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Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis.

Lukas A Basedow, Tomislav Majić, Nicklas Jakob Hafiz, Engi A E Algharably, Reinhold Kreutz, Thomas G Riemer

Scientific reports June 26, 2024 DOI: 10.1038/s41598-024-65391-9 via PubMed

Summary

AI-generated from the abstract

A systematic review and meta-analysis examined how psychedelics and MDMA affect cognitive performance during acute drug effects and the sub-acute (afterglow) window. Acute psychedelic use impairs attention and executive function, while MDMA primarily impairs memory, leaving executive functions and attention unaffected. During the sub-acute period (at least 24 hours after acute effects subside), executive functioning and creativity may be increased following psychedelics, but no such effects were observed for MDMA. These findings can inform harm reduction recommendations for recreational use and support differential therapeutic approaches for psychedelics and MDMA.

Study at a glance

Characteristics Systematic review and meta-analysis Qualitative Peer reviewed
Interventions Psychedelics MDMA
Duration At least 24 h after acute effects
Topics MDMA
Keywords Afterglow Subacute Psychedelics hallucinogens Entheogens
Citations 13
Key finding Acute cognitive performance is differentially affected: psychedelics impair attention and executive function, whereas MDMA primarily affects memory; sub-acutely, psychedelics may increase executive functioning and creativity.

Abstract

Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.

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