Safety and risk assessment of psychedelic psychotherapy: A meta-analysis and systematic review.

Psychedelic-assisted psychotherapies show promise for psychiatric disorders. A systematic review and meta-analysis of 30 studies found that over more than 1000 administrations, only nine serious adverse events occurred (one during the acute phase, eight post-acute). No suicide attempts happened during the acute phase, but three participants engaged in self-harm post-acute. Psychedelics increased risk of elevated heart rate, systolic and diastolic blood pressure across all dose ranges, and nausea during the acute phase. Common side effects included headaches, anxiety, and decreased concentration or appetite. The analysis indicates that psychedelics are well-tolerated with a low risk of serious adverse events in controlled settings with appropriate inclusion criteria.

Study at a glance

Abstract

Psychotherapies assisted by psychedelic substances have shown promising results in the treatment of psychiatric disorders. The aim of this systematic review and meta-analysis was to evaluate safety data in human subjects. We carried out a search on MEDLINE, Embase and PsycINFO databases between 2000 and 2022. Standardized mean differences between different dose ranges and between acute and subacute phases were calculated for cardiovascular data after psychedelic administration. Risk differences were calculated for serious adverse events and common side effects. Thirty studies were included in this meta-analysis. There were only nine serious adverse events for over 1000 administrations of psychedelic substances (one during the acute phase and 8 during the post-acute phase). There were no suicide attempts during the acute phase and 3 participants engaged in self-harm during the post-acute phase. There was an increased risk for elevated heart rate, systolic and diastolic blood pressure for all dose range categories, as well as an increased risk of nausea during the acute phase. Other common side effects included headaches, anxiety, and decreased concentration or appetite. This meta-analysis demonstrates that psychedelics are well-tolerated, with a low risk of emerging serious adverse events in a controlled setting with appropriate inclusion criteria.