Frontiers in Psychiatry
February 21, 2020
Max Wolff, Ricarda Evens, Lea J. Mertens et al.
188 citations
A conceptual model proposes that psychedelic-assisted therapies reduce experiential avoidance and increase acceptance through mechanisms similar to those in cognitive behavioral therapy. In controlled clinical settings, psychedelics relax avoidance-related beliefs, boosting motivation for acceptance via operant conditioning. This allows relatively avoidance-free exposure to intensified private events, where relaxed beliefs encounter corrective information and become revised. Such belief revision may explain lasting increases in acceptance and decreases in psychopathology. The article outlines open research questions and clinical implications.
Progress in neuro-psychopharmacology & biological psychiatry
February 2, 2018
Simon Reiche, Leo Hermle, Stefan Gutwinski et al.
125 citations
Anxiety and depression are common in people with life-threatening diseases, harming quality of life and prognosis. Serotonergic hallucinogens like LSD and psilocybin were first studied in the 1960s, and interest has recently revived. A systematic review of clinical trials from 1960 to 2017 identified 11 eligible trials with 445 participants: 7 on LSD (323 participants), 3 on psilocybin (92), and 1 on DPT (30). Four more recent randomized controlled trials (104 participants) had higher methodological quality than earlier studies. Evidence supports that these substances reduce anxiety and depression in patients with life-threatening diseases, with anecdotal reports of improved quality of life and reduced fear of death. Side effects were low in studies following safety guidelines.
Journal of Psychoactive Drugs
October 24, 2019
Toby Lea, Nicole Amada, Henrik Jungaberle
121 citations
People are self-administering very low doses of psychedelic drugs, known as microdosing, to improve mental health, wellbeing, and cognitive function, but little research has been conducted. A content analysis of Reddit discussions examined motivations, dosing practices, and perceived benefits and limitations. Motivations included managing mental health issues, improving psychosocial wellbeing, and cognitive enhancement. Self-reported benefits included cognitive and creative enhancement, reduced depression and anxiety, enhanced self-insight, improved mood, and better social interactions. Limitations included dosing problems, adverse physical effects, taking illegal substances, limited or no improvement, increased anxiety, and concerns about dependence. Standard doses in therapeutic settings show potential for treating mental health conditions, but clinical research on microdosing is needed.
International Journal of Drug Policy
November 25, 2019
Toby Lea, Nicole Amada, Henrik Jungaberle et al.
119 citations
People who microdose psychedelics like psilocybin or LSD are most often doing so to improve their mental health, for personal development, or to enhance cognitive performance. A 2018 international online survey of 525 current microdosers found that the perceived short-term benefits cluster into three areas: improved mood and reduced anxiety, a greater sense of connection to others and the environment, and cognitive enhancement. Unwanted effects included stronger-than-expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported using at least one harm reduction practice. The findings indicate that microdosing is commonly used as a self-managed mental health therapy, often as an alternative or complement to conventional treatments.
The Lancet Psychiatry
December 12, 2023
Gerhard Gründer, Manuela Brand, Lea J. Mertens et al.
103 citations
Treatment of psychiatric disorders with psychedelic substances is promising, but there is debate over whether therapeutic effects come solely from the drug or require psychotherapy. Some recent studies suggest the substance alone may be responsible, with therapists providing only safety support. This Personal View argues that viewing psychedelic treatment as a purely biological intervention with psychological support for safety reflects an outdated, reductionistic dualism that has long dominated psychiatry. The discussion has important implications for how these compounds are studied and regulated.
Neuropharmacology
November 1, 2018
Henrik Jungaberle, Sascha Thal, Andrea Zeuch et al.
70 citations
A review of 77 studies with 9876 participants examined how psychedelics and entactogens relate to positive psychology—the study of healthy functioning, well-being, and eudaemonia. The substances produced acute and long-term effects on mood, well-being, prosocial behaviors, empathy, cognitive flexibility, creativity, openness, value orientations, nature-relatedness, spirituality, self-transcendence, and mindfulness-related capabilities. Evidence is preliminary due to methodological restrictions. Longitudinal data on both positive and adverse effects are lacking, so more rigorous, standardized measures from positive psychology should be applied in less biased populations with prospective longitudinal designs to assess the benefit-risk ratio.
