Clinical psychedelic research in adolescents: a scoping review and overview of ethical considerations
Khaleel Rajwani, Edward Jacobs, Lori Bruce, Jamila Hokanson, Melanie Almonte, F. Feroz, Elisha Waldman, Katherine Cheung, Neil Levy, Julian Savulescu, Ilina Singh, David B. Yaden, Brian D. Earp
The Lancet Child & Adolescent Health September 2, 2025 DOI: 10.1016/s2352-4642(25)00208-1 via OpenAlex
Summary
AI-generated from the abstractA scoping review of medical literature from 2000 to 2025 found no completed or published clinical trials testing psychedelic-assisted therapy in adolescents under 18, despite three trial registrations and one trial plan. The proposed studies would have investigated MDMA-assisted or psilocybin-assisted psychotherapy for adolescents with post-traumatic stress disorder, autism with social anxiety, or self-harm. Ethical approval and recruitment details were inconsistently reported. This absence of data represents a major evidence gap that could hinder informed care. The authors argue for cautious, ethically grounded research starting with older adolescents who have the highest foreseeable benefit-risk ratio due to special circumstances.
Study at a glance
| Characteristics | Scoping review Peer reviewed |
|---|---|
| Keywords | Psychology Engineering ethics Medline Political science |
| Citations | 6 |
| Key finding | No completed or published clinical trials have investigated psychedelic-assisted therapy in adolescents under 18, revealing a major evidence gap. |
Abstract
The potential use of psychedelic-assisted therapy for adolescents with mental illness has sparked both interest and concern. Modern psychedelic research has focused on adults, and adolescents younger than 18 years are typically excluded due to ethical and legal challenges. To explore whether adolescents have been included in 21st century psychedelic research, we conducted a scoping review of the medical literature from January, 2000, to April, 2025. Three trial registrations and one trial plan showed involvement of participants younger than 18 years, but none of these trials were completed and no trial findings have been published. The proposed studies would investigate 3,4-methylenedioxymethamphetamine (MDMA)-assisted or psilocybin-assisted psychotherapy as an intervention for adolescents with post-traumatic stress disorder, autism with social anxiety, or self-harm. Ethical approval and recruitment details were inconsistently reported. This scarcity of data highlights a major evidence gap that could hinder informed care. Given that many medications are used off-label in adolescents, we argue for cautious, ethically grounded research-starting with older adolescents with the highest foreseeable benefit-risk ratio due to special circumstances-to better understand the potential risks and benefits of psychedelic therapies for this vulnerable population.