A systematic review of 31 studies involving 2639 participants found that 12 studies reported a significant decrease in craving for alcohol, opioids, cocaine, or tobacco after psychedelic use. However, all but two studies had moderate to high risk of bias due to methodological issues, so the promising anti-craving effects must be interpreted cautiously. The review highlights the need for larger, well-controlled trials to better understand psychedelics' effects on craving, a core symptom of substance use disorders and a predictor of relapse.
In patients with treatment-resistant depression receiving esketamine, mystical experiences—similar to those induced by classic psychedelics—occurred in 58% of patients, with high variability across sessions. Higher mean and peak scores on the Mystical Experience Questionnaire (MEQ-30) were associated with greater improvement in depression severity, while dissociative or other non-mystical effects were not. Positive mood and mystical dimensions of the MEQ predicted therapeutic outcomes, and baseline spirituality predicted both treatment response and peak MEQ scores in the first week. These findings suggest that psychedelic-like mystical experiences may contribute to esketamine's therapeutic efficacy.