Neuroscience Applied
January 1, 2022
Lea J. Mertens, Michael Koslowski, Felix Betzler et al.
40 citations
Clinical trials with psychedelics like psilocybin face unique methodological challenges, particularly the difficulty of maintaining blinding due to the substances' pronounced subjective effects, which raises risks of expectation bias and nocebo effects. A phase II randomized, double-blind, active placebo-controlled parallel group trial with 144 patients is underway to evaluate psilocybin's efficacy and safety in treatment-resistant major depression. The trial, called EPIsoDE, is funded by the German Federal Ministry of Education and Research and addresses these challenges in its design.
Journal of Psychopharmacology
May 1, 2024
Max Wolff, Ricarda Evens, Lea J. Mertens et al.
34 citations
A new questionnaire, the General Change Mechanisms Questionnaire (GCMQ), reliably measures five psychotherapy processes—resource activation, therapeutic relationship, problem actuation, clarification, and mastery—during psychedelic experiences. Validated in 1153 English-speaking and 714 German-speaking users, the GCMQ showed good internal consistency and convergent validity. Experiences varied with setting and use motives (therapeutic, hedonic, escapist). Resource activation, clarification, and mastery moderated the link between stressful life events and well-being, suggesting potential therapeutic benefits. Five distinct user profiles emerged, which may inform clinical use and harm reduction.
Pharmacopsychiatry
May 12, 2021
Gerhard Gründer, Henrik Jungaberle
32 citations
Serotonergic psychedelics like psilocybin, LSD, and DMT, along with MDMA and ketamine, are among the most promising new treatments in psychiatry. Psychedelic-assisted psychotherapy requires redefining psychotherapeutic processes and embedding drug interventions in a new treatment infrastructure. Key challenges for practice and research include informed patient referral, screening, dosing preparation, assisted dosing sessions, psychological integration, and supporting patient communities. Defining treatment delivery infrastructures and therapist training requirements are further challenges. Implementation in routine mental health care must include public communication about the potential and risks. This paper provides a synopsis of challenges for practitioners, researchers, and regulators in the approval processes.
Anthropology of Consciousness
August 23, 2010
Janine Tatjana Schmid, Henrik Jungaberle, Rolf Verres
25 citations
Ayahuasca, a psychoactive beverage used in ritualized settings such as Santo Daime and neo-shamanic rituals, is often called a 'healing ritual' by participants. Interviews with 15 people who used ayahuasca for conditions like chronic pain, cancer, asthma, depression, alcohol abuse, or Hepatitis C revealed diverse motivations, subjective effects, and user types. Most participants believed ayahuasca positively influenced their illness or improved their coping, and enhanced their general well-being. The authors conclude that ayahuasca's effects should not be reduced to a pharmacological model; instead, it acts as a psychological catalyst shaped by sociocultural ideas.
Commun Psychol
April 13, 2025
Martha N. Havenith, Max Leidenberger, Jelena Brasanac et al.
14 citations
Altered states of consciousness (ASCs) similar to those induced by psychedelics can be achieved through circular breathwork, a non-pharmacological practice. During breathwork sessions, deliberate hyperventilation reduces end-tidal CO2 pressure, which is significantly correlated with the onset of ASCs. The depth of these ASCs predicted subsequent improvements in well-being and reductions in depressive symptoms. Two forms of breathwork, Holotropic and Conscious-Connected, produced highly similar outcomes. The findings identify physiological conditions for ASCs outside of drug use, suggesting breathwork's potential as an accessible psychotherapeutic tool.
Fortschritte der Neurologie · Psychiatrie
July 1, 2017
Tomislav Majić, Henrik Jungaberle, Timo Torsten Schmidt et al.
