-year-old man experienced a rare hypotensive adverse event—neurocardiogenic syncope (fainting)—about 60 minutes after taking 25 mg of oral psilocybin in a clinical trial. His blood pressure dropped to 93/51 mmHg, with rapid heart rate and sweating, but he stabilized quickly with leg elevation and oral hydration. The episode may have been triggered by upright seated posture, restrictive EEG equipment, and anxiety about upcoming transcranial magnetic stimulation. Fewer than one-quarter of contemporary psychedelic trials report systematic adverse event assessment, highlighting the need for transparent documentation of both hypertensive and hypotensive events as psilocybin moves toward potential FDA approval.
Accountability in research
May 1, 2026
Katherine Cheung, Rebecca Ehrenkranz, Brian D Earp et al.
Several proposals across fields suggest including independent actors in research to manage bias, such as independent auditors for adverse events in psychedelic science or independent researchers in trial teams. However, the concept of independence is often undefined. While introducing independent actors seems beneficial for reducing bias and improving rigor, it may also have significant drawbacks. The authors argue that the implicit sense of independence is freedom from influences that could reduce the trustworthiness or accuracy of findings. They explore whether such actors can be identified without trade-offs with other scientific goals, like expertise. Two models from law and science are offered to guide incorporation of independent actors.
Journal of psychopharmacology (Oxford, England)
January 1, 2026
Jack E Henningfield, Frederick S Barrett, Suzette M Evans et al.
Roland R. Griffiths was a highly influential scientist in behavioral and neuropsychopharmacology, known for his rigorous research on abuse liability of substances including alcohol, benzodiazepines, caffeine, tobacco, and psychedelics. This review, authored by his former mentees and collaborators, describes his methodical approach to research, his inclusive and collegial mentoring style, and his role in advancing scientific methods for abuse liability assessment, policy, and regulation. His work culminated in the establishment of the Johns Hopkins Center for Psychedelic and Consciousness Research, reflecting his curiosity-driven, humanity-serving science that continues to inspire innovation.