Meta-correlation of the effect of ketamine and psilocybin induced subjective effects on therapeutic outcome.
Jack D C Dahan, David Dadiomov, Tijmen Bostoen, Albert Dahan
Npj mental health research October 6, 2024 DOI: 10.1038/s44184-024-00091-w via PubMed
Summary
AI-generated from the abstractSubjective effects of psychedelics like ketamine and psilocybin appear to play a modest role in their therapeutic outcomes for depression and substance use disorder. A meta-analysis of 23 ketamine studies (471 patients) and 8 psilocybin studies (183 patients) found that subjective experiences explained 5–10% of therapeutic improvement for ketamine and 24% for psilocybin. Psilocybin showed a greater mediating effect than ketamine, especially for depression. Substance use disorder treatment showed a larger mediating effect than depression, regardless of the drug.
Study at a glance
| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Sample size | 654 |
| Population | Patients with depression or substance use disorder |
| Interventions | Ketamine Psilocybin |
| Topics | Psychedelic-assisted therapy |
| Keywords | Therapeutic efficacy Mental health treatment Ketamine research Psilocybin studies |
| Citations | 13 |
| Key finding | Subjective effects of ketamine and psilocybin mediate therapeutic outcomes, with psilocybin showing a stronger mediating effect than ketamine, particularly for depression. |
Abstract
There is some evidence that the subjective effects of ketamine and other psychedelics like psilocybin are crucial for their therapeutic outcomes, such as treatment of depression or substance use disorder (SUD). We performed a meta-analysis and systematic review on the correlation of subjective symptoms and dissociation versus ketamine-induced therapeutic outcomes in patients with depression or SUD. A similar analysis was conducted for psilocybin-induced therapeutic improvement. We retrieved 23 papers studying ketamine (21 on depression, 2 on SUD) in 471 patients and 8 papers studying psilocybin (6 on depression, 2 on SUD) in 183 patients. Our study demonstrated a modest role for subjective effects mediating therapeutic outcomes, with R2-values ranging from 5-10% for ketamine and for psilocybine the R2 was 24%. A greater mediating effect for psilocybin compared to ketamine was detected, particularly when restricting the analysis to depression. Additionally there is a greater mediating effect in SUD than depression, irrespective of treatment.