Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews

Aug 14, 2018Expert review of clinical pharmacology

Effectiveness and safety of serotonin-based psychedelics for mood, anxiety, and addiction disorders: a review of reviews

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Abstract

Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence.

Serotonergic hallucinogens may have anxiolytic, antidepressive, and antiaddictive effects.
Ayahuasca is associated with reduced depression symptoms in treatment-resistant depression.
Many studies included in the review were open label, with few randomized controlled trials and small sample sizes.
The long-term effects and safety of these substances remain unclear due to a lack of long-term studies.

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Mood, anxiety, and substance-use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent studies suggest that serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) have anxiolytic, antidepressive, and antiaddictive effects. Areas Covered: A systematic review of systematic reviews assessing the efficacy, safety, and tolerability of serotonergic hallucinogens/psychedelic was performed using the PubMed data base until 11 April 2018. Systematic reviews with or without meta-analysis were analyzed, but only reviews that described at least one randomized controlled trial (RCT) were included. Expert Commentary: Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression. Although the results are promising, several studies were open label, and only few were RCTs, and most had small sample sizes and a short duration. Single or few doses of these drugs seem to be well tolerated, but long-term studies are lacking. New RCTs with bigger samples and longer duration are needed to replicate these findings.

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Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews

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