Naturalistic psychedelic use and changes in depressive symptoms.

In a large observational study of US adults aged 18–50, naturalistic psychedelic use was modestly linked to increased depressive symptoms over time. Among 12,345 participants followed longitudinally, 505 reported psychedelic use. Those who used psychedelics in a 'risk context'—such as a negative mindset or lack of psychological support—showed a moderate increase in depressive symptoms compared to non-users and to users without such risks. This association was explained by more challenging psychedelic experiences in that context. The findings indicate that psychedelic use outside controlled therapeutic settings may not be generally beneficial and could worsen depressive symptoms under certain conditions.

Study at a glance

Abstract

While growing evidence suggests that psychedelic-assisted therapy may have antidepressant effects in certain populations, little is known about the effects of psychedelic use on depressive symptoms in non-clinical, naturalistic settings. This observational cohort study included a large sample of US residents (18-50 years old) and longitudinally evaluated the relationships between naturalistic psychedelic use and changes in depressive symptoms. 21,990 participants completed the T1 survey and 12,345 completed the T2 survey (56.1 % retention). In total, 505 participants (i.e., 4.1 % of T2 survey completers) reported psychedelic use during the study period. The covariate-adjusted models showed a modest association between psychedelic use during the study period and increases in depressive symptoms (β = 0.12, p = .019). When disaggregated by context of use, psychedelic use in a 'risk context' (e.g., negative mindset prior to psychedelic experience, no psychological support present during psychedelic experience) was associated with moderate increases in depressive symptoms relative to no psychedelic use (β = 0.30, p < .001) and psychedelic use not in a 'risk context' (β = 0.27, p = .004). Notably, psychedelic use in a 'risk context' was strongly associated with having a more challenging psychedelic experience (β = 0.59, p < .001), which in turn was associated with modest increases in depressive symptoms (β = 0.16, p = .007) and accounted for the association between psychedelic use in a 'risk context' and increases in depressive symptoms. In conclusion, the findings suggest that naturalistic psychedelic use may not be generally therapeutic and may result in worsening depressive symptoms under certain circumstances. Future epidemiological research should further investigate factors associated with worsening depressive symptoms following naturalistic psychedelic use.