Don’t be afraid, try to meditate- potential effects on neural activity and connectivity of psilocybin-assisted mindfulness-based intervention for social anxiety disorder: A systematic review

Current first-line treatments for social anxiety disorder (SAD) have limited efficacy, prompting a need for novel approaches. This systematic review proposes combining meditation-based interventions with a psychedelic, such as psilocybin, as a future alternative. Thirty experimental studies on neural effects of meditation or psilocybin in healthy and patient samples suggest that psilocybin-assisted meditation could alter cognitive processes like biased attention to threat by modulating salience network connectivity, balancing cortical-midline structure activity, and increasing frontoparietal control over amygdala reactivity. The authors conclude that future studies should investigate whether this combination provides therapeutic benefits for SAD patients who do not remit with conventional therapy.

Study at a glance

Abstract

BACKGROUND: Current first-line treatment for social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is limited in its efficacy. Hence, novel treatment approaches are urgently needed. The current review suggests a combination of meditation-based interventions and the administration of a psychedelic as a future alternative treatment approach. While both separate treatments show promise in the treatment of (other) clinical conditions, their combination has not yet been investigated in the treatment of psychopathologies. AIM: With a systematic literature review, we aim to identify the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying SAD and exert therapeutic effects. RESULTS: Thirty experimental studies investigating the neural effects of meditation or psilocybin treatment in healthy and patient samples were included. Findings suggest that psilocybin-assisted meditation interventions might change cognitive processes like biased attention to threat linked to SAD by modulating connectivity of the salience network, balancing the activity and connectivity of cortical-midline structures, and increasing frontoparietal control over amygdala reactivity. CONCLUSIONS: Future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who are do not remit following conventional therapy.