10 citations
The use of serotonergic hallucinogens (psychedelics) such as LSD and psilocybin, and entactogens such as MDMA, in psychotherapy has recently gained increasing scientific interest. This review summarizes current evidence on substance-assisted psychotherapy with serotonergic psychoactive substances. A selective literature search in PubMed and the Cochrane Library identified studies since 2000 examining these substances in psychotherapy. Indications studied include alcohol dependence (LSD and psilocybin), nicotine dependence (psilocybin), anxiety and depression in life-threatening physical illness (LSD and psilocybin), obsessive-compulsive disorder (psilocybin), treatment-resistant major depression (psilocybin), and post-traumatic stress disorder (MDMA). Dependence disorders, PTSD, and anxiety and depression in life-threatening physical illness are the best-evaluated indications. Evidence suggests efficacy with relatively good tolerability, but further studies are needed to assess these substances as future options for certain treatment-resistant mental disorders.
JAMA Psychiatry
March 18, 2026
Lea J. Mertens, Michael Koslowski, Felix Betzler et al.
9 citations
A phase 2b randomized clinical trial tested 25 mg of psilocybin with psychotherapy against a 5 mg dose and a placebo (nicotinamide) in 144 adults aged 25 to 65 with treatment-resistant depression who had stopped antidepressants. The primary outcome—a 50% or greater reduction in depression scores at six weeks—was not statistically significant: 17.0% of those receiving 25 mg responded, versus 12.5% on 5 mg and 10.6% on placebo. Exploratory analyses suggested a clinically meaningful reduction in depressive symptoms with the 25 mg dose. The treatment was generally well tolerated, but safety signals included higher reports of suicidal ideation on dosing days and two serious adverse reactions, one case of hallucinogen persisting perception disorder.
General hospital psychiatry
January 1, 2025
Max Wolff, Hans Rutrecht, Gerhard Gründer et al.
9 citations
As psychedelic treatments move from research settings into hospitals, clinics, and community practices, a new competencies framework outlines the skills needed for safe, effective, and ethically sound therapy. The framework is substance-unspecific and transtheoretical, covering foundational domains including psychotherapy, biomedicine, philosophy, socio-cultural awareness, existential concerns, legal issues, and self-experience. It translates these into practical competencies for multi-professional cooperation, screening, preparation, dosing, integration, and harm-reduction. Developed within the MIND Foundation's Augmented Psychotherapy Training program, the framework awaits systematic evaluation but offers an initial blueprint for future accredited certification and clinician training as these treatments enter mainstream care.
Journal of Psychoactive Drugs
March 6, 2019
Ansgar Rougemont-Bücking, Henrik Jungaberle, Milan Scheidegger et al.
6 citations
Among 4,475 young adult men in Switzerland, those who used psychedelics in the past year showed no significant difference in mental health (depressive symptoms, overall mental health, perceived stress, life satisfaction) compared to those who used no drugs. In contrast, users of MDMA, psychostimulants, and cannabis had poorer mental health. These effects were influenced by stressful life events and past family functioning. The findings suggest that some men may use substances to cope with life adversity, and the lack of a negative mental health association with psychedelics warrants further research in both men and women.
Fortschritte der Neurologie · Psychiatrie
June 20, 2022
Christopher W. Schmidt, Max Wolff, Gerhard Gründer et al.
5 citations
A survey of 530 psychiatrists and psychotherapists found divided opinions about psilocybin and psilocybin-assisted therapies. Many respondents considered psilocybin promising for treating mental disorders, with a majority viewing it as promising for depression. Greater knowledge about psilocybin was linked to more optimistic views about its therapeutic use. Providing additional scientific information about current research partly led to more favorable attitudes. As scientific and public discourse on psilocybin grows, shifts in psychotherapists' and psychiatrists' attitudes are expected.
Zeitschrift für Medizinische Psychologie
August 1, 2011
Lisa Fiedler, Henrik Jungaberle, Rolf Verres
4 citations
Members of the Santo Daime Church in the Netherlands primarily use ayahuasca for religious or spiritual reasons, as well as for medicinal-psychotherapeutic self-treatment. Among 21 participants interviewed over a longitudinal study (2003–2012), 20 showed these motives. Other important reasons included the desire for social interaction (16 participants) and seeking new or extraordinary experiences (17 participants). Hedonistic motives, performance enhancement, or underlying pathologies were negligible. The findings indicate that reasons for ayahuasca use are diverse and not limited to addiction.
Deutsches Ärzteblatt international
December 16, 2024
Moritz Spangemacher, Andrea Jungaberle, Henrik Jungaberle et al.
3 citations
Psilocybin treatment works differently from standard psychiatric medication, potentially offering rapid and lasting benefits across multiple diagnoses. It may improve not just symptoms but broader aspects of mental health, suggesting it could modify the underlying disease process and promote well-being. Psychedelic-assisted psychotherapy might become the first disease-modifying treatment in psychiatry.
Research Square
February 22, 2024
Martha Havenith, Max Leidenberger, Jelena Brasanac et al.
3 citations
Circular breathwork, which involves deliberate hyperventilation, can induce altered states of consciousness (ASCs) comparable to those produced by psychedelics, without the legal, medical, or financial barriers. A reduction in end-tidal CO2 pressure due to hyperventilation is instrumental in catalyzing these ASCs. The depth of the ASCs predicted psychological and physiological follow-on effects, including improved well-being and a reduction of depressive symptoms. Two popular forms of breathwork—Holotropic Breathwork® and Consciously-Connected breathwork—produced highly similar physiological, experiential, and psychological outcomes. These findings outline physiological boundary conditions for ASCs in a non-pharmacological context and suggest breathwork's potential as an accessible psychotherapeutic tool.
Der Nervenarzt
February 12, 2025
Nina Hartter, Marvin Däumichen, Christopher Schmidt et al.
1 citation
An online survey of 1,456 mental health experts, patients, and the general public found that greater knowledge about psilocybin-assisted therapy (PAT), self-assessed knowledge, personal treatment experience, and prior experience with psychedelics predicted more positive attitudes toward introducing PAT. Providing information about PAT's potential only increased acceptance when combined with information about its risks. Participants were generally optimistic about implementing PAT. The link between knowledge and acceptance was confirmed, suggesting that balanced education and reporting on PAT can foster higher acceptance.
Psychotherapy and psychosomatics
May 27, 2026
Lea J Mertens, Felix Betzler, Manuela Brand et al.
A single 25 mg dose of psilocybin, or two such doses given six weeks apart, combined with psychotherapy produced a stable and clinically meaningful reduction in depression symptoms for up to twelve months in people with treatment-resistant depression. The average improvement on the Hamilton Rating Scale for Depression was about 7.9 points at six months and 7.7 points at twelve months, with no significant difference between dosing groups. Restarting standard antidepressant medication during follow-up was strongly linked to higher depression scores. This naturalistic follow-up of a phase 2b trial is the largest and most complete long-term assessment of psilocybin for depression to date.
Psychological review
November 1, 2025
Max Wolff, Hans Rutrecht, Lea J Mertens et al.
Psychedelic therapy is often viewed as a distinct form of psychotherapy, but this article argues that its effectiveness can be understood through the same general change mechanisms that operate in all effective psychotherapies. Drawing on Klaus Grawe's empirically grounded model of common factors, the authors propose that psychedelic therapy works via five mechanisms: resource activation, therapeutic relationship, problem actuation, clarification, and mastery. The article integrates evidence from psychedelic research to support this transtheoretical framework and discusses its implications for clinical practice, training, and future studies.
Psychopharmacology
May 1, 2020
Toby Lea, Nicole Amada, Henrik Jungaberle et al.
An international online survey of 1102 people who had microdosed psychedelics found that 21% did so primarily for depression, 7% for anxiety, 9% for other mental disorders, and 2% to reduce or stop substance use. Forty-four percent perceived their mental health as "much better" as a result. Perceived improvements were associated with gender, education, microdosing duration and motivations, and recent use of larger psychedelic doses. The authors call for clinical trials to determine microdosing's potential role in psychiatric treatment and for further social research on its use as a self-managed therapy.