Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis

Nov 8, 2025European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology

Effectiveness, dropout rates, and safety of serotonin-related psychedelics and MDMA for treating mental health conditions

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Abstract

30 clinical trials involving 1,480 participants were analyzed for the effects of MDMA and serotonergic psychedelics on mental disorders.

  • MDMA significantly reduced PTSD symptoms compared to control groups.
  • Psilocybin, ayahuasca, and LSD were linked to reduced depressive symptoms in major depressive disorder.
  • Both MDMA and serotonergic psychedelics may lower anxiety symptoms, though the evidence varies.
  • Psilocybin and LSD did not improve abstinence rates in alcohol use disorder.
  • LSD showed no significant effect on ADHD symptoms.
  • Moderate certainty was found for MDMA's effectiveness on PTSD, while the risk of discontinuation was not higher with these treatments.